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PK16-088 - Original - ServiceMaster Cleaning and Restoration - Contract - 03/08/2016
1 it i/r r r i r c,ro.,F ✓ ,.r;-at r r q C z: ki r s n� t KEN / S' 'hin f l Document 1NasHIrve'�ary ,a" i i�N „< 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 Fame: Serv'iceMaster Cleaning and Restoration Vender Number: JD Edwards Number Contract Number: This is assigned by City Clerk's Office Project Name Dire Damage Cleanup — Men's Restroom at Riverbend Golf Course Description: El Tnterlocal Agreement El Change Order 0 Amendment XEI Contract ❑ Other: Contract Effective Date: 03/08/16 Termination Date: 04/07/16 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Nancy Clary Department: Parks, Facilities Division Contract Amount: $9,077.61 Approval Authority: (CIRCLE ONE) Department Director Mayor Cit C IciJ,_,_.W Detail: (i.e. address, location, parcel number, tax id, etc.): As of: 08/27/14 • KENT wwa Hi"oron GOODS & SERVICES AGREEMENT between the City of Kent and ServiceMaster Cleaning and Restoration THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and ServiceMaster Cleaning and Restoration organized under the laws of the State of Washington, located and doing business at 8681 154t' Ave NE, Redmond, WA 98052, Pam Aebly, (425) 867-5035 (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: ServiceMaster Cleaning and Restoration shall provide labor and supplies/materials required to clean up fire damage sustained due to an electrical fire in the men's restroom at Riverbend Golf Course, 2019 W. Meeker Street, Kent, 98032. The work shall be completed In accordance with Estimate #2016-02-17-1356, which Is attached as Exhibit A. 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 unquallfled 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 30 days. III. COMPENSATION. The City shall pay the Vendor an amount not to exceed $9,077.61, 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: Vendor to Invoice upon Acceptance of Work by City. Payable: Net 30 Days. 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. GOODS&SERVICES AGREEMENT - 1 ($20,000 or Less, Incl. WSST) 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. 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. 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 Identifiier (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 parry 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 GOODS &SERVICES AGREEMENT- 2 ($20,000 or Less, Including WSST) 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 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 GOODS &SERVICES AGREEMENT- 3 ($20,000 or Less, Including WSST) 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 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. GOODS &SERVICES AGREEMENT- 4 ($20,000 or Less, Including INSST) 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 purpose. All work shall be done at Vendor's own risk, and Vendor 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. 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. 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. GOODS&SERVICES AGREEMENT- 5 ($20,000 or Less, Including WSST) I, Public Records Act. The Vendor acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes, emalls, and other records prepared or gathered by the Consultant in Its performance of this Agreement may be subject to public reviewer and disclosure, even if those records are not produced to or possessed by the City of Kent. As such, the Vendor agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public records Act. J. City Business License Re uired. 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. K. Counter its and Signatures by Fax or Email, 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. Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that signature shall have the same force and effect as If the Agreement bearing the original signature was received in person, IN WITNESS, the parties below execute this Agreement, Which shall became effective can the last date entered below. VENDOR: CITY OF KENT: n By. By f (signature) (signatur ' Print Name: J14- /,)e . � " Print Dame: Alex Ackley Its: - n Its: Superintendent, Faclities Division, DATE: - A, (title) Parks Recreation and Community Services, DATE: 5 —0 TO- NOTICES TO BE SENT TSB: NOTICES TO BE SENT TC3: V'ENVDOR: CITY OF KENWT Pam Aebly Nancy Clary ServiceMaster Cleaning and Restoration City of Kent 8681 154th Ave NE 220 Fourth Avenue South Redmond, WA 98052 Kent, WA 98032 (425) 867-5035 (telephone) (253) 856-5084 (telephone) (425) 558-7675 (facsimile) (2 3) 854-6080 (facsimile) GOODS &SERVICES AGREEMENT - 6 ($20,000 or Less, Jnclu,ding WSST) 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 fallowing 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: For: 5rRv 1 err A S+M Title: /FRCS 1 Pw-t Date: -� ' -7' I id EEO COMPLIANCE DOCUMENTS - 1 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: For• Title: Date: EEO COMPLIANCE DOCUMENTS - 3 of 3 EXHIBIT A se l.ir,-1 411 ServiceMaster Cleaning and Restoration(Redmond Wa ServiceMaster Cleaning and Restoration 8681 154th Ave Ne Redmond,Wa 98052 phone:(425)867-5035 fax:(425)558-7675 Tax ID:91-1935799 Insured: City of Kent Facilities(River Bend Golf Course) Home: (253)508-9461 Property: 2019 W.Meeker St E-mail: tthiessen@kentwa.gov Kent,WA 98032 Claim Rep.: Aebly,Pam Business: (425)867-5035 Business: 868I 154th Ave NE Redmond,WA 98052 Estimator: Pam Aebly Business: (425)867-5035 Company: ServiceMaster Cleaning&Restoration E-mail: parn@svmrestoration.com Home: 8681 154th Ave NE Redmond,WA 98052 Claim Number: N/A Policy Number:N/A Type of Loss: Fire Date Contacted: 2/17/2016 12:00 AM Date of Loss: 2/17/2016 12:00 AM Date Received: 2/17/2016 12:00 AM Date Inspected: 2/17/2016 12:00 AM Date Entered: 2/17/2016 1:56 PM Price List: WASE8X_FEB 16 Restoration/Service/Remodel Estimate: 2016-02-17-1356 ServiceMaster Tax ID 91-1935799 The following estimate reflects prevailing wages per the state of Washington labor laws. Please call with any questions or concerns. S6`r1dC0AWTER ServiceMaster Cleaning and Restoration(Redmond Wa) '�eatr; ServiceMaster Cleaning and Restoration 8681 154th Ave Ne Redmond,Wa 98052 phone:(425)867-5035 fax:(425)558-7675 Tax ID:91-1935799 2016-02-17.1356 2016-02-17-1356 DESCRIPTION QTY REMOVE REPLACE TAX TOTAL 1. Cargo van and equipment-per day 2.00 EA 0.00 97.50 I8.53 213.53 2. Negative air fan/Air scrubber(24 hr 6.00 DA 0.00 74.45 42.44 period)-No monit 489.14 3. Cleaning Technician-per hour 64.00 HR 0.00 87.90 534.43 6,160.03 Labor for the cleaning of all surfaces and fixtures above and below the ceiling including the ceiling file acoustical ceiling grid. 4. Supplies,Chemicals,and materials 1.00 EA 0.00 600.00 57.00 657.00 5. Smoke seal 8.00 HR 0.00 75.60 57A6 662.26 6. R&R Batt insulation-4"-RI- 3.00 HR 0.20 108.04 30.85 paper faced 355.57 7. Add for personal protective 8.00 EA 0.00 20.00 15.20 equipment(hazardous cleanup) 175.20 8. Haul debris-per pickup truck load- 1.00 EA 100.00 0.00 9.50 including dump fees 109.50 Total: 2016-02-17-1356 Labor Minimums Applied 765.41 8,822.23 DESCRIPTION QTY REMOVE REPLACE TAX TOTAL 9. Insulation labor minimum 1.00 EA 0.00 111.48 10.59 122.07 10. Finish hardware labor minimum 1.00 EA 0.00 121.74 11.57 133.31 Totals: Labor Minimums Applied 22.16 255.38 Line Item Totals:2016-02-17-1356 787.57 9,077.61 2016-02-17-1356 2/17/2016 Page:2 �E�rrhicca�stn ServiceMaster Cleaning and Restoration (Redmond,Wa) 'Gleam ServiceMaster Cleaning and Restoration 8681 154th Ave Ne Redmond,Wa 98052 phone:(425)867-5035 fax:(425)558-7675 Tax ID:91-1935799 Summary for Dwelling Line Item Total Sales Tax 8,290.04 787.57 Replacement Cost Value Net Claim $9,077.61 $9,077.61 Pam Aebly 2016-02-17-1356 2/17/2016 Page:3 EXHIBIT B (Continued ) 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 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. EXHIBIT B (Continued ) 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 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. 'a`vRv® CERTIFICATE OF LIABILITY INSURANCEff-2 (MM/DDlYYYY) /4/2016 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 MEud CT Judy Sheets, CPIW Bell Anderson Agency, Inc. (425)291-5200 Fax 600 SW 39th St, Suite 200 IA/C.No:(425)291-5100 S:judys@bell-anderson.corn Renton WA 98057INSURERS AFFORDING COVERAGE NAIC# INSURED A:Libert Northwest InsuranceServicemaster Cleaning & Restoration S:J.C. Services, Inc. DBA: C:8681 154th Ave NE 0:Redmond E: WA 98052 INSURERF: COVERAGES CERTIFICATE NUMBER.CL1572310834 nct THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A13OVEFOR 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 a LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP X I COMMERCIAL GENERAL LIABILITY MMIDDJYYYY MMIDIVYYYY LIMITS EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X OCCUR E N E P EMISES a eecurre ce $ 100,000 C10175480 8/1/2015 8/1/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENI AGGREGATE LIMIT APPLIES PER: POLICY a]JEC LOC GENERAL AGGREGATE $ 2,000,000 OTHER: PRODUCTS-COMP/OPAGG S 2,000,000 AUTOMOBILE LIABILITY $ X CO a�deMSINGLE LIMIT $ 1,000,000 A ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS AUTOS C10175480 8/1/2015 8/1/2016 BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE $ Pera c'dent X UMBRELLA LIAR X OCCUR combined sin fe limit $ A EXCESS LIAR CLAIMS-MADE EACH OCCURRENCE $ 5 000 000 DED I I RETENTION$ C10175480 8/1/2015 8/1/2025 AGGREGATE $ 5 000 000 WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY ANY PROPRIETOPJPARTNERlEXECUTIVE Y!N PER OTH- OFFICERlMEMBER EXCLUDED? ❑ N 1 A STOP GAP ST H AC ER A (Mandatory in NH) C10175480 E.L.EACH ACCIDENT $ 1 000 000 HySddescribeunder 8/1/2015 8/1/2016 E.L.DISEASE-EA EMPLOYE $ 1 000 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more spaco Is required) Certificate holder is an additional insured for general liability, but only if required by written contract or written agreement per CG8416 12/03. Waiver of Transfer of Rights of Recovery Against Others per CG8416 12/03. General Liability coverage provided to the Certificate Holder will be Primary and Non-Contributory per CG8416 12/03 CERTIFICATE HOLDER CANCELLATION FAUTHORIZED OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent TION DATE THEREOF, NOTICE WILL BE DELIVERED IN Parks, Recreation & Community Services E WITH THE POLICY PROVISIONS. 400 West Gowe Kent, WA 98032 ESENTATIVE JRS1 ACORD 25 2014/01 01988-2014 ACORD CORPORATION. 111 rights reserved. ( ) The ACORD name and logo are registered marks of ACORD INS025 nmann SERVICEMASTER CLEANING AND RESTORATION POLICY C10175480 COMMERCIAL GENERAL LIABILITY CG 85 8310 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED CONTRACTORS - PRODUCTS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II -Who Is An Insured is amended to include as an additional insured any person(s) or organization(s)whom you have agreed to add as an additional insured in a written contract or written agreement, but only with respect to liability for"bodily injury"or"property damage"caused by"your work" performed for that additional insured and included in the"products-completed operation hazard". B. The following additional provisions apply to the additional insured: 1. When the Named Insured is required to add an additional insured on this policy in a written contract or written agreement;the written contract or written agreement must be: a. Currently in effect or becoming effective during the term of this policy; b. Executed prior to the"bodily injury," or"property damage'; and C. Between a Named Insured and the additional insured. 2. That person or organization is an additional insured only for liability caused by your negligence specifically resulting from "your work"for the additional insured which is the subject of the written contract or written agreement. No coverage applies for any liability due to negligence attributable to any person or entity other than the Named Insured, the Named Insured's employees or subcontractors. 3. The Limits of Insurance applicable to the additional insured are the lesser of: a. Those specified in the written contract or written agreement, or b. Those provided by this policy and defined in Section III -Limits Of Insurance. These Limits of Insurance are inclusive of,and not in addition to,the Limits Of Insurance shown in the Declarations and defined in Section III- Limits Of Insurance. 4. The insurance provided to the additional insured does not apply to: "Bodily injury"or"property damage"arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving,or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawing and specifications;and b. Supervisory, inspection, architectural or engineering activities. CG 86 8310 06 Includes Copyrighted Material of ISO Properties,Inc.,with its permission. Pagel of 2 5. The following replaces Exclusion I. under Paragraph 2., Exculsions of Section I—Coverage A— Bodily Injury And Property Damage Liability: I. Damage To Your Work This insurance does not apply to"property damage"to"your work"arising out of it or any part of it and included in the"product-completed operations hazard". 6. We have no duty to defend or indemnify an additional insured under this endorsement: a. For any liability due to negligence attributable to any person or entity other than the Named Insured, the Named Insured's employees or subcontractors. b. For any loss which occurs prior to our Named Insured commencing operations at the location of the loss. C. Until we receive written notice of a claim or"suit"from the additional insured as required in Section IV—Conditions, Duties In The Event Of Occurrence, Offense Claim Or Suit. C. Section IV-Conditions are amended as follows: 1. The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement must comply with all provisions of this section. 2. As respects the coverage provided under this endorsement, Paragraph 4.b., Other Insurance is deleted and replaced by the following: 4. Other Insurance b. Excess Insurance This insurance is excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis unless the written contract or agreement described in A.above specifically requires that this insurance be provided on either a primary basis or a primary and noncontributory basis. CG 85 8310 05 Includes Copyrighted Material of ISO Properties,Inc.,with its permission. Page 2 of 2 Clary, Nancy From: Pam Aebly <pam@svmrestoration.com> Sent: Tuesday, March 08, 2016 9:29 AM To: Clary, Nancy Subject: RE: COI request Hi Nancy, That is correct! With warm regards! AavA 4 t 4J V 7 Fire Loss and Packout Coordinator Ser,riceMaster Cleaning Sc Restoration 8681 154th Ave NE Redmond, WA 98052 Office: 425-867-5035 Fax: 425-558-7675 Pam@svmrestoration.com. w-ww.servicemasterkingcountv.com Facebook/Twitter Please consider the environment before printing this email. From:Clary, Nancy [mailto:NCla,ry@kentwa.gov] Sent:Tuesday, March 08, 2016 9:11 AM To:Jennifer Egts<iennifer@svmrestoration,com> Cc: Pam Aebly<Pam@svmrestoration.com> Subject: RE: C01 request Good morning Jennifer, Thank you for providing the additional insurance documents required for our Agreement with ServiceMaster. I have added ServiceMaster's name and policy number to the Additional Insured document (attached), please verify that I have listed the correct Policy number. Thank you, Nancy Nancy Clary, Facilities Assistant Facilities Management I Parks, Recreation and Community Services 400 West Gowe, Kent, WA 98032 Main 253-856-5080 I Direct 253-856-5084 nclarY(1KentWA,qov CITY OF KENT,WASHINGTON KentWA.gov Facebook TvAtter YouTube PLEASE CONSIDER THE ENVIRONMENT BEFORE PRINTING THIS E-MAIL .......... ...........................................................From: Jennifer Egts rmailto:iennifer(a)svmrestoration.comI Sent: Monday, March 07, 2016 2:53 PM To: Clary, Nancy Subject: COI request Hi Nancy- Attached is the C01 for Service Master and the additional paperwork. Let me know if there is anything else you need. Thank you- Jennifer Egts 8681 154 th Ave NE I Redmond,WA 98052 Phone:425-867-5035 Fax:425-558-7675 www.servicemasterkingcounty.com Facebook I Twitter 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MASTER PAK FOR COMMERCIAL AUTOMOBILE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM This endorsement changes the policy effective on the Inception date of the policy unless another date is indicated below. Endorsement effective Policy No. Named Insured Countersigned by (Authorized Representative) (If no entry appears above, the information required to complete this endorsement will be shown in the declarations as applicable to this endorsement.) This summarizes the various coverages provided by this endorsement; no coverage is given by this summary. Actual coverage descriptions are within the form. SUBJECT LIMITS OF INSURANCE OR CHANGE ITEM# IN CONDITION ACCIDENTALAIRBAG DEPLOYMENT 13 ADDITIONALTRANSPORTATION $50 Per Day;$1000Maximum 6 EXPENSE WAIVEROFTRANSFEFE)F RIGHTSOF 12 RECOVER'AGAINSTOTHERSTO US CELLPHONECOVERAGE Included If Permanently Installed 17 DUTIESIN THEEVENTOFAN ACCIDENT 8 EMPLOYEE HIREDAUTO COVERAGE 18 -LIABILITY&PHYSICALDAMAGE FELLOWEMPLOYEEEXCLUSION 4 GLASSBREAKAGE 7 HIREDCARCOVERAGBERRITORY World Wide 10 HIREDCARPHYSICALDAMAGE- Excess Coverage;$35,000Maximum 5 Excess Coverage 0 MENTALANGUISH 11 PARKEEAUTO COLLISIONCOVERAGE Private PassengerTypes&Light Trucks 15 (WAIVEROF DEDUCTIBLE) RENTALREIMBURSEMENT Private PassengerTypes&Light Trucks 16 $50 Per Day;$1000 Maximum SUPPLEMENTAR`PAYMENTS 3 -Bail Bonds $3000 -Loss Of Earnings Up To$500 Per Day TOWING&LABORCOVERAGE Private PassengerTypes&Light Trucks 14 Up To$50 Per Occurrence UNINTENTIONALFAILURETO DISCLOSE 9 WHO IS AN INSURED 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 85 14 07 04 Copyright, Insurance Services Office, Inc., 2003 Page 1 of 4 MASTER PAK FOR COMMERCIAL AUTOMOBILE The provisions contained in this endorsement replace those found elsewhere in the policy. 1. Cancellation Provision Paragraph 2.B. of the Common Policy Provisions -Cancellation reads as follows: 60 days before the effective date of cancellation if we cancel for any other reason. 2. Who Is An Insured Paragraph A.1 -Who Is An Insured -of Section II, Liability Coverage, is amended to add: D. Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the coverage form. However, "Insured" does not include any subsidiary that is an o "Insured" under any other automobile liability policy or would be an "Insured" under such policy but for its termination or the exhaustion of its limits. E. Any organization that is acquired or formed by you and over which you maintain majority owner- ship. However, "Insured" does not include any newly formed or acquired organization: (1) that is a joint venture or partnership; (2) that is an "Insured" under any other policy; (3) that has exhausted its limit of insurance under any other policy; or (4) 180 days or more after its acquisition of formation by you, unless you have given us notice. Coverage does not apply to "bodily injury" or "property damage" that results from an accident that goccurred before you formed or acquired the organization. F. Any employee of yours while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. 3. Coverage Extensions -Supplementary Payments Paragraph A. Supplementary Payments. Sub Paragraphs A.2. and A.4. are amended as follows: (2) Up to $3000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. 4. Fellow Employee Exclusion In those states where Workers Compensation laws have not been legally determined to be the sole remedy for employee injuries, the following provision is added: Section Il - Liability Coverage, Exclusion B.5., Fellow Employee is amended by adding the following: But this exclusion does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. Coverage is excess over any other collectible insurance. In those states where Workers' Compensation Insurance has been determined to be the sole remedy for employee injuries, this coverage enhancement does not apply. 5. Hired Car Physical Damage -Excess Coverage If hired "autos" are covered autos for Liability Coverage and if Comprehensive, Specified Causes of Loss or Collision Coverages are provided under this coverage form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire of the private passenger type or light truck (10,000 pounds or less gross vehicle weight) type, subject to the following: (a) The most we will pay for any one.accident or loss is $35,000, actual cash value or cost of repair whichever is the least, minus a deductible. (b) No deductible applies to loss caused by fire or lightning. (c) The deductible will be equal to the largest deductible applicable to any owned auto of the private passenger or light truck (10,000 pounds or less gross vehicle weight) type for that coverage. (d) Hired car physical damage coverage is excess over any other collectible insurance available to the insured or the employee renting the vehicle, either from another auto policy or from the collision damage waiver provisions of a credit card. (e) Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own of the private passenger type or light truck (10,000 pounds or less gross vehicle weight) type shown in the declarations. We will also cover loss of use of the hired borrowed auto if it results from an accident for which you are legally liable and the lessor incurs an actual financial loss, subject to a maximum limit of $500 per accident. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 85 14 07 04 Copyright, Insurance Services Office, Inc., 2003 Page 2 of 4 MASTER PAK FOR COMMERCIAL AUTOMOBILE 6. Physical Damage -Additional Transportation Expense Coverage Paragraph A.4, of Section III Physical Damage Coverage is amended to provide a limit of $50 per day and a maximum limit of $1000. 7. Physical Damage -Glass Breakage The following paragraph is added to A.3., Glass Breakage, of Section III, Physical Damage Cov- erage: Any deductible shown in the Declarations for Comprehensive Coverage will not apply to glass breakage if such glass is repaired, in a manner acceptable to us, rather than replaced. 8. Duties In The Event Of Accident, Claim, Suit Or Loss. A. The requirement in Condition 2.A. that you must notify us of an "accident" applies only when the "accident" is known to: (1) you, if you are an individual; (2) a partner, if you are a partnership; or (3) an executive officer or insurance manager, if you are a corporation. (4) your partners, employees, members of limited liability companies, directors or sharehold- ers but only while acting within the scope of their duties. B. The requirement in Condition 2.B. that you must notify us of a claim or "suit" will not be considered breached unless the breach occurs after such claim or "suit" is known to: (1) you, if you are an individual; (2) a partner, if you are a partnership; or (3) an executive officer or insurance manager, if you are a corporation. (4) your partners, employees, members of limited liability companies, directors or sharehold- ers but only while acting within the scope of their duties. 9. Unintentional Failure To Disclose Hazards If you unintentionally fail to disclose any hazards existing at the inception or renewal date of the policy, we will not deny coverage under this coverage part because of such failure. This provision does not apply to any auto owned, leased, acquired or held for sale by you prior to the effective date of the policy or the current renewal. 10. Hired Car-Coverage Territory Paragraph E. is added to the definition of coverage territory in General Condition 7- Policy Period, Coverage Territory: E. For autos hired 30 days or less, the coverage territory is anywhere in the world, provided that if the insured's responsibility to pay for damages is determined in a"suit", that suit is brought in the territory described in Paragraph B.7. -Policy Period, Coverage Territory -under Section IV Business Auto Conditions. 11. Mental Anguish 10 The definition of"bodily injury" in the definitions section is replaced by the following: "bodily injury" means bodily injury, sickness or disease sustained by any person, including mental anguish, or death resulting from any of these. 12. Waiver Of Transfer Of Rights Of Recovery Against Others To Us Paragraph 5, TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US in Section IV, Busi- ness Auto Conditions, is amended by the addition of the following: If the person or organization has waived those rights before a loss, our rights are waived also. 13. Accidental Air Bag Deployment Coverage We will pay for the cost of reinstalling factory installed air bag(s) in "your covered auto" for any reason other than deployment due to a collision loss. Any insurance we provide shall be excess over any other collectible insurance, or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other coverage or warranty. This coverage is ap- plicable only if "other than collision" coverage is on your policy. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 85 14 07 04 Copyright, Insurance Services Office, Inc., 2003 Page 3 of 4 MASTER PAK FOR COMMERCIAL AUTOMOBILE 14. Towing and Labor Costs Coverage We will pay up to $50 for towing and labor costs incurred each time a covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs or less as defined by the manufacturer as the maximum loaded weight the auto is designed to carry is disabled. How- ever, the labor must be performed at the place of disablement. 15. Parked Auto Collision Coverage (Waiver of Deductible Under Collision Coverage) The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as the maximum loaded weight the auto is designed to carry while it is: 1. In the charge of an "insured"; 2. Legally parked; and 3. Unoccupied. Q 4. Must be reported to police authorities within 24 hours of known damage. A The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or —, organization engaged in the automobile business. 16. Rental Reimbursement Coverage When there is a"loss" to a covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as the maximum loaded weight the auto is designed to carry we will pay for rental reimbursement expenses incurred by you for the rental of an "auto" of similar type. Payment applies in addition of the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. This coverage applies only: 1. For those expenses incurred during the policy period beginning 24 hours after the loss; 2. To necessary and actual expenses incurred; 3. To a "loss" for which we also pay a "loss" under PHYSICAL DAMAGE COVERAGE for Com- prehensive Coverage, Specified Causes of Loss Coverage or Collision Coverage; and 4. If there are no spare or reserve "autos" available to you for your operations. Our payment will be limited to that period of time reasonably required to repair or replace the covered "auto". We will pay up to $50 per day to a maximum of$1000. 17. Permanently Installed Cellular Telephones Exclusion B.4.c. of Section III - Physical Damage Coverage does not apply to any permanently installed, non removable telephone designed to be operated by use of the power from the auto's electrical system. 18. Employee Hired Auto Coverage -Liability and Physical Damage s If this policy provides Liability and/or Physical Damage Coverage for Hired Autos, these coverages will be extended to any employee renting a vehicle in their own named, but only while used in the business of the named insured. For Employee Hired Auto Coverage, the following conditions apply: m 1. The hired auto must be rented under a written rental agreement; 2. Coverage will only apply while the employee is conducting business on behalf of the • insured; 3. Employee Hired Auto Coverage is excess over any personal auto policy applicable to the employee; and 4. Employee Hired Auto Coverage does not apply to any Loss of Use or administrative charges imposed by the rental car agency. All the above additional coverages are subject to all other provisions of this policy. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CA 85 14 07 04 Copyright, Insurance Services Office, Inc., 2003 Page 4 of 4 ordinance No.3962 C ty of Kent Contractor Licens KEN T City f Kent Customer Services • 226 Fourth Avenue S.w Kent,WA gson ss9s • (253)856.5210 Fax(253)856.000 ,rwah�'N paid PLEASE TYPE OR PRESS P RMLY—SLACK-OR DARK BLUE INI�QNLY Fee Must AcoontpanyAppii openin9juiyt Drafter All licenses expire December 1.Renewal Invoices mailed in JanuaeyAR Q 2016 $1 Q 1 , $5 Date: ;�% ;r4 ti�acer,nten�t 1. Name of Business: �t• 6 1 . I �jbmis '( , Business Address: 6 City' rAffrW1 LState• ZIP: Phone: i� ) 506-6 ill+ Qp HI Mailing Address. Dlat AV� �WUACity: N. )I State: 1'Vfl ZIP: 2. WA State UBI#: { �✓ 3. WA State TRN(Tax Regi tion Number): f k r 1 0-4- Q WD 4. O Indio C1 Partners lip CI LLC !(Corporation Avvideownershipinformation indudesupp enrdfistlfneeded Ovrner(s)NameIs): S ) Address: 1 lip e � City: State: Z1P: Phone:(4 —8ta7" 5 FAX S. ContactPerson: 1W V PhoneqJ6—g�—L— & 60.i 6. Description of Busnnes :-,6y-,j4 1 la I 7. Is your Business subject o the State of Washington B&O Tax(Chapter 82.04 Revised Code of Washington 7 Yes © No Is your Business subject to City of Kent B&OTax(please reference the list of exemptions noted on page 2 ofthe Business Activities Qu lonnalre)7 ❑ Yes Q No Exemption Number 1 hereby certify that the st tements and information fumished by me on this application are true and complete t the best ofmyknowledge. 1 also acknowledge that a statements and information furnished by me on this application are publicrecords a dare available fr�rpublic inspection pursuant to S to of Washington RCW4Z 17.260.1 understand thatissuance of this license Is cond'do ed upon compliance ata# times with all applicableo dinances,regulations andstatutesofthe City ofKentandthe State ofWashington.7h Issuance ofthisbusiness license does notimplycor ipliance with theZoning,Uniform Fire and Building Codes Signature: Print Name: 0 1 Title: jE e Date: 8 . I FOR OFFICE USE ONLY: BLOC# Date Rec'd Date Mailed 1:R.# Amt Paid Other RcsWo7541_3_13 White:BLFlle Canary;Applicant'sRecelptCapy