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HomeMy WebLinkAboutPW16-223 - Original - H.D. Fowler Company - 2nd Ave Water Main Replacement - 05/27/2016 l/ i Kecords M a,,,,,, e KENT WJe S ik1M 0T0H Document lent CONTRACT COVERS'"' HEFT 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 Dame: H. D. Fowler Company Vendor Number: JD Edwards Number Contract Number: 1 This is assigned by City Clerk's Office Project Name: 2nd Ave. Water Main Replacement Description: ❑ Interlocal Agreement ❑ Change Order 0 Amendment Contract ❑ Other: Contract Effective Date: 5/27/16 Termination gate: 6/30/16 Contract Renewal Notice (Days): Dumber of days required notice for termination or renewal or amendment Contract Manager: Paul Johnson Department: PW Operations Contract Amount: $11,67.31 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Supply materials for the project. __ ._. . ...__..._.._. .. _..._.. ... _.....__.._.__ _.. ...,_ ........ __. CJ'J'Y f LEFIi As of: 08/27/14 r • KENT GOODS & SERVICES AGREEMENT between the City of Kent and H. D. Fowler Company THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and H. D. Fowler Company organized under the laws of the State of Washington, located and doing business at 13440 SE 30th St., Bellevue, WA 98009, Phone: (425) 746-8400/Fax: (425) 641-8885, Contact: Ryan Huff (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: The Vendor shall supply the City's Water Department with materials for the 2"d Ave. Water Main Replacement Project. For a list of materials, see the Vendor's bid which is attached as Exhibit A and incorporated by this reference. Vendor acknowledges and understands that it is not the City's exclusive provider of these goods, materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and services through other sources. II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete the work and provide all goods, materials, and services by June 30, 2016. III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Eleven Thousand, Six Hundred Twenty Seven Dollars and thirty one cents ($11,627.31), 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: After receipt of all materials listed in Exhibit A and receipt of invoice. If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. 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 Identifier (UBI) number from the State of Washington. F. The Vendor maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. VI. CHANGES. The City may issue a written amendment for any change in the goods, materials or services to be provided during the performance of this Agreement. If the Vendor determines, for any reason, that an amendment is necessary, Vendor must submit a written amendment request to the person listed in the notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days of the date Vendor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Vendor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the amended work upon receiving either a written amendment from the City or an oral order from the City before actually receiving the written amendment. If the Vendor fails to require an 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) J , 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 WSST) 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, 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 Vendor agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. i J. City Business License Required. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. 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. VENDOR: CITY O NT: �1 By: By; ( 'gr)att/re} rgn ture) Print Name:— a ��/leaT t y�� Print Name: Timothy J. LaPorte, P.E. Its:_ NAUA.%C %MCA` Its: Public Works Director (title) DATE: 51ZLA /1 b DATE: I I I NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Ryan Huff Timothy J. LaPorte, P.E. H. D. Fowler Company City of Kent 13440 SE 30th St. 220 Fourth Avenue South Bellevue, WA 98009 Kent, WA 98032 (425) 746-8400 (telephone) (2S3) 8S6-S500 (telephone) (425) 641-8885 (facsimile) (253) 856-6500 (facsimile) HD Fowler-2'Ave WM Repl/Johnson I i I GOODS &SERVICES AGREEMENT - 6 ($20,000 or Less, including 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 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: 11 For: Title: c��n Lt�a�, ��LP 5 Date: 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. 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H1nOS 3AV aNZ :aweN qof 9ZOZ/b/5 :91ea P!s Suamo!aey:)!W :j0jeua!jS3 9178LUID :#a;on'o IN3N 30 AID :aauaopno ANVd W O] H31MO:f 'a'H Z 10 T 88ed 9t,8100.ON PIS d 1181 HX3 EXHIBIT B INSURANCE REQUIREMENTS FOR SERVICE CONTRACTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Contractor shall obtain insurance of the types described below: 1. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. 2. 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. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Commercial General Liability insurance shall be written with limits no less than $2,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products-completed operations aggregate limit. 2. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $2,000,000 per accident. 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 A:VII. 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. HDFOW-1 OP ID:RK CERTIFICATE OF LIABILITY INSURANCE DATE__ 01b 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), AUTHORYZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(ISS)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditlons 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 endorsomi nt{S. ACT PRODUCER Phone:603-224.2500'co"E, Bethany Sutherland Anchor insurance&Surety Inc Fax:603-224-9830 SON D 603.224-2600 ar Noll,603-224-9830 1201 SW 12th Ave.,Suite Boo Portland,OR 97206-2030 Via ts:bsutheriand@anchorlas.com Gene M.D)etzman INSURER AFFORDING COVERAGE NAIC S INSURERA•Travelers Prop Cas Cc or Amer 26674 INSURED H.D.Fowler Co.,Inc. INSURER B r Travelers Indemnity Co. 26666 PO Box 160 INSURERc rA.M.Best=A++ Bellevue,WA 98009.0160 INSURER D INSURER E INWRERFr COVERAGES CERTIFICATE NUMBER: 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,'PERM 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. TYPE OF INSURANCE POLSCYNUMDER PML EFF D LIMITS G£NERALLIABRM / EACH OCCURRENCE $ 1,000,00 A X COhW. ERCIALGENERALLIABILITY X •SM6E62804e ✓ OTMI2016 071011201E REMISES' vrre e $ 100,00 CLAIMS-MADE M OCCUR / MEDEXP cnapers $ 6,00 A WA STOP GAP 0710112016 07101/2016 PERSONAL&ADV INJURY $ 1,000,00 GSNERALAGGREOATE $ 2,000,00 GENL AGGREGATE L[MIT APPLIES PER: PRODUCTS-COMPIOPAGG S 2,000,00 POLICY X PR4 LOC WA EL t 1,000,00 AUTOMOBILE Wtaiuw COMBI ED I R 9,QOQ,OO B JXNY AAUTO X et06E828008 07/0112016 07101/2016 BODILY INJURY(Perpereon) $ BOOMED A�UHOECULED SOULYINJURY(Peraccident) S HIRED AUTOS )( NON-OV ED P eE out E $ AUTOS camp and Coil S 1,00 X UMBRELLAIJAB N OCCUR EACH OCCURRENCE $ 16,000,00 A EXCESS LIAR CLAIMS-MADE M-CUP-W26048 07/0112016 07/0112016 AGGREGATE 3 16,000,00 DED I X I RETENTION$ Ill_ S WORKERS COMPENSATION WC i) IL I AND EMPLOYERS'LIASILnY Y1 M ANY PROPRiETORIPARTNERIEXECUTIVEYQ NIA E.L.EACH ACCIDENT $ OFFICERMMSER EXCLUDED? EL DISEASE-FA EMPLOYEE $ if In NH) ff pes deeglba under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES IMach ACCRD lot,Additional Remaft Schedule,It moro apace to required) Operations of the insured subject to policy terms and conditiona. (See page 2) CERTIFICATE HOLDER CANCELLATION KENTC-2 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 Ave S AUTHaRIZED REPRESENTATIVE KenE,WA 96032 ���✓�� 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010106) The ACORD name and logo are registered marks of ACORD r HDFOW-1 Paee 2 NOTEPAD WSUREtPs NAi E H.D.Fowler Co.,Inc. OP ID:RK DA-re 07/16116 erti.ficate Holder and all required entities are Additional. Insured when r quired by written contract. Endorsements attachedt Blanket additional insured includes waiver of subrogation CG D4 58 07/13; primary wording CG I 0 37 04/05; and Auto additional insured with waiver CA T3 53 02/15. CA T4 45 04/09 Blanket auto loss payable provisions I POLICY NO.: Y-630-SE626048 INSURED: N.D.Fowler Co.,Inc. COMMERCIAL GENERAL LIABILITY THIS ENDORSEM9NT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INTERNATIONAL XTEND ENDORSEMENT This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRiPTION OF COVERAGE—This endorsement broadens coverage.However,coverage for any Injury,damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part,and these coverage broadening provisions do not apply to the extent that coverage Is excluded or Ilrnited by such an endersomonl.The following Usting is a general cover- age deeorfption only.Limitations and exclusions may apply to these coverages.Road all the provisions of this en• dorsement and the rest of your policy carefully to determine rights,duties,and what Is and is not covered, A. Broadened Named Insured K. Bodily Injury to Co-employees and Co. B. Blanket--Additional Insured — Broad Form Volunteer Workers Vendors L Aircraft Chartered with Crew C. Limited Worldwide Uabiitly Coverage — In- M. Non-Owned Watercraft-Increased from 25 demnlly Basis feet to 80 feet D. Damage To Premises Rented To You N. Increased Supplementary Payments • Perlis of fire, explosion,lightning, smoke, Cost of bail bonds Increased to$2,600 water Loss of earnings increased to $500 per • Urnit Increased to$300,000 day E. Blanket Welver of Sbbrogagon 0. Medical Payments-Limit increased to F. Blanket Additional Insured--Owners,Manag• $10,000 per person ers or Lessors of Premises P. Knowledge and Notice of Occurrence or Of- G. Blanket Additional Insured - Lessors of fense Leased Equipment Q. Unintentional Omission H. Incidental Medical Malpractice R. Reasonable Force-Bodily Injury or Property I. Personal Injury Assumed by Contract Damage J. Amended Sodily Injury Definition S. Transportation Expenses For Repatriation or Rolocation of Injured Or Slck Employees PROVISIONS a. Coverage under this provision Is afforded A. BROA09NED NAMSD INSURED only until the 180111 day after you acquire 7. The following is added to St~CTiON U—WHO or form the organization or the end of the IS INSURED: policy period,whichever Is earlier,unless reported In writing to us within 180 days. Any organization, other than a partnership or S. BLANKET ADDITiONAL INSURED — BROAD joint venture,over which you malntatn owner- FORM VENDORS ship or majority interest on the effective date The following is added to SECTION 11-WHO IS of the policy quatiflos as a Named Insured, AN INSURED: However,average for any such organization wilt cease as of the data during the policy pe- Any person or organlzatlon-.that Is a vendor and dod that you no longer malntaln ownership of, that you have agreed In a written contract or or majority interest in,such organizallon. agreement to Include as an additional Insured on 2. The following replaces Paragraph 4.a. of this-Coverage Part Is-an Insured,but only with re- 890TION 11—WHO 18 AN INSURED: spool to Ilablaty for "bodily Injury" or "properly damage"that: CO D4 0810 08 02e08TheTravalarsCompant %Ina, Page 1 of 9 • t i COMMERCIAL GENERAL LIABILITY ! a. la caused by an"occurrence"that takes place dlent, part or container entering Into, accom- after you have signed and.executad that.con• panyIng•orrcontathing such products;or tract or agreement;-and b, Any vendor for whcch.�cdverage•as an addl- b. Arises out,of"your produata" which are dis- Ilonal Insured specifically Is scheduled by en- lributed or sold-in,the regular course.of.such dorsement, vendor's business. C. LIMITED WORLDWIDE LIABILITY COVERAGE The Insurance-provided to such vendor.is-subjuct —INDEMNITY BASIS to the following provisions: 1. The following replaces the definition of"caw a. The limits:of.insurance�provlded to such van- arage territory"In the 09FMITIONS Section: dor.will'be the limits which you agreed to-pro. "coverage territory,means: vide In-ft written contract-or;agreement, or a, The United States of America (InaludIng the limits shown in.the Declafallona of-this Its territories and possessions), Puerto Coverage Part,•whichever.are Idea. Rico and Canada; b. The Insurance-provided to such.vendor does b, International waters or airspace,but only notapply to; u: (1) "Bodily Injury'! or "properly.damage° for (1) The"bodily Injury"or"property dam- which.'the vendor..Is ob0gated- to -pay age" is caused by an "occurrence" datnrfges.by.reason:ofAhe assumption of that takes place;or Ilabliity in a'contract or agreement. This exclusion does not apply to liability for (2) The "personal Injury" or °advertising damages#hat'the vendor would have In injur/"Is caused by an offense com- the absence of the contract or-agreement, milted; (2) Any express warranty unauthorized by In the course of travel or transportation you; between any places Included in Para- (3) Any pbysloat or chemical change in"your graph a.above;or products" made Intentionally by such c. All other parts of the world except the vendor; "prohibited area", but only if the injury or (4) Repackaging, unless unpacked sololy for damage arises out of: the-purposs of Inspection,demonstration, (1) Goods or products made,sold, han• testtng,.or the•substllution,af'parts under died or distributed by you,or services Instructions from the manufacturer, and provided by you to your customers or then•repackaged In the orlginal•contalner; clients, In the territory described In (a) Any failure-to-make such Inspections,ad- Paragraph a.above; justments, tests or servicing as vendors (2) The activities of a person whose agree to:perform or normally.i ndettake to hems Is In the territory described in perform In'the regular course of business, Paragraph a.above,but Is away for a in connecdonvith the distribution.or sale short Ome on your business;or of"your products'; (3) "Personal injury" or "advertising in- (8) Demonstralton."Installdtlon, servicing or jury"offenses committed through the repair operations,except such operallons Internet or similar electronic means of performed at such_vendoes premises In communication; connection with the sale-of"your.prod- provided that the Insured's responaiblilly to ucts";or pay damages is determined in a"suit"on the (7) "Your products" which, after distribution merits brought anywhere In the world except or sale by you, have been labeled'or re- the "prohibited area", or in a settlement we labeled-or used as-a container,part or In- agree to. gredient of any other thing or substance With respect to"occurrences"that take place, by or far such vendor. or"personat Injury"or"advertising Injury"of- Coverage under this provision does not apply to; fenses committed within the territory de- a. Any person or.organization from whom you soribed in paragraph c. above, the following have acqulred "your products", or any Ingre- conditions apply: Page 2 of 0 0 2008 Tho Travelem Componles,Ina CO 04 5810 08 COMMERCIAL GENERAL LIABILITY 2. The following replaces Paragraph 8,of sLC• iItVi{{� ="tt3MJIi1 Rot t -Al�li TION III—LIMITS OF INSURANCE: Subject to 8 above the Damage To Pram- itU (?' `� ` `' 4 '. g S "7)"h s 1 l�s.a�1�e," NI M 4 Vo`. 1 1.i4 ! L 1 '1.ti 3'T'3" 5+•b._ t3•, +"J", ilea Rented To You Limit is the most we will .ii� orti , M fib �b13c0�dMrlP pay under Coverage A for damages because 11!�akbt'tbi�� � Fn3t '" ig: of "property damage" to any one prom.foea ` j .x' wr Ad ntF • ,. , 6� �,� � tw vFte while rented6 to you,or temporarily occUpled r°'f4 : h + �g, #n; ,R� .� T •, by you with petmfsslon of the owner,caused by lire; explosion; lightning, smoke resulting v*il .(,19 .} 1b l Rt, ;r: b"rk;;t i �, ,¢y sa : plosion or II htnln or we- :44 . } � b � U` from,such tire,ex g !fI + i§ r' Ub ter. The•Damage To Premises Rented To ��+ r oto !r�Cbiiootat} 3f; You Limit will apply to all damage proximately caused by the some "occurrence", whether F, BLANKET ADDITIONAL INSURED—OWNERS, suoh damage resuits from tire; explosion; MANAGERS OR LESSORS OF PREMISES lightning,,smoke resulting from such tire,ex The following is added to SECTION Ii—WHO iS plosion, or Ilghtning;water, or any combine- AN INSURED: lion of any of these. Any person or organization that Is a premises The Damage To premises dented To You owner, manager or lessor and that you have Limit will be the higher of., agreed In a written contract or agreement to a. $300,Ot)0;or name as an additional Insured on this Coverage Pert Is an insured,but only,with respect to liability b. The amount shown on ilia Declarations of for "bodil+ injury", "property. dwage", "personal this Coverage Part for Damage To-Prom- inJur 'or 'advertising injury' hat: Isea Rehied To You Limit. a. .is"bodily injury'or"properly damage"caused 4. The following replaces Paragraph a. of the by an "occurrence"that takes place, or"per« delinitfan of"insured contraot"in the DEFINI• sonal Injury'or"advertising Injury"caused by TIONS Section: an offense that is committed, after you have a. A contract for a lease of premises. How- signed and executed that contract or agree- ever, that portion of the contract for a ment;and lease of premises that Indemnifles any b, Arises out of the ownership, maintenance or person or -organization for damage to use of that part of any promises teased to promises while rented to you, or tempo- you. rarity occupied by you with permission of The Insurance provided to such premises owner, the owner,caused by: manager or lessor is subject to the following pro- (1) Fire; visions: (2) Explosion; a. The limits of Insurance provided to such (t3) Lightning. hell limits whlehr�you agreed to er or lessor provide tin thll e y g A (4) Smoke resulting from such tire, ex- written contract or agreement, or the limits plosion,or lightning;or shown on the Declarations of this Coverage (6) Water. Part,whichever are less. is not an"Insured contract"; b, The insurance provided to such premises S. The following re owner,manager or lessor does not apply to: places paragraph 4.b.(1)(b) of SECTION IV—COMMERCIAL GENERAL (1) "Bodily Injury" or "property damage" LIABILITY CONDITIONS: caused by an "occurrence" that takes (b) That is tnst�rance for premises ranted to place,,or"personal Injury"or"advertising you, or temporarily occupied by you with mlls caused by an offense that Is tn- ihe permission of the owner; milted, after you cease to be a tenanntt in that promises;or ! � F3l?11 '11? '►� 3`. F? 1711 ;�3`AiICiN, (2) Structural alterations,new construction or e Fp l Is#s p( bxN P j r& hn8y Tr'pr 60 demciltlon operations performed by or on O: `s:: 1 Ftsa�tifl!AafiiBt Q.tf;(srsrlSlJ.si Page 4 of 9 0 200aThe Travelers Coitpantes,Inc. CID Del 5810 08 COMMERCIAL GENERAL LIABILITY behalf of such premises owner,manager H. INCIDENTAL MEDICAL.MALPRACTICE or lessor. 1. The following is added to the definitlon of"oc- o. The insurance provided to such premises ourrenoe"In the DEFINITIONS Section: owner,manager or lessor Is excess over any Unless you are in the business or occupation valid and collectible other insurance available of providing professional health dare services, to such premises owner, manager or lessor, "occurrence" also means an not or omission unless you have agreed In a'written contract committed In providing or falling to provide for this insurance to apply on a primary or "Incidental medical servtoee to a person. contributory basis. g. The following is added to the DEFINITIONS 0. BLANKET ADDITIONAL INSURED-LESSORS Section: OF LgASED'EQUIPMENT "Incidental medical services"means: `the following Is added to SECTION 11-WHO IS a;:Medical,surgical,dental,laboratory,x-ray AN INSURED: or nursing service or treatment,advice or Any person or organization that Is an equipment Instruction, or the related furnishing of lessor and that you have agreed In a written con- food or beverages: tract or agreement to Include as an additional In- b. The furnishing or dispensing of drugs or sured on this Coverage Part Is an Insured, but medical, dental, or surgical supplies or aniy with respect to Ilablilly, for "bodily Injury", appllances;- "pi<operty damage","personal injury"or"advertls- c, First aid:or Ing Injury"that; a. Is"bodily Injury"or"property damage"caused d. "flood Samaritan services". by an "ecourrence"that lakes place,or"per, uGood Samaritan services"moans any ernes sonal Injury"or"advedlsing Injury"caused by genoy medical services for which no compen- an offense that Is committed,after you have sation is demanded or received, signed and executed that contract or agree- 3. The following is added to Paragraph 2.a.(1)of ment;and SECTION 11-WHO 1S AN INSURED: b. 1s caused,In whole or In part,by your acts or Unless you are in the business or occupation omissions In the maintenance, operation or of providing professional health care services, use by you of equipment leased to you by Paragraphs (1)(a), (b), (c) and(4)above do such equipment lessor. not apply to any"bodily Injury"arising out of The Insurance provided to such equipment lessor any providing or falling to provide"incidental Is subject to the following provisions: medical services" by any of your "employ. a. The limits of insurance provided to such cea", other than an employed doctor. Any equipment lessor will be the 11Mi1e which you such "employees" providing or falling to pro- agreed to provide in the written contract or vide"Incidental medical s'ervloas"during their agreement,or the limits shown on the Decla- work hours for you will be deemed to be act- 0 of this Coverage Part,whlchaver are Ing within the scope of their employment by you or performing duties related to the con• less, b. The Insurance provided to such equipment duet of your business. lessor does not apply to any"bodily Injury'or 4. The following exclusion Is added to Para- "properly damage" caused by an "occur- graph 2., Exoluslons,or SECTION i-COV- rence"that lakes place,or"personal Injury"or ERA0E$-COVERAGE A BODILY INJURY "advertlAg Injury"caused by an offense that AND PROPERTY DAMAGE LIABILITY. is committed, after the equipment lease ex- Sale Of pharmaceuticals pins, "Bodily Injuy' or"property damage" adsing c. The Insurance provided to suph equipment out of the Wilful violation of a portal statute or lessor Is excess over any valid and eolfeotlple ordinance relating to the sale of pharmaceutl- other Insurance available to such equipment cats committed by, or with the knowledge or lesser, unless you have agreed in a written consent of,the insured. contract for this Insurance to apply on a prf- S. The following Is added to Paragraph 5. of Mary at contrlbutory basis. SECTION IIi•-LIMITS OF INSURANCE: ' r • t CG 04 5810 09 02008 The Travelers Companles,Ina. Page 6 of 9 COMMERCIAL GENERAL LIABILITY For the purposes of dolomrining the appilos- has also been assumed In the blo Each Occurrence Limit,all related acts or some"Insured contract";and omissions committed in the providing or fall- (b) Such attorney fees and litigation ing to provide"Incidental medical services"to expanses are for defense of that any one person will be considered one "oo- party against a civil or alternative ourrence". dispute resolution proceeding'in 8. The following Is added to Paragraph 4.b.,Ox- which damages to which this in- coss Insurance, of SECTION IV — COM- surenoe applies are alleged. MLRCIAL GENERAL LIABILITY CONDI- 2, The following replaces the third sentence of TIONS: Paragraph 2. of SUPPLEMENTARY PAY This Iftstirence is excess over any valid and MENTS—COVERAGES A AND 8: collectible other Insurance, whether primary, Notwithstanding the provisions of Paragraph excess,contingent or on any other basis,that .2,b,(2)of Secllon i—Coverage A--Bodily In- is available to any of your "employees" for jury And Properly Damage Liability or Pate- "bodily lnjury"that arises.out of providing or graph 2.e.of Section I—Coverage B—Per. falling to provide"Incidental medical services" sonai and Advertising injury Liability, suah to any person to the extent not subject to payments will not be deemed to be damages Paragraph 2.a.(1) of SECTION 11—WHO IS because of"bodily Injury","properly damage" AN INSURED. or"personal Injury', and will not reduce the 1. PERSONAL INJURY — ASSUMED BY CON- limits of Inourenco. TRACT 3. The following replaces Paragraph 24 of 9. The following replaces Exclusion e.,Contrac- SUPPLEMENTARY PAYMENTS — COVER. tual Liability,In Paragraph 2.of SECTION i AGES A AND B: -- COVERAGES — COVERAGE 0 PER- d. The silegallons In the "sull" and the in- SONAL AND ADVERTISING INJURY LI- formation we know about the "occur- ABILITY: rence"or offense am such that no conflict e. Contractual Liability appears to exist between the Interests of "Personal Injury"or"advertising Injury"for the Insured and the Interests of the In. which the insured is obligated to pay demnttee; damages by reason of the assumption of 4. The following replaces the first subparagraph liability in a contract or agreement. This of Paragraph f, of The definition of 'insured exclusion does not apply to: contraol"In the DEFINITIONS Section: (1) Liability for damages that the Insured f. That part of any other contract or agree- would have In the absence of the ment pertaining to your business(Includ- contract or agreement;or ing an Indomnifloation of a munfolpaitly In 2 Liability for damages because of connectlon with work performed for a ( ) municipality)under which you assume the "personal Injury' assumed In a con- tort liability of another party to pay for tract or agreement that Is an"insured "bodily injury,""property damage"or"per- contract",provided that the"personal sonal Injury"to a third person or organiza- injury'is caused by an offense,com- tlon, Tort liability means a liability that milted subsequent to the execution of would be Imposed by law In the absence the contract or agreement.Solely for of any contract or agreement. the purposes of liability assumed In J. EXTENSION OF COVERAGE — BODILY IN- an"Insured contract", reasonable at. JURY tomeys fees and necessary litigation The following replaces the definition of"bodily In- expenses Incurred by or for a party jury"in the DEFINITIONS Ssoflon: other than an Insured will be deemed to be damages because of"personal "Bodily injury" means bodily inlury, mental on- Injury',provided that: gulsh, mental injury, shook, frlghhl, disability, hu- a Liability to such arty far, or for millalion,sickness or disease sustained by a per- ( ) Y P son,including death resulting from any of these at the cost of, that par lys defense any time. Page 6 of 9 02008 no Tnwelm Conspantes,Ina. CO D4 68 10 08 I I i COMMERCIAL GENERAL LIABIL ITY K. BODILY INJURY TO CO-EMPLOYEES AND vehicle to which the Bodily injury Liability CO-VOLUNTEER WORKERS Coverage applies.We do not have to fur- The following is added to Paragraph 2^(1) of nish these bonds. SECTION 11—WHO IS AN INSURED: 2. The following replaces Paragraph i.d. of Paragraph (1)(a)above does not apply to"bodily SUPPLEMENTARY PAYMENTS —COVER- Injury"to a co-amployse"in the course of the co. AGES A AND B of SECTION I—COVER- "employae's" employment by you or performing AGES: duties related to the conduct of your business,or d. All reasonable expenses Incurred by the to"bodily injury'to your other"volunteer workers" Insured at our request to asslst us In the while perforrlaing duflee related to the conduct of Investigation or defense of the claim or your Wetness. "suit",Including actual loss of earnings up L. AIRCRAFT CHARTERED WITH CREW to $600 a day because of time off from work. The following is added to ftcluslon g.,Aircraft, 0. MEDICAL PAWAENTS—INCREASED LIMITS Auto Or Watercraft,In Paragraph 2.of 890TION I—COVERAGES--COV9RAGE A BODILY IN. The following replaces Paragraph 7.of SECTION JURY AND PROPERTY DAMAGE LIABILITY: III-LIMITS OF INSURANCE: This exclusion doss not apply to an aircraft that 7. Subject to 6. above, the Medical Expense Is: Limit Is the most we will pay under Coverage (a) Chartered with crew to any Insured; C.for all Medical expenses because of"bcd- Ily injury sustained by any one person,and (b) Not owned by any Insured;and wI11 be the higher of: (c) Not being used to carry any person or prop- (a) $10,000;or erly for a charge. M. NON-OWNED WATERCRAFT (b) The amount shown on the Declarations of this Coverage Part for Medical Expense 1. The following replaces Paragraph (2) of Ex. Limit. cluslon g., Aircraft, Auto Or Watercraft, In P. KNOWLEDGE~ AND NOTICE OF OCCUR- Paragraph 2.of SECTION I—COVERAGES RENCE OR OFFENSE — COVERAGE A BODILY INJURY AND The following is added to Paragraph 2.,Duties In PROPERTY DAMAGE LIABILITY: The event of Occurrence, Offense, Claim or (2) A watercraft you do not own that is: Suit, of SECTION IV - COMMERCIAL GEN. (a) Fifty feet long or less;and ERAL LIABILITY CONDITIONS: (b) Not being used to carry any person or e. The following provisions apply to Paragraph property for a charge. a.above, but only for the purposes of the In. 2. The following to added to Paragraph 2. of surance provided under this Coverage Part to SECTION It—WHO IS AN INSURED: you or any Insured listed In Paragraph 1.or 2. of Section Il—Who Is An Insured: Any person or organization that,with your ex- (1) Notice to us of such "occurrence" or of- press or Implied consent,either uses or to re= fense must be given as soon as practice- sponsible for the use of a watercraft that you ble only after the"occurrence"or offense do not own that is; Is known to you(If you are an individual), (1) Fifty feat long or less;and any of your partners or members who is (2) Not being used to carry any person or an Individual (if you are a partnership or property for a charge, joint venture),any of your managers who N. INCREASED SUPPLEMENTARY PAYMENTS Is an Individual(If you are a ifmtied liability company),any of your trustees who Is an 1. The following replaces Paragraph 1.b. of Individual(If you are a trust),any of your SUPPLEMENTARY PAYMENTS — COVER- "executive officers"or directors(if you are AGES A AND B of SECTION I-.,COVER- an organization other than a partnership, AGES: joint venture, limited liability company or because of accidents or traffic laaww crust) or any "employee" authorized by quired b b. Up to eau far cost of ball bonds you to give notice of an "occurrence"or vlolatlons arising out of the use of any offense. CG D4 6810 08 02008 The Travalem Companies,Ino, Page 7 of 0 COMMERCIAL GENI=RAL LIABILITY (2) if you are a partnership,jointventure,Ilm• celled upon in Issuing this policy will not prejudice tied liability company or trust,and none of your rights under this insurance. However, this your partners, joint venture members, provision does not affect our right to collect adds• managers or trustees are Individuals, no- tional premium or to exercise our rights of cancel- tice to us of such"occurrence"or offense lallon or nonrenewal in accordance with applica- must.be given as soon as practicable only bte Insurance laws or regulations. after the"occurrence"or offense is known R. REASONABLE FORCE—B0131LY INJURY OR by. PROPERTY DAMAGE (a) Any Individual who Is: The following replaces Exclusion a.,Expected Or (1)•A partner or member of any part- Intended Injury,in Paragraph 2.of SECTION I— nershlp or joint venture; COVERAGES — COVERAGE A BODILY IN- (11) A manager of any illnited liability JURY AND PROPERTY DAMAGE LIABILITY: company; a. gipebted or intended injury or Damage (Iln A trustee of any trust;or "Bodily injury!or"property damage"expected (iv)An executive.'offlcer or director of or Intended from the standpoint or the In. any other organization; cured.This exclusion does not apply to"bod- ihak is your partner, joint venture ity injury or property damage resulting from p j the use of reasonable force to protect any member,manager or trustee;or person or property. (b) Any "employes" authotlied by such S, TRANSPORTATION EXPENSES FOR REPA- partnership, joint venture, limited il- TRiATION OR RELOCATION OF INJURED OR ability company,trust or other organl- SICK EMPLOYEES zalron to give notice of an "occur- rence"or offense. 1. The follow[ng Is added to SUPPLEMENTARY 3 Notice to us of such "occurrence" or of- PAYMENTS -- COVERAGE A AND B of ( ) sEcrlvN i—COVERAGES: fense will be deemed to be given as soon We will reimburse you for the reasonable as pmellcable If it lb given In good faith as 14ransportailoh expenses"that you Incur,over soon as practicable to your workers' and above "normal transportation costs", for compensation Insurer.This applies only it the repatriation or relocation of any of your In- you subsequently give notice to us of the"occurrence"or offense as soon as prat. jue. diseased, sick or deceased "employ- ttoabie after any of the persons described eas°.But only If., In Paragraphs e.(1)or(2) above dlecov- a. The Injury, disease, sickness, or death srs that the"oocutrencd" or offense may occurred during the policy period and result In sums to which the insurance We such"employed' was employed or provided under this Coverage Part may assigned to work by you anywhere In the apply. world other than: However, if thle policy Includes an endorse- (1) The United States of America Uivolud- ment that provides limited coverage for"bod• ing Its territories and possessions), Ily Injury" or"property damage" or pollution Puerto Rico and Canada;and costs arising out of a discharge, release or (2) Any country or jurisdiction In the escape of "pollutants" which contains a re- "prohibited area"; qutrement that the discharge, release or es- b. The relocation or repatriation is noes. cape of"pollutants" must be reported to us within a speolflo number of days after Its eaty in the opinion of competent medical abrupt commencement, this Paragraph e. authorities;and does not affect that requirement. c. The relocation or repatriation is from the Q. UNINTENTIONAL OMISSION country where the Injury, disease, sick- ness, or death occurred to a destination The following Is added to Paragraph 8., Repre- In another country. sentatlons, of SlICTION IV -- COMMERCIAL GENERAL LIABILITY CONDITIONS: The most we will pay as reasonable 11rans- 7he unintentional omission of,or unintentional er- porfatron expenses"for the repatriation or re- ror In,any Information provided by you which we location of any one of your employees is Page 8 of 9 020Qe The Travelers companies,Ina CO D4 5010 08 o COMMERCIAL GENERAL LIABILITY $25,000.The most we will pay as reasonable 3. The following is added to the DEFINITIONS "transportation expenses"for the repatriation section: or relocation of all of your "employees" Is "Normal transportation costs" means the $60,000.These payments will not reduce the costs of transporting your"employee"In good limits of Insurance. health, and In conformance with your busl- 2. The folowing is added to Paragraph 4.b.,Ex- ness travel policy,from the country of Injury, coos Insurance, of SECTION IV w COM- disease, sickness,or death to the country of MERCIAL GENERAL LIABILITY CONDI. relocation or repatriation. TIONS: "Transportation expenses" Includes the fol- This-insurance Is excess over any valid and lowing expenses: collectible other Insurance, whether primary, a. Costs of embalming to meet united excess,contingent or on any other basis,that States standards,and Is available for the reasonable"Irenspor#atlon b.'All reasonable expenses of transportation expanses" that you Incur, over and above to return the remains of the deceased to "normal transportation costs",for the repatrla- the country of burial or funeral. Hen or relocation of any of your Injured, dls- eased,slok or deceased"employees". Ce 04 6810 08 02008 The Uvelers Companies,Ina Page 9 of 9 0 POLICY NO.: Y-630-5E626048 INSURED: H.D.Fowler Co.,Inc. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY,PLEASE READ IT CAREFULLY. OTHER INSURANCE -ADDITIONAL INSUREDS This endotsoment modifies Insurance provided under the fbUowing: COMMdRCIAt-GENERAL LIABILITY WWRAdE PART PROVISIONS b. The"personal Injury"or"advertising Injury°for COMMERCIAL GENERAL LIABILITY CONDiTIONO which coverage Is sought arises out of an ot- tense committed a(Sectionamended IV)as o paragraph 4. (Other Insurance), is subsequent to the signing and execution of that a�rsndstl as fellows: � � 9. The following Is added to Paragraph a. Primary contract or agreement by you. insurance: 2. The first btrbpardgraph (2) of Paragraph b. Efc- However,.lf you specifically agree In a written oon- eggs Insurance regarding any other primary In. tract or written agreement that the insurance pro- suranee available to you is deleted, vided to an additional Insured under this 3. The following is added to Paragraph b. Excess Coverage Part must ap ty on a prlmaty basis,or Insuratice,as an addigonal subparagraph under a ` a"Iyii4> fli'iflo ;baets,this insur- Subparagraph(1): Sties Is primary to other Insurance that is avail- That Is available to the Insured when the Insured able to such additional Insured which covers such is added as an additional insured under any other addilionaf insured as a named Itretlred, and we policy,Inotuding any umbrella or excess policy. will not share with that other Insurance, provided that: a. The"bodily Injury" or "properly damage"for which coverage Is sought occurs;and CO DO 37 04 05 Copyright 2005 The St.Paul Travelers Companies,ins All rights reserved. Page 1 of i o , POLICY NO.: Y-810-SE626048 INSURED: N.D.Fowler Co,inc. i i COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies Insurance provided under the following.: BUSINESS AUTO COV9RACE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modi- Red by the endorsement. GENERAL DESCRIPTION OF COVERAGE-This endorsement broadons coverage.However,coverage for any injury.damage or tnediaat expanses described In any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Dart,and these coverage broadening provisirtna do not apply to the extant that coverage is excluded or Rmlted by such an endorsement.The following listing is a general cover- age deacrlptiat only.Limitations and excfuslons may apply to ihuse coverages.Read all the provisions of this an. darsement and the rest of your perilcy canefully to determine rdghls,duRem,and what is and la not covered. A. BROAD FORM NAMED INSURED H. HIRED OF USE AUTO INCREASED PHYSICAL DAMAGE-• LOSS 1• PHYSICA 8 DMA INCREASED t.GE SPORTATION EXP0. EMPLOYEE HIRED AUTO J. PERSONAL EFFECTS D. EMPLOYEES AS INSURED K. AIRBAGS e. SUPPLEMENTARY PAYMENTS-INCREASED L. NOTICE AND KNOWLEDGE OF ACCIDENT LIMITS OR LOSS F. HIRED AUTO - LIMITED WORLDWIDE *0mIS;itn"ERsA)fi:3 1 0iD1l Im COVERAGE--INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE-GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS ju4gA. BROAD FORM NAMED INSURED �il���t}d t,�Y��!'11��t" o`l :tt�p'�" nit•' 'fin t("',.�'�Qt The following Is added to Paragraph A b Who Is t, x �, x, ,y. . r dolt' edodvn �.. An insured, of SECTION ii- 41ASt41TY COV" tl4t'• g` 1 'n ii' t:RAfiE: g =p3` Any organtxation newly acquire trig the policy period over which you maintain d•1 l � �r�ep� �! Y Y or form dur- •��,,.�s I?�l�, 80% or more ownershi Interest and that Is not P Vi�fxb:�ls`.:i1: t�8r���prv�7lr�dnl�tite t 'zS001tdn' separately Insured far Business Auto Coverage. lip; Coverage under this provision is afforded only uny C. EMPLOYEE HIRED AUTO ill the 180th day after you acquire or form the or- ganization or the and of the policy period,which. 1' Who f lowing s a deed tSt:C ragrap A.1., everla earlier. B WARKIiw�'��t DITI�0�At:IN010,00:: ABILITY COVERAGE: s i}(i g I � d t9 R rq$'f'p Yk t` ► ; An"employee"of yours Is an"insured"while WJtas4kistliii.,i3t �pS.E�r1`� Vl;`tlA �fl',Y operating an "auto" hired or rented under a GQ�tirif contract or agreement In that "employee's° ,t j,.,.. name,with your permission,white performing 7aaprs0n�or ganlxitbh ►hsjiiQIii'daPr duties related to the conduct of your busi- a; ritflstcbn� ; rLaie� tet; Jn !Pn nags. CATS 53 0310 0 201 O The Trevelera IndoamitY CompenY• Page i of 4 includes ccpyr#ghted materiel ortnsurenes Services Ofte,Inc.with its permlesion. 0 COMMERCIAL.AUTO 2. The following reptaces Paragraph b.In 9.6., within suoh country or Jurisdiction,for Llablllly Other Insurance, of SECTION IV — 13USI. Coverage for any covered "auto" that you NESS AUTO CONDITIONS; lease,biro,rent or borrow without a driver for b. For Mired Auto Physiool Damage Cover- a period of 30 days or leas and that Is not an age,fhe following are deemed to be cov- "auto" you lease, hire, rent or barrow from ered"autos"you own: any of your"employees",partners(if you are 1 covered "auto" u lease, hire, a partnership),members(If you are a limited ( ) Any you liability company)or members of their house- rent or borrow;and holds. (21 Any covered"auto"hired or rented by (a) With respect to any claim made or"suil" your"employee" under a coiltracl In brought outside the United States of that Individual "employee's". name, Amerlea, the territories and possessions with your permission, while perform- of the United States of America, Puerto Ing duties related to the conduct of Rico and Oanada: your business: p) You must arrange to defend the"in- However,any"aula"that is leased,hired, sured"against,and Investigate or set- rented or borrowed-with a driver Is not a ile any such claim or"sult"and keep covered"auto", us advised of all proceedings and ac- D. EMPLOYEES AS INSURED lions. the following Is added to Paragraph A.1.,Who Is (11) Neither you nor any other involved An Insured, of SECTION 1f--LIABILITY COV 'Insured" will make any settlement 9RAGE: without our consent, Any"employee"of yours is an"insured"while us,. 011)We may,at our discretion,participate Ing a covered"auto"you don`(own,hire or borrow to defending the"Insured"against,or In your business or your personal arfafre. In the settlement of, any claim or E. SUPPLEMENTARY PAYMENTS--INCREASED "suit". LIMITS (iv)We will reimburse the "Insured" for 1. The following replaces Paragraph A.2.a.M, sums that the"Insured" legally must of SECTION 11—LIABILITY COVERAGE: pay as damages because Hof bodily Injury or property damage to which (2) Up to $3,000 for cost of ball bonds Qn- this Insurance applies, that the "In- cluding bonds for related traffic law viola- sured" pays wilh our consent, but Ilene) required because of an 110coldent" only up to the limit described In Para- we cover, We do not have to fumish graph C.,Limit Of Insurance,of SEC, these bonds. TION 11-»LIABILITY COVERAGE. 2. The following replaces Paragraph A.2.a.(4), (v) We will reimburse the "Insured" for of SECTION 11—LIABILITY COVERAGE' the reasonable expenses Incurred (4) All reasonable expenses Incurred by the with our consent for your Invesilga- 'lnsured"at our request. Including actual lion of such claims and your defense loss of earnings up to $600 a day be- of the "Insured" against any such cause of time off from work. "sult", but only up to and Included F. HIRED AUTO — LIMITED WORLDWIDE COV- within the limit described In Para- i RAGE—INDEMNITY BASIS graph C., Limit Insurance, of SECTION II — LIAA BILITY COVER- The following replaces Subparagraph(6)In Para- AOE,and not in addition to such limit. graph B.7., Policy Period, Coverage Territory, Our duty to make suoh payments of SECTION IV -- BUSINESS AUTO CONDI- ends when we have used up the sp= TIONS: pllcable limit of Insurance In pay- (6) Anywhere In the world,except any country or meats for damages, settlements or Jurisdiction while any trade sanction, em. defense expenses. bargo, or,similar regulation imposed by the (b) This Insurance to excess over any valid United States of America applies to and pro- and collectible other insurance available hibits the iraneactlon of business with or Page 2 of 4 02010 Tho Travelers indemrtlty Company. CA T3 53 0310 indudes oopyrtghied material of Insurance services o lee,ino.with Its permission. a COMMERCIAL AUTO I to the"Insured"whether primary, excess J. PERSONAL EFFECTS contingent or on any other basis. The following Is added to Paragraph AA., Cover- This Insurance Is not a substitute for re. age Extensions, of SECTION III -- PHYSICAL qulred or compulsory Insurance in any DAMAGE COVERAGE; country outside the United States,Its ler- Personal Effects rltcrles and possessions, Puerto Rfoo and We will pay up to$400 for"ions"to wearing ail- Canada, paral and other personal effects which are: You agree to maintain all required or compulsory Insurance In any such coun• (4) owned by an"insured";and .try up to the minimum limits required by (2) In or on your covered"auto'. local law. Your failure to comply with This coverage applies only in the event of a total compulsory Insurance requirements will !haft of your covered"auto". not Invalidate the coverage afforded by this policy,but we.wlll,only be liable to the No deductibles apply to this Personal Effects same extent we would have been liable coverage. had you opmpiled with the compulsory in,. K. AIRBAGS surancs requirements. The following is added to Paragraph B.3., Exclu- (d) It is understood that we are not an admit- sions, of SECTION ill PHYSICAL DAMAGE red or authorized insurer outside the COVERAGE: United States of America, Its territories Exclusion 3.a.does npt apply to"loss"to one or and possessions, Puerto Rico and Can- more airbags In a covered"auto"you own that in. ada.We assume no responsibility for the (late due to a cause other then a cause of"loss" fumishfng of certificates of Insurance, or set forth In Paragraphs A.1.b. and A.1.c., but for compliance in any way with the laws only; of other countries relating to Insurance. ' G. WAIVER OF D1rDUC716LE—GLASS a. If that"auto"Is a covered"auto"far Compre- hensive Coverage under this policy; The following Is added to Paragraph D.,Deducti- b. The airbags are not covered under any war- ble, of SECTION Ill — PHYSICAL DAMAGE ranty;and COVERAGE; No deductible for a covered "auto"will apply to °• The airbags were not Intentionally Inflated. We will pay up to a maximum of$1,000 for any glass damage If the glass is repaired rather than replaced. one"loss". H. HIRED AUTO PHYSICAL DAMAGE«-LOSS OF L. NOTICE AND KNOWLEDGE OF ACCIDENT OR USE-INCREASED LIMIT LOSS The following replaces the last sentence of Para, The following Is added to Paragraph A.2.a., of graph AA.b., Loss Of Use Expenses, of SEC. SECTION IV—BUSINESS AUTO CONDITIONS: ' TION fll--PHYSICAL DAMAGE COVERA09: Your duty to give us or our authorized represents- However,the most we will pay for any expenses five prompt notice of the"acaldent"or"loss" ap- for toss of use is$66 per day, to a maximum of plies only when the"acaldent"or"foss"Is known $750 for any one"accident". to. 1. PHYSICAL DAMAGE - TRANSPORTATION (a) You(if you are an Individual); EXPENSES—INCRETASED LIMIT (b) A partner(!f you are a partnership); The following replaces the first sentence In Para- (c) A member(if you are a limited liability com• graph a4.a., Transportation Expenses, of pany); SECTION III -- PHYSICAL DAMAGE COVER- (d) An executive officer, director or Insurance AGE: manager(if you are a corporation or other or- We will pay up to$60 per day to a maximum of ganizatlon);or $1,500 for temporary transportation expense In. (e) Any"employea"authorized by you to give no- curred by you because of the total theft of a cov- floe of the"accident"or"lose". ored auto of the private passenger type. CA T3 63 0310 02010 The Travolere Indemnity Company, Page 3 of 4 Includesoopyrlghtod metertai of insurance SeMces office.Inc.tvllh Its permisslon. f COMMERCIAL AUTO IVI'�:;,;���1<tC�;��t'�tIS►A1111r���F���.E7�o',�A:i'��.1.V: `s�c�,l,��in���t�T'f��Wati���4..,���tQ§��b����tott�i�. Y� i rt n+ S\,1 s� [,l .i•l}�h4e { '1'S,}iki y� y ,gL1ti,1•t�Y( r,bs ! li ,�l f�'Jab ,flit �• x+•..i.. �fti al{1 ICI;��; I;Y� 1 ��u.A1�'4iM I� pIR_�:�1�4y M t ha` bliir1 a tr l3ri�fs k S 7 . Ai�r�gH�a,O��ita��c�bi►br;iaA'ghiil�s;,�he��,�t`��'1��� �onftaCtiC .D N. UNINTENTIONAL ERRORS OR OMISSIONS 1 fOlB.` The following Is added to paragraph B.2„ Con- 4; :,:r`h1"'sT;a' � lii`s�41E`:1 `bv$ry1"g`� t coalment, Misrepresentation, Or Fraud, of ��$^ gnX4��j� SECTION IV—BUSINESS AUTO CONDITIONS: eayr�`i,e ny r fit ag-r# r -A.�'g a►� e, The unintentional omfsslon of, or unintentional ` , .�_i3 x error In, any Information given by you shall not prejudlce your rights under this insurance. How. ? ec oafi h � �; over this provision does not affect our right to col• ,bps!', Iact'addilional premium or exorcise our right of ifr1r) u,' �`b"1 p lto °Ii�?a�in lR e bY' cancellation ornon•renewal. Page 4 of 4 ®2010 The Pavolars Indemalfy Company. CA T3 53 0310 Inatudes copyrighted meledal of Insorenoe Sarvlces Olfloo,Ino.Wth lie permisslon.