HomeMy WebLinkAboutPW16-225 - Original - Ott-Sakai and Associates, LLC - Contract - 05/27/2016 n."a lz� I I I U
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CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to City Clerks Office. All portions are to be completed.
If you have questions, please contact City Clerk's Office.
Vendor Name: Ott-Sakai and Associates, LLC
Vendor Number:
7D Edwards Number
Contract Number: ?WI"-
This is assigned by City Clerk's Office
Project Name: S. 228`' St. UPRR Grade Separation
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract
❑ Other:
Contract Effective Date: 5/27/16 Termination Date: 1.2/31/16
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Susanne Smith Department: Engineering
Contract Amount: $9,945.00
Approval Authority: (CIRCLE ONE) Department Director Mayor City Council
Detail: ( .e. address, location, parcel number, tax id, etc.):
Participate in a Value Engineering Study and provide 60% constructability review services
for the project.
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KENT
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CONSULTANT SERVICES AGREEMENT
between the City of Kent and
Ott-Sakai and Associates, LLC
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Ott-Sakai and Associates, LLC organized under the laws of the State of
Washington, located and doing business at 129 E. Lake Sammamish Shorelane NE, Sammamish, WA
98074, Phone: (425) 890-3533, Contact: William Ott (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:
The Consultant shall participate in a Value Engineering Study and provide 60%
constructability review services for the S. 228th Street UPRR Grade Separation project. For
a description, see the Consultant's Scope of Work which is attached as Exhibit A and
incorporated by this reference.
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 December 31, 2016.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed
Nine Thousand, Nine Hundred Forty Eight Dollars ($9,948.00), 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; lrovided, 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 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.
CONSULTANT SERVICES AGREEMENT - 4
($20,000 or Less)
i 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 bellow execute this Agreement, which shall become effective on
the last date entered below.
CONSULTANT: CITY KENT:
By: v
9(51 n )"(9ignature)
Na
,Zre
Print me: /;1-17 Print Name: Timothy 3, LaPorte, P.E.
Its; Its: Public Works Director
ititle)
DATE: 5 DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
William Ott Timothy J. LaPorte, P.E.
Ott-Sakai and Associates, LLC City of Kent
129 E. Lake Sammamish Shoreland': NE 220 Fourth Avenue South
Sammamish, WA 98074 Kent, WA 98032
(425) 890-3533 (telephone) (253) 856-5500 (telephone)
_(253 856-6500 (facsimile)
Ott-Sakai-228"UP Grade Sep VE/SmAh
CONSULTANT SERVICES AGREEMENT - 5
($20,0,00 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: /��
For: (�7'i--,S:5z ka-a 3S40C, L C
Title: �/':17c"PQ I
Date: ✓—I? "20/te5
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
EXHIBIT A
OTT--SAKAI AND ASSOCIATES., LLC
129 E. Lake Sammamish Shorelane NE
Sammamish WA 98074
425-890-3533
bill@ott-sakai.com
April 29,2016
City of Kent
Public Works Department
400 West Gowe Street
Kent, WA 98032
Attention: Susanne Provencio Smith,Design Engineer II
2213
Subject: So.20th Street over UPRR Grade Separation
Proposal for 30% Constructibility Review
Susanne,
I propose the following activities to be addressed in a 60% Constructability Review
exercise by Ott-Sakai and Associates. Our Billing Rate is $204/hr.
4 hrs City meeting & site visit
32 hrs VE Study(review project & 3day VE Study)
11 hrs Constructability
47 hrs @ $204/hr (Sr. Constr. Specialist) _ $9588
3 hrs @ $120/hr(Bookkeeper/Pa olloll) _ $360
TOTAL $9948
Our hourly-billing rate is all inclusive of direct salary, overhead, and fee and are the lowest
hourly rates I charge to my preferred clients for this type and size of work.
Thank You,
r
William P. Ott
f�
f
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.
2. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability arising from
premises, operations, independent contractors, products-completed
operations, personal injury and advertising injury, and liability
assumed under an insured contract. The City shall be named as an
insured under the Consultant's Commercial General 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.
3. Workers' Compensation coverage as required by the Industrial
Insurance laws of the State of Washington.
4. Professional Liability insurance appropriate to the Consultant's
profession.
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 propprty damage of $1,000,000 per
accident. 5 -9-Zo/(,
�`l,d60, Doi
2. Commercial General Liability insurance shall be written with limits
no less than each occurrence, $2,000,000 general
aggregate a d a $1,000,000 products-completed operations
aggregate limit.
EXHIBIT B (Continued)
3, Professional Liability insurance shall be written with limits no less
than $2yea@=,@ft per claim an $2,000,000 policy aggregate limit.
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
insurance:
1. The Consultant's insurance coverage shall be primary insurance as
respect the City. Any Insurance, self-insurance, or insurance pool
coverage maintained by the City shall be excess of the Consultant's
insurance and shall not contribute with it.
2. The Consultant's insurance shall be endorsed to state that coverage
shall not be cancelled by either party, except after thirty (30) days
prior written notice by certified 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 Contractor before commencement of the work.
F. Subcontractors
Consultant shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Consultant.
Client#: 1045900 WILLIOTT2
GATE(MMIDDlYYYY)
ACORD.. CERTIFICATE OF LIABILITY INSURANCE 1 5/1012016
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:
Kibbie&Prentice,a USI Co PR PHONE 206 441-6300 Alt No; 610-362-8530
A1C No Ext
601 Union Street, Suite 1000 aooREss: PL.CertRequest@usi.biz
Seattle,WA 98101 INSURER S)AFFORDING COVERAGE NAIC p
INSURER A:Travelers Indemnity Co.of Amer 25666
INSURED INSURERS;Navigators Insurance Company 42307
Ott-Sakai&Associates
INSURER C
14915 88th Place NE
INSURER D
Kenmore,WA 98028
INSURER E:
INSURER F:
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, TERM OR CONDITION OF ANY CONTRACTOR 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.
TRR TYPE OF INSURANCE NSRADDL WVD POLICY NUMBER MMfLDDY EFF MWDDY EXP LIMBS
A X COMMERCIAL GENERAL LIABILITY 680OD943278 4105/2016 04/05/2017 EACH OCCURRENCE $1 OOO O00
CLAIMS-MADE �OCCUR PREMISES EaEoeeu ante $1 000 000
MED EXP(Any one person) $10 000
PERSONAL&ADV INJURY $1 000 000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000
PRO LOC PRODUCTS-COMPIOP AGG s2,000,000
POLICY a
OTHER: $
A AUTOMOBILE LIABILITY 680OD943278 4/05/2016 04/05/201 Ee aacl Cent SINGLE LIMIT 1,000,000
ANY AUTO BODILY INJURY(Per person) S
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUTOS
X HIRED AUTOS X NON-OWNED PPReOaPERT DAMAGE $
AUTOS
$
UMBRELLA LIAR HOCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DED I I RETENTION$ $
A WORKERS COMPENSATION 68GOD943278 4/05/2016 04/05/201 X STATUTE PER OTH-
AND EMPLOYERS'LIABILITY g-
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN (WA Stop Gap) E.L.EACH ACCIDENT $1 00O 000
OFFICER/MEMBER EXCLUDED? � N 1 A
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1 000 000
If yes,tlasedbe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000 o0O
B Professional CM16DPLO478431V 0410512016 04/0512017 $1,000,000 per claim
Liability $2,000,000 annl aggr.
DESCRIPTION OF OPERATIONS!LOCATIONS J VEHICLES(ACORD 101,Additional Remarks Schedule,may bo attached If more space Is required)
RE: Cosnutlant Services Agreement-S.228th Street-UPPR Grade Separation.
The General Liability policy includes an automatic Additional Insured endorsement that provides Additional
Insured status to the City of Kent only when there is a written contract that requires such status,and
only with regard to work performed on behalf of the named insured.
CERTIFICATE HOLDER CANCELLATION
ANYBE
City of Kent Engineering THE SHOULD EXP RATOIONH DATE VTHEREOF,E NOTICE CIEI ELLED WILL ES CBE CDELIVER DO IN
400 West Gowe ACCORDANCE WITH THE POLICY PROVISIONS.
Kent,WA 98032
AUTHORIZED REPRESENTATIVE
01988-2014 ACORD CORPORATION.All rights reserved.
ACORD 25(2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S17835890/Ml7648012 VPSBC
POLICY NUMBER: 680-OD943278-COP-16
EFFECTIVE DATE: 04-05-16
ISSUE DATE: 02-10-16
LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS
BY LINE OF BUSINESS.
IL TO 19 02 05 COMMON POLICY DEC
MP TO 01 02 OS BUSINESSOWNERS COVERAGE PART DECS
IL T8 01 O1 01 FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS
IL T3 16 05 12 COMMON POLICY CONDITIONS - WASHINGTON
IL T3 20 09 97 EARLIER NOT CANCEL/NONRENEKAL PROV BY US
BUSINESSOWNERS
MP T1 30 02 05 TBL OF CONT-BUSINESSOWNERS COV-DELUXE
MP T1 02 02 05 BUSINESSOWNERS PROPERTY COV-SPEC FORM
MP T1 05 02 05 AMENDATORY PROVISIONS-OFFICES
MP PO 01 09 07 ARCHITECTS,ENGINEERS & SURVEYORS END
MP T3 25 01 15 FEDERAL TERRORISM RISK INSURANCE ACT DIS
MP T3 50 11 06 EQUIP BREAKDOWN SERV INTERRUPTION LIM
MP T3 56 02 08 AMENDATORY PROVISIONS-GREEN BLD
CP 01 60 12 98 WASHINGTON CHANGES - DOMESTIC ABUSE
MP T4 31 12 09 WA CHANGES
COMMERCIAL GENERAL LIABILITY
CG TO 34 11 03 TABLE OF CONTENTS
CG 00 01 10 01 COMMERCIAL GENERAL LIABILITY COV FORM
CG D2 55 11 03 AMENDMENT OF COVERAGE - POLLUTION
CG D3 09 11 03 AMEND ENDT-PRODUCTS-COMPLETED OPR HAZARD
CG D3 81 09 07 ADDT INSURED ARCHITECT,ENGINEER,SURVEYOR
CG D4 71 01 15 AMEND COVERAGE B - PERS & ADV INJURY
ON 01 13 11 03 EMPLOYERS OVERHEAD LIABILITY
CG DO 37 04 05 OTHER INSURANCE-ADDITIONAL INSUREDS
CG D2 03 12 97 AMEND-NON CUMULATION OF EACH OCC
CO D3 79 09 07 ARCHITECT,ENGINBER,SURVEYOR XTEND ENDORS
CG D4 13 04 08 AMENDMENT OF COVERAGE-COOLING-POLLUTION
MP T1 25 11 03 HIRED AUTO AND NON-OWNED AUTO LIAB
CG D3 26 10 11 EXCLUSION - UNSOLICITED COMMUNICATION
CG D3 56 05 14 MOBILE EQUIP REDEFINED-EXCL OF VEHICLES
CG D3 80 10 11 EXCL-ENGIN ARCHITECT OR SURVEY PROF LIAB
CG D4 21 07 08 AMEND CONTRAC LIAB EXCL-EXC TO NAMED INS
CG D6 18 10 11 EXCL-VIOLATION OF CONSUMER FIN PROT LAWS
CG D7 46 01 15 EXCL-ACCESS OR DISCL OF CONF/PERS INFO
CO F7 68 08 13 WA CHGS - AMEND LIQ EXCL EX SCHED ACTIV
CG DO 76 06 93 EXCLUSION-LEAD
CG D1 42 01 99 EXCLUSION-DISCRIMINATION
CG F2 45 07 02 EXCLUSION - WAR - WASHINGTON
CG T4 78 02 90 EXCLUSION-ASBESTOS
CG F2 66 11 03 WA CHANGES EMPLOY RELATED PRACTICES EXCL
IL TO 01 01 01 PAGE: 1 OF 2
POLICY NUMBER: 680-OD943278-COP-16
EFFECTIVE DATE: 04-05-16
ISSUE DATE: 02-10-16
COMMERCIAL GENERAL LIABILITY (CONTINUED)
CG F4 66 01 08 WASHINGTON CHANGES-WHO IS AN INSURED
CG T3 33 11 03 LIMIT WHEN TWO OR MORE POLICIES APPLY
INLAND MARINE
CM T3 98 01 15 FEDERAL TERRORISM RISK INSURANCE ACT DIS
INTERLINE ENDORSEMENTS
IL T4 00 12 09 DESIGNATED ENTITY-C/NR PROVIDED BY US
IL T4 12 03 15 AMNDT COMMON POLICY COND-PROHIBITED COVG
IL T4 14 01 15 CAP ON LOSSES CERTIFIED ACT OF TERRORISM
IL T3 82 05 13 EXCL OF LOSS DOE TO VIRUS OR BACTERIA
IL 01 23 11 13 WASHINGTON CHANGES - DEFENSE COSTS
IL 01 57 07 02 WA CHANGES - ACTUAL CASH VALUE
IL 01 73 07 02 WA CHANGES-EXCLUDED CAUSES OF LOSS
IL 01 98 09 08 NUCLEAR ENERGY LIABILITY EXCLUSION
IL T8 010101 PAGE: 2 OF 2
COMMERCIAL GENERAL LIABILITY
POLICY NUMBER: 680-OD94327B-COF-16 ISSUE DATE: 02-10-16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
HIRED AUTO AND NONOWNED AUTO LIABILITY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SCHEDULE
Insurance is provided only with respect to those coverages for which a specific premium charge is shown:
COVERAGE ADDITIONAL PREMIUM
Hired Auto Liability $ INCLUDED
Nonowned Auto Liability $ INCLUDED
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
PROVISIONS C. WHO IS AN INSURED
A. COVERAGE Section II — Who Is An Insured is replaced by
If a premium charge is shown in the SCHEDULE the following:
above, the Insurance provided under Section I — Each of the following is an insured under this In-
Coverage A — Bodily Injury And Property surance to the extent set forth below:
Damage Liability applies to "bodily injury" and 1. You;
"property damage"arising out of the maintenance
or use of a "hired auto" or "nonowned auto". 2. Anyone else including any partner or"execu-
Maintenance or use of a "nonowned auto" in- tive officer" of yours while using with your
cludes test driving in connection with an "auto permission a "hired auto" or a "nonowned
business". auto"except:
B. EXCLUSIONS a. The owner or lessee (of whom you are a
With respect to the insurance provided by this sublessee)of a"hired auto" or the owner
endorsement: or lessee of a "nonowned auto" or any
agent or"employee"of any such owner or
1. The exclusions, under Section I—Coverage lessee:
A — Bodily Injury And Property Damage
Liability,other than exclusions a.,b.,d.,e.,f. b. Your "employee" if the covered "auto" is
and i. and the Nuclear Energy Liability Exclu- owned by that "employee" or a member
sion (Broad Form) are deleted and replaced of his or her household;
by the following: c. Your"employee" if the covered "auto" is
a. "Bodily injury"to: leased, hired or rented by him or her or a
member of his or her household under a
(1) Any fellow "employee" of the Insured lease or rental agreement for a period of
arising out of and in the course of: 180 days or more;
(a) Employment by the insured;or d. Any partner or"executive officer"with re-
(b) Performing duties related to the spect to any "auto" owned by such part-
conduct of the insured's busi- ner or officer or a member of his or her
ness. household;
b. "Property damage"to: e. Any partner or"executive officer"with re-
(1) Property owned or being transported sped to any "auto" leased or rented to
by,or rented or loaned to the insured; such partner or officer or a member of his
or or her household under a lease or rental
(2) Property in the care, custody or con- agreement for a period of 180 days or
trol of the Insured. more;
MP T1 25 1103 Copyright,The Travelers Indemnity Company,2003 Page 1 of 2
Includes copyrighted material of Insurance Services Office, Inc.,with its permission.
COMMERCIAL GENERAL LIABILITY
f. Any person while employed in or other- E. ADDITIONAL DEFINITIONS
wise engaged in duties in connection with Section V—Definitions is amended by the addi-
an "auto business", other than an "auto tion of the following definitions:
business"you operate; 1. "Auto Business" means the business or oc-
g. Anyone other than your "employees", cupation of selling, repairing, servicing, stor-
partners, a lessee or borrower or any of ing or parking"autos".
their "employees", while moving property 2. "Hired auto" means any "auto" you lease,
to or from a "hired auto"or a "nonowned hire,rent or borrow.This does not include:
auto";or
3. Any other person or organization, but only a. Any"auto"you lease,hire or rent under a
with respect to their liability because of acts lease or rental agreement for a period of
or omissions of an Insured under 1. or 2. 180 days or more,or
above. b. Any"auto"you lease, hire, rent or borrow
D. AMENDED DEFINITIONS from any of your "employees", partners,
stockholders, or members of their house-
The Definition of"insured contract"of Section V— holds.
Definitions Is amended by the addition of the fol-
lowing exceptions to paragraph if.: 3. "Nonowned auto" means any "autos" you do
Paragraph f. does not Include that part of any not own, lease, hire, rent or borrow that are
contract or agreement: being used in the course and scope of your
business at the time of an "occurrence". This
(4) That pertains to the loan,lease or rental of an includes "autos" owned by your"employees"
"auto" to you or any of your "employees", if or partners or members of their households
the"auto" is loaned, leased or rented with a but only while being used In the course and
driver;or scope of your business at the time of an"oc-
(5) That holds a person or organization engaged currence".
in the business of transporting property by If you are a sole proprietor, "nonowned auto"
"auto"for hire harmless for your use of a cov- means any "autos" you do not own, lease,
ered "auto" over a route or territory that per- hire, rent or borrow that are being used in the
son or organization is authorized to serve by course and scope of your business or per-
public authority. sonal affairs at the time of an"occurrence".
Page 2 of 2 Copyright,The Travelers Indemnity Company, 2003 MP T1 25 11 03
Includes copyrighted material of Insurance Services Office,Inc.,with its permission.
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ARCHITECTS, ENGINEERS AND SURVEYORS
XTEND ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE Provisions A. — T. and V. of this endorsement broaden coverage.
Provisions U. and W. of this endorsement may limit coverage. The following listing is a general coverage descrip-
tion only. Limitations and exclusions may apply to these coverages. Read all the PROVISIONS of this endorse-
ment carefully to determine rights, duties, and what is and is not covered.
A. Broadened Named Insured N. Additional Insured — Architect, Engineer Or Sur-
B. Incidental Medical Malpractice veyor
C. Reasonable Force — Bodily Injury Or Property 0. Who Is An Insured — Newly Acquired Or Formed
Damage Organizations
D. Non-Owned Watercraft — Increased To Up To 75 P. Who Is An Insured — Unnamed Partnership Or
feet Joint Venture—Excess
E. Aircraft Chartered With Crew Q. Per Project General Aggregate Limit
F. Extension Of Coverage — Damage To Premises R. Knowledge And Notice Of Occurrence Or Offense
Rented To You S. Unintentional Omission
G. Malicious Prosecution — Exception To Knowing T. Waiver Of Transfer Of Rights Of Recovery
Violation Of Rights Of Another Exclusion Against Others To Us When Required By Con-
H. Medical Payments Limit tract Or Agreement
I. Increased Supplementary Payments U. Amended Bodily Injury Definition
J. Additional Insured — Owner, Manager Or Lessor V. Amended Insured Contract Definition — Railroad
Of Premises Easement
K. Additional Insured—Lessor Of Leased Equipment W. Amended Property Damage Definition — Tangible
L. Additional Insured — State Or Political Subdivi-
Property
sions—Permits Relating To Premises X. Additional Definition — Contract or Agreement
M. Additional Insured — State Or Political Subdivi-
Requiring Insurance
sions—Permits Relating To Operations
PROVISIONS coverage for any such additional organization
A. BROADENED NAMED INSURED will cease as of the date, if any, during the
policy period, that you no longer are the sole
1. The Named Insured in Item 1. of the Common owner of, or maintain the majority ownership
Policy Declarations is amended as follows: interest in, such organization.
The person or organization named in Item 1. 2. This Provision A. does not apply to any per-
of the Common Policy Declarations and any son or organization for which coverage is ex-
organization, other than a partnership, joint cluded by another endorsement to this Cov-
venture, limited liability company or trust, of erage Part.
which you are the sole owner or in which you
maintain the majority ownership interest on
the effective date of the policy. However,
CG D3 79 09 07 Copyright 2007 The Travelers Companies, Inc. Page 1 of 8
COMMERCIAL GENERAL LIABILITY
B. INCIDENTAL MEDICAL MALPRACTICE any other basis, except for insurance pur-
l. The following is added to Paragraph 1. Insu- chased specifically by you to apply in excess
ing Agreement of COVERAGE A BODILY of the Limits of Insurance shown in the Decla-
INJURY AND PROPERTY DAMAGE LI- rations for this Coverage Part.
ABILITY in COVERAGES (Section 1): C. REASONABLE FORCE — BODILY INJURY OR
"Bodily injury" arising out of the rendering of, PROPERTY DAMAGE
or failure to render, "first aid" or "Good Sa- The Expected Or Intended Injury Exclusion in
maritan services" to a person, other than a Paragraph 2. Exclusions of COVERAGE A
co-"employee" or "volunteer worker", will be BODILY INJURY AND PROPERTY DAMAGE
deemed to be caused by an "occurrence". For LIABILITY in COVERAGES (Section 1) is deleted
the purposes of determining the applicable and replaced by the following:
limits of insurance, any act or omission to- Expected Or Intended Injury Or Damage
gether with all related acts or omissions in the
furnishing of the services to any one person "Bodily injury" or "property damage" expected or
will be deemed one"occurrence". intended from the standpoint of the insured. This
exclusion does not apply to "bodily injury" or
2. As used in this Provision B.: "property damage" resulting from the use of rea-
a. "First aid" means medical or nursing ser- sonable force to protect any person or property.
vice, treatment, advice or instruction; the D. NON-OWNED WATERCRAFT — INCREASED
related furnishing of food or beverages; TO UP TO 75 FEET
the furnishing or dispensing of drugs or
medical supplies or appliances; 1. The exception contained in Subparagraph (2)
of the Aircraft, Auto Or Watercraft Exclu-
b. "Good Samaritan services" means those sion in 2. Exclusions of COVERAGE A
medical services rendered or provided in BODILY INJURY AND PROPERTY DAM-
an emergency and for which no remu- AGE LIABILITY in COVERAGES (Section 1)
neration is demanded or received. is deleted and replaced by the following:
3. Paragraph 2.a.(1)(d) of WHO IS AN IN- (2) A watercraft you do not own that is:
SURED (Section II) does not apply to any of (a) Less than 75 feet long; and
your"employees", who are not employed as a
doctor or nurse by you, but only while per- (b) Not being used to carry persons or
forming the services described in Paragraph property for a charge;
1. above and while acting within the scope of 2. Only as respects the insurance provided by
their employment by you. Any such "employ- this Provision D., WHO IS AN INSURED
ees" rendering "Good Samaritan services"will (Section II) is amended to include as an in-
be deemed to be acting within the scope of sured any person who, with your expressed
their employment by you. or implied consent, either uses or is responsi-
4. The following exclusion is added to Para- ble for the use of the watercraft.
graph 2. Exclusions of COVERAGE A BOD- 3. The insurance provided by this Provision D.
ILY INJURY AND PROPERTY DAMAGE LI- shall be excess over any valid and collectible
ABILITY in COVERAGES (Section 1): other insurance available to the insured,
Sale of Pharmaceuticals whether primary, excess, contingent or on
"Bodily injury" or "property damage" any other basis, except for insurance pur-
arising out of the willful violation of a chased specifically by you to apply in excess
penal statute or ordinance relating to the of the Limits of Insurance shown in the Decla-
sale of pharmaceuticals committed by or rations for this Coverage Part.
with the knowledge or consent of the E. AIRCRAFT CHARTERED WITH CREW
insured. 1. The following is added to the exceptions con-
5. The insurance provided by this Provision B. tained in the Aircraft, Auto Or Watercraft
shall be excess over any valid and collectible Exclusion in Paragraph 2. Exclusions of
other insurance available to the insured, COVERAGE A BODILY INJURY AND
whether primary, excess, contingent or on
Page 2 of 8 Copyright 2007 The Travelers Companies, Inc. CG D3 79 09 07
COMMERCIAL GENERAL LIABILITY
PROPERTY DAMAGE LIABILITY in COV- Subject to 5. above, the Damage To Prem-
ERAGES (Section 1): ises Rented To You Limit is the most we will
Aircraft chartered with crew, including a pilot, pay under Coverage A for the sum of all
to any insured. damages because of "property damage" to
any one premises while rented to you, or
2. This Provision E. does not apply if the char- temporarily occupied by you with permission
tered aircraft is owned by any insured. of the owner, caused by: fire; explosion; light-
3. The insurance provided by this Provision E. ning; smoke resulting from such fire, explo-
shall be excess over any valid and collectible sion, or lightning; or water. The Damage To
other insurance available to the insured, Premises Rented To You Limit will apply to all
whether primary, excess, contingent or on "property damage" proximately caused by the
any other basis, except for insurance pur- same 'occurrence", whether such damage
chased specifically by you to apply in excess results from: fire; explosion; lightning; smoke
of the Limits of Insurance shown in the Decla- resulting from such fire, explosion, or light-
rations for this Coverage Part. ning; or water; or any combination of any of
F. EXTENSION OF COVERAGE — DAMAGE TO these causes.
PREMISES RENTED TO YOU The Damage To Premises Rented To You
1. The last paragraph of COVERAGE A BOD- Limit will be the higher of:
ILY INJURY AND PROPERTY DAMAGE LI- a. $1,000,000; or
ABILITY in COVERAGES (Section 1) is de- b. The amount shown for the Damage To
leted and replaced by the following: Premises Rented To You Limit in the
Exclusions c. through n. do not apply to dam- Declarations for this Coverage Part.
age to premises while rented to you, or tem- 4. Paragraph a. of the definition of"insured con-
porarily occupied by you with permission of tract" in DEFINITIONS (Section V) is deleted
the owner, caused by: and replaced by the following:
a. Fire; a. A contract for a lease of premises. How-
b. Explosion; ever, that portion of the contract for a
c. Lightning; lease of premises that indemnifies any
person or organization for damage to
d. Smoke resulting from such fire, explosion, premises while rented to you, or tempo-
or lightning; or rarily occupied by you with permission of
e. Water. the owner, caused by: fire; explosion;
A separate limit of insurance applies to this lightning; smoke resulting from such fire,
coverage as described in LIMITS OF IN- explosion, or lightning; or water is not an
SURANCE (Section III). "insured contract';
2. The insurance under this Provision F. does S. This Provision F. does not apply if coverage
not apply to damage to premises while rented for Damage To Premises Rented To You of
to you, or temporarily occupied by you with COVERAGE A BODILY INJURY AND
permission of the owner, caused by: PROPERTY DAMAGE LIABILITY in COV-
ERAGES (Section 1) is excluded by another
a. Rupture, bursting, or operation of pres- endorsement to this Coverage Part.
sure relief devices;
G. MALICIOUS PROSECUTION — EXCEPTION TO
b. Rupture or bursting due to expansion or KNOWING VIOLATION OF RIGHTS OF AN-
swelling of the contents of any building or OTHER EXCLUSION
structure, caused by or resulting from wa-
ter; or The following is added to the Knowing Violation
Of Rights Of Another Exclusion in 2. Exclu-
c. Explosion of steam boilers, steam pipes, sions of COVERAGE B PERSONAL INJURY,
steam engines, or steam turbines. ADVERTISING INJURY AND WEB SITE IN-
3. Paragraph 6. of LIMITS OF INSURANCE JURY LIABILITY of the WEB XTEND LIABILITY
(Section III) is deleted and replaced by the Endorsement:
following:
CG D3 79 09 07 Copyright 2007 The Travelers Companies, Inc. Page 3 of 8
COMMERCIAL GENERAL LIABILITY
This exclusion does not apply to "personal injury" ter you cease to be a tenant in that
caused by malicious prosecution. premises;
H. MEDICAL PAYMENTS LIMIT (2) Any structural alterations, new con-
The Medical Expense Limit shown in the struction or demolition operations
Declarations for this Coverage Part is increased performed by or on behalf of such
to$10.000. additional insured; or
I. INCREASED SUPPLEMENTARY PAYMENTS (3) Any premises for which coverage is
excluded by another endorsement to
Paragraphs 1.b. and i.d. of SUPPLEMENTARY this Coverage Part.
PAYMENTS — COVERAGES A AND B in COV- 3. This Provision J. does not apply on any
ERAGES(Section 1)are amended as follows: basis to any person or organization for
1. In Paragraph 1.b., the amount we will pay for which coverage as an additional insured
the cost of bail bonds is increased to$2500. specifically is added by another en-
2. In Paragraph 1.d., the amount we will pay for dorsement to this Coverage Part.
loss of earnings is increased to$500 a day. K. ADDITIONAL INSURED—LESSOR OF LEASED
J. ADDITIONAL INSURED — OWNER, MANAGER EQUIPMENT
OR LESSOR OF PREMISES 1. WHO IS AN INSURED (Section II) is
1. WHO IS AN INSURED (Section 11) is amended to include as an insured:
amended to include as an insured: Any person or organization that you have
Any person or organization that you have agreed in a contract or agreement to include
agreed in a contract or agreement to include as an additional insured on this Coverage
as an additional insured on this Coverage Part, but:
Part, but: a. Only with respect to liability for"bodily in-
a. Only with respect to liability for"bodily in- jury" or"property damage"that occurs, or
jury" or"property damage" that occurs, or "personal injury" caused by an offense
"personal injury" caused by an offense committed, after you have entered into
committed, after you have entered into that contract or agreement;and
that contract or agreement; and b. Only if the "bodily injury", "property Jam-
b. Only if the "bodily injury", "property dam- age" or "personal injury" is caused, in
age" or "personal injury" is caused, in whole or in part, by acts or omissions of
whole or in part, by acts or omissions of you or any person or organization per-
you or any person or organization per- forming operations on your behalf, in the
forming operations on your behalf, and maintenance, operation or use of equip-
arises out of the ownership, maintenance ment leased to you by such additional in-
or use of that part of any premises leased sured.
to you under that contract or agreement_ 2. The insurance provided to such additional in-
2. The insurance provided to such additional in- sured under this Provision K. is subject to the
sured under this Provision J. is subject to the following provisions:
following provisions: a. The limits of insurance afforded to such
a. The limits of insurance afforded to such additional insured shall be the limits
additional insured shall be the limits which you agreed to provide in the con-
which you agreed to provide in the con- tract or agreement, or the limits shown in
tract or agreement, or the limits shown in the Declarations for this Coverage Part,
the Declarations for this Coverage Part, whichever are less; and
whichever are less; and b. The insurance afforded to such additional
b. The insurance afforded to such additional insured does not apply:
insured does not apply to: (1) To any "bodily injury" or "property
(1) Any "bodily injury" or "property dam- damage" that occurs, or"personal in-
age" that occurs, or "personal injury" jury" caused by an offense commit-
caused by an offense committed, af- ted, after the equipment lease ex-
pires; or
Page 4 of 8 Copyright 2007 The Travelers Companies, Inc. CG D3 79 09 07
COMMERCIAL GENERAL LIABILITY
(2) If the equipment is leased with an 1. The following is added to Paragraph 2. of
operator. WHO IS AN INSURED (Section II)to include
3. This Provision K. does not apply on any basis as an insured:
to any person or organization for which cov- Any architect, engineer or surveyor engaged
erage as an additional insured specifically is by or for you that you agree in a "contract or
added by another endorsement to this Cover- agreement requiring insurance" to include as
age Part. an additional insured on this Coverage Part,
L. ADDITIONAL INSURED — STATE OR POLITI- but only with respect to liability for "bodily in-
CAL SUBDIVISIONS—PERMITS RELATING TO jury", "property damage" or "personal injury"
PREMISES that is caused, in whole or in part, by acts or
omissions of you or any person or organiza-
The following is added to Paragraph 2. of WHO tion acting on your behalf in connection with
IS AN INSURED (Section II) to include as an in- your premises or"your work".
sured:
2. This Provision N. does not apply on any basis
Any state or political subdivision that has issued a to any person or organization for which cov-
permit in connection with premises owned or oc- erage as an additional insured specifically is
cupied by, or rented or loaned to, you, but only added b another endorsement to this Cover-
with respect to "bodily injury", "property damage", Y
p Y � 1 ry"• 'p p Y 9 age Part.
"personal injury" or "advertising injury" arising out 0. WHO IS AN INSURED — NEWLY ACQUIRED
of the existence, ownership, use, maintenance, OR FORMED ORGANIZATIONS
repair, construction, erection or removal of adver-
tising signs, awnings, canopies, cellar entrances, 1. Paragraph 4.a. of WHO IS AN INSURED
coal holes, driveways, manholes, marquees, hoist (Section II) is deleted and replaced by the
away openings, sidewalk vaults, elevators, street following:
banners or decorations for which that state or po- a. Coverage under this provision is afforded
litical subdivision has issued such permit. only until the 180th day after you acquire
M. ADDITIONAL INSURED — STATE OR POLITI- or form the organization or the end of the
CAL SUBDIVISIONS—PERMITS RELATING TO policy period, whichever is earlier. Any
OPERATIONS such newly acquired or formed organiza-
The following is added to Paragraph 2. of WHO tion that you report in writing to us within
IS AN INSURED (Section II) to include as an in- 180 days after you acquire or form the
sured: organization will be covered under this
provision until the end of the policy pe-
Any state or political subdivision that has issued a riod, even if there are more than 180 days
permit, but only with respect to "bodily injury", remaining until the end of the policy pe-
"property damage", "personal injury" or "advertis- riod;
ing injury" arising out of operations performed by
you or on your behalf for which that state or politi- 2. This Provision O. does not apply to any or-
cal subdivision has issued such permit. However, ganization for which coverage is excluded by
no such state or political subdivision is an insured another endorsement to this Coverage Part.
for: P. WHO IS AN INSURED— UNNAMED PARTNER-
1. 'Bodily injury", "property damage", "personal SHIP OR JOINT VENTURE—EXCESS
injury" or"advertising injury" arising out of op- 1. The last paragraph of WHO IS AN INSURED
erations performed for that state or political (Section II) is deleted and replaced by the
subdivision; or following:
2. "Bodily injury" or "property damage" included No person or organization is an insured with
within the "products — completed operations respect to the conduct of any current or past
hazard". partnership, joint venture or limited liability
N. ADDITIONAL INSURED — ARCHITECT, ENGI- company that is not shown as a Named In-
NEER OR SURVEYOR sured in the Common Policy Declarations.
However, this exclusion does not apply to
your liability with respect to your conduct of
CG D3 79 09 07 Copyright 2007 The Travelers Companies, Inc. Page 5 of 8
COMMERCIAL GENERAL LIABILITY
the business of any current or past partner- eral Aggregate Limit for that "project", but
ship or joint venture: shall not reduce:
a. That is not shown as a Named Insured in a. Any other Per Project General Aggregate
the Common Policy Declarations, and Limit for any other"project";
b. In which you are a member or partner b. The General Aggregate Limit; or
where each and every one of your co- c. The Products-Completed Operations Ag-
ventures in that joint venture is an archi- gregate Limit.
tectural, engineering, or surveying firm.
The limits shown in the Declarations for this
2. This Provision P. does not apply to any per- Coverage Part for Each Occurrence, Damage
son or organization for which coverage is ex- To Premises Rented To You and Medical Ex-
cluded by another endorsement to this Cov- pense are also subject to the Per Project
erage Part. General Aggregate Limit when the Per Pro-
3. The insurance provided by this Provision P. ject General Aggregate Limit applies.
shall be excess over any valid and collectible 3. As used in the Provision Q.:
other insurance, whether primary, excess,
contingent or on any other basis, which is "Project" means an area away from premises
available covering your liability with respect to owned by or rented to you at which you are
your conduct of the business of any current or performing operations pursuant to a contract
or agreement. For the purposes of determin-
past partnership or joint venture that is not
shown as a Named Insured in the Common ing the applicable aggregate limit of insur-
Policy Declarations and which is issued to once, each "project" that includes premises
such partnership or joint venture. involving the same or connecting lots, or
Q. PER PROJECT GENERAL AGGREGATE LIMIT premises whose connection is interrupted
only by a street, roadway, waterway or right-
1. Paragraph 2. of LIMITS OF INSURANCE of-way of a railroad shall be considered a sin-
(Section III) is deleted and replaced by the gle"project".
following: R. KNOWLEDGE AND NOTICE OF OCCUR-
The General Aggregate Limit is the most we RENCE OR OFFENSE
will pay for the sum of: The following is added to Paragraph 2. Duties In
a. Damages under Coverage B; and The Event of Occurrence, Offense, Claim Or
b. Damages from "occurrences" under Cov- Suit of COMMERCIAL GENERAL LIABILITY
erage A and for all medical expenses CONDITIONS(Section IV):
caused by accidents under Coverage C Notice of an "occurrence" or of an offense which
which cannot be attributed only to opera- may result in a claim must be given as soon as
tions at a single"project". practicable after knowledge of the"occurrence" or
2. The following is added to LIMITS OF IN- offense has been reported to you, one of your
SURANCE (Section III): "executive officers" (if you are a corporation), one
of your partners who is an individual (if you are a
A separate Per Project General Aggregate partnership), one of your managers (if you are a
Limit applies to each "project for all sums limited liability company), one of your trustees
which the insured becomes legally obligated who is an individual (if you are a trust), or an
to pay as damages caused by "occurrences" "employee" (such as an insurance, loss control or
under Coverage A and for all medical ex- risk manager or administrator) designated by you
penses caused by accidents under Coverage to give such notice.
C which can be attributed only to operations
at a single "project", and that limit is equal to Knowledge by any other"employee" of an "occur-
the amount of the General Aggregate Limit rence" or offense does not imply that you also
shown in the Declarations for this Coverage have such knowledge.
Part. Notice of an "occurrence" or of an offense which
Any payments made under Coverage A for may result in a claim will be deemed to be given
damages and under Coverage C for medical as soon as practicable to us if it is given in good
expenses shall reduce the Per Project Gen- faith as soon as practicable to your workers' com-
Page 6 of 8 Copyright 2007 The Travelers Companies, Inc. CG D3 79 09 07
COMMERCIAL GENERAL LIABILITY
pensation, accident, or health insurer. This ap- when, the"bodily injury" or"property damage" oc-
plies only if you subsequently give notice of the curs, or the "personal injury" offense or"advertis-
"occurrence" or offense to us as soon as practi- ing injury" offense is committed.
cable after you, one of your"executive officers" (if U. AMENDED BODILY INJURY DEFINITION
you are a corporation), one of your partners who
is an individual (if you are a partnership), one of The definition of "bodily injury" in DEFINITIONS
your managers (if you are a limited liability com- {Section V) is deleted and replaced by the follow-
pany), one of your trustees who is an individual (if ing:
you are a trust), or an "employee" (such as an in- "Bodily injury" means:
surance, loss control or risk manager or adminis- a. Physical harm, including sickness or disease,
trator) designated by you to give such notice dis- sustained by a person;
covers that the "occurrence" or offense may in-
volve this policy. b. Mental anguish, injury or illness, or emotional
S. UNINTENTIONAL OMISSION distress, resulting at any time from such
physical harm, sickness or disease; or
1. The following is added to Paragraph 6. Rep- c. Care, loss of services or death resulting at
resentations of COMMERCIAL GENERAL any time from such physical harm, sickness
LIABILITY CONDITIONS (Section IV): or disease.
The unintentional omission of, or uninten- V. AMENDED INSURED CONTRACT DEFINITION
tional error in, any information provided by —RAILROAD EASEMENT
you which we relied upon in issuing this policy
hall not prejudice your rights under this in- 1. Subparagraph c. of the definition of "insured
shall
. contract" in DEFINITIONS (Section V) is
deleted and replaced by the following:
2. This Provision S. does not affect our right to
collect additional premium or to exercise our c. Any easement or license agreement;
right of cancellation or nonrenewal in accor- 2. Subparagraph f.(1) of the definition of
dance with applicable insurance laws or regu- "insured contract" in DEFINITIONS (Section
lations. V) is deleted.
T. WAIVER OF TRANSFER OF RIGHTS OF RE- W. AMENDED PROPERTY DAMAGE DEFINITION
COVERY AGAINST OTHERS TO US WHEN —TANGIBLE PROPERTY
REQUIRED BY CONTRACT OR AGREEMENT The definition of "property damage" in DEFINI-
The following is added to Paragraph 8. Transfer TIONS (Section V) is deleted and replaced by
of Rights of Recovery Against Others to Us of the following:
COMMERCIAL GENERAL LIABILITY CONDI- "Property damage" means:
TIONS (Section IV):
a. Physical injury to tangible property, including
We waive any rights of recovery we may have all resulting loss of use of that property. All
against any person or organization because of such loss of use shall be deemed to occur at
payments we make for "bodily injury", "property the time of the physical injury that caused it;
damage", "personal injury" or "advertising injury or
arising out of:
b. Loss of use of tangible property that is not
1. Premises owned by you, temporarily occu- physically injured. All such loss of use shall
pied by you with permission of the owner, or be deemed to occur at the time of the "occur-
leased or rented to you; rence"that caused it.
2. Ongoing operations performed by you, or on For the purposes of this insurance, tangible prop-
your behalf, under a contract or agreement erty does not include data.
with that person or organization;
X. The following definition is added to SECTION V—
3. "Your work'; or DEFINITIONS:
4. "Your products". "Contract or agreement requiring insurance"
We waive these rights only where you have means that part of any contract or agreement un-
agreed to do so as part of a contract or agree- der which you are required to include a person or
ment entered into by you before, and in effect organization as an additional insured on this Cov-
CG D3 79 09 07 Copyright 2007 The Travelers Companies, Inc. Page 7 of 8
e
COMMERCIAL GENERAL LIABILITY
erage Part, provided that the "bodily injury" and b. While that part of the contract or agreement is
"property damage" occurs, and the "personal in- in effect; and
jury" is caused by an offense committed: c. Before the end of the policy period.
a. After you have entered into that contract or
agreement;
Page 8 of 8 Copyright 2007 The Travelers Companies, Inc. CG D3 79 09 07