HomeMy WebLinkAboutPK17-094 - Original - Al Vinson Inc dba SeaTac Sweeping - Sweeping of City Parking Lots - 03/01/2017 r / .
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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: Al Vinson Inc. dba Sea Tac Sweeping
Vendor Number: 34267
JD Edwards Number
Contract Number: Q K 1-1 6
This is assigned by City Clerk's Office
Project Name: Sweeping Service of City Parking Lots
Description: 0 Ynterlocal Agreement ❑ Change Order ❑ Amendment X❑ Contract
® Other:
Contract Effective Date: 03101/17 Termination Date: 02/28/22
Contract R,enewa,I Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Nancy Clary Department Parks, Facilities
Contract Amount: $15,579.62
Approval Authority: (CIRCLE ONE) IDepartment Directo Mayor City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):
As of� 08/27/14
s
K E N T
w.nnr,oro.,
GOODS & SERVICES AGREEMENT
FOR ORDINARY MAINTENANCE
between the City of Kent and
Al Vinson Inc, dba Sea Tac Sweeping
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Al Vinson Inc. dba Sea Tac Sweeping organized under the laws of the State of
Washington, located and doing business at 26305 79th Ave S, Kent WA 98032, Al Vinson, 253 854-9717
(hereinafter the "Vendor").
AGREEMENT
I. DESCRIPTION OF WORK.
Vendor shall provide the following goods and materials and/or perform the following services for
the City:
Sea Tac Sweeping Service shall provide weekly parking lot sweeping services to the
following City of Kent buildings: Kent Commons, 525 4th Ave North, Senior Center, 600 E
Smith Street, and monthly parking lot sweeping services to the following: Centennial Center
Garage, 2"d &Titus, City Hall, 220 4th Ave S, City Hall Annex, 302 West Gowe, in accordance
with the proposal which is attached and incorporated as Exhibit A.
Vendor acknowledges and understands that it is not the City's exclusive provider of these goods,
materials, or services and that the City maintains its unqualified right to obtain these goads, materials,
and services through other sources.
II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete
the work and provide all goods, materials, and services by February 28, 2022.
III. COMPENSATION. The City shall pay the Vendor an amount not to exceed $15,579.62,
including applicable Washington State Sales Tax, for the goods, materials, and services contemplated in
this Agreement. The City shall pay the Vendor the following amounts according to the following schedule:
Vendor shall bill all services on a monthly basis. Terms: Net 30 days
If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option
to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make
every effort to settle the disputed portion.
GOODS & SERVICES AGREEMENT
FOR ORDINARY MAINTENANCE - 1
($20,000 or Less, including WSST)
A. Defective or Unauthorized Work. The City reserves its right to withhold payment from
Vendor for any defective or unauthorized goods, materials or services. If Vendor is unable,
for any reason, to complete any part of this Agreement, the City may obtain the goods,
materials or services from other sources, and Vendor shall be liable to the City for any
additional costs incurred by the City. "Additional costs" shall mean all reasonable costs,
including legal costs and attorney fees, incurred by the City beyond the maximum
Agreement price specified above. The City further reserves its right to deduct these
additional costs incurred to complete this Agreement with other sources, from any and all
amounts due or to become due the Vendor.
B. Final Payment: Waiver of Claims. VENDOR'S ACCEPTANCE OF FINAL PAYMENT SHALL
CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE
AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR FINAL PAYMENT
IS MADE.
IV. PREVAILING WAGES. Vendor shall file a "Statement of Intent to Pay Prevailing Wages,"
with the State of Washington Department of Labor & Industries prior to commencing the Contract work.
Vendor shall pay prevailing wages in effect on the date the bid is accepted or executed by Vendor, and
comply with Chapter 39.12 of the Revised Code of Washington, as well as any other applicable prevailing
wage rate provisions. The latest prevailing wage rate revision issued by the Department of Labor and
Industries is attached.
V. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in
accordance with Ch. 51.08 RCW, the parties make the following representations:
A. The Vendor has the ability to control and direct the performance and details of its
work, the City being interested only in the results obtained under this Agreement.
B. The Vendor maintains and pays for its own place of business from which Vendor's
services under this Agreement will be performed.
C. The Vendor has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed before the City
retained Vendor's services, or the Vendor is engaged in an independently established
trade, occupation, profession, or business of the same nature as that involved under
this Agreement.
D. The Vendor is responsible for filing as they become due all necessary tax documents
with appropriate federal and state agencies, including the Internal Revenue Service
and the state Department of Revenue.
E. The Vendor has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by Vendor's
business, and has obtained a Unified Business Identifier (UBI) number from the
State of Washington.
F. The Vendor maintains a set of books dedicated to the expenses and earnings of its
business.
VI. 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.
VII. CHANGES. The City may issue a written change order for any change in the goods,
materials or services to be provided during the performance of this Agreement. If the Vendor
determines, for any reason, that a change order is necessary, Vendor must submit a written change order
GOODS &SERVICES AGREEMENT
FOR ORDINARY MAINTENANCE - 2
($20,000 or Less, including WSST)
request to the person listed in the notice provision section of this Agreement, section XIV(D), within
fourteen (14) calendar days of the date Vendor knew or should have known of the facts and events giving
rise to the requested change. If the City determines that the change increases or decreases the Vendor's
costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good
faith, to reach agreement with the Vendor on all equitable adjustments. However, if the parties are
unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Vendor
shall proceed with the change order work upon receiving either a written change order from the City or an
oral order from the City before actually receiving the written change order. If the Vendor fails to require a
change order within the time allowed, the Vendor waives its right to make any claim or submit subsequent
change order requests for that portion of the contract work. If the Vendor disagrees with the equitable
adjustment, the Vendor must complete the change order work; however, the Vendor may elect to protest
the adjustment as provided in subsections A through E of Section VII, Claims, below.
The Vendor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate
acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by
Vendor as provided in this section shall constitute full payment and final settlement of all claims for
contract time and for direct, indirect and consequential costs, including costs of delays related to any
work, either covered or affected by the change.
VIII. CLAIMS. If the Vendor disagrees with anything required by a change order, another
written order, or an oral order from the City, including any direction, instruction, interpretation, or
determination by the City, the Vendor may file a claim as provided in this section. The Vendor shall give
written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the events
giving rise to the claims, or within fourteen (14) calendar days of the date the Vendor knew or should
have known of the facts or events giving rise to the claim, whichever occurs first . Any claim for
damages, additional payment for any reason, or extension of time, whether under this Agreement or
otherwise, shall be conclusively deemed to have been waived by the Vendor unless a timely written claim
is made in strict accordance with the applicable provisions of this Agreement.
At a minimum, a Vendor's written claim shall include the information set forth in subsections A,
items 1 through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN
THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN
ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED
BY THAT DELAY.
A. Notice of Claim. Provide a signed written notice of claim that provides the following
information:
1. The date of the Vendor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions in this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that estimate
was determined; and
5. An analysis of the progress schedule showing the schedule change or
disruption if the Vendor is asserting a schedule change or disruption.
B. Records. The Vendor shall keep complete records of extra costs and time incurred as a
result of the asserted events giving rise to the claim. The City shall have access to any of
the Vendor's records needed for evaluating the protest.
The City will evaluate all claims, provided the procedures in this section are followed. If the
City determines that a claim is valid, the City will adjust payment for work or time by an
equitable adjustment. No adjustment will be made for an invalid protest.
GOODS & SERVICES AGREEMENT
FOR ORDINARY MAINTENANCE - 3
($20,000 or Less, including WSST)
C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall proceed
promptly to provide the goods, materials and services required by the City under this
Agreement.
D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor
also waives any additional entitlement and accepts from the City any written or oral order
(including directions, instructions, interpretations, and determination).
E. Failure to Fallow Procedures Constitutes Waiver. By failing to follow the procedures of this
section, the Vendor completely waives any claims for protested work and accepts from the
City any written or oral order (including directions, Instructions, interpretations, and
determination).
IX. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING
FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE
CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT SHALL BE FOREVER BARRED.
THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD.
X. WARRANTY. Vendor warrants that it will faithfully and satisfactorily perform all work
provided under this Agreement in accordance with the provisions of this Agreement. In addition to any
other warranty provided for at law or herein, this Agreement is additionally subject to all warranty
provisions established under the Uniform Commercial Code, Title 62A, Revised Code of Washington.
Vendor warrants goods are merchantable, are fit for the particular purpose for which they were obtained,
and will perform in accordance with their specifications and Vendor's representations to City. The Vendor
shall promptly correct all defects in workmanship and materials: (1) when Vendor knows or should have
known of the defect, or (2) upon Vendor's receipt of notification from the City of the existence or
discovery of the defect. In the event any part of the goods are repaired, only original replacement parts
shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for
that portion of the work shall extend for an additional year beyond the original warranty period applicable
to the overall work. The Vendor shall begin to correct any defects within seven (7) calendar days of its
receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a
reasonable time as determined by the City, the City may complete the corrections and the Vendor shall
pay all costs incurred by the City in order to accomplish the correction.
XI. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the
Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national
origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who
is qualified and available to perform the work to which the employment relates.
Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration,
Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached
Compliance Statement.
XII. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers,
officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or
suits, including all legal costs and attorney fees, arising out of or in connection with the Vendor's
performance of this Agreement, except for that portion of the injuries and damages caused by the City's
negligence.
The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds
to avoid any of these covenants of indemnification.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL
INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES
FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER.
GOODS & SERVICES AGREEMENT
FOR ORDINARY MAINTENANCE - 4
($20,000 or Less, including WSST)
In the event Vendor refuses tender of defense in any suit or any claim, if that tender was made
pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having
jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Vendor's part, then Vendor
shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable
attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the
Vendor's part.
The provisions of this section shall survive the expiration or termination of this Agreement.
XIII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement,
insurance of the types and in the amounts described in Exhibit B attached and incorporated by this
reference.
XIV. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary precautions
and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of
the contract work and shall utilize all protection necessary for that purpose. All work shall be done at
Vendor's own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other
articles used or held for use in connection with the work.
XV. MISCELLANEOUS PROVISIONS.
A. Reelable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price
preference may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this
Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those
covenants, agreements or options, and the same shall be and remain in full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any
dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means
of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules
and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred
in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or
award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section XII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at
the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written
notice hereunder shall become effective three (3) business days after the date of mailing by registered or
certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this
Agreement or such other address as may be hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written consent
of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment,
the terms of this Agreement shall continue in full force and effect and no further assignment shall be
made without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of the City
and Vendor.
GOODS & SERVICES AGREEMENT
FOR ORDINARY MAINTENANCE - S
($20,000 or Less, including WSST)
G. L-_nLiLq_AgEgement, 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. Cgn2pliqnge_with Laws, The Vendor agrees to comply with all federal, state, and municipal
laws, rules, and regulations that are now effective or in the future become applicable to Vendor's business,
equipment, and personnel engaged in operations covered by this Agreement or accruing out of the
performance of those operations.
I. R(Ak�hcRec�ords A�ct, The Vendor acknowledges that the City is a public agency subject to the
Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes,
emails, and other records prepared or gathered by the Vendor in its performance of this Agreement may
be subject to public review and disclosure, even if those records are not produced to or possessed by the
City of Kent,. As such, the Vendor agrees to cooperate fully with the City in satisfying the City's duties and
obligations under the Public Records Act.
!City Business License RUc.uired. Prior to commencing the tasks described in Section I,
Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of
the Kent City Code,
K. Counterparts and Signatures by Fax or Emall. 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.
t,_,__--1-----"--" ----------------
VENDOR: CITY OF KENT:
By: By:
(signature)
Par sco
lanature e (Signature)
Print Name. t1l 6 6 Y) Pri Name: Julie Parascondola, Director
Its: Its: Parks, Recreation and Community
(utle) Services
DATE:— DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
VENDOR: CITY OF KENT:
Al Vinson Nancy Clary
Al Vinson, Inc. dba Sea Tac Sweeping City of Kent
26305 79'r' Ave S 220 Fourth Avenue South
Kent, WA 98032 Kent, WA 98032
253 854-9717 (telephone) (253) 856-5084 (telephone)
253 854-7244 (facsimile)
GOODS & SERVICES AGREEMENT
FOR ORDINARY MAINTENANCE - 6
($20,000 or Less, including WSST)
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
By:
✓ s
For: l�C— GtV
Title:
Date:—
EEO COMPLIANCE DOCUMENTS - 1 of 3
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2 of 3
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered into on
the (date), between the firm I represent and the City of
Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 3 of 3
Page 1 of 1
State of Washington
Department of Labor & Industries
Prevailing Wage Section - Telephone 360-902-5335
PO Box 44540, Olympia, WA 98504-4540
Washington State Prevailing Wage
The PREVAILING WAGES listed here include both the hourly wage
rate and the hourly rate of fringe benefits. On public works
projects, worker's wage and benefit rates must add to not less
than this total. A brief description of overtime calculation
requirements are provided on the Benefit Code Key.
Journey Level Prevailing Wage Rates for the Effective Date: 03/01/2017
County Trade Job Wag e Holiday Overtime Note
Classification
King Street And I'm kin,, Lot Journey Level $19.09 1
Swemer Woi kei s
httnq-//fnrtre-,-,.wa.gov/lni/wagelenkun/mvWa.geleekun.asnx 1/30/2017
EXHIBIT
_CITY OF KENT-QUOTE FOR PARKING LOT SWEEPING SERVICES
COMPANY NAME ., .P�__ ?
COMPANY REP:
I TOTAL TOTAL TOTAL TOTAL � TOTAL
CITY OF KENT INCL WSST INCL WSST�INCI,WSST INCL WSST INCL WSST
FACILITY AND 09/2016- 09/201.7- C19/2018- � 09/2,019 - 09/2020-
ADDRESS SWEEPING FREQUENCY&GAY TIME 08 2017 08 2018 08 2019 08 2020 08 2021.
KENT COMMONS IWeekly Service m Sundays after 5 pp p,m
525 4TH AVE NORTH
m..1m .m._.m
20-E—E dT A
W_
SENIOR CENTER I Weekly Service-Sundays after 6:00 p m, ��y•'�� ���� � d���`�, � �� �Cl 5,�l�� �(��,._�.�Cd�'f
600 E SMITH STREET
CENTENNIAL GARAGE Once,Per Meath
2ND &TITUS
CITY HALL Owe per Month-Sundays after 3:00 p.m,_.,Y��1�-� ��' (�a�ia��, r"�1 �''� ��� * 1--
220 4TH AVE SOUTH _ , _ I _
CITY HALL ANNEXOnce per Meath -Sundays after 3 00 p.m.
302 WEST GOWE
.+ TOTAL EACH YEAR
REQUIREMENTS FOR CITY OF KENT GOODS&SERVICES FOR ORDINARY MAINTENANCE AGREEMENT
AGREETO ALL LANGUAGE IN ATTACHED AGREEMENT
ABILITY TO MEET INSURANCE REQUIREMENTS AS OUTLINED IN,ATTACHED EXHIBIT B
MUST PAY PREVAILING WAGES-REQUIRED TO FILE INTENT WITH STATE OF WASHI'NGTON AND PROVIDE STATE
ASSIGNED INTENT NUMBER
IvfAINTAIN AND SHOW PROOF OF CITY OF KENT BUSINESS LICENSE FOR EACH YEAR AGEEMENT IS IN EFFECT
EXHIBIT B
INSURANCE REQUIREMENTS FOR
SERVICE CONTRACTS
Insurance
The Contractor shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Contractor, their agents, representatives, employees or
subcontractors.
A. Minimum scope of Insurance
Contractor shall obtain insurance of the types described below:
1. Commercial General Liability insurance shall be written on
ISO occurrence form CG 00 01 and shall cover liability
arising from premises, operations, independent contractors,
products-completed operations, personal injury and
advertising injury, and liability assumed under an insured
contract. The City shall be named as an insured under the
Contractor's Commercial General Liability insurance policy
with respect to the work performed for the City using ISO
additional insured endorsement CG 20 10 1185 or a
substitute endorsement providing equivalent coverage.
2. Automobile Liability insurance covering all owned, non-
owned, hired and leased vehicles. Coverage shall be written
on Insurance Services Office (ISO) form CA 00 01 or a
substitute form providing equivalent liability coverage. If
necessary, the policy shall be endorsed to provide
contractual liability coverage.
3. Workers' Compensation coverage as required by the
Industrial Insurance laws of the State of Washington.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Commercial General Liability insurance shall be written with
limits no less than $1,000,000 each occurrence, $2,000,000
general aggregate and a $2,000,000 products-completed
operations aggregate limit.
2. Automobile Liability insurance with a minimum combined
single limit for bodily injury and property damage of
$2,000,000 per accident.
EXHIBIT B (Continued)
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
insurance:
1. The Contractor's insurance coverage shall be primary insurance as respect
the City. Any Insurance, self-insurance, or insurance pool coverage
maintained by the City shall be excess of the Contractor's insurance and
shall not contribute with it.
2. The Contractor's insurance shall be endorsed to state that coverage shall
not be cancelled by either party, except after thirty (30) days prior
written notice by certified mail, return receipt requested, has been given
to the City.
3. The City of Kent shall be named as an additional insured on all policies
(except Professional Liability) as respects work performed by or on behalf
of the contractor and a copy of the endorsement naming the City as
additional insured shall be attached to the Certificate of Insurance. The
City reserves the right to receive a certified copy of all required insurance
policies. The Contractor's Commercial General Liability insurance shall
also contain a clause stating that coverage shall apply separately to each
insured against whom claim is made or suit is brought, except with
respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than ANII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Contractor before commencement of the work.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Contractor.
Client#: 133857 SEATSWEE
ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE 112017(MMIDDI 210(MMIDWYYYY)
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 Leslie Burleson
Propel Insurance NAME PHONE 800 499-0933 FA 866 577-1326
Tacoma Commercial Insurance E-AILo Ex1: Alc,Ne
ADDRESS: leslie.burieson@propelinsurance.com
1201 Pacific Ave,Suite 1000 INSURER(S)AFFORDING COVERAGE NAIC p
Tacoma,WA 98402 INSURER A:Union Insurance Company 25844
INSURED INSURER B
AI Vinson Inc.,dba Sea-Tac Sweeping •
26305 79th Avenue South INSURERC:
Kent,WA 98032 INSURER D•
-
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.
LTR TYPE OF INSURANCE IINSRL y VD POLICY NUMBER MANDDY EFF POLICY EXP LIMITS
A GENERAL LIABILITY X X CPA2880043 0610112016 06101112017 EACH OCCURRENCE $1 000 000
ix
COMMERCIAL GENERAL LIABILITY PREMISES EaENT D nce s 300 000
CLAIMS-MADE EX OCCUR MED EXP(Any one person) $1 O 000
PD Ded:500 PERSONAL&ADV INJURY $1,000,000
GENERAL AGGREGATE 52,000 000
GEUL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 2,000,000
POLICY X PRO- LOC S
ECT
A AUTOMOBILE LIABILITY X X CPA2880043-27 6/01/2016 06/01/201 COMBINEDSINGLE LIMIT
Ea acc ED 5110009000
X ANY AUTO BODILY INJURY(Per person) S
ALL OWNED SCHEDULED BODILY INJURY(Per accident) 5
AUTOS AUTOS
X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $
AUTOS Per accident
$
A X UMBRELLA LIAB X OCCUR X X CPA2880043-27 0610112016 0610112017 EACH OCCURRENCE $5 00O 000
EXCESS LIAB CLAIMS-MADE AGGREGATE $6 000 000
DED RETENTIONS $
A WORKERS COMPENSATION CPA2880043-27 6/01/2016 06/01/201 JO Y X oTH-
AND EMPLOYERS'LIABILITY YIN LIMITSFR
ANY PROPRIETORIPARTNERIEXECUTIVE WA Stop Gap Only E L.EACH ACCIDENT S1 O0O 000
OFFICERIMEMBER EXCLUDED? � N I A
(Mandatory in NH) E.L.DISEASE-EAEMPLOYEE1$1 00O 000
If yes,describe under E.L.DISEASE-POLICY LIMIT 000$1 000 DESCRIPTION OF OPERATIONS below , ,
A Auto Physical CPA2880043-27 1610112016 06/01/201 $1,000 Comp Deductible
Damage-Specified $1,000 Collision Deduct
Vehicles Only
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required)
City of Kent is included as an additional insured per attached endorsement.
CERTIFICATE HOLDER CANCELLATION
City of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ty THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Attn: Nancy Clary ACCORDANCE WITH THE POLICY PROVISIONS.
220 4th Ave S
Kent,WA 98032 AUTHORIZED REPRESENTATIVE
01988-2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S25736331M2223740 LRB01
1?
This page has been left blank.'intentionalIy: " " -
COMMERCIAL GENERAL LIABILITY
CL CG FS 01 09 08
Policy Number: CPA 2880043 -27
SCHEDULE OF FORMS AND ENDORSEMENTS
The following Declarations, Coverage Forms, Conditions, and Endorsements are applicable to:
Commercial General Liability
State* Number Edition Descriotion
ALL 9-CG DS 01 10-2001 Commercial General Liability Declarations
ALL CL CG 99 32 01-2015 Commercial General Liability Supplemental Declarations Schedule
ALL CL CG FS 01 09-2008 Schedule of Forms and Endorsements
ALL CG 00 01 12-2007 Commercial General Liability Coverage Form
ALL CG 00 68 05-2009 Recording And Distribution Of Material Or Information In Violation Of Law
Exclusion
ALL CG 01 97 12-2007 Washington Changes-Employment- Related Practices Exclusion
ALL CG 03 00 01-1996 Deductible Liability Insurance
ALL CG 04 35 12-2007 Employee Benefits Liability Form
ALL CG 04 42 11-2003 Stop Gap -Employers Liability Coverage Endorsement-Washington
ALL CG 04 50 05-2008 Washington Changes-Who Is An Insured
ALL CG 20 18 11-1985 Additional Insured -Mortgagee, Assignee, Or Receiver
ALL CG 21 06 05-2014 Exclusion-Access or Disclosure of Confidential Or Personal Information
and Data-Related Liability-With Limited Bodily Injury Exception
ALL CG 21 54 01-1996 Exclusion- Designated Operations Covered By A Consolidated (Wrap-
Up) Insurance Program
ALL CG 21 71 01-2015 Exclusion of Other Acts of Terrorism Committed Outside The United
States; Cap on Losses From Certified Acts of Terrorism
ALL CG 21 76 01-2015 Exclusion Of Punitive Damages Related To A Certified Act Of Terrorism
ALL CG 21 86 12-2004 Exclusion -Exterior Insulation And Finish Systems
ALL CG 21 96 03-2005 Silica Or Silica- Related Dust Exclusion
ALL CG 24 26 07-2004 Amendment Of Insured Contract Definition
ALL CG 26 77 12-2004 Washington - Fungi or Bacteria Exclusion
ALL CL CG 00 13 08-2013 General Liability Platinum Endorsement
ALL CL CG 00 20 01-2012 Contractor General Liability Platinum Endorsement
ALL CL CG 02 02 01-2012 Notice Of Cancellation To Designated Person(s) Or Organization(s)
Other Than The Named Insured
ALL CL CG 20 52 01-2012 Additional Insured -Owners, Lessees, Contractors Or Others-Ongoing
Operations-Automatic Status, Including Primary Non-Contributory
ALL CL CG 21 08 07-2002 Asbestos Exclusion
ALL CL IL 99 18 L 07-2012 Blank Endorsement General Liability
'When the word"ALL"appears in the state column,the form applies to all states on the policy.
CL CG FS 0109 08 Page 1 of 1
COMMERCIAL AUTO
CL CA FS 0109 08
Policy Number: CPA 2880043-27
SCHEDULE OF FORMS AND ENDORSEMENTS
The following Declarations, Coverage Forms,Conditions, and Endorsements are applicable to:
Commercial Auto
State" Number Edition Description
ALL B CA DS 03 06-2015 Business Auto Declarations
ALL CL CA FS 01 09-2008 Schedule of Forms and Endorsements
ALL CA 00 01 10-2013 Business Auto Coverage Form
ALL CA 01 35 10-2013 Washington Changes
ALL CA 02 40 10-2013 Suspension of Insurance
ALL CA 21 34 10-2013 Washington Underinsured Motorists Coverage
ALL CA 23 92 10-2013 Washington Exclusion of Terrorism
ALL CA 23 94 10-2013 Silica Or Silica-Related Dust Exclusion For Covered Autos Exposure
ALL CA 99 03 10-2013 Auto Medical Payments Coverage
ALL CL CA 0108 02-2015 Asbestos Exclusion
ALL CL CA 01 49 02-2015 Commercial Automobile Expansion Endorsement Platinum
ALL CW 32 28 WA 02-2015 Named Driver Exclusion-Washington
When the word"ALL"appears in the state column, the fort applies to all states on the policy.
CL CA FS 01 09 08 Page 1 of 1
COMMERCIAL LIABILITY UMBRELLA
CL CU FS 0109 08
Policy Number: CPA 2880043-27
SCHEDULE OF FORMS AND ENDORSEMENTS
The following Declarations, Coverage Forms, Conditions,and Endorsements are applicable to:
Commercial Umbrella
State" Number Edition Description
ALL B CU DS 01 01-2007 Commercial Liability Umbrella Declarations
ALL CL CU FS 01 09-2008 Schedule of Forms and Endorsements
ALL CL CU 2105 03-2008 Driver Exclusions
ALL CL CU 2166 01-2007 Exclusion-Asbestos
ALL CL CU 2167 01-2007 Exclusion Punitive Damages
ALL CL CU 21 75 01-2007 Exclusion-Lead
ALL CL CU 22 76 09-2015 Exclusion-Cyber Liability
ALL CL CU 24 04 01-2007 Changes-Premium Audit
ALL CL CU 24 05 06-2008 Per Location And Products-Completed Operations Aggregate Limits
ALL CL CU 24 16 01-2007 Employee Benefits Liability Coverage
ALL CL CU 24 74 09-2013 Blanket Waiver of Transfer of Rights of Recovery Against Others To Us
ALL CU 00 01 12-2007 Commercial Liability Umbrella Coverage Form
ALL CU 00 04 05-2009 Recording And Distribution Of Material Or Information In Violation Of Law
Exclusion
ALL CU 0121 09-2000 Washington Changes
ALL CU 0124 12-2001 Washington Changes-Employment-Related Practices Exclusion
ALL CU 2123 02-2002 Nuclear Energy Liability Exclusion Endorsement
ALL CU 21 31 01-2015 Exclusion of Other Acts of Terrorism Committed Outside the United
States; Cap on Losses From Certified Acts of Terrorism
ALL CU 2136 01-2015 Exclusion Of Punitive Damages Related To a Certified Act of Terrorism
ALL CU 2142 12-2004 Exclusion -Exterior Insulation And Finish Systems
ALL CU 2150 03-2005 Silica Or Silica-Related Dust Exclusion
ALL CU 2186 05-2014 Exclusion-Access or Disclosure of Confidential Or Personal Information
and Data-Related Liability-With Limited Bodily Injury Exception
ALL CU 24 14 09-2000 Fellow Employee Auto Coverage
ALL CU 24 32 12-2005 Limited Coverage Territory
ALL CU 26 77 12-2004 Washington-Fungi Or Bacteria Exclusion
'When the word"ALL"appears in the state column,the form applies to all states on the policy.
CL CU FS 0109 08 Page 1 of 1
COMMERCIAL AUTO
CLCA01490215
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT
- PLATINUM
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to the coverages provided by this endorsement,the provisions of the Business Auto Coverage Form
apply unless modified by this endorsement.
A. NEWLY ACQUIRED OR FORMED ORGANIZA- ganization is liable for"bodily injury" or"prop-
TIONS erty damage": because of the conduct of an
The following is added to Paragraph A.I. Who Is "insured" under Paragraphs a. or b. under
An Insured of Section II - Covered Autos Liability Paragraph A.I.Who Is An Insured of Section
Coverage: II -Covered Autos Liability Coverage,caused
by an"accident"and resulting from the owner-
Any organization you newly acquire or form,other ship, maintenance or use of a covered"auto";
than a partnership,joint venture or limited liability 2. The written contract or agreement described
company or any organization excluded either by above must have been executed prior to the
this Coverage Part or by endorsement, and over "accident" that caused the "bodily injury" or
which you maintain ownership or majority interest "property damage"and be in effect at the time
of more than 50 percent will qualify as a Named of such"accident";
Insured. However:
The insurance afforded to any such additional
1. This insurance does not apply to any newly ac- 3. "insured"does not apply to any"accident"be-
yond or formed organization that is an in- yond the period of time required by the written
sured" under any other automobile policy or would be an "insured" under such policy but contract or agreement described above;
for its termination or the exhaustion of its Limit 4. The most we will pay on behalf of such addi-
of Insurance. tional"insured's)" is the lesser of:
2. Coverage does not apply to "bodily injury" or a. The Limits of Insurance specified in the
'Property damage" that occurred before you written contract or agreement described
acquired or formed the organization. above-,or
3. Coverage under this provision is afforded only b. The Limits of Insurance shown in the Dec-
until the 180th day after you acquire or form larations.
the organization or the end of the policy pe- This provision shall not increase the Limit of
riod,whichever is earlier. Insurance shown in the Declarations in this
B. ADDITIONAL INSURED BY CONTRACT OR policy or coverage part;and
AGREEMENT 5. The following changes are made to Paragraph
The following is added to Paragraph A.1.,Who Is 5. Other Insurance of B. General Conditions
An Insured of Section II - Covered Autos Liability under Section IV- Business Auto Conditions:
Coverage:
a. The following is added to Paragraph 5.a.:
When you have agreed in a written contract or If required by the written contract or
agreement to include a person or organization as
an additional "insured", such person or organiza- agreement described above, the insur-
tion is included as an "insured"subject to the fol- ance afforded to the additional insured un-
lowing: der this provision will be primary to, and
will not seek contribution from, the addi-
1. Such person or organization is an additional tional insured's own insurance.
"insured"only to the extent such person or or-
b. Paragraph S.c. is deleted in its entirety.
CL CA 0149 0215 Includes copyrighted material of Insurance Services Page 1 of 5
Office, Inc.,with its permission
6. Paragraph A.i.c. under Section II - Covered 2. We will also pay reasonable and necessary
Autos Liability Coverage is deleted in its en- expenses to facilitate the return of the stolen
tirety. "auto"to you.
7. The definition of"insured contract"under Sec- 3. It is agreed and understood and it is our stated
tion V- Definitions is amended to add the fol- intent that expenses incurred by you under the
lowing: Transportation Expenses Coverage Exten-
An "insured contract" does not include that sion will not also be covered or paid under the
part of any contract or agreement: Rental Reimbursement Coverage provided by
this endorsement or any rental reimbursement
That pertains to the ownership, maintenance coverage added by separate endorsement to
or use of an "auto" and which indemnifies a this policy.
person or organization for other than the vicar- H. EXTENDED COVERAGE-AIRBAGS
ious liability of such person or organization for
"bodily injury"or"property damage"caused by The following is added to Exclusion B.3.a.of Sec-
your operation or use of a covered"auto". tion III- Physical Damage Coverage:
However, a person or organization is an addi- However,this exclusion does not apply to the un-
tional"insured"under this provision only to the intended discharge of an airbag.
extent such person or organization is not This coverage is excess over any other collectible
named as an "insured" by separate endorse- insurance or warranty providing such airbag cov-
ment to this policy.
erage.
C. EMPLOYEES AS INSUREDS I. AUTO LOAN/LEASE GAP COVERAGE
The following is added to Paragraph A.I. Who Is The following is added to Section III - Physical
An Insured Section 11 - Covered Autos Liability Damage Coverage, Paragraph C. Limits of Insur-
Coverage: ance.
Any"employee"of yours is an "insured"while us- 4. In the event of a total "loss" to a covered
ing a covered"auto"you don't own, hire or borrow "auto",we will pay any unpaid amount due on
in your business or your personal affairs. the lease or loan for a covered"auto", less:
D. INCREASED COVERAGE- BAIL BONDS a. The amount under the Physical Damage
The Supplementary Payments Coverage Exten- Coverage section of the policy;and
sion of Section II - Covered Autos Liability Cover- b. Any:
age is amended as follows:
The Limit of Insurance in paragraph A.2.a.(2) is (1) Overdue lease/loan payments at the
increased to$5,000.
time of the"loss";
E. INCREASED COVERAGE - LOSS OF EARN- (2) Financial penalties imposed under a
INGS lease for excessive use, abnormal
wear and tear or high mileage;
The Supplementary Payments Coverage Exten- (3) Security deposits not returned by the
sion of Section II -Covered Autos Liability Cover- lessor;
age is amended as follows:
The Limit of Insurance in paragraph A.2.a.(4) is (4) Costs for extended warranties, Credit
increased to$1,000. Life Insurance, Health, Accident or
Disability Insurance purchased with
F. FELLOW EMPLOYEE COVERAGE the loan or lease;and
The Fellow Employee Exclusion contained in Sec- (5) Carry-over balances from previous
tion II-Covered Autos Liability Coverage does not loans or leases.
apply. This coverage is excess over any other col- J. GLASS REPAIR-NO DEDUCTIBLE
lectable insurance.
G. COVERAGE EXTENSION-TRANSPORTATION The following is added to Paragraph D.Deductible
EXPENSES of Section III - Physical Damage Coverage:
Paragraph A.4.a. Transportation Expenses of Any Comprehensive Coverage deductible shown
Section III-Physical Damage Coverage is in the Declarations does not apply to "loss" to
amended as follows: glass when you elect to patch or repair rather than
replace the glass.
1. The Limits of Insurance are increased to $75 K. INCREASED COVERAGE - ELECTRONIC
per day to a maximum of$2,500. EQUIPMENT
Page 2 of 5 Includes copyrighted material of Insurance Services CL CA 0149 0215
Office, Inc., with its permission
The$1,000 limit indicated in Paragraph C.1.b.un- The following is added to Paragraph A.4. Cover-
der Section III - Physical Damage Coverage is in- age Extensions of Section III - Physical Damage
creased to$2,500. Coverage:
L. EXTENDED COVERAGE - PERSONAL PROP- If hired "autos" are covered "autos" for Covered
ERTY Autos Liability Coverage and if Physical Damage
The following is added to Paragraph A.4. Cover- Coverage is provided for any"auto"you own,then
age Extensions of Section III - Physical Damage the Physical Damage coverages provided are ex-
tended to "autos" you lease, rent, hire or borrow
Coverage: from someone other than your"employees", part-
Physical Damage Coverage on a covered "auto" ners or members of their households subject to the
may be extended to "loss" to your personal prop- following:
erty or,if you are an individual,the personal prop- 1. The most we will pay in any one "loss" is the
erty of a family member, that is in the covered lesser of:
"auto"at the time of"loss"and caused by an "ac-
cident"and resulting from the ownership, mainte- a. The actual cash value of the"auto";
nance or use of a covered"auto". b. The cost to repair or replace the"auto";or
The insurance provided by this coverage exten- c. $100,000.
sion is excess over any other collectible insur-
ance. The most we will pay for any one"loss"un- 2. Paragraph 1.above is subject to a deductible.
der this coverage extension is$500. However,our The deductible shall be equal to the amount of
payment for"loss"to personal property will only be the highest deductible shown for any owned
for the account of the owner of the property. "auto" of the same classification for that cov-
Under this provision, personal property does not erage. In the event there is no owned "auto"
include and we will not pay for"loss"of currency, of the same classification,the highest deduct-
coins,securities or contraband. ible for any owned "auto will apply for that
coverage.
No deductible applies to this coverage extension. No deductible will apply to "loss" caused by
M. TOWING fire or lightning.
Paragraph A.2. Towing of Section III - Physical 3. Hired Auto Physical Damage Coverage is
Damage Coverage, is replaced by the following: subject to the following:
If a private passenger type "auto" or light truck a. If symbol 8 is shown in the Covered Auto
"auto"(0-10,000 Lbs.GVW)is provided both Com- section of the Declarations page for any of
prehensive and Collision Coverage,we will pay up the Physical Damage coverages,then the
to $150 for towing and labor costs incurred each Hired Auto Physical Damage coverage
time such "auto" is disabled. If a medium, heavy described in this endorsement does not
or extra-heavy truck or extra-heavy Truck-tractor apply.
"auto"(greater than 10,000 Lbs.GVW)is provided b. Other than indicated in Paragraphs a. di-
both Comprehensive and Collision Coverage, we rectly above, coverage provided under
will pay up to $250 for towing and labor costs in-
curred each time such "auto" is disabled. How- this provision will be excess over any
ever, the labor must be performed at the place of other collectible insurance or coverage.
disablement. 4. In addition to the limit set forth in Paragraph 1.
N. FIRE EXTINGUISHER RECHARGE above we will pay up to $500 per day, to a
maximum of$3,500 per"loss"for:
The following is added to Paragraph A.4. Cover-
age Extensions of Section IV - Physical Damage a. Any costs or fees associated with the
"loss"to a hired"auto";and
Coverage:
When fire extinguishers are kept in your covered b. Loss of use of the hired"auto", provided it
"auto"and any are discharged in an attempt to ex- is the consequence of an "accident" for
tinguish a fire, we will pay the lesser of the actual which you are legally liable, and as a re-
cost of recharging or replacing such fire extin- sult of which a monetary loss is sustained
guisher(s). by the leasing or rental concern.
No deductible applies to this coverage However, Paragraph A.4.b. Loss of Use Ex-
penses under Section III - Physical Damage Cov-
O. HIRED AUTO PHYSICAL DAMAGE COVER- erage of the Business Auto Coverage Form does
AGE not apply.
P. RENTAL REIMBURSEMENT COVERAGE
CL CA 0149 0215 Includes copyrighted material of Insurance Services Page 3 of 5
Office, Inc., with its permission
We will pay for rental reimbursement expenses in- (3) Your members or managers, if you
curred by you for the rental of an "auto" because are designated in the Declarations as
of"loss"to a covered"auto". a limited liability company;
1. Payment applies in addition to the otherwise (4) Your executive officers if you are des-
applicable amount of each coverage you have ignated in the Declarations as an or-
on the covered"auto". ganization other than an individual,
2. No deductible applies to this coverage. partnership,joint venture or limited li-
ability company;and
3. We will pay only for those expenses incurred
during the policy period beginning 24 hours af- (5) The spouse of any person named in
ter the"loss"and ending, regardless of the ex- Paragraphs i.a.{1). through 1.a
piration date of the policy, with the lesser of while a resident of the same housse-
e-
the following number of days: hold;
a. The number of days when the covered Except:
"auto" has been repaired or replaced, or (a) Any"auto" owned by that individ-
b. 45 days. ual or by any member of his or
her household.
4. Our payment is limited to the lesser of the fol- (b) Any"auto" used by that individual
lowing amounts: or his or her spouse while working
a. Necessary and actual expenses incurred; in a business of selling, servicing,
or repairing or parking "autos".
b. Not more than$75 for any one day; 2. Changes In Auto Medical Payments And
5. We will pay up to an additional $300 for the Uninsured And Underinsured Motorists
reasonable and necessary expenses you in- Coverages
cur to remove your materials and equipment The following is added to Who Is An Insured:
from the covered"auto"and replace such ma- Any individual named in 1.a above and his or
terials and equipment on the rental "auto". her"family members"are"insured"while"oc-
6. This coverage does not apply while there are cupying" or while a pedestrian when being
spare or reserve "autos" available to you for struck by any "auto" you don't own except:
your operations. Any"auto"owned by that individual or by any
7. If"loss"results from the total theft of a covered "family member".
"auto" of the "private passenger type", we will 3. Changes In Physical Damage Coverage
pay under this coverage only that amount of
your rental reimbursement expenses which is Any private passenger type "auto" you don't
not already provided for under the Physical own, hire or borrow is a covered "auto" while
Damage Coverage Extension of the Business in the care,custody or control of any individual
Auto Coverage Form or any endorsements named in Q.1.a. above or his or her spouse
thereto while a resident of the same house-hold ex-
However, this provision does not apply to the cept:
extent that rental reimbursement is provided a. Any"auto" owned by that individual or by
by separate endorsement to this policy. any member of his or her household; or
Q. DRIVE OTHER CAR COVERAGE b. Any"auto"used by that individual or his or
1. The following is added to Section II-Covered her spouse while working in a business of
Autos Liability Coverage: selling,servicing,repairing or parking"au-
tos".
a. Any "auto" you don't own, hire or borrow 4. The most we will pay for the total of all dam-
is a covered "auto" for Liability Coverage ages under Covered Autos Liability Uninsured
while being used by: Motorists Coverage and Underinsured Motor-
(1) You, if you are designated in the Dec- ists Coverage is the Limit Of Insurance shown
larations as an individual; in the Declarations as applicable to owned
(2) Your partners or members, if you are "autos".
designated in the Declarations as a 5. Our obligation to pay for, repair, return or re-
partnership or joint venture; place damaged or stolen property under Phys-
ical Damage Coverage, will be reduced by a
deductible equal to the amount of the highest
Page 4 of 5 Includes copyrighted material of Insurance Services CL CA 01 49 02 15
Office, Inc., with its permission
deductible shown for any owned private pas- prejudice the coverage provided to you. However,
senger type "auto" applicable to that cover- this provision does not affect our right to collect
age. If there are no owned private passenger additional premium or exercise our right of cancel-
type "autos", the deductible shall be $250 for lation or nonrenewal.
Comprehensive Coverage and $500 for Colli- U. LIBERALIZATION
sion Coverage. No deductible will apply to
"loss"caused by fire or lightning. If we revise this endorsement to provide greater
6. Additional Definition coverage without additional premium charge, we
will automatically provide the additional coverage
As used in this DRIVE OTHER CAR Provi- to all endorsement holders as of the day the revi-
sion: sion is effective in your state.
"Family member" means a person related to
the individual named in 1.a. by blood, mar-
riage or adoption who is a resident of the indi-
vidual's household, including a ward or foster
child.
R. KNOWLEDGE OF AN ACCIDENT, CLAIM, SUIT
OR LOSS
The following is added to Paragraph A.2. of Sec-
tion IV- Business Auto Conditions:
Your obligation to provide prompt notice of an"ac-
cident", claim, "suit" or"loss" is satisfied if you or
a person designated by you to be responsible for
insurance matters is notified of, or in any manner
made aware of an"accident",claim,"suit"or"loss"
and provides us such notice as soon as practica-
ble
S. WAIVER OF SUBROGATION BY CONTRACT
OR AGREEMENT
The following is added to Paragraph A.5 of Sec-
tion IV- Business Auto Conditions:
We waive any right of recovery we may have
against a person or organization because of pay-
ments we make for "bodily injury" or "property
damage" when you and such person or organiza-
tion have agreed in writing in a contract or agree-
ment to waive such right of recovery, provided:
1. Such written contract or agreement was:
a. Made prior to the "accident" or "loss" resulting in
the covered "bodily injury" or "property damage";
and
b. Was in effect at the time of the covered"bodily in-
jury"or"property damage".
2. The covered "bodily injury" or "property damage"
must arise out of the operations specified in such
written contract or agreement.
3. At our request you must provide us with a copy of
the aforementioned written contract or agreement.
T. UNINTENTIONAL OMISSIONS
The following is added Paragraph B.2. of Section
IV- Business Auto Conditions:
If you fail to disclose any hazards existing at the
inception date of this policy, such failure will not
CL CA 01 49 02 15 Includes copyrighted material of Insurance Services Page 5 of 5
Office, Inc.,with its permission
COMMERCIAL GENERAL LIABILITY
CL IL 9918 0712
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANK ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL PROPERTY COVERAGE PART
BUSINESSOWNERS
INLAND MARINE
CRIME COVERAGE PART
COMMERCIAL AUTO COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS COMPLETED OPERATIONS LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
COMMERCIAL EXCESS POLICY
WORKERS'COMPENSATION POLICY
The following endorsement is added to the policy:
Al #1.OA General Liability Platinum Amendment-Additional Insured -Provision N. (Revised)
CLIL99180712
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POLICY NO: CPA 2880043-27 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Al #1 .0A GENERAL LIABILITY PLATINUM AMENDMENT -
ADDITIONAL INSURED - Provision N. (Revised)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY PLATINUM ENDORSEMENT
A. Provision N.ADDITIONAL INSURED-OWNERS, b. If the written contract specifically requires
LESSEES OR CONTRACTORS - AUTOMATIC you to provide additional insured
INCLUDING PRIMARY NON-CONTRIBUTORY coverage via the 10101 edition of CO2010
is deleted in its entirety and replaced with the (aka CG 20 10 10 01) or via the 11/85
following: edition of CG2010(aka CG 20 10 11 85),
N. ADDITIONAL INSURED - OWNERS, then in paragraph 2.a. above, the words
LESSEES OR CONTRACTORS - caused in whole or in part by are replaced
AUTOMATIC INCLUDING PRIMARY by the words arising out of.
NON-CONTRIBUTORY c. The insurance afforded to such additional
1. Section 11 -Who is An Insured is amended insured only applies to the extent
to include as an additional insured any permitted by law.
person(s)or organizations)for whom you are d. If coverage provided to the additional
required by virtue of a written contract or insured is required by a contract or
agreement that such person(s) or agreement, the insurance afforded to
organization(s) be added as an additional such additional insured will not be broader
insured on your policy. than that which you are required by the
2. The insurance provided to the additional contract or agreement to provide for such
insured is limited as follows: additional insured.
a. Such person or organization is an e. This insurance ends at the earliest of the
additional insured only with respect to following times:
liability for "bodily injury", "property (1) When any Named Insured(s) work
damage" or "personal and advertising called for in the written contract has
injury"caused in whole or in part by: been completed
(1) Acts or omissions of the Named (2) When all of any Named Insured(s)
Insured; or work done at a job site has been
(2) The acts or omissions of those acting completed if the written contract calls
on behalf of the Named Insured;
for work at more than one job site
in the performance of the Named (3) When that part of any Named
Insured's ongoing work for the additional Insured(s)work done at a job site has
insured(s) specified in the written contract been put to its intended use by any
provided the contract or agreement person(s) or organization(s) other
requires you to provide the additional than the Named Insured or those
insured such coverage and is: acting on the Named Insured(s)
behalf.
L Currently in effect or becomes Work that may need service, maintenance,
effective during the term of this correction, repair or replacement, but is
policy; and otherwise complete, will be treated as
III. Was executed prior to the"bodily completed.
injury", "property damage" or f. This insurance does not apply to any
"personal and advertising injury". additional insured scheduled on your
policy by separate endorsement.
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g. For purposes of paragraph A. of this 4. Limits of Insurance
endorsement, the terms "you" and "your" With respect to the insurance afforded to
refer to the Named Insured shown in the
Declarations, these additional insureds, the following is
added to Section III -Limits Of Insurance:
3. Exclusions If coverage provided to the additional insured
With respect to the insurance afforded to is required by a contract or agreement, the
these additional insureds, the following most we will pay on behalf of the additional
additional exclusions apply to "bodily injury", insured is the amount of insurance:
"property damage" or "personal and a. Required by the contract or agreement;or
advertising injury arising out of:
a. The rendering of or failure to render any b. Available under the applicable Limits of
professional services by you or on your Insurance shown in the Declarations;
behalf, but only with respect to either or whichever is less.
both of the following operations: This endorsement shall not increase the
(1) Providing engineering, architectural applicable Limits of Insurance shown in the
or surveying services to others in your Declarations.
capacity as an engineer, architect or 5. Other Insurance
surveyor; and
(2) Providing, or hiring independent For purposes of this endorsement, the
professionals to provide,engineering, following is added to the Section IV -
architectural or surveying services in Commercial General Liability Conditions,
connection with construction work 4.Other Insurance condition and supersedes
you perform. any provision to the contrary:
b. Subject to Paragraph c. below, This insurance is excess of all other insurance
professional services include: available to an additional insured whether on
a primary, excess, contingent or any other
(1) Preparing, approving, or failing to basis. But, if required by a written contract or
prepare or approve, maps, shop written agreement to be primary and
drawings, opinions, reports, surveys, noncontributory, this insurance will be primary
field orders, change orders, or to and will not seek contribution from any
drawings and specifications; and insurance on which the additional insured is a
(2) Supervisory or inspection activities
Named Insured.
performed as part of any related No other coverage or limit in the policy applies
architectural or engineering activities. to loss or damage insured by this coverage.
c. Professional services do not include B. The following coverage is added:
services within construction means, CONTRACTUAL LIABILITY RAILROADS
methods, techniques, sequences and
procedures employed by you or 1. With respect to operations performed for a
performed by or for the construction Railroad within 50 feet of railroad property,the
manager, its employees or its definition of"insured contract" in Section V-
subcontractors in connection with your Definitions is replaced by the following:
ongoing operations.
9. "Insured Contract" means:
This exclusion applies even if the claims a. A contract for a lease of premises.
against any insured(s) alleged negligence or However, that portion of the contract
other wrongdoing in the supervision, hiring, for a lease of premises that
employment, training or monitoring of others
by that insured, if the "occurrence" which indemnifies any person or
caused the "bodily injury" or "property organization for damage by fire to
damage", or the offense which caused the premises while rented to you or
"personal and advertising injury", involved the temporarily occupied by you with
rendering of, or the failure to render, any permission of the owner is not an
professional architectural, engineering or "insured contract";
surveying services. b. A sidetrack agreement;
c. Any easement or license agreement;
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d. An obligation,as required by ordinance,to No other coverage or limit in the policy applies
indemnify a municipality, except in to loss or damage insured by this coverage.
connection with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or
agreement pertaining to your business
(including an indemnification of a
municipality in connection with work
performed for a municipality)under which
you assume the tort liability of another
party to pay for"bodily injury"or"property
damage"to a third person or organization.
Tort liability means a liability that would be
imposed by law in the absence of any
contract or agreement.
Paragraph f.does not include that part of
any contract or agreement:
(1) That indemnifies an architect,
engineer or surveyor for injury or
damage arising out of:
(a) Preparing, approving or failing to
prepare or approve maps, shop
drawings, opinions, reports,
surveys, field orders, change
orders or drawings and
specifications; or
(b) Giving directions or instructions,
or failing to give them, if that is the
primary cause of the injury or
damage;
(2) Under which the insured, if an
architect, engineer or surveyor,
assumes liability for an injury or
damage arising out of the insured's
rendering or failure to render
professional services, including those
listed in Paragraph (1) above and
supervisory, inspection, architectural
or engineering activities.
2. Other Insurance
For purposes of this endorsement, the
following is added to the Section IV -
Commercial General Liability Conditions,
4.Other Insurance condition and supersedes
any provision to the contrary:
This insurance is excess of all other insurance
that is Railroad Protective Liability or similar
coverage for "your work" performed for a
Railroad. But, if required by a written contract
or written agreement to be primary and
noncontributory,this insurance will be primary
to and will not seek contribution from any
insurance on which the Railroad is a Named
Insured.
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COMMERCIAL GENERAL LIABILITY
CL CG 00 13 0813
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY PLATINUM ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. MEDICAL PAYMENTS
If SECTION I -COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage
Part:
1. The Medical Expense Limit provided by this policy, subject to the terms of SECTION III - LIMITS
OF INSURANCE, shall be the greater of:
a. $10,000;or
b. The Medical Expense Limit shown in the Declarations of this Coverage Part.
B. FIRE, LIGHTNING, EXPLOSION, SMOKE AND SPRINKLER LEAKAGE DAMAGE TO PREMISES
YOU RENT
If damage to premises rented to you under Coverage A. is not otherwise excluded from this policy,
the following applies:
1. The last paragraph of SECTION I-COVERAGE A.2. Exclusions is deleted and replaced by the
following:
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or sprinkler
leakage to premises while rented to you or temporarily occupied by you with permission of the
owner. A separate limit of insurance applies to this coverage as described in SECTION III -
LIMITS OF INSURANCE.
2. Paragraph 6. of SECTION III - LIMITS OF INSURANCE is deleted and replaced by the
following:
6. Subject to Paragraph 5.above,the greater of:
a. $300,000;or
b. the Damage To Premises Rented To You Limit shown in the Declarations;
is the most we will pay under COVERAGE A for damages because of"property damage" to
any one premises, while rented to you or temporarily occupied by you with the permission of
the owner.
3. Paragraph 4.b.(1)(a)(ii) Other Insurance of SECTION IV - COMMERCIAL GENERAL
LIABILITY CONDITIONS is deleted and replaced by the following:
(ii) That is Fire, Lightning, Explosion, Smoke or Sprinkler Leakage insurance for
premises rented to you or temporarily occupied by you with the permission of the
owner;
4. Paragraph 9.a. of SECTION V- DEFINITIONS is deleted and replaced by the following:
a. A contract for a lease of premises. However, that portion of the contract for a lease of
premises that indemnifies any person or organization for damage by fire, lightning,
explosion, smoke or sprinkler leakage to premises while rented to you or temporarily
occupied by you with permission of the owner is not an "insured contract';
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C. LIMITED NON-OWNED WATERCRAFT
1. Paragraph g.(2) of SECTION 1 - COVERAGE A.2. Exclusions is deleted and replaced by the
following:
A watercraft you do not own that is:
a. Less than 51 feet long; and
b. Not used to carry persons or property for a charge.
D. SUPPLEMENTARY PAYMENTS
SECTION I-SUPPLEMENTARY PAYMENTS-COVERAGES A AND B is amended as follows:
1. The limit of insurance in paragraph 1.b. is increased from$250 to$2,500;and
2. The limit of insurance in paragraph 1.d. is increased from$250 to$500.
E. AUTOMATIC ADDITIONAL INSURED - SPECIFIED RELATIONSHIPS - PRIMARY
NON-CONTRIBUTORY
The following is added to Paragraph 2.of SECTION II-WHO IS AN INSURED:
e. Any person or organization described below, when you are obligated by virtue of a written
contract or agreement that such person be added as an additional insured on your policy.
When required by virtue of a written contract or agreement, coverage provided to any
additional insured will be on a primary basis and will not seek contribution from the additional
insured's policy.
Only the following persons or organizations are additional insureds under this endorsement:
(1) Managers Or Lessors Of Premises. The manager or lessor of a premise leased to
you, but only with respect to liability arising from the ownership, maintenance or use of
that part of the premises leased to you and subject to the following additional exclusions:
This insurance does not apply to:
(a) Any"occurrence"which takes place after you cease to be a tenant of that premises.
(b) Structural alterations, new construction or demolition operations performed by or on
behalf of the manager or lessor.
(2) Lessor Of Leased Equipment. Any person or organization from whom you lease
equipment, but only with respect to liability for "bodily injury", "property damage" or
"personal and advertising injury" caused, in whole or in part, by your maintenance,
operation or use of equipment leased to you by such person(s)or organization(s).
However, this insurance does not apply to any "occurrence" which takes place after the
equipment lease expires.
(3) Vendors. Any person or organization, but only with respect to "bodily injury" or
"property damage" arising out of "your products" shown in the Schedule which are
distributed or sold in the regular course of the vendor's business, subject to the following
additional exclusions:
a. The insurance afforded the vendor does not apply to:
1. "Bodily injury" or "property damage" for which the vendor is obligated to pay
damages by reason of the assumption of liability in a contract or agreement.
This exclusion does not apply to liability for damages that the vendor would have
in the absence of the contract or agreement;
2. Any express warranty unauthorized by you;
3. Any physical or chemical change in the product made intentionally by the
vendor;
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4. Repackaging, unless unpacked solely for the purpose of inspection,
demonstration, testing, or the substitution of parts under instructions from the
manufacturer, and then repackaged in the original container;
5. Any failure to make such inspections, adjustments, tests or servicing as the
vendor has agreed to make or normally undertakes to make in the usual course
of business, in connection with the distribution or sale of the products;
6. Demonstration, installation, servicing or repair operations, except such
operations performed at the vendor's premises in connection with the sale of the
product;
7. Products which, after distribution or sale by you, have been labeled or relabeled
or used as a container, part or ingredient of any other thing or substance by or
for the vendor.
b. This insurance does not apply to any insured person or organization, from whom
you have acquired such products, or any ingredient, part or container, entering into,
accompanying or containing such products.
(4) State Or Political Subdivision - Permits Or Authorizations Relating To Premises.
Any state or political subdivision, subject to the following additional provision:
This insurance applies only with respect to the following hazards for which the state or
political subdivision has issued a permit in connection with premises you own, rent, or
control and to which this insurance applies:
(a) The existence, maintenance, repair, construction, erection, or removal of advertising
signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes,
marquees, hoist away openings, sidewalk vaults, street banners, or decorations and
similar exposures;or
(b) The construction, erection, or removal of elevators;or
(c) The ownership, maintenance, or use of any elevators covered by this insurance.
Limits of insurance for such additional insured are the limits in this coverage form or the limits you
and such additional insured agreed to by virtue of a contract or agreement,whichever is less. These
limits are inclusive of and are not in addition to the Limits Of Insurance shown in the Declarations.
When required by virtue of a written contract or agreement, coverage provided to any additional
insured AUTOMATIC ADDITIONAL INSURED - SPECIFIED RELATIONSHIPS - PRIMARY
NON-CONTRIBUTORY will be on a primary basis and will not seek contribution from the additional
insured's policy.
F. BROADENED NAMED INSURED-NEWLY ACQUIRED 180 DAYS
Paragraph 3.of SECTION II-WHO IS AN INSURED is deleted and replaced by the following:
Any organization you newly acquire or form, other than a joint venture, and over which you maintain
ownership or majority interest of more than 50% will be a Named Insured if there is no other similar
insurance available to that organization. However:
a. Coverage under this provision is afforded only until the 180th day after you acquire or form
the organization or the end of the policy period,whichever is earlier.
b. COVERAGE A does not apply to "bodily injury" or "property damage" that occurred before
you acquired or formed the organization.
c. COVERAGE B does not apply to "personal and advertising injury" arising out of an offense
committed before you acquired or formed the organization.
G. AGGREGATE LIMITS OF INSURANCE
The General Aggregate Limit under SECTION III - LIMITS OF INSURANCE applies separately to
each of your:
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1. Projects away from premises owned by or rented to you.
2. "Locations"owned by or rented to you.
"Location" means premises involving the same or connecting lots, or premises whose
connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad.
When paragraph B. Construction Project General Aggregate Limit on form CL CG 00 20 is a
part of this policy, then paragraph G. Aggregate Limits of Insurance of this endorsement does
not apply.
H. KNOWLEDGE OF OCCURRENCE
The following is added to paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or
Suit of SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS:
e. A report of an"occurrence", offense, claim or"suit"to:
(1) You, if you are an individual,
(2) A partner, if you are a partnership,
(3) An executive officer, if you are a corporation,or
(4) A manager,if you are a limited liability company;
is considered knowledge and requires you to notify us of the "occurrence", offense,
claim,or"suit"as soon as practicable.
f. We are considered on notice of an "occurrence", offense, claim or "suit" that is reported to
your Workers' Compensation insurer for an event which later develops into an "occurrence",
offense, claim or "suit" for which there is coverage under this policy. However, we will only
be considered on notice if you notify us as soon as you know the claim should be addressed
by this policy rather than your Workers'Compensation policy.
I. UNINTENTIONAL OMISSIONS
The following is added to paragraph 6. Representations of SECTION IV - COMMERCIAL
GENERAL LIABILITY CONDITIONS:
d. If you unintentionally fail to disclose any exposures existing at the inception date of your
policy, we will not deny coverage under this Coverage Part solely because of such failure to
disclose. However, this provision does not affect our right to collect additional premium or
exercise our right of cancellation or non-renewal.
This provision does not apply to any known injury or damage which is excluded under any
other provision of this policy.
J. MENTAL ANGUISH
Paragraph 3.of SECTION V-DEFINITIONS is deleted and replaced by the following:
3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental
anguish or death resulting from any of these at any time.
K. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS
Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of SECTION IV -
COMMERCIAL GENERAL LIABILITY CONDITIONS is amended by the addition of the following:
We waive any right of recovery we may have because of payments we make for "bodily injury" or
"property damage" arising out of your ongoing operations or "your work" done under a contract
requiring such waiver with that person or organization and included in the "products-completed
operations hazard".
However, our rights may only be waived prior to the "occurrence" giving rise to the injury or damage
for which we make payment under this Coverage Part. The insured must do nothing after a loss to
impair our rights. At our request, the insured will bring "suit" or transfer those rights to us and help
us enforce those rights.
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Paragraph K.WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS does not
apply if another waiver of transfer of rights of recovery against others is endorsed separately to this
policy.
L. OTHER INSURANCE
When Coverage applies in this General Liability Enhancement Endorsement, no other coverage or
limit of insurance in the policy applies to loss or damage insured by this coverage.
M. NON-EMPLOYMENT DISCRIMINATION LIABILITY(DEFENSE WITHIN LIMITS)
The following is added to paragraph 14. "Personal and advertising injury" SECTION V -
DEFINITIONS of COMMERCIAL GENERAL LIABILITY COVERAGE FORM:
h. Non-employment discrimination.
Non-employment discrimination means violation of a person's civil rights with respect to such
person's race, color, national origin, religion, gender, marital status, age, sexual orientation or
preference, physical or mental condition, or any other protected class or characteristic established by
any federal, state or local statutes, rules or regulations. Non-employment discrimination does not
include violation of civil rights arising out of past, present or prospective employment.
Our obligation under the Personal and Advertising Injury Liability Coverage to pay non-
employment discrimination liability damages on your behalf applies only to the amount of damages in
excess of$5,000 deductible as the result of any one offense regardless of the number of persons or
organizations who sustain damages because of the offense.
The most we will pay for all damages for non-employment discrimination is $15,000 annual
aggregate. No other liability to pay sums or perform acts or services is covered.
Supplemental Payments - Coverages A and 6 do not apply to non-employment discrimination
coverage.
N. ADDITIONAL INSURED- OWNERS, LESSEES OR CONTRACTORS OR OTHERS- AUTOMATIC,
INCLUDING PRIMARY NON-CONTRIBUTORY
1. SECTION II-WHO IS AN INSURED is amended to include as an additional insured any person
or organization for whom you are performing operations when you are obligated by virtue of a
written contract or agreement that such person or organization be added as an additional
insured on your policy. Such person or organization is an additional insured only with respect to
liability for"bodily injury", "property damage" or"personal and advertising injury" caused by your
ongoing operations for the additional insured and only to the extent that such "bodily injury",
"property damage" or "personal and advertising injury" is caused by your negligence or the
negligence of those performing operations on your behalf.
This insurance does not apply to "bodily injury", "property damage", "personal and advertising
injury" included within the"products-completed operations hazard".
This insurance does not apply to any additional insured scheduled on your policy by separate
endorsement
2. Limits of Insurance
Limits of insurance for such additional insured are the limits in this coverage form or the limits
you and such additional insured agreed to by virtue of a contract or agreement, whichever is
less. These limits are inclusive of and are not in addition to the Limits Of Insurance shown in the
Declarations.
3. Exclusions
A. With respect to the insurance afforded to these additional insureds, the following additional
exclusions apply to "bodily injury", "property damage" or "personal and advertising injury"
arising out of:
1. The rendering of or failure to render any professional services by you or on your behalf,
but only with respect to either or both of the following operations:
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a. Providing engineering, architectural or surveying services to others in your capacity
as an engineer, architect or surveyor; and
b. Providing, or hiring independent professionals to provide, engineering, architectural
or surveying services in connection with construction work you perform.
2. Subject to Paragraph 3. below, professional services include:
a. Preparing, approving, or failing to prepare or approve, maps, shop drawings,
opinions, reports, surveys, field orders, change orders, or drawings and
specifications;and
b. Supervisory or inspection activities performed as part of any related architectural or
engineering activities.
3. Professional services do not include services within construction means, methods,
techniques, sequences and procedures employed by you or performed by or for the
construction manager, its employees or its subcontractors in connection with your
ongoing operations.
B."Bodily injury"or"property damage"occurring after:
1. All work, including materials, parts or equipment furnished in connection with such work,
on the project (other than service, maintenance or repairs) to be performed by or on
behalf of the additional insured(s) at the location of the covered operations has been
completed;or
2. That portion of "your work" out of which the injury or damage arises has been put to its
intended use by any person or organization other than another contractor or
subcontractor engaged in performing operations for a principal as a part of the same
project.
4. Primary Non-Contributory
When required by virtue of a written contract or agreement, coverage provided to any additional
insured by ADDITIONAL INSURED - OWNERS, LESSEES, CONTRACTORS OR OTHERS -
ONGOING OPERATIONS - AUTOMATIC, INCLUDING PRIMARY NON CONTRIBUTORY will
be on a primary basis and will not seek contribution from the additional insured's policy.
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COMMERCIAL LIABILITY UMBRELLA
CL CU 24 74 09 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF TRANSFER OF RIGHTS
OF RECOVERY AGAINST OTHERS TO US
This endorsement modes insurance provided under the following:
COMMERCIAL LIABILITY UMBRELLA COVERAGE PART
The Transfer Of Rights Of Recovery Against Others To Us Condition under Section IV - Conditions is
amended by the addition of the following:
We waive any right of recovery we may have because of payments we make for"bodily injury" or "property
damage" arising out of your ongoing operations or "your work" done under a written contract requiring such
waiver with that person or organization and included in the"products-completed operations hazard".
However, our rights may only be waived prior to the"occurrence"giving rise to the injury or damage for which
we make payment under this Coverage Part. The insured must do nothing after a loss to impair our rights. At
our request,the insured will bring"suit"or transfer those rights to us and help us enforce those rights.
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Offices, Inc.with its permission
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTOR GENERAL LIABILITY PLATINUM ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. PROPERTY DAMAGE TO BORROWED EQUIPMENT
1. Paragraph 2.j. of SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND
PROPERTY DAMAGE LIABILITY is amended as follows:
Paragraphs (3) and (4) of this exclusion do not apply to tools or equipment loaned to you,
provided they are not being used to perform operations at the time of loss.
2. SECTION III—LIMITS OF INSURANCE is deleted and replaced by the following.-
The most we will pay in any one "occurrence" for "property damage" to borrowed equipment is
$15,000_ This limit of insurance is the most we will pay regardless of the number of:
a. Insureds;
b. Claims made or"suits"brought; or
c. Persons or organizations making claims or bringing"suits".
3. Deductible
a. Our obligation to pay damages on behalf of the insured applies only to the amount of
damages in excess of $250 as applicable to "property damage" as the result of any one
"occurrence", regardless of the number of persons or organizations who sustain damages
because of that"occurrence".
b. The terms of this insurance, including those with respect to our right and duty to defend the
insured against any "suits" seeking those damages; and your duties in the event of an
"occurrence", claim, or"suit"apply irrespective of the application of the deductible amount.
c. We may pay any part or all of the deductible amount to effect settlement of any claim or suit
and, upon notification of the action taken; you shall promptly reimburse us for such part of the
deductible amount as we have paid.
B. CONSTRUCTION PROJECT GENERAL AGGREGATE LIMIT
1. For all sums which the insured becomes legally obligated to pay as damages caused by
"occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by
accidents under COVERAGE C(SECTION 1), which can be attributed only to ongoing operations
at a single construction project away from premises owned by or rented to the insured:
a. A Single Construction Project General Aggregate Limit applies to each construction project
away from premises owned by or rented to the insured, and that limit is equal to the amount
of the General Aggregate Limit shown in the Declarations.
b. The Single Construction Project General Aggregate Limit is the most we will pay for the sum
of all damages under COVERAGE A,except damages because of"bodily injury" or"property
damage" included in the "products-completed operations hazard", and for medical expenses
under COVERAGE C regardless of the number of:
(1) Insureds;
(2) Claims made or"suits" brought; or
(3) Persons or organizations making claims or bringing "suits".
c. Any payments made under COVERAGE A for damages or under COVERAGE C for medical
expenses shall reduce the Single Construction Project General Aggregate Limit for that
construction project away from premises owned by or rented to the insured. Such payments
shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce
any other Single Construction Project General Aggregate Limit for any other separate
construction project away from premises owned by or rented to the insured.
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d. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical
Expense continue to apply. However, instead of being subject to the General Aggregate
Limit shown in the Declarations, such limits will be subject to the applicable Single
Construction Project General Aggregate Limit.
2. For all sums which the insured becomes legally obligated to pay as damages caused by
"occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by
accidents under COVERAGE C (SECTION 1), which cannot be attributed only to ongoing
operations at a single designated construction project away from premises owned by or rented to
the insured:
a. Any payments made under COVERAGE A for damages or under COVERAGE C for medical
expenses shall reduce the amount available under the General Aggregate Limit or the
Products-Completed Operations Aggregate Limit,whichever is applicable; and
b. Such payments shall not reduce any Single Construction Project General Aggregate Limit.
3. When coverage for liability arising out of the"products-completed operations hazard" is provided,
any payments for damages because of "bodily injury" or "property damage" included in the
"products-completed operations hazard" will reduce the Products-Completed Operations
Aggregate Limit, and not reduce the General Aggregate Limit or the Single Construction Project
General Aggregate Limit.
4. If the applicable construction project away from premises owned by or rented to the insured has
been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting
parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be
deemed to be the same construction project.
5. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this
endorsement shall continue to apply as stipulated.
C. LIMITED JOB SITE POLLUTION
1. Exclusion C under Section I—Coverage A is replaced by the following:
2. Exclusions
This insurance does not apply to:
f. Pollution
(1) 'Bodily injury' or "property damage" arising out of the actual, alleged or threatened
discharge, dispersal, seepage, migration, release or escape of"pollutants":
(a) At or from any premises, site or location on which any insured or any contractors
or subcontractors working directly or indirectly on any insured's behalf are
performing operations if the operations are to test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or in any way respond to, or assess the
effects of, "pollutants'; or
(b) At or from a storage tank or other container, ducts or piping which is below or
partially below the surface of the ground or water or which, at any time, has been
buried under the surface of the ground or water and then subsequently exposed
by erosion, excavation or any other means if the actual, alleged or threatened
discharge, dispersal, seepage, migration, release or escape of"pollutants"arises
at or from any premises, site or location which any insured or any contractors or
subcontractors working directly or indirectly on any insured's behalf are
performing operations if the"pollutants"are brought on or to the premises, site or
location in connection with such operations by such insured, contractor or
subcontractor.
Subparagraph (b) does not apply to "bodily injury" or "property damage" arising
out of heat, smoke or fumes from a"hostile fire".
(2) Any loss, cost or expense arising out of any:
(a) Request, demand, order or statutory or regulatory requirement issued or made
pursuant to any environmental protection or environmental liability statutes or
regulations that any insured test for, monitor, clean up, remove, contain, treat,
detoxify or neutralize, or in any way respond to, or assess the effects of,
"pollutants"; or
CL CG 00 20 01 12 Includes copyrighted material of Insurance Services Page 2 of 4
Office,Inc with its permission
(b) Claim or suit by or on behalf of a governmental authority for damages because of
testing for, monitoring, cleaning up, removing, containing, treating, detoxifying, or
neutralizing or in any way responding to or assessing the effects of, "pollutants".
However, this paragraph does not apply to liability for those sums the insured
becomes legally obligated to pay as damages because of"property damage"that the
insured would have in the absence of such request, demand, order or statutory or
regulatory requirement, or such claim or "suit" by or on behalf of a governmental
authority.
2. With respect to "bodily injury" or "property damage" arising out of the actual, alleged or
threatened discharge, dispersal, seepage, migration, release or escape of"pollutants":
a. The"Each Occurrence Limit"shown in the Declarations does not apply.
b. Paragraph 7.of Limits Of Insurance (Section III) does not apply.
c. Paragraph 1.of Section III—Limits Of Insurance is replaced by the following:
The Limits Of Insurance shown in this endorsement, or in the Declarations and the rules
below fix the most we will pay regardless of the number of:
(1) Insureds;
(2) Claims made or"suits"brought; or
(3) Persons or organizations making claims or bringing"suits".
d. The following are added to Section III—Limits Of Insurance:
8. Subject to 2. or 3. above, whichever applies,the most we will pay for the sum of:
a. Damages under Coverage A; and
b. Medical expenses under Coverage C
because of 'bodily injury" or "property damage" arising out of the actual, alleged or
threatened discharge, dispersal, seepage, migration, release or escape of"pollutants" is
$100,000 aggregate.
9. Subject to 8. above, the Medical Expense Limit is the most we will pay under Coverage C
for all medical expenses because of 'bodily injury" sustained by any one person arising
out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release
or escape of"pollutants".
D. VOLUNTARY PROPERTY DAMAGE
1. The following is added to Section 1 —COVERAGES:
We will pay, at your request for"property damage"to that part of any property:
a. Which you or any subcontractors working directly or indirectly on your behalf are performing
operations; or
b. That must be restored, repaired or replaced because "your work" was incorrectly performed
on it.
This insurance applies only to "property damage" to property of others while in your care,
custody, or control, and arising out of operations away from your insured premises and
incidental to your business.
Exclusions j.(3),(4),(5)and (6) do not apply to this coverage.
This insurance does not apply to "property damage" included within the "explosion hazard",
the"collapse hazard" or the"underground property damage hazard".
2. For the purposes of the coverage provided by D. VOLUNTARY PROPERTY DAMAGE,
SECTION III—LIMITS OF INSURANCE is replaced by the following:
A. Limits of Insurance
1. Unless a higher limit is shown in the Declarations, the most we will pay in any one
"occurrence"for"property damage" under this endorsement is$15,000.
2. Unless a higher limit is shown in the Declarations, the most we will pay for all covered
"occurrences"during any one policy period is$15,000 Aggregate Limit of Insurance.
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Office, Inc with its permission
The Limits of Insurance of this endorsement apply separately to each consecutive annual
period and to any remaining period of less than 12 months, starting with the beginning of the
policy period shown in the Declarations, unless the policy period is extended after issuance
for an additional period of less than 12 months. In that case, the additional period will be
deemed part of the last preceding period for purposes of determining the Limits of Insurance.
3. Deductible
a. Our obligation to pay damages on behalf of the insured applies only to the amount of
damages in excess of $250 as the result of any one "occurrence", regardless of the
number of persons or organizations who sustain damages because of that"occurrence".
b. The terms of this insurance, including those with respect to our right and duty to defend
the insured against any"suits" seeking those damages; and your duties in the event of an
"occurrence', claim, or "suit" apply irrespective of the application of the deductible
amount.
c. We may pay any part or all of the deductible amount to effect settlement of any claim or
suit and, upon notification of the action taken; you shall promptly reimburse us for such
part of the deductible amount as we have paid.
4. For the purposes of the coverage provided by D. VOLUNTARY PROPERTY DAMAGE,
SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows:
a. The following is added to paragraph 2. Duties In The Event Of Occurrence, Offense,
Claim or Suit:
In the event of loss covered by this endorsement, the insured shall, if requested by us,
replace the property or furnish the labor and materials necessary for repairs at actual cost
to the insured, excluding prospective profit or overhead charges of any nature. Any
property so paid for or replaced shall, at our option, become our property. Any payment
made by us shall not constitute an admission of liability by an insured, or by us_
b. Paragraph 4.Other Insurance is amended as follows:
(1) Paragraph 4.a. Primary Insurance is deleted.
(2) Subparagraphs (1) and (2) of paragraph 4.b. Excess Insurance are deleted and
replaced with the following:
This insurance is excess over any of the other insurance, whether primary, excess,
contingent or on any other basis_
All other provisions that apply to paragraph 4. Other Insurance contained in the Commercial
General Liability Coverage Form are applicable.
5. For the purposes of the coverage provided by D. VOLUNTARY PROPERTY DAMAGE, the
following definitions are added to SECTION V—DEFINITIONS:
a. "Collapse hazard" includes "structural property damage" and any resulting "property
damage"to any other property at any time.
b. "Explosion hazard" includes "property damage" arising out of blasting or explosion. The
"explosion hazard" does not include "property damage' arising out of the explosion of air
or steam vessels, piping under pressure, prime movers, machinery or power transmitting
equipment.
c. "Structural property damage' means the collapse of or structural injury to any building or
structure due to:
(1) Grading of land, excavating, borrowing, filling, back-filling, tunneling, pile driving,
cofferdam work or caisson work; or
(2) Moving, shoring, underpinning, raising or demolition of any building or structure or
removal or rebuilding of any structural support of that building or structure.
d. "Underground property damage hazard" includes "underground property damage" and
any resulting"property damage"to any other property at any time.
e. "Underground property damage' means "property damage' to wires, conduits, pipes,
mains, sewers, tanks, tunnels, any similar property, and any apparatus used with them
beneath the surface of the ground or water, caused by and occurring during the use of
mechanical equipment for the purpose of grading land, paving, excavating, drilling,
borrowing,filling, back-filling or pile driving.
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Page 1 of 4
State of Washington
Department of Labor & Industries
Prevailing Wage Section - Telephone 360-902-5335
PO Box 44540, Olympia, WA 98504-4540
Statement of Intent to Pay Prevailing Wage
Project
Project Detail - Dashboard
Document Intent Affidavit ID: Status: Approved
Received Date: ID: On 2/11 /2017
2/2/2017 814151
Company Details
Company Name: SEA-TAC SWEEPING SERVICE
Address: 26305 79TH AVE S
KENT, WA, 98032
Contractor Registration No. SEATASS919KN
WA UBI Number 601735583
Phone Number 253-854-9717
Industrial Insurance Account 91933600
ID
Email Address seatacsweepingCseatacsweeping.com
Filed By Vinson, Alfred
Prime Contractor
Company Name SEA-TAC SWEEPING SERVICE
Contractor Registration No. SEATASS919KN
https:Hfortress.wa.gov/lni/wagelookup/IntentDetails.aspx 2/13/2017
Page 2 of 4
WA UBI Number 601735583
Phone Number 253-854-9717
Project Information
Awarding Agency KENT, CITY OF
220 - 4TH AVE S KENT, WA -
98032-5895
Awarding Agency Contact Nancy Clary
Awarding Agency Contact Phone 253-586-5080
Number
Contract Number
Project Name Parking Lot Sweeping Various
City Facilities
Contract Amount $15579.62
Bid due date 2/1 /2017
Award Date 2/1 /2017
Project Site Address or Directions Various City Facilities
Payment Details
Check Number:
Transaction Id: 105600737
Intent Details
Expected project start date: 2/1 /2017
(MM-DD-YYYY)
In what county (or counties) King
will the work be performed?
In what city (or nearest city) Kent
will the work be performed?
What is the estimated $151579.62
contract amount? OR is this
https://fortress.wa.gov/lni/wagelookup/IntentDetails.aspx 2/13/2017
Page 3 of 4
a time and materials
estimate?
Will this project utilize No
American Recovery and
Reinvestment Act (ARRA)
funds?
Specifically, will this project No
utilize any weatherization or
energy efficiency upgrade
funds (ARRA or otherwise)?
Does your company intend No
to hire ANY subcontractors?
Does your company intend No
to hire subcontractors to
perform ALL work?
Will your company have Yes
employees perform work on
this project?
Do you intend to use any No
apprentices? (Apprentices
are considered employees. )
How many owner/operators 0
performing work on the
project own 30% or more of
the company?
,Journey Level Wages
County Trade Occupation Wage Fringe #
Workers
King Street And Parking Lot Journey Level $19.09 2
Sweeper Workers
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Page 4 of 4
Public Notes
o Show/Hide Existing Notes
No note exists
https://fortress.wa.gov/lni/wagelookup/IntentDetails.aspx 2/13/2017
City of Kent
40 Business License
KENT
WABNINGTON
SEA-TAC SWEEPING SERVICE
AL VINSON
26305 79TH AVE S
KENT,WA 98032
_---------------------------------------------------
BUSINESS LICENSE an RCW 82.14 al sales
and use tag must t b b e coded
LICENSE MUST BE PAID ANNUALLY BY No.1715 for all qualified
JANUARY 1sl TO AVOID PENALTY sales within the city of
KENTIssuance of Liccosc Does Not Imply Licensee's Kent.
W A S R I N G T O N Compliance with State and Local Laws
THIS LICENSE MUST BE POSTED IN A CONSPICUOUS Year : 2017
PLACE.NOT TRANSFERABLE OR ASSIGNABLE
NAME AND ADDRESS OF BUSINESS
BLC-9613751
SEA-TAC SWEEPING SERVICE MAYOR
26305 79 AVE S The City of Kent
KENT,WA.98032 Al 230 AT11 AVE:SO
KENT,WASHINGTON 93032