HomeMy WebLinkAboutPD17-026 - Original - Kent Youth and Family Services - Drug & Alcohol Prevention/Life Skills Classes - 01/16/2017 T �^ ° Document
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: Kent Youth and Family Services
Vendor Number: 33841
JD Edwards Number
Contract Number: I-1 _ 07(0
This is assigned by City Clerk's Office
Project Name: 2016-2017 KYFS Contract for STOP and DFC Grants
Description: Interlocal Agreement ❑ Change Order ❑ Amendment XX Contract
❑ Other:
Contract Effective Date: 1/16/2017 Termination Date: 9/29/2017
Contract Renewal Notice (Days): N/A
Number of days required notice for termination or renewal or amendment
Contract Manager: Sara Wood Department: Police
Contract Amount: $10,000
Approval Authority: (CIRCLE ONE) Department Director Mayor City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):
This contract is for counseling, prevention, and intervention services provided by Kent
Youth and Family Services in support of the DFC and STOP grants,
As of: 08/27/14
` • K OT
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
Kent Youth and Fancily Services
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Kent Youth and Family Services organized under the laws of the State of
Washington, located and doing business at 232 2nd Avenue South, Ste. 201, Kent, WA 98032 (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;
Kent Youth and Family Services will provide ongoing education classes for elementary and
middle school aged youth on drug and alcohol prevention and life skills. Kent Youth and
Family Services will also provide classes to Bt" grade students transitioning to high school.
Classes wil also be offered to Kent School District middle school staff on signs of drug and
alcohol use among youth. Hours of preparation, in person prepatory meetings, and
coordination of clases are also included.
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 September 29, 2017.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed
$10,000, 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.
CONSULTANT SERVICES AGREEMENT- 1
($20,000 or Less)
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 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.
CONSULTANT SERVICES AGREEMENT - 2
($20,000 or Less)
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE CONSULTANT'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 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 Mplerigig. 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. Resalution of Disrautes 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
CONSULTANT SERVICES AGREEMENT - 3
($20,000 or Less)
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 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. t1 signment. 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. Fintire 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. Cgmnliance 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)
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. All acts consistent with the authority of this Agreement and prior
to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed
to have applied.
CONSULTANT: CITY O EN
q/
(sgnature) , ti (signature)
Print Na e;� L� Print Name: Kenneth E. Thomas
Its: �� rfet a Its: Chief of Police
(fftl�
DATE: Joa/A DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Kent Youth and Family Services Sara Wood
232 2nd Avenue South, Ste. 201 City of Kent
Kent, WA 98032 220 Fourth Avenue South
Kent, WA 98032
253-859-0300 (telephone) (253) 856-5856 (telephone)
253-859-0745 (facsimile) (253) 856-6800 (facsimile)
CONSULTANT SERVICES AGREEMENT - 5
($20,000 or Less)
DECLARATION
CITY OF KENTE UALEMPLOYME T Q N 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.
For: /gyp
Title: r ��,Lv ,✓e c-oft
Date:
EEO COMPLIANCE DOCUMENTS - 1
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered into on
the (date) between the firm I represent and the City of
Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 3
Contract between the Kent Police Department and Kent"Youth and FamIly_5g yr_1cga
Hourly rate: $40.00 per hour
Number of schools: Up to 10 elementary/middle schools
Total Hours: 250 hours
Total Contract: Not to exceed $10,000
$4,000 - paid for via DFC Grant N00062
$6,000 - paid for via STOP Grant N00083
Mileage: To be reimbursed at .57 cents per mile
Classes will include 8" grade transition to high school education, training for Kent
School District staff on youth drug/alcohol use, elementary school education, and
affected others groups at middle schools.
KentYF555
t'MA'ra'P ' I�;d of �77t�`,:°dey�?rr?`aa�C��.�pt tpr�yin9 Nip r w�Tfrw �i1 lgtM�1'2�'�lyt"t�lta�"nlM3fl rrKia'rrdl { �,IIM '�'1,�"r4�'r'T,�7t�I�`�il�lrtt srlw,ylr �^ I 1� 1 Y
r+'Lev "M nny{rb Irv'NyrT'4
f d � s•nr �ew 'i "`re C u r ih� , ,� �f y1'�N Y
[HIS CLRI IFICAIE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
NCI AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUE A CONTRACT
BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESFNTAT IVE OR PRODUCER,AND THE CERT IFICATF HOLDER, m
IMPORTANT If the certiFicate holder Is an ADDITIONAL INSURED,the pallVcyCies)must be endorsed If SUBROGRATION IS WAIVED,subject to the terms and conditions of
the policy,certain cuverage may require an endorsement. A statement an buts certificate does not confer rights to the cetfucate holder m[fee of such endorsement(s)
I, R " ry}1rCa A?7r5' P I I IFa
. w77
r rus
GENERAL LIABIL TY
Clear Risk Solutions American Alternative Insurance Corporation
451 Diamond Drive
Ephrata, WA 98823 AUTOMOBILE LIABILITY
American Alternative Insurance Corporation
,i,. Rya `!V➢� !:(,"1'Ih L,r,m,,,t",?`�rh{y,)",` „ t iiriu�, u,.+I, " a"' li f",{.-I �,�.'ip
PROPERTY
Kent Youth and Family Services American Alternative Insurance Corporation, et al,
232 2nd Avenue South MISCELLANEOUS PROFESSIONAL LIABILITY
Kent WA, 98032 Princeton Excess and Surplus Lines Insurance Company
Torus Specialty Insurance Company
f, EV Ipr Iuirwr inMEr4 ri ,. tr , _
Lr
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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 5H OWN MAY HAVE BEEN REDUCED BY PAID Cl AIMS.
,"% vru ri „ 1g9mx r ItnQ
nsl L tl II F J r Hitle ut r
t i,; r , i�' t� f rl r n+ a �; �1 �€� �G��r� �a rr✓ � r� il��r�lt 9j� lu t I ar I atlFa
rrriy iy . i14. u nor t i} d s niq t ri I ik rn i. II e,l l't a„ "lit .E U I.uu ei:i4
COMMERCIAL GENERAL.1 V 9+ . a.J.?! ..- ,„., ,if !: Tv..,�, xk4 , .1 '0 .11l d,.f.._-..
L' $5,000,000
LIABILITY NbAP-ri.L.0000013.08 O6IOV2016 O610V2018 PER OCCURRENCE
OCCURRENCEFORM PER MEMBER AGGREGATE $10,000,000
INCLUDES STOP GAP PRODUCT DOMPOP $5,000,000
PERSONAL&ADV.INJURY $5,0001000
LIABILITY IS SUBJECT 7O A$50 q00 51R PAYAFtd.0 FROM PROGRAM FUNDS r 1 ,� tI,wANNWASr POOL AGGRCCATFr ana nr rbr rn„ $$50v000,0011tJ1:
ANY AUTO N1 A2-RL 000001308 O6/0L2016 O6Po112018 CDPneINE❑SINGLE LIMIT $5000000
LIAB7LIIY 1G SUBJLC4 I O A$50 000 $IR PAYABLE FROM PRO["'RAM FUNDS ANNUAL POOL AGGREGATE NONE
N7-A2-RL-0000013�08 061011Z016 0610172018 ALL RISK PER OCC EXCL EQ&FL $75,000 000
EARTHQUAKE PER OCC $1,000,000
FLOOD PER OCC $1,000,000
PROPERTY I5 SUBJECT TO A S50 000 SIR PAYABLE FROM PROGRAM FtI I ANNUAL.POOL AGGREGATE NQNE
y�' an diuwM ne iN i ti •W,yl4� tel %tTj o� Ylgrf
r pr t iIY�IVG'.YP•�. M' .-rew if {r,,, t I TITr{,1,'�rbI,i{rII, d' k.,i}, t u�I jijI., v n. 1.11.a4 LI{ _iM r�3. ,.
I N1-A3-RL0000060.07 uOluI 2016 Li li2018 PER CLAIM $40,000,00
LtABII n4 IS SBJBJFCT TO A $60000 SIR PAYABLE FROM PROGRAM rUNOo
ANNUAL POOL AGC`REGATL $40 000 000
PCIQk�. , f7, .,T4dkJa" 8l-1 rt;L.�. 'n", ., 3Gtratpi"
Regarding Funding received. The City of Kertt and its 0Nected and appointed officials are named aS Adtlibonal
Insured for this funding only and are subject to policy team conditions,and exclusions.
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
WITH THE POI I CY PROVISIONS ash !MP'CpGTMlfllllwrr e°a} p re {. . VECmanalr in �, '�fl +s++"tl3> ,,at liiwu -§i,.tvl,jt
I J
Parks& Recreation&Human Services
City of Kent
220 4th Ave S
Kent,WA 98032
3105414
AMERICAN ALTERNATIVE
INSURANCE COMPANY
ADDITIONAL INSURED — DESIGNATED PERSON OR ORGANIZATION
(GENERAL LIABILITY)
Named Insured
Non Profit Insurance PPogram NPfIP ,,,, ..._....
Policy Number Endorsement Effective
N7-A2-RL-0000013-08 91112016
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
This endorsement modifies insurance provided under the following:
GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above.
Schedule
Person or Organization(Additional Insured): As Per Schedule on file with Clear Risk Solutions,Underwriting Administrator
Parks&Recreation&Human Services
City of Kent
220 4th Ave S
Kent,WA 98032
Regarding funding received. The City of Kent and its elected and appointed officials are named as Additional
Insured for this funding only and are subject to policy terms,conditions,and exclusions.
A. With respects to the General Liability Coverage Part only,the definition of Insured in the Liability Conditions,Definitions
and Exclusions section of this policy is amended to include as an Insured the Person or Organization shown in the above
Schedule.Such Person or Organization is an Insured only with respect to liability for Bodily Injury,property Damage,or
Personal and Advertising Inj dry caused In whole or in.part by your acts or omissions or the acts or omissions of those
acting on your behalf:
1. In performance of your ongoing operations;or
2. In connection with your premises owned or rented to you.
B. The Limits of Insurance applicable to the additional Insured are those specified in either the:
1. Written contract or written agreement;or
2. Declarations for this policy,
whichever is less.These limits of Insurance are inclusive and not in addition to the Limits Of Insurance shown in the Declarations.
All other terms and conditions remain unchanged.
Includes copyrighted material of the Insurance Services Office,Inc.,with its permission.
RL 2163 12l12 Page 1 of t
3105415