HomeMy WebLinkAboutPK16-127 - Change Order - Northwest Playground Equipment, Inc - Contract - 04/01/16 10 R
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W A S M I NI G 4 6 M
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prier to submission
to City Clerks Office. All portions are to be completed.
If you have questions, please contact City Clerk's Office.
Vendor Name: Northwest Playground Equipment, Inc.
Vendor Number:
JCS Edwards Number
Contract Number: I —1
This is assigned by City Clerk's Office
Project Name: Lunar Rover Design and Layout
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment 0 Contract
❑ Other:
Contract Effective Crate: 4/1/16 Termination Date: 4/8/2017
Contract Renewal Notice (Days): 0
Number of days required notice for termination or renewal or amendment
Contract Manager: Lynn Osborn/8L Department: Parks Planning & Dev.
Contract Amount: $19,000 00
Approval Authority: E Department director ❑Mayor ❑City Council
Detail': (i.e. address, location, Parcel number, tax id, etc.):
Lesign and layout frr an interactive replica of a Lunar Rover
Division Contract #PPD16-10
adccW I 08a7_s_14
KENT
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
Northwest Playground Equipment, Inc.
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Northwest Playground Equipment, Inc. organized under the laws of the State
of Washington, located and doing business at 345 NW Dogwood Street, Issaquah, WA 98027; 425-313-
9161 (hereinafter the "Consultant").
I. DESCRIPTION OF WORK.
Consultant shall perform the following services for the City in accordance with the following
described plans and/or specifications:
As described in Exhibit A, attached hereto:
Provide a general themed design and layout for an interactive replica of a Lunar Rover
Consultant further represents that the services furnished under this Agreement will be performed in
accordance with generally accepted professional practices within the Puget Sound region in effect at the
time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in
Section I above immediately upon the effective date of this Agreement. Consultant shall complete the
work described in Section I by April 8, 2017.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed
$19,000.00, for the services described in this Agreement. This is the maximum amount to
be paid under this Agreement for the work described in Section I above, and shall not be
exceeded without the prior written authorization of the City in the form of a negotiated and
executed amendment to this agreement. The Consultant agrees that the hourly or flat rate
charged by it for its services contracted for herein shall remain locked at the negotiated
rate(s) for a period of one (1) year from the effective date of this Agreement. The
Consultant's billing rates shall be as delineated in Exhibit A.
B. The Consultant shall submit monthly payment invoices to the City for work performed, and
a final bill upon completion of all services described in this Agreement. The City shall
provide payment within forty-five (45) days of receipt of an invoice. If the City objects to
all or any portion of an invoice, it shall notify the Consultant and reserves the option to only
pay that portion of the invoice not in dispute. In that event, the parties will immediately
make every effort to settle the disputed portion.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in
accordance with Ch. 51.08 RCW, the parties make the following representations:
CONSULTANT SERVICES AGREEMENT - 1
($20,000 or Less)
A. The Consultant has the ability to control and direct the performance and details of its
work, the City being interested only in the results obtained under this Agreement.
B. The Consultant maintains and pays for its own place of business from which
Consultant's services under this Agreement will be performed.
C. The Consultant has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed before the City
retained Consultant's services, or the Consultant is engaged in an independently
established trade, occupation, profession, or business of the same nature as that
involved under this Agreement.
D. The Consultant is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, including the Internal
Revenue Service and the state Department of Revenue.
E. The Consultant has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by Consultant's
business, and has obtained a Unified Business Identifier (UBI) number from the
State of Washington.
F. The Consultant maintains a set of books dedicated to the expenses and earnings of
its business.
V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party thirty (30) days written notice at its address set forth on the signature block of
this Agreement. After termination, the City may take possession of all records and data within the
Consultant's possession pertaining to this project, which may be used by the City without restriction. If
the City's use of Consultant's records or data is not related to this project, it shall be without liability or
legal exposure to the Consultant.
VI. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the
Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation,
national origin, or the presence of any sensory, mental, or physical disability, discriminate against any
person who is qualified and available to perform the work to which the employment relates. Consultant
shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with
City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance
Statement.
VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its officers,
officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or
suits, including all legal costs and attorney fees, arising out of or in connection with the Consultant's
performance of this Agreement, except for that portion of the injuries and damages caused by the City's
negligence.
The City's inspection or acceptance of any of Consultant's work when completed shall not be
grounds to avoid any of these covenants of indemnification.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW
4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to
property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers,
officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to the extent
of the Consultant's negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL
CONSULTANT SERVICES AGREEMENT- 2
($20,000 or Less)
INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES
FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER.
In the event Consultant refuses tender of defense in any suit or any claim, if that tender was made
pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having
jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant's part, then
Consultant shall pay all the City's costs for defense, including all reasonable expert witness fees and
reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful
refusal on the Consultant's part.
The provisions of this section shall survive the expiration or termination of this Agreement.
VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by
this reference.
IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide
reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the
work under this Agreement.
X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings,
designs, reports, or any other records developed or created under this Agreement shall belong to and
become the property of the City. All records submitted by the City to the Consultant will be safeguarded
by the Consultant. Consultant shall make such data, documents, and files available to the City upon the
City's request. The Consultant 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. As such, the Consultant agrees to
cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act.
The City's use or reuse of any of the documents, data, and files created by Consultant for this project by
anyone other than Consultant on any other project shall be without liability or legal exposure to
Consultant.
XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor
with the authority to control and direct the performance and details of the work authorized under this
Agreement, the work must meet the approval of the City and shall be subject to the City's general right of
inspection to secure satisfactory completion.
XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary
precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the
performance of the contract work and shall utilize all protection necessary for that purpose. All work shall
be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to
materials, tools, or other articles used or held for use in connection with the work.
XIII. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price
preference may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this
Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those
covenants, agreements or options, and the same shall be and remain in full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any
dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means
of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules
and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in
CONSULTANT SERVICES AGREEMENT- 3
($20,000 or Less)
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred
in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or
award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section VII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at
the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written
notice hereunder shall become effective three (3) business days after the date of mailing by registered or
certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this
Agreement or such other address as may be hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written consent
of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment,
the terms of this Agreement shall continue in full force and effect and no further assignment shall be
made without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of the City
and Consultant.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative
of the City, and such statements shall not be effective or be construed as entering into or forming a part
of or altering in any manner this Agreement. All of the above documents are hereby made a part of this
Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any
language contained in this Agreement, the terms of this Agreement shall prevail.
H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable to
Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or
accruing out of the performance of those operations.
I. Public Records Act. The Consultant 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, emails, and other records prepared or gathered by the Consultant in its performance of this
Agreement may be subject to public review and disclosure, even if those records are not produced to or
possessed by the City of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying
the City's duties and obligations under the Public Records Act,
J. City Business License Reauired. 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.
CONSULTANT SERVICES AGREEMENT - 4
($20,000 or Less)
K. Counterparts 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 become effective on
the last date entered below.
CONSULTANT: CITY OF KENT:
By: ` By:
(signature) (signature)
Print Name: 2 o\-, 1, 4 -^�u�L� Pri t Na e: Jeff Watling
Its: art C' .5- Its. Director of Parks, Recreation and
(title) Community Services
DATE: r
DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Chris McGarvey Brian Levenhagen
Northwest Playground Equipment City of Kent
PO Box 2410 220 Fourth Avenue South
Issaquah, WA 98027 Kent, WA 98032
(425) 313-9161 (telephone) (253) 856-5116 (telephone)
chris@nwplayground.com I bilevenhagen@kentwa.gov
P:\Planning\Downtown Design\Lunar Rover\NWPE-Rover Design-CONTRACT.docx
CONSULTANT SERVICES AGREEMENT- 5
($20,000 or Less)
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
By: 10/ " C�
For: e5 `�` ,19��
Title: �e
Date:
EEO COMPLIANCE DOCUMENTS - 1
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
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
Northwest Playground Equipment, Inc. EXHIBIT A
i
110 Box 2410,Issaquah,WA 9�8027-0109
Phone(425)313-9161 FAX(425)313-9194 t Ernail:sarahrg,)nw1 layground.com
QUOTE
Quote# 3/24116-MCG-2
To: City of Kent Date: 3124/2016
Creative Development and Design Agreement for Lunar Rover Interactive
Contact Name: Brian Levenhagen Phone: 253-856-5116
Email: Bilevenhacjen(@,kgnj�a. ov Fax: 253-856-6050
-Item# City Description Price Total Price
SCOPE OF WORK
General therned design and layout for Lunar Rover Interactive
I Replica, Includes consultation with CreMay as referenced in S 19,000.00
Exhibit A of Design contract.
Schedule for Design and Payment as follows:
45 days after contract issuance;
1.preliminary concept drawings from Cre8PIay
2. Invoice$9,500.00
10 days for owner review of concept drawings
20 days to resubmitted drawings to owner by Cre8Play
10 days for owner review
20 days following;
1.final drawings
2. Invoice balance-$9,500.00
Design Contract Subtotal $ 19,000.00
Performance Bond(If Required): 3.0%,
Location Code: Tax(not included): M% $ -
ORDER TOTAL. $ 19,00M0
All quotes are subject to material and fuel surcharges.
Acceptance of Proposal:
(Please be sure you have read, signed, initialed and understand the Terms and Conditions or) Page 2 of this Quote)
The items, prices and conditions listed herein are satisfactory and are hereby accepted.
Sarafi3rouck
Sales Assistant Customer Signature Date
Thank you for considering Northwest Playground Equipment, Inc. for your
Park, Playground, Shelter and Sports Equipment requirements.
PAGE 1 of 2 Revised 8124/11
Northwest Playground Equipment, Inc. EXHIBIT A(Continued)
POBox 2410,Issaquah,WA 9802 7-0109
Phone(425)313-9161 FAX(425)313-9194
A Email:sar-al-iC4),iiwl)laykic)tjzi(i.cc)ni
Project Name: City of Kent Quote# 3/24/16-MCG-2
TERMS AND CONDITIONS
QUOTE CONDITIONS AND ACCEPTANCE:
This quote is only valid for 30 days,
Orders placed or requested for delivery after 30 days are subject to price nncreases.
... (Pis Initial)It is the Buyer's responsibility to verify quantities and description of items quoted.
Once your order has been placed,any changes including additions,deletions or color changes,will delay your shipment.
EXCLUSIONS: Unless specified,this quote specifically excludes all of the following:
Required Permits;Davis Bacon,Certified Payroll or Prevailing Wage fees
Performance/Payment Bonds
Site work and landscaping
Removal of existing equipment
Unloading; Receiving of inventory or equipment; Storage of equipment
Equipment assembly and/or installation
Safety surfacing„Borders or drainage requirements
FREIGHT AND DELIIVERY:
Shipping is FOB Origin.A 24-hr Call Ahead is available at additional cost.
Delivery is currently 5+weeks after order submittal.Unless otherwise noted,all equipment is delivered unassembled.
... (Pis Initial)Buyer is responsible to meet and provide a minimum of 2 persons to unload truck
A Check List,detailing all items shipped,will be rnaHed to you and a copy will be included with the shipment.
Buyer is responsible for ensuring the Sales Order and Item Numbers on all boxes and pieces match the Check List.
... (Pis Initial)Shortages or damages must be noted on the driver's delivery receipt.Shortages or damages not noted bec
the buyers financial responsibility,
Damaged Freight Must be refused. Please notify Northwest Playground Equipment immediately of any damages.
Shortages and Conceated Damage must be reported to Northwest Playground Equipment within 10 days of delivery.
A reconsignment fee will be charged for any changes made to delivery address after order has been placed.
TAXES:
All orders delivering in Washington are subject to applicable sales tax unless a tax exemption or Reseller Permit is on file
at the time the order is placed.
PAYMENT TERMS:An approved Credit Application is required for new customers.50%down payment is due at time of order
with balance due upon delivery,unless other credit terms have been approved. Interest may be charged on past due
balances at an annual rate of 18%. A 31%charge will be added to all credit card orders.
RESTOCKING.- Items canceled,returned or refused will be subject to a r-ninir-num 25%restocking fee.All return freight
charges are the responsibility of the Buyer.
MAINTENANCEIWARRANTY:
Manufacturer's standard product warranties apply and cover equipment replacement and freight costs only;labor is not included.
Northwest Playground Equipment offers no additional warranties.
Maintenance of the equipment and safety surfacing is the responsibility of the Customer.
Any unauthorized alterations or modifications to the equipment(including layout)will void Your warranty.
INSTALLATION: (if applicable)
A private locate service for underground utilities must be completed before your scheduled installation.
Site must be level and free of loose debris(this includes ground cover/chips).
A minimum 6 foot opening with good access must be available to the site for delivery trucks and tractor.
An onsite dumpster must be provided for disposal of packaging materials.
Arrangements must be made in advance for the disposal of dir-Urocks from within the installation area.
Arrangements must be made in advance for the removalli:Esposal of existing equipment.
Additional charges may apply if large rocks or concrete are found beneath the surface.
Access to power and water must be available.
Site supervision is quoted in 8-hour days.
Acceptance of Terms & Conditions
Acceptance of this proposal,made by an authorized agent of your company,indicates agreement to the above terms and conditions.
Sarah Jliouc(,
Sales Assistant Customer Signature Date
Thank you for,choosing Northwest Playground Equipment
PAGE 2 of 2 Revised 8/24/11
EXHIBIT A
Ut
"10f'.
Creative Development and Design Agreement
This Agreement is made on August 31,2015,between City of Kent Parks Department,220 4th Ave.S Kent,WA
98032_(hereinafter referred to as Client),and CREBPLAY,LLC(hereinafter referred to as Designer),specifically for
the following project:
I. THE PROJECT
The Project that is the subject of this agreement shall consist of the following scope of work:
General themed design and layout know as 9272 Lunar Rover Project.Includes consultation for purposes to clarify
scope of design.This initial communication is followed up with preliminary sketch development to clearly represent
suggested theme and communicate CreSPlay's intended design direction. Upon receipt of preliminary sketches,
client will review and critique initial sketches,in conjunction with Cre8Play staff consultation, in order to clarify
and solidify direction for overall project, Also includes additional sets of more detailed drawings of project for
review and/or approval. These renderings will be presented in black&white format,with limited color addition as
predetermined.
II. TIME SCHEDULE
The Client and Designer agree that the work shall be completed according to Client's and Designer's coordinated
schedule.
W. SERVICES
Designer shall provide the Basic and Supplementary Services as specified within the scope of the Project. Designer
shall provide Basic Services for the Project consisting of consultation,design,checking quality of implementation,
and coordination of the Project and its production and execution with the build team and Client's designated Project
Manager.
In connection with performing Basic Services,the Designer shall prepare and present materials to the Client that
demonstrate or describe the Designer's intentions and shall prepare various materials, such as artwork, drawings,
and specifications when needed,to enable the design to be printed,fabricated,installed,or otherwise implemented.
IV. DESIGNFEE
Client shall pay,(subject to sales terms)the Designer for services described in this Agreement as follows:
Total Fee for Project: $1 000.00
V. MATERIALS PROVIDED BY THE CLIENT
Client shall provide accurate and complete information and supporting materials to Designer and shall be
responsible for the accuracy and completeness of all information and materials so provided.Client guarantees that
all materials supplied will be received directly from Project representatives and that Client and Designer have the
rights to such materials for use in the design of the Project.
i •
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EXHIBIT A(Continued)
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VI. APPROVAL OF DRAWINGS
The signature of the Project's representative shall be conclusive as to the approval of all work and other items prior
to their release for fabrication and installation.
VII. REPRESENTATIONS
This Agreement represents the entire agreement between Client and Designer and may be changed or modified only
in writing.
Client represents that it has full power and authority to enter into this Agreement and that it is binding upon the
Client and enforceable in accordance with its terms.
Designer represents that it has full power and authority to enter into this Agreement and that it is binding upon the
Designer and enforceable in accordance with its terms.
VIII. FABRICATION AND SUPPLY
Should the client contract with CreMay,LLC to fabricate and supply the designed elements,a portion of the Design
Fee will be applied to the contracted amount and will be credited on the last billing.
r'p IX. COPYRIGHTS
,MC. Ms agreementis i e o
shall considered confide no a transmitted or assimilated in an arm
This Agreement is hereby entered into between Designer and Client as of the day and date set forth below.
By: By:
Signature: Signature:
Todd Lehman,Owner Name:Jeff Watling
CregPlay,LLC Title:Director of Parks,Recreation and Community
Date:
Date:
-V E.,R:0:.,J
5txI Vl nile kb l4vc..$ylle 1a6,...ow>lio'a,i.5 j..•:., i ::rho� '$�z.6`4: i+15 auo b.lt,z86.7y4...� 'f:-.<.r�,t3plp:Y• gfi (f*rCa `p Yfa .O.ant•
i
EXHIBIT A(Continued)
Design Fee-$19,000.00
45 days after contract issuance;
1. preliminary concept drawings from Cre8Play
2. Invoice$9,500.00
10 days for owner review of concept drawings
20 days to resubmitted drawings to owner by Cre8Play
10 days for owner review
20 days following;
1. final drawings
2. Invoice balance-$9,500.00
Nickolas Demetrakas
Cre8Play
CUSTOM PLAY ENVIRONMENTS
602.526.4483 Cell
612.670.8195 x.102 •Fax 612.486.7740
nick(d)creBolay.com
cre8play.com
EXHIBIT B
INSURANCE REQUIREMENTS FOR
CONSULTANT SERVICES AGREEMENTS
Insurance
The Consultant shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Consultant, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Consultant shall obtain insurance of the types described below:
1. Automobile Liability insurance covering all owned, non-
owned, hired and leased vehicles. Coverage shall be written
on Insurance Services Office (ISO) form CA 00 01 or a
substitute form providing equivalent liability coverage. If
necessary, the policy shall be endorsed to provide
contractual liability coverage.
Commercial General Liability insurance shall be written on
ISO occurrence form CG 00 01. The City shall be named as
an Additional Insured under the Consultant's Commercial
General Liability insurance policy with respect to the work
performed for the City using ISO additional insured
endorsement CG 20 10 11 85 or a substitute endorsement
providing equivalent coverage.
2. Workers' Compensation coverage as required by the
Industrial Insurance laws of the State of Washington.
B. Minimum Amounts of Insurance
Consultant shall maintain the following insurance limits:
1. Automobile Liability insurance with a minimum combined
single limit for bodily injury and property damage of
$1,000,000 per accident.
2. Commercial General Liability insurance shall be written with
limits no less than $2,000,000 each occurrence, $4,000,000
general aggregate.
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 Consultant's insurance coverage shall be primary insurance as
respect the City. Any Insurance, self-insurance, or insurance pool
coverage maintained by the City shall be excess of the Consultant's
insurance and shall not contribute with it.
2. The Consultant's insurance shall be endorsed to state that coverage shall
not be cancelled by either party, except after thirty (30) days prior
written notice by certified mail, return receipt requested, has been given
to the City.
3. The City of Kent shall be named as an additional insured on all policies
(except Professional Liability) as respects work performed by or on behalf
of the Consultant and a copy of the endorsement naming the City as
additional insured shall be attached to the Certificate of Insurance. The
City reserves the right to receive a certified copy of all required insurance
policies. The Consultant's Commercial General Liability insurance shall
also contain a clause stating that coverage shall apply separately to each
insured against whom claim is made or suit is brought, except with
respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than ANII.
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 Consultant 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.
' 1 ® DATE(MMIDDIYYYY)
�►�v CERTIFICATE OF LIABILITY INSURANCE F 3/29/2016
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 CONTACT NAME: Nick Ghaffari
CHOICE Insurance, LLC 8 PHONE (425) 739-6565IFAX
C No:(425) 739-9955
1715 Market Street E-MAIL
Suite 100 ADDRESS: Service®choiceinsurance.net
Kirkland WA 98033
INSURER(S)AFFORDING COVERAGE NAtC#
INSURERA:Western National Assurance 24465
INSURED (415) 313-9161 INSURERB:
Northwest Playground Equipment Inc
Play Safe Construction, Inc. INSURERC:
PO Sox 2410 INSURERD:
Issaquah WA 98027 INSURERE:
INSURER F:
COVERAGES CERTIFICATE NUMBER:cart ID 10212 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.
ILTR ADDL S BR POLICY EFF POLICY EXP LIMITS
TYPE OF INSURANCE POLICY NUMBER MMIOD MMlDDIYYYY
GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
DAMAGE TO RENTI=U
A X COMMERCIAL GENERAL LIABILITY Y Y CPP 1037280 3/1/2016 3/1/2017 PREMISES Ea occurrence) $ 100,000
CLAIMS-MADE Ex_1 OCCUR MEDEXP(Any one parson) S 5,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GENI AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
POLICY X PRO LOC EPL $ 100,000
MBINED
AUTOMOBILE LIABILITY Ea accidentSINGLE LIMIT 1,000,000
A ANY AUTO CPP 1037051 3/l/2016 3/l/2017 BODILY INJURY(Perperson) S
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
XAUTOS AUTOS NON OWNED PROPERTY DAMAGE $
X HIRED AUTOS X AUTOS Per accident
$
A X UMBRELLA LIAB X OCCUR UMH 1006108 3/l/2016 3/1/2017 EACH OCCURRENCE S 5,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000
DIED I X I RETENTION$ 10,000 $
WORKERS COMPENSATION WC STUMITS
ATU- X OTH-
A AND EMPLOYERS'LIABILITY CPP 1037280 3/1/2016 3/1/2017
ANY PROPRIETORIPARTNERIEXECUTIVEa NIA WA State Stop Gap E.L.EACH ACCIDENT S 1,000,000
OFRCERIMEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYE S 1,0
If Es E.L.DSEASE-POLICYLI
CRe
DIPTIONunder
MIT S 1,000,000
OF OPERATIONS betow
A Property - EPP CPP 1037280 3/1/2016 3/l/2017 Deductible $1,000 $ 128,750
A Property - Inland Marine CPP 1037423 3/l/2016 3/1/2017 Installation $ 150,000
Floater Ded:$1,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required)
RE: Kent Lunar Rover Design Project. Certificate Holder is included as Additional Insured with
respect to work performed by or on behalf of the Named Insured and coverage is Primary &
Non-Contributory per Endorsement WNGL49. Waiver of Subrogation included per Endorsement WNGL39.
Completed operations wording included per Form WNGL50. Additional Insured shall apply by written
contract and/or agreement
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 4th Avenue South AUTHORIZED REPRESENTATIVE
TH �
Kent WA 98032 6" AVW
OO 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
Page 1 of 1
WN GL 39 0715
COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT
The Commercial General Liability Enhancement Endorsement is an optional endorsement that provides coverage en-
hancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is pro-
vided by this summary, refer to following endorsement for changes in your policy.
SUMMARY OF COVERAGES PAGE
Bodily Injury And Property Damage Liability
Non Owned Watercraft Up To 50 Feet......................................................................................2
Property Damage Liability
• Elevators....................................................................................................................................3
• Fire, Lightning, Explosion Or Sprinkler Leakage Exception.......................................................3
• Borrowed Equipment($25,000 Per Occurrence,$50,000 Aggregate,
$2,500 Deductible Per Occurrence.........................................................................................3
Supplementary Payments—Amended
• Bail Bonds Up To$5,000...........................................................................................................4
• Loss of Earnings Up To$500/Day ............................................................................................4
Who Is An Insured Amendments
• Employee Bodily Injury To A Co-Employee...............................................................................4
• Newly Formed Or Acquired Organizations For Up To 180 Days...............................................4
• Blanket Additional Insured—Vendors—As Required By Contract............................................4
• Blanket Additional Insured—Lessor Of Leased Equipment......................................................6
• Blanket Additional Insured—Managers Or Lessors Of Premises..............................................6
• Blanket Additional Insured—State Or Governmental Agency Or Subdivision
Or Political Subdivision—Permits Or Authorizations..............................................................7
• Blanket Additional Insured—State Or Governmental Agency Or Subdivision
Or Political Subdivision—Permits Or Authorizations Relating To Premises...........................8
Damage To Premises Rented To You — $300,000...............................................................................9
Medical Payments Increased Limit — $10,000 Or Amount Shown on Declarations.............................9
Conditions
• Knowledge of Occurrence, Offense, Claim Or Suit Amended...................................................9
• Unintentional Failure To Disclose Hazards................................................................................9
• Waiver of Subrogation..............................................................................................................10
InsuredContract Amended...................................................................................................................10
Personal And Advertising Injury Redefined
• Televised,Videotaped Or Electronic Publication.....................................................................10
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 1 of 10
WNGL390715
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT
This endorsement modifies the insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified
by this endorsement. The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement
will be amended as shown below.
SECTION I—COVERAGES AMENDMENTS (4) Liability assumed under any "insured con-
COVERAGE A — BODILY INJURY AND PROPERTY tract"for the ownership, maintenance or use
of aircraft or watercraft; or
DAMAGE LIABILITY
(5) "Bodily injury" or "property damage" arising
A. Non Owned Aircraft Or Watercraft out of:
Item 2. Exclusions, Paragraph g. is replaced by the (a) The operation of machinery or equip-
following: ment that is attached to, or part of, a
g. Aircraft, Auto Or Watercraft land vehicle that would qualify under the
"Bodily injury" or "property damage" arising out definition of"mobile equipment" if it were
of the ownership, maintenance, use or entrust- not subject to a compulsory or financial
ment to others of any aircraft, "auto" or water- responsibility law or other motor vehicle
craft owned or operated by or rented or loaned insurance law where it is licensed or
to any insured. Use includes operation and principally garaged; or
"loading or unloading". (b) The operation of any of the machinery
This exclusion applies even if the claims against or equipment listed in Paragraph f. (2)
any insured allege negligence or other wrong- or f. (3) of the definition of "mobile
doing in the supervision, hiring, employment, equipment".
training or monitoring of others by that insured, if B. Damage To Property Coverage Extensions
the"occurrence" which caused the"bodily injury" Item 2. Exclusions, Paragraph j. is replaced by the
or "property damage" involved in the ownership, following:
maintenance, use or entrustment to others of j, Damage To Property
any aircraft, "auto" or watercraft that is owned or
operated by or rented or loaned to any insured. "Property damage"to:
This exclusion does not apply to: (1) Property you own, rent, or occupy, including
(1) A watercraft while ashore on premises you any costs or expenses incurred by you, or
own or rent; any other person, organization or entity, for
(2) A watercraft you do not own that is: repair, replacement, enhancement, restora-
tion or maintenance of such property for any
(a) Less than 50 feet long; and reason, including prevention of injury to a
(b) Not being used to carry persons or prop- person or damage to another's property;
erty for a charge; (2) Premises you sell, give away or abandon, if
This Subparagraph (2) applies to any per- the"property damage" arises out of any part
son, who with your expressed or implied of those premises;
consent, either uses or is responsible for the (3) Property loaned to you;
use of the watercraft; (4) Personal property in the care, custody or
(3) Parking an"auto" on, or on the ways next to, control of the insured;
premises you own or rent, provided the
"auto" is not owned by or rented or loaned to
you or the insured;
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 2 of 10
(5) That particular part of real property on which Paragraph (6) of this exclusion does not apply to
you or any contractors or subcontractors "property damage" included in the "products-com-
working directly or indirectly on your behalf pleted operations hazard".
are performing operations, if the "property The insurance provided for "property damage" from
damage"arises out of those operations; or the use of elevators and for "property damage" to
(6) That particular part of any property that must borrowed equipment is excess over any other valid
be restored, repaired or replaced because and collectible property insurance (including any de-
"your work"was incorrectly performed on it. ductible portion thereof) available to the insured
Paragraphs (1), (3) and (4) of this exclusion do not whether primary, excess, contingent or on any other
apply to "property damage" (other than damage by basis.
fire, lightning, explosion or sprinkler leakage) to C. Damage To Premises Rented To You
premises, including the contents of such premises, Item 2. Exclusions, the last paragraph is replaced
rented to you for a period of seven or fewer by the following:
consecutive days. A separate limit of insurance
applies to Damage To Premises Rented To You as Exclusions c. through n. do not apply to damage by
described in SECTION III — LIMITS OF fire, lightning, explosion or sprinkler leakage to
INSURANCE. However, the provisions of this premises while rented to you or temporarily occupied
paragraph do not apply if coverage for Damage To by you with permission of the owner. A separate
Premises Rented To You is excluded by en- limit of insurance applies to this coverage as de-
dorsement. scribed in Paragraph 6. of SECTION III—LIMITS OF
Paragraph (2) of this exclusion does not apply if the INSURANCE.
premises are "your work" and were never occupied, COVERAGE B — PERSONAL AND ADVERTISING
rented or held for rental by you. INJURY LIABILITY
Paragraphs (3)and (4) of this exclusion do not apply D. Personal And Advertising Injury
to the use of elevators.
Paragraphs (3), (4), (5) and (6) of this exclusion do Item 2. Exclusions is amended by replacing Sub-
paragraphs b.and c.with the following:
not apply to liability assumed under a sidetrack
agreement. b. Material Published With Knowledge Of
Falsity
Paragraph (4) of this exclusion does not apply to "Personal and advertising injury" arising out of
"property damage" to borrowed equipment while not oral, written, televised, videotaped or electronic
being used to perform operations at the jobsite.Subject to Paragraph 2. of SECTION III — LIMITS publication, in any manner, of material, if done
by or at the direction of the insured with
OF INSURANCE, the rules below fix the most we knowledge of its falsity.
will pay for"property damage" under this provision:
(1) $25,000 any one "occurrence", regardless of the c. Material Published Prior To Policy Period
number of persons or organizations who sustain "Personal and advertising injury" arising out of
damages because of that"occurrence"; oral, written, televised, videotaped or electronic
publication, in any manner, of material whose
(2) $50,000 annual aggregate; and first publication took place before the beginning
(3) We will pay only for damages in excess of of the policy period.
$2,500 as a result of any one "occurrence", re-
gardless of the number of persons or organiza-
tions who sustain damages because of that"oc-
currence". We may, or if required by law, pay all
or any part of any deductible amount, if applica-
ble, to effect settlement of any claim or "suit".
Upon notice of our payment of a deductible
amount, you shall promptly reimburse us for the
part of the deductible amount we paid.
WN GL 39 0715 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 3 of 10
SUPPLEMENTARY PAYMENTS—COVERAGES A The following are added:
AND B C. Blanket Additional Insured — Vendors — As Re-
E. Supplementary Payments—Coverages A and B quired By Contract
Item 1. is amended by replacing Subparagraphs b. 1. Section II—Who Is An Insured is amended to
and d.with the following: include as an additional insured any person(s)or
organization(s) {referred to throughout this
b. Up to $5,000 for cost of bail bonds required be- endorsement as vendor) with whom you have
cause of accidents or traffic law violations aris- agreed in a written contract, executed prior to
ing out of the use of any vehicle to which the loss, to name as an additional insured, but only
Bodily Injury Liability Coverage applies. We do with respect to "bodily injury" or "property
not have to furnish these bonds. damage"arising out of"your products"which are
d. All reasonable expenses incurred by the insured distributed or sold in the regular course of the
at our request to assist us in the investigation or vendor's business.
defense of the claim or "suit", including actual However,
loss of earnings up to $500 a day because of a. The insurance afforded to such vendor only
time off from work. applies to the extent permitted by law; and
b. If coverage provided to the vendor is
SECTION II—WHO IS AN INSURED AMENDMENTS required by a contract or agreement, the
insurance afforded to such vendor will not
A. Employee Bodily Injury To A Co-Employee be broader than that which you are required
Paragraph 2.a. (1)is replaced by the following: by the contract or agreement to provide for
(1) "Bodily injury" or "personal and advertising such vendor.
injury": 2. With respect to the insurance afforded to these
(a) To you, to your partners or members (if you vendors, the following additional exclusions
are a partnership or joint venture), to your apply:
members (if you are a limited liability com- a. The insurance afforded the vendor does not
pany), or to your other "volunteer workers" apply to:
while performing duties related to the con- (1) "Bodily injury" or "property damage" for
duct of your business; which the vendor is obligated to pay
(b) For which there is any obligation to share damages by reason of the assumption
damages with or repay someone else who of liability in a contract or agreement.
must pay damages because of the injury This exclusion does not apply to liability
described in Paragraph (1)(a)above; or for damages that the vendor would have
(c) Arising out of his or her providing or failing to in the absence of the contract or
provide professional health care services. agreement;
B. Newly Acquired Organizations (2) Any express warranty unauthorized by
you;
Paragraph 3.a. is replaced by the following: (3) Any physical or chemical change in the
a. Coverage under this provision is afforded only product made intentionally by the
until the 1801h day after you acquire or form the vendor;
organization or the end of the policy period, (4) Repackaging, except when unpacked
whichever is earlier; solely for the purpose of inspection,
demonstration, testing, or the
substitution of parts under instructions
from the manufacturer, and then
repackaged in the original container;
WN GL 39 07 16 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 4 of 10
(5) Any failure to make such inspections, 4. With respect to the insurance afforded to these
adjustments, tests or servicing as the vendors, the following is added to Section III —
vendor has agreed to make or normally Limits Of Insurance:
undertakes to make in the usual course
of business, in connection with the If coverage provided to the vendor is required by
distribution or sale of the products; a contract or agreement, the most we will pay on
(6) Demonstration, installation, servicing or behalf of the vendor is:
repair operations, except such a. The minimum amount required by the
operations performed at the vendor's contract or agreement; or
premises in connection with the sale of b. The Limits of Insurance shown in the
the product; Declarations;
(7) Products which, after distribution or sale whichever is less.
by you, have been labeled or relabeled
or used as a container, part or This endorsement shall not increase the
ingredient of any other thing or applicable Limits of Insurance shown in the
substance by or for the vendor; or Declarations.
(8) "Bodily injury or "property damage" 5. With respect to the insurance afforded to these
arising out of the sole negligence of the additional insureds, the following additional
vendor for its own acts or omissions or exclusion applies:
those of its employees or anyone else This insurance does not apply to:
acting on its behalf. However, this
exclusion does not apply to: a. "Bodily injury", "property damage" or
(i) The exceptions contained in 'personal and advertising injury arising out
of the rendering of, or the failure to render,
Subparagraphs(4}or(6}; or any professional architectural, engineering
(ii) Such inspections, adjustments, tests or surveying services, including:
or servicing as the vendor has (1) The preparing, approving, or failing to
agreed to make or normally prepare or approve, maps, shop
undertakes to make in the usual drawings, opinions, reports, surveys,
course of business, in connection field orders, change orders or drawings
with the distribution or sale of the and specifications; or
products.
3. This Provision C.does not apply: (2) Supervisory, inspection, architectural or
engineering activities.
a. To any insured person or organization from This exclusion applies even if the claims
whom you have acquired such products, or against an additional insured allege
any ingredient, part or container, entering negligence or other wrongdoing in the
into, accompanying or containing such supervision, hiring, employment, training
products; or monitoring of others by that insured, if
b. To any vendor for which coverage as an the "occurrence" which caused the
additional insured specifically is scheduled "bodily injury" or "property damage", or
by endorsement; or the offense which caused the "personal
c. When liability included within the "products- and advertising injury", involved the
completed operations hazard" has been ex- rendering of or failure to render any
cluded for such product either by the provi- professional services by you with
sions of the coverage part or by endorse- respect to your providing engineering,
ment. architectural or surveying services in
your capacity as an engineer, architect
or surveyor.
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 6 of 10
D. Blanket Additional Insured — Lessor Of Leased 4. With respect to the insurance afforded to these
additional insureds, the following additional
Equipment exclusion applies:
1. Section II —Who Is An Insured is amended to This insurance does not apply to:
include as an additional insured any person(s)or
organization(s) from whom you lease equipment a. "Bodily injury", "property damage" or
when you and such person(s) or organization(s) "personal and advertising injury' arising out
have agreed in writing in a contract or of the rendering of, or the failure to render,
agreement, executed prior to loss, that such any professional architectural, engineering
person(s) or organization(s) be added as an or surveying services, including:
additional insured on your policy. Such (1) The preparing, approving, or failing to
person(s) or organization(s) is an insured only prepare or approve, maps, shop
with respect to liability for "bodily injury", drawings, opinions, reports, surveys,
"property damage" or "personal and advertising field orders, change orders or drawings
injury' caused, in whole or in part, by your and specifications; or
maintenance, operation or use of equipment (2) Supervisory, inspection, architectural or
leased to you by such person(s) or
organization(s). engineering activities.
However, the insurance afforded to such This exclusion applies even if the claims
additional insured: against an additional insured allege
a. Only applies to the extent permitted by law; negligence or other wrongdoing in the
and supervision, hiring, employment, training or
monitoring of others by that insured, if the
b. Will not be broader than that which you are "occurrence" which caused the "bodily
required by the contract or agreement to injury" or "property damage", or the offense
provide for such additional insured. which caused the "personal and advertising
A person's or organization's status as an addi- injury", involved the rendering of or failure to
tional insured under this endorsement ends render any professional services by you with
when their contract or agreement with you for respect to your providing engineering,
such leased equipment ends. architectural or surveying services in your
2. With respect to the insurance afforded to these capacity as an engineer, architect or
additional insureds, this insurance does not ap- surveyor.
ply to any "occurrence" which takes place after E. Blanket Additional Insured — Managers Or Les-
the equipment lease expires. sors Of Premises
3. With respect to the insurance afforded to these 1. Section II — Who Is An Insured is amended to
additional insureds, the following is added to include as an additional insured any person(s)or
Section III—Limits Of Insurance: organization(s)with whom you have agreed in a
If coverage provided to the additional insured is written contract, executed prior to loss, to name
required by a contract or agreement, the most as an additional insured, but only with respect to
we will pay on behalf of the additional insured is: liability arising out of the ownership,
a. The minimum amount required by the maintenance or use of that part of the premises
contract or agreement; or leased to you, subject to the following additional
exclusions:
b. The Limits of Insurance shown in the This insurance does not apply to:
Declarations;
whichever is less. a. Any "occurrence" which takes place after
This endorsement shall not increase the you cease to be a tenant in that premises.
Structural alterations, new construction or
applicable Limits of Insurance shown in the b.
Declarations. demolition operations performed by or on
behalf of such additional insured.
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 6 of 10
However: F. Blanket Additional Insured — State Or
a. The insurance afforded to such additional Governmental Agency Or Subdivision Or Politi-
insured only applies to the extent permitted cal Subdivision—Permits Or Authorizations
by law; and Section II —Who Is An Insured is amended to in-
b. If coverage provided to the additional clude as an additional insured any state or
insured is required by a contract or governmental agency or subdivision or political
agreement, the insurance afforded to such subdivision with whom you have agreed in a written
additional insured will not be broader than contract, executed prior to loss, to name as an
that which you are required by the contract additional insured, subject to the following
or agreement to provide for such additional provisions:
insured. 1. This insurance applies only with respect to op-
2. With respect to the insurance afforded to these erations performed by you or on your behalf for
additional insureds, the following is added to which the state or governmental agency or sub-
Section III—Limits Of Insurance: division or political subdivision has issued a
If coverage provided to the additional insured is permit or authorization.
required by a contract or agreement, the most However:
we will pay on behalf of the additional insured is: a. The insurance afforded to such additional
a. The minimum amount required by the insured only applies to the extent permitted
contract or agreement; or by law; and
b. The Limits of Insurance shown in the b. If coverage provided to the additional
Declarations; insured is required by a contract or
whichever is less, agreement, the insurance afforded to such
additional insured will not be broader than
This endorsement shall not increase the that which you are required by the contract
applicable Limits of Insurance shown in the or agreement to provide for such additional
Declarations. insured.
3. With respect to the insurance afforded to these 2. This insurance does not apply to:
additional insureds, the following additional a. "Bodily injury', "property damage" or "per-
exclusion applies: sonal and advertising injury" arising out of
This insurance does not apply to: operations performed for the federal govern-
a. "Bodily injury", "property damage" or ment, state or municipality; or
"personal and advertising injury" arising out b. "Bodily injury' or "property damage" in-
of the rendering of, or the failure to render, cluded within the "products-completed op-
any professional architectural, engineering erations hazard".
or surveying services, including: 3. With respect to the insurance afforded to these
(1) The preparing, approving, or failing to additional insureds, the following is added to
prepare or approve, maps, shop Section III—Limits Of Insurance:
drawings, opinions, reports, surveys, If coverage provided to the additional insured is
field orders, change orders or drawings required by a contract or agreement, the most
and specifications; or we will pay on behalf of the additional insured is:
(2) Supervisory, inspection, architectural or a. The minimum amount required by the
engineering activities. contract or agreement; or
This exclusion applies even if the claims b. The Limits of Insurance shown in the
against an additional insured allege Declarations;
negligence or other wrongdoing in the
supervision, hiring, employment, training or whichever is less.
monitoring of others by that insured, if the This endorsement shall not increase the
"occurrence" which caused the "bodily applicable Limits of Insurance shown in the
injury" or "property damage", or the offense Declarations.
which caused the "personal and advertising
injury", involved the rendering of or failure to
render any professional services by you with
respect to your providing engineering,
architectural or surveying services in your
capacity as an engineer, architect or
surveyor.
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 7 of 10
4. With respect to the insurance afforded to these b. The construction, erection or removal of
additional insureds, the following additional elevators; or
exclusion applies: c. The ownership, maintenance or use of any
This insurance does not apply to: elevators covered by this insurance.
a. 'Bodily injury", "property damage" or However,
"personal and advertising injury" arising out a. The insurance afforded to such additional
of the rendering of, or the failure to render, insured only applies to the extent permitted
any professional architectural, engineering by law; and
or surveying services, including: b. If coverage provided to the additional
(1) The preparing, approving, or failing to insured is required by a contract or
prepare or approve, maps, shop agreement, the insurance afforded to such
drawings, opinions, reports, surveys, additional insured will not be broader than
field orders, change orders or drawings that which you are required by the contract
and specifications; or or agreement to provide for such additional
(2) Supervisory, inspection, architectural or insured.
engineering activities. 2. With respect to the insurance afforded to these
This exclusion applies even if the claims additional insureds, the following is added to
against an additional insured allege Section III—Limits Of Insurance:
negligence or other wrongdoing in the If coverage provided to the additional insured is
supervision, hiring, employment, training or required by a contract or agreement, the most
monitoring of others by that insured, if the we will pay on behalf of the additional insured is:
"occurrence" which caused the "bodily
injury" or "property damage", or the offense a. The minimum amount required by the
which caused the "personal and advertising contractor agreement; or
injury", involved the rendering of or failure to b. The Limits of Insurance shown in the
render any professional services by you with Declarations;
respect to your providing engineering, whichever is less.
architectural or surveying services in your
capacity as an engineer, architect or This endorsement shall not increase the
surveyor. applicable Limits of Insurance shown in the
Declarations.
G. Blanket Additional Insured — State Or 3. With respect to the insurance afforded to these
Governmental Agency Or Subdivision Or Politi- additional insureds, the following additional
cal Subdivision — Permits Or Authorizations Re- exclusion applies:
lating To Premises This insurance does not apply to:
Section II —Who Is An Insured is amended to in- a. `Bodily injury", "property damage" or
clude as an additional insured any state or "personal and advertising injury" arising out
governmental agency or subdivision or political of the rendering of, or the failure to render,
subdivision with whom you have agreed in a written any professional architectural, engineering
contract, executed prior to loss, to name as an or surveying services, including:
additional insured, subject to the following provision: (1) The preparing, approving, or failing to
1. This insurance applies only with respect to the prepare or approve, maps, shop
following hazards for which the state or drawings, opinions, reports, surveys,
governmental agency or subdivision or political field orders, change orders or drawings
subdivision has issued a permit or authorization and specifications; or
in connection with premises you own, rent or (2) Supervisory, inspection, architectural or
control and to which this insurance applies: engineering activities.
a. The existence, maintenance, repair,
construction, erection or removal of
advertising signs, awnings, canopies, cellar
entrances, coal holes, driveways, manholes,
marquees, hoist away openings, sidewalk
vaults, street banners or decorations and
similar exposures; or
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 8 of 10
This exclusion applies even if the claims
against an additional insured allege SECTION IV — COMMERCIAL GENERAL LIABILITY
negligence or other wrongdoing in the CONDITIONS AMENDMENTS
supervision, hiring, employment, training or A. Knowledge Of Occurrence
monitoring of others by that insured, if the
"occurrence" which caused the "bodily Item 2. Duties In The Event Of Occurrence, Of-
injury" or "property damage", or the offense fense, Claim or Suit is amended by adding the fol-
which caused the "personal and advertising lowing:
injury", involved the rendering of or failure to e. You must give us or our authorized representa-
render any professional services by you with tive prompt notice of an 'occurrence", claim or
respect to your providing engineering, loss only when the "occurrence", claim or loss is
architectural or surveying services in your known to:
capacity as an engineer, architect or (1) You, if you are an individual;
surveyor.
(2) A partner, if you are a partnership;
SECTION III — LIMITS OF INSURANCE AMEND- (3) An executive officer or insurance manager, if
MENTS you are a corporation; or
A. Damage To Premises Rented To You (4) A member or manager, if you are a limited
Paragraph 6. is replaced by the following: liability company.
S. Subject to Paragraph 5. above, the most we will B. Other Insurance
pay under Coverage A for damages because of Item 4. Other Insurance, b. Excess Insurance (1)
property damage" to any one premises, while (a)(ii) is replaced by the following:
rented to you, or in the case of damage by fire, (ii) That is fire, lightning, explosion or sprinkler leak-
lightning, explosion or sprinkler leakage, while age insurance for premises rented to you or
rented to you or temporarily occupied by you temporarily occupied by you with permission of
with permission of the owner is the greater of: the owner;
a. $300,000; or C. Unintentional Failure To Disclose Hazards
b. The amount shown next to the Damage To Item 6. Representations is replaced by the
Premises Rented To You Limit in the Decla- following:
rations. 6. Representations And Unintentional Failure
However, the provisions of this paragraph do not To Disclose Hazards
apply if Damage To Premises Rented To You a. By accepting this policy, you agree:
Coverage is excluded by endorsement. (1) The statements in the Declarations are
B. Medical Expense Limit accurate and complete;
Paragraph 7. is replaced with the following: (2) Those statements are based upon
7. Subject to Paragraph 5. above, the most we will representations you made to us; and
pay under Coverage C for all medical expenses (3) We have issued this policy in reliance
because of"bodily injury" sustained by any one upon your representations.
person is the greater of: b. If you unintentionally fail to disclose any haz-
a. $10,000; or ards existing at the inception date of your
b. The amount shown next to the Medical Ex- policy, we will not deny coverage under this
pense Limit in the Declarations. Coverage Part because of such failure.
However, this provision does not affect our
This insurance does not apply if coverage for right to collect additional premium or exer-
Medical Expenses is excluded either by the pro- cise our right of cancellation or non-renewal.
visions of the coverage part or by endorsement.
WN GL 39 0716 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 9 of 10
D. Waiver of Subrogation SECTION V—DEFINITIONS AMENDMENTS
Item 8. Transfer of Rights of Recovery Against A. Insured Contract Amended
Others to Us is hereby amended by the addition of Paragraph 9.a. is replaced by the following:
the following:
W a• A contract for a lease of premises. However,
We waive any right of recovery we may have be-
that portion of the contract for a lease of prem-
cause of payments we make for injury or damage ises that indemnifies any person or organization
arising out of your ongoing operations or"your work"
for damage by fire, lightning, explosion or sprin-
done under a written contract, executed prior to loss,
requiring such waiver with that person or organiza- kler leakage to premises while rented to you or
temporarily occupied by you with permission of
tion and included in the products-completed opera- the owner is not an"insured contract";
tions hazard". However, our rights may only be
waived prior to the "occurrence" giving rise to the B. Personal And Advertising Injury Redefined
injury or damage for which we make payment under Paragraph 14. d. and e. are replaced by the follow-
this Coverage Part. The insured must do nothing ing:
after a loss to impair our rights. At our request, the
insured will bring "suit" or transfer those rights to us d. Oral, written, televised, videotaped or electronic
and help us enforce those rights. publication of material that slanders or libels a
person or organization or disparages a person's
or organization's goods, products or service;
e. Oral, written, televised, videotaped or electronic
publication of material that violates a person's
right of privacy;
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 10 of 10
COMMERCIAL GENERAL LIABILITY
WN GL 49 07 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS WHEN
REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU
PRIMARY AND NONCONTRIBUTORY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these
include as an additional insured any person or or- additional insureds, the following additional exclu-
ganization for whom you are performing opera- sion applies:
tions when you and such person or organization This insurance does not apply to:
have agreed in writing in a contract or agreement 1. "Bodily injury", "property damage"or"personal
that such person or organization be added as an and advertising injury" arising out of the ren-
additional insured on your policy. Such person or dering of, or the failure to render, any profes-
organization is an additional insured only with re- sional architectural, engineering or surveying
spect to liability for "bodily injury", "property dam- services, including:
age" or "personal and advertising injury" caused, a. The preparing, approving, or failing to pre-
in whole or in part, by:
pare or approve, maps, shop drawings,
1. Your acts or omissions; or opinions, reports, surveys, field orders,
2. The acts or omissions of those acting on your change orders or drawings and specifica-
behalf; tions; or
in the performance of your ongoing operations for b. Supervisory, inspection, architectural or
the additional insured. engineering activities.
A person's or organization's status as an additional This exclusion applies even if the claims
insured under this endorsement ends when your against an additional insured allege negli-
operations for that additional insured are complet- gence or other wrongdoing in the supervision,
ed. hiring, employment, training or monitoring of
However: others by that insured, if the "occurrence"
1. The insurance afforded to such additional in- which caused the "bodily injury" or "property
cured only applies to the extent permitted by damage", or the offense which caused the
law; and "personal and advertising injury", involved the
rendering of or failure to render any profes-
2. If coverage provided to the additional insured sional services by you with respect to your
is required by a contract or agreement, the in- providing engineering, architectural or survey-
surance afforded to such additional insured ing services in your capacity as an engineer,
will not be broader than that which you are re- architect or surveyor.
quired by the contract or agreement to provide
for such additional insured.
WN GL 49 0715 Page 1 of 2
Includes copyrighted material of Insurance Services Office,Inc.,with its permission.
2. "Bodily injury" or "property damage" occurring D. The following is added to the Other Insurance
after: Condition and supersedes any provision to the
a. All work, including materials, parts or contrary:
equipment furnished in connection with Primary And Noncontributory Insurance
such work, on the project (other than ser- This insurance is primary to and will not seek
vice, maintenance or repairs) to be per- any contribution from any other insurance
formed by or on behalf of the additional in- available to an additional insured under your
sured(s) at the location of the covered policy provided that:
operations has been completed; or
(1) The additional insured is a Named Insured
b. That portion of "your work" out of which
under such other insurance; and
the injury or damage arises has been put
to its intended use by any person or or- (2) You have agreed in writing in a contract or
ganization other than another contractor or agreement that this insurance would be
subcontractor engaged in performing op- primary and would not seek contribution
erations for a principal as a part of the from any other insurance available to the
same project. additional insured.
C. With respect to the insurance afforded to these
additional insureds, the following is added to Sec-
tion III—Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is:
1. The minimum amount required by the contract
or agreement; or
2. The Limits of Insurance shown in the Declara-
tions;
whichever is less.
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
WN GL 49 0715 Page 2 of 2
Includes copyrighted material of Insurance Services Office,Inc.,with its permission.
POLICY NUMBER: CPP 1037280 COMMERCIAL GENERAL LIABILITY
WN GL 50 07 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
PRIMARY AND NONCONTRIBUTORY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Or anization s : Location And Description Of Completed Operations
PER WRITTEN CONTRACT OR AGREEMENT PER WRITTEN CONTRACT OR AGREEMENT
WHERE YOU AGREE TO NAME A PARTY OR
PARTIES AS ADDITIONAL INSURED (S)
Information required to complete this Schedule, if not shown above,will be shown in the Declarations.
A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these
include as an additional insured the person(s) or additional insureds, the following additional exclu-
organization(s) shown in the Schedule, but only sion applies:
with respect to liability for"bodily injury' or "prop- This insurance does not apply to:
erty damage" caused, in whole or in part, by
"your work" at the location designated and de- 1. "Bodily injury", "property damage" or "personal
scribed in the schedule of this endorsement per- and advertising injury"arising out of the render-
formed for that additional insured and included in ing of, or the failure to render, any professional
the"products-completed operations hazard". architectural, engineering or surveying services,
However: including:
1. The insurance afforded to such additional in- a. The preparing, approving, or failing to pre-
sured only applies to the extent permitted by pare or approve, maps, shop drawings,
law; and opinions, reports, surveys, field orders,
2. If coverage provided to the additional insured change orders or drawings and specifica-
is required by a contract or agreement, the tions; or
insurance afforded to such additional insured b. Supervisory, inspection, architectural or en-
will not be broader than that which you are gineering activities.
required by the contract or agreement to pro-
vide for such additional insured.
WN GL 50 0715 Page 1 of 2
Includes copyrighted material of Insurance Services Office Inc.with its permission.
This exclusion applies even if the claims D. The following is added to the Other Insurance
against an additional insured allege negli- Condition and supersedes any provision to the con-
gence or other wrongdoing in the supervi- trary:
sion, hiring, employment, training or monitor- Primary And Noncontributory Insurance
ing of others by that insured, if the This insurance is primary to and will not seek con-
"occurrence" which caused the"bodily injury" tribution from any other insurance available to an
or "property damage", or the offense which additional insured under your policy provided that:
caused the personal and advertising injury",
involved the rendering of or failure to render (1) The additional insured is a Named Insured
any professional services by you with respect under such other insurance; and
to your providing engineering, architectural or (2) You have agreed in writing in a contract or
surveying services in your capacity as an en- agreement that this insurance would be pri-
gineer, architect or surveyor. mary and would not seek contribution from
C. With respect to the insurance afforded to these any other insurance available to the additional
additional insureds, the following is added to insured.
Section III—Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement,the most we
will pay on behalf of the additional insured is:
1. The minimum amount required by the con-
tract or agreement; or
2. The Limits of Insurance shown in the Decla-
rations;
whichever is less.
This endorsement shall not increase the applica-
ble Limits of Insurance shown in the Declara-
tions.
WN GL 50 07 15 Page 2 of 2
Includes copyrighted material of Insurance Services Office Inc.with its permission.