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HomeMy WebLinkAboutPW17-033 - Original - DOWL Engineers, Inc. - Willis and Naden Access Improvements - 01/23/2017 Records s Management ent wAs o 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: DOWL Enqineers Inc, Vendor Number: ]D Edwards Number Contract Number: This is assigned by City Clerk's Office Project Name: Surveyinq Services for Willis and Naden Access Improvements Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 1/23/17 Termination Date: 1/20/17 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Eric Knowles Department: Public Works Contract Amount: $13,400.00 Approval Authority: (CIRCLE ONEf Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Consultant will provided surveying services for the Willis and Naden St, access improvements. As of: 08/27/14 PUBLIC WORKS DEPARTMENT Timothy J. LaPorte, P.E. Public Works Director 400 West Gowe Kent, 98032 K E.N T Fax: 253-8 856 6500 6500 WASHINGTON Phone: 253-856-5500 LETTER OF TRANSMITTAL DATE: January 24, 2017 TO: Paul Rice Dowl Engineers Inc. 8420 154'h Ave NE Redmond, WA 98052 RE: Surveying Services for Willis and Naden St. Access Improvements Copies Description -- _. 1 onginal Professional Services Agreement Enclosed is your executed Professional Services Agreement for the above referenced project. Please note that invoices should be emailed to accOuntsoayablcia)kernkwp cov. If you should have any questions, please contact me at (253) 856-5653. Copies to: Andrew Dacuag Eric Knowles Public Works Operations Toby„-,Molleitt 220 4eh Ave. S. __.................._............. Kent, Washington 98032 Phone: 253-856-5653 Fax: 253-856-6600 Email: ADacuag@KentWa.gov OT PROFESSIONAL SERVICES AGREEMENT between the City of Dent and DOWL Engineers Inc. THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and DOWL Engineers Inc. organized under the laws of the State of Alaska, located and doing business at 8420 154`h Ave NE, Redmond, WA 98052, Phone: (425) 869-2670, CONTACT: Paul T. Rice (hereinafter the "Contractor"). I. DESCRIPTION OF WORK. Contractor shall perform the following services for the City: The Contractor shall provide surveying services for Willis and Naden St. Access Improvements. For a description, see the Contractor's Scope of Work which is attached as Exhibit A and incorporated by this reference. Contractor 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, and Contractor shall complete the work by January 20, 2017. III. COMPENSATION. The City shall pay Contractor a total amount not to exceed Thirteen Thousand, Four Hundred Dollars($13,400.00) for the services described in this Agreement. The Contractor shall invoice the City monthly based on time and materials incurred during the preceding month. The hourly rates charged for Contractor's services shall be as delineated in the attached and incorporated Exhibit A. All hourly rates charged shall remain locked at the negotiated rates throughout the term of this Agreement. 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 Contractor 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 Contractor maintains and pays for its own place of business from which Contractor's services under this Agreement will be performed. C. The Contractor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Contractor's services, or the Contractor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Contractor 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. PROFESSIONAL SERVICES AGREEMENT - 1 ($20,000 or Less) E. The Contractor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Contractor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Contractor 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 seven (7) calendar days written notice at its address set forth on the signature block of this Agreement. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Contractor, its subcontractors, or any person acting on behalf of the Contractor or subcontractor shall not discriminate against any person who is qualified and available to perform the work to which the employment relates as provided for by the City of Kent's Equal Employment Opportunity Policy. Contractor 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. Contractor 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 Contractor's performance of this Agreement, but only to the extent of the Contractor's negligence. The City's inspection or acceptance of any of Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. The provisions of this section shall survive the expiration or termination of this Agreement. In the event Contractor 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 Contractor's part, then Contractor 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 Contractor's part. VIII. INSURANCE. The Contractor 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. CONTRACTOR'S WORK AND RISK. The Contractor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Contractor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those services. All work shall be done at Contractor's own risk, and Contractor 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. X. 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. PROFESSIONAL SERVICES AGREEMENT - 2 ($20,000 or Less) C. Resolution of Dis®utes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section 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. 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 Contractor. 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. 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. Public Records Act. The Contractor 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 Contractor 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 Contractor agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. I. 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. PROFESSIONAL SERVICES AGREEMENT - 3 ($20,000 or Less) J. 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. CONTnR_ACTOOR: CI TY QE.kKENT: BY: ! unn� �t n (j tjL By(:r Z. (signature) V (,lgnature) Print Name: l A-V(- Liu Print Name: Timoth J. LaPorte, P.E. DATE: v ( r11) DATE: Director Its: ti1j" (OX. Its: ublic Works NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONTRACTOR: CITY OF KENT: Paul T. Rice, PLS Timothy J. LaPorte, P.E. Dowl Engineers Inc. City of Kent 8420 1541h Ave NE. 220 Fourth Avenue South Redmond, WA 98052 Kent, WA 98032 (425) 869-2670 (telephone) (253) 856-5500 (telephone) (800) 865-9847 (facsimile) (253) 856-6500 (facsimile) PROFESSIONAL SERVICES AGREEMENT - 4 ($20,000 or Less) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. Dated this /(9flh day of janwrcn 20 By: For: U W� Title: LhhvD f-vA-",j M61Z, 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. Dated this __ day of 20 By: For: Title: Date: EEO COMPLIANCE DOCUMENTS - 3 b O W L DOWL Project No.: 2027.13845.00 E)HIBIT A-SCOPE OF SERVICES Project Undergg!l4ine We understand that The City of Kent, Washington (Client) is looking at packaging and selling several properties which are currently under their control. The properties lie South of West Meeker Street, East of State Highway 167,North of State I-ghway 516, and west of the Puget Sound Energy right of way(outlined in blue in Site Map below), and contains roughly 8.9 acres. The area to be surveyed includes Naden Avenue, a north south roadway (shown in Site Map outlined in red) which was shown on the unrecorded plat of Naden's Addition, and apparently also under City control. In advance of the sale, Client would like DOWL (Consultant)to perform an ALTA/NSPS Land Title Survey of the Property, which will be certified to Client and Client's Title hrsurer.T'he Scope of services that we will perform is listed below. Site Man III I I h III II Iul Standard Short Fomn Contract-WA Page 2 of 6 DOWL September 20,2011 DOWI DOWL Project No.: 2027.13845.00 Scope of Service3 DOWL will perform the following Land Survey services for the project. ALTAINSPS Land Title Survey Consultant will prepare an ALTA/NSPS Land Title Survey of the properties, in accordance with the"2016 Minimum Standard Detail Requirements"for ALTA/NSPS Land Title Surveys and containing the following items from Table A thereof,which will be certified to Client,and Client's Title Insurer. 4. Gross land area. 11, Location of utilities existing on or serving the surveyed property as determined by observed evidence, together with evidence obtained from utility companies, and markings by utility companies. We will coordinate with a Professional Utility locating service to mark the conductible underground utilities. That company's costs will be billed as a reimbursable expense to the project. We suggest that you budget $1,200 for that reimbursable expense. 13.Names of adjoining owners of land according to current tax.records. 19. Include any plottable offske easements or servitudes disclosed in documents provided to or obtained by the surveyor as a part of the survey pursuant to Sections 5 and 6. Deliverable products: • ALTANSPS Land Title Survey on 24"x 36"Bond paper. • AutoCADO Civil 3D version 2014 files of the map. We believe we have reasonably described the scope of the services involved. It is always possible,however, for unanticipated conditions to arise during the work that could indicate a change in the scope or budget may be needed. If that should happen,we would discuss it with you at that time and obtain your agreement for an equitable adjustment to our contract. Revisions to work completed or in progress requested by the owner or the owner's agents, through no fault of DOWL, will be considered extra services for which additional compensation is due. Assumptions • Consultant will not set property corners or file a Record of Survey with the King County recorder's office. • Client will provide DOWL with current title reports for the properties to be used in the preparation of the survey. • Client will arrange for DOWL's access to all areas to be surveyed. Standard Short Form Contract-WA _ Page 3 of 6 DOWL September20,2011 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 Liabilit 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 property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,OOOgeneral EXHIBIT B (Continued) aggregate and a $1,000,000 products-completed operations aggregate limit. 3. Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 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. �- DATE(MMIDDIYYYY) ,,. CERTIFICATE OF LIABILITY INSURANCE 1/10/2017 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 Morgexy Moberly, CIE, CISR PPJ ... .. ,,,, Insurance Brokers of Alaska PHONE (9D7)56.1-1250 IFAx (907)551 43L5 .t$YG...Np.Eacl), ..... 1NC MuJ an Acrisure Agency Partner E-MAIL -a[„tG@;e9.$ m Moberly@ alaskausainsurance.com __ _____......__._.__.__....._........._..___. _...._._ PO Sox 291207 INSURERISI AFFORDING COVERAGE NAICd Anchorage AK 99524 INSURER a Natioal n Surety Corp,, 21881 INSURED INSURERS DOWL, LLD operating as DOWL INSURER c: 8420 154th Ave Ne INSURER D: INSURER Redmond WA 98502 INSURER P: ----. --. ...... COVERAGES CERTIFICATE NUMBER:16-17 WA REDMOND REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN IIREDUCED BY PAID CLAIMSr.. I To l- __-TYPE OF INSURANCE ADDLI$U'SRf POLICY NUMBER V AWDCYYYMY 1Ml ILYYVYY-Y - LIMITS- --- - X COMMERCIAL GENERAL LIABILITY f E EACH OCCURRENCE 5 1,000,000 A �f CLAIMS-MADE I X1OCCUR DVMA6E MERITED L 100,000 R� WA Stop Gap X sUCCO"74054 12/1/2016 12/1/2019 MEDEXP(An,one person) $ 5,000 Employers Liability PERSONALSADVINJURY g 1,000,000 GEN L AGGREGATE LIMIT APPLIES PER f GENERAL A0GFtFGATE g "..2,000,000 _-X� FOLIC[� I � LUC PRODUCT COMP/OP AGO $ 2,000,000 E rployes Benefits L 1,000,OD0 OTHER AUTOMOBILE LIABILITY I 14YtNi Etleu41 SIN6l.E V.Rn11r y 1,000,000 A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED pptp,80321095 12/1/2016 12/1/2017 BODILY INJURY(Peracmdenl) $ AUTOS BURLS X _ NON OWNEDPROPERTY DAMAGE ___-- HIRED AUTOS AUTOS )( (PMr AC4tde}J 5 Undennsuredmolonet S Included UMBRELLA LIAR OCCUR _EACHOCCURRENCE S 10 00.0i000 A EXCESS LIAR CLAIMS MADE ) AGGREGATE S nED X RF'FNTIQN$ o XAE24591451 12/1/2016 12/1/2019 S WORKERS COMPENSATION PER HE OGH AND EMPLOYERS'LIABILITY .I ...... ..... ANY PROPRIETORTARTNERIEXECUTIVE Y!N E L EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) "" EL DISEASE-EA EMPLOYE. $ If yes descnbe under .... """"""""" ""'-" DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMI r t DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) COWL Project No. 2027.13845.01. Project Name: Kent Naden Avenue Properties. The Certificate Holder is an Additional Insured on the General Liability & Automobile policies, but only with respect to work done by or on behalf of the named insured for the project referenced. Subject to policy terms, conditions & exclusions. It is acreed that such insurance as afforded the Certificate Holder on the General Liability & CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Kent, Washington THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 220 Fourth Avenue So ACCORDANCE WITH THE POLICY PROVISIONS. Kent, WA 98032-5895 AUTHORIZED REPRESENTATIVE .........„.a M Moberly, CTC, cl."BV �. _ , ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I NS0251?n1 aon COMMENTS/REMARKS JUIL nawyk In IM)l Alan shaii lou primary and non-conLribukoyy A Vh any c4hor insurance if, o r ("'e Poi Poir or which may be j-,aj r cha.s(=d hy I It(� ur�i-,Lif i ca In Ho J do i'. OUREMARK COPYRIGHT 2000, AMS SERVICES INC. TERRA INSURANCE COMPANY Terra Insurance Company (A Risk Retention Group) FF TERRA Two Fifer Avenue, Suite 100 INSURANCE COMPANY Corte Madera, CA 94925 CERTIFICATE OF INSURANCE DATE 01/10/17 NAME AND ADDRESS OF INSURED DOWL, LLC operating as DOWL 8420-154th Avenue, N.L. Redmond, WA 98052-3864 This certifies that the"claims made" insurance policy(described below by policy number)written on forms in use by the Company has been issued. This certificate is not a policy or a binder of insurance and is issued as a matter of information only,and confers no rights upon the certificate holder. This certificate does not alter, amend or extend the coverage afforded by this policy. The policy of insurance listed below has been issued to the insured named above for the policy period indicated. Notwithstanding any requirement,term or condition of any contract or other document with respect to which Oils certificate may be issued or may pertain,the insurance afforded by the policy described hereon is subject to all the terms,exclusions and conditions of such policy. Aggregate limits shown may have been reduced by paid claims. TYPE OF INSURANCE Professional Liability _ ... .. ...... __ POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE 217089 01/01/17 12/31/17 LIMITS OF LIABILITY $1,000,000 EACH CLAIM $1,000,000 ANNUALAGGREGATE PROJECT DESCRIPTION Kent Naden Aveme Properties 2027.13845.01 CANCELLATION: If the described policy is cancelled by the Company before its expiration date, the Company will mail written notice to the certificate holder thirty (30) days in advance,or ten (10) days in advance for non-payment of premium. If the described policy is cancelled by the insured before its expiration date, the Company will mail written notice to the certificate holder within thirty (30) days of the notice to the Company from the insured. ISSUING COMPANY: CERTIFICATE HOLDER TERRA INSURANCE COMPANY City of Kent, Washington (A Risk Retention Group) 220 Fourth Avenue So � n„% � �� Kent, WA 98032-5895 J�a Y} President 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, thie undersigned, a duly represented agent of DOWL Engineers Inc. Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as Willis and Naden St. Access Imorovements that was entered into on the January 23, 201 (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: P4vL T_ Fo r: Title: Date: 13 EEO COMPLIANCE DOCUMENTS - 1 vv