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HomeMy WebLinkAboutPW17-117 - Original - Otak, Inc. - Briscoe Desimone Levee Reach 1, 2, & 3 - 02/24/2017 /,//t �//r�/yiir ri n/��/� /r�r�iY��liru��✓�r �i�r`�,/�>%11 ffl f i r1111/r/i l ���(�� • r M / A77i ,. ° K1�N TDocument ,/ r ri,, WASMVMO'TOW r "/ t 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: Otak, Inc. Vendor Number: ]D Edwards Number Contract Number: n _ 1 1 This is assigned by City Clerk's Office Project Name: Briscoe-Desimone Levee Reach 1 2 and 3 Description: ❑ Interlocal Agreement El Change Carder ❑ Amendment Z Contrast ❑ Other: Contract Effective Date: 2/24/17 Termination Date: 12/31/17 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: lien Lan hol . Department: Engineering Contract Amount: 15 500.00 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Provide landscape architectural services for the project. _._._____.______ AS of: 08/27/14 • KENT CONSULTANT SERVICES AGREEMENT between the City of Kent and Otak, Inc. THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Otak, Inc. organized under the laws of the State of Washington, located and doing business at 11241 Willows Rd. NE, Suite 200, Redmond, WA 98052, Phone: (425) 822-4446, Contact: Chad Weiser (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: The Consultant shall provide landscape architectural services for the Briscoe-Desimone Levee Reach 1, 2 and 3 Project. For a description, see the Consultant's Scope of Work which is attached as Exhibit A and incorporated by this reference. Consultant further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices within the Puget Sound region in effect at the time those services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon the effective date of this Agreement. Consultant shall complete the work described in Section I by December 31, 2017. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Fifteen Thousand Five Hundred Dollars ($15,500.00), for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit A. B. The Consultant shall submit monthly payment invoices to the City for work performed, and a final bill upon completion of all services described in this Agreement. The City shall provide payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any portion of an invoice, it shall notify the Consultant and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor- Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: CONSULTANT SERVICES AGREEMENT - 1 ($20,000 or Less) A. The Consultant has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Consultant maintains and pays for its own place of business from which Consultant's services under this Agreement will be performed. C. The Consultant has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Consultant's services, or the Consultant is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Consultant is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. E. The Consultant has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Consultant's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Consultant maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project, which may be used by the City without restriction. If the City's use of Consultant's records or data is not related to this project, it shall be without liability or legal exposure to the Consultant. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Consultant shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Consultant's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Consultant's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL. CONSULTANT SERVICES AGREEMENT - 2 ($20,000 or Less) 'INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Consultant refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant's part, then Consultant shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Consultant's part. The provisions of this section shall survive the expiration or termination of this Agreement. VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work under this Agreement. X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents, and files available to the City upon the City's request. The Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. The City's use or reuse of any of the documents, data, and files created by Consultant for this project by anyone other than Consultant on any other project shall be without liability or legal exposure to Consultant. XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor with the authority to control and direct the performance and details of the work authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIII. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in CONSULTANT SERVICES AGREEMENT - 3 ($20,000 or Less) 'writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section VII of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Consultant. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. I. Public Records Act. The Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes, emails, and other records prepared or gathered by the Consultant in its performance of this Agreement may be subject to public review and disclosure, even if those records are not produced to or possessed by the City of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. J. City Business License Required. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. CONSULTANT SERVICES AGREEMENT - 4 ($20,000 or Less) K. Counterparts and Signatures by Fax or Email. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that signature shall have the same force and effect as if the Agreement bearing th,e original signature was received in person. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below., All acts consistent with the authority of this Agreement and prior to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. CONSULTANT: KE CITY 0 NT: 7 - By: By: .......... i ture 'tu 1(se J� ) v Print Name: Print Name: Timot y J. LaPorte, P.E. Its: Its: Public Works Director (title) DATE: DATE: 17 NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT. Chad Weiser Timothy 3, LaPorte, P.E. Otak, Inc. City of Kent 11241 Willows Rd. NE, Suite 200 220 Fourth Avenue South Redmond, WA 98052 Kent, WA 98032 (425) 822-4446 (telephone) (253) 856-5500 (telephone) (425) 827-257.7 (facsirri_le) .... (253) 8.56-6500 (facsimile) Otak-Bhscoe Levee 4/Langholz CONSULTANT SERVICES AGREEMENT - 5 ($20,000 or Less) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equaQ 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. 1 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: Fo r: Title: Date: EEO COMPLIANCE DOCUMENTS - I CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (date) between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. By: For: Title: Date: EEO COMPLIANCE DOCUMENTS - 3 Exhibit "A" Scope of Work January 26, 2017 Briscoe/Desimone Levee Reach 1, 2 & 3 Replanting and Irrigation Purpose The City of Kent is following up on permit requirements for Reach 1, 2 and 3 of the Briscoe/Desimone Levee project. The City of Kent has made a request for Otak to provide landscape architectural services for the projects to address landscape restoration/mitigation requirements.The primary consideration is the replacement and establishment of plants on Reaches 1, 2 and 3. Specifically,Reach 1 requires irrigation plan review and Reaches 2 and 3 require replanting plans and temporary irrigation plans to bring the restoration/mitigation plantings into compliance with monitoring requirements. Scope of Work Task 1.0 Reach 1 Contract Support Otak will review the Reach 1 irrigation plan which was submitted by the contractor.The irrigation plan was designed by the contractor. Otak will make a recommendation to the City of Kent for the acceptance,acceptance with changes or denial of the irrigation plan.Any suggested changes will be presented on a PDF of the submitted irrigation plan. It is assumed this task will include a site visit and up to one (1) meeting with City staff. Deliverable Set of Revieuzerl Read) I Lri,gation Plan in PDF format Task 1.0— Hourly Labor Allowance (NTE) $2,500 Task 2.0 Reach 2 and 3 Planting and Irrigation Plan Otak will review the Reach 2 and 3 sites during a site visit.The final construction documents will include replanting plans,replanting detail drawings, temporary irrigation plan, temporary irrigation details and Supplemental Specifications.A 75%draft set of construction drawings will be provided to the City for review and comment. Otak will then address City of Kent comments on the 75%package and prepare final construction documents for small works roster bidding. Otak will also prepare a construction cost estimate for landscape restoration replanting and temporary irrigation plan elements. It is assumed this task will include two (2) site visits and up to two (2) meetings with City staff. Delrvembles. 75%Set of Construction Dra;vings 100%.Set of Construction Documents 100%Construction Cost Estimate Cit,v of Kent — Briscoe/Desimone Levee Improve ►nents I ota k C:\Users\KLangholMppData\Loca)kMicrosoft\Windows\Temporary Internet FileslContent.OutlookOFLHTSQ8132474F BDLreach 1+2+3ScopeOlwork20170I26.docx 1 Scope of Work Continued Task 2.0— Hourly Labor Allowance (NTE) $1.3,000 Compensation As compensation for the performance of the services described above, Otak will be reimbursed by City of Kent on a time and materials basis. In house reimbursable expenses for all tasks will be invoiced on a cost plus ten percent(10a/o) basis.Any out-of--house direct costs will be invoiced at cost plus ten percent(10%). An hourly rate schedule for each anticipated labor category has been attached as reference. Invoices will be sent monthly in a format acceptable to the Client. Otak agrees to inform the Client if the Scope of Work extends beyond that which is currently contracted prior to performing the work. Otak will require written approval before completing work in addition to the estimated time and materials allowance presented in this proposal. Schedule We will work with the City of Kent to establish submittal dates on for the project. It is expected that consulting services will be completed by October 1, 2017 for a fall 2017 planting. Assumptions This proposal and Otak's agreement to perform said services is based upon the following assumptions; 1. The Client shall furnish basic information,prepared or obtained by others,which is pertinent to the services contained in this proposal including available survey/topographic maps and site plans depicting locations of Green River ordinary high water mark, Green River trail, completed levee wall, and all other site features.This data will be provided in an AutoCad format version 2010 or more current. 2. The Client shall be primary liaison with all other stakeholders and regulatory agencies with Otak providing support to the City of Kent. 3. No public meeting support or attendance is part of this scope of work. 4. The Client will coordinate and obtain all necessary permits from any agencies with jurisdiction. 5. The Client shall provide access and make all provisions necessary to enter public and private property as required to perform services covered by this proposal. 6. One construction document package (replanting plan/replanting details/temporary irrigation plan/temporary irrigation details/supplemental specifications)will be produced and packaged for Reach 2 and Reach 3. 7. Only one review of construction documents in Tasks 2.0 is assumed with this scope of City of Kent — Briscoe / Desimone Levee Improvements 2 otak C:\Users\KLanghol7\AppData\Local\Microsoft\Windowsvremporary Internet Files\Content.0utlook\DFLHTSQ8\32474F BDLrcachl42 3Scopcofwork20170126.docx i 'e I Y Scope of Work Continued work; the City of Kent will provide consolidated comments on the 75%Set of Construction Drawings submittal. 8. If services extend beyond October 1,2017, hourly rates may be adjusted at that time. i City of Kent—Briscoe/Desimone Levee Improvements 3 otak C:\Users\Y,Imgholz\AppDataUxcal\MicrosofllWindows\Temporary Internet Files\Content.Outlook\DFLHTSQ8132474F BDLreach 1+2+3ScopeOfWork20170126.doex Otak,Inc. Bill Rate Schedule PIC/Sr.PM Architecture $225 Sr.PM-Architecture $165 Project Manager/Design $120 Architect IV $125 Architect III $114 Architect II $100 Architect I $94 Architectural Tech V $105 Architectural Tech IV $93 Architectural Tech III $82 Architectural Tech II $72 Architectural Tech I $65 3D/Visualization Spec II $101 Sr.PIC/Sr.PM Civil $230 PIC/Sr.PM Civil $195 Civil E ngineer X $169 Civil Engineer IX $159 Civil Engineer VI II $145 Civil Engineer VI I $135 Civil Engineer VI $126 Civil Engineer V $119 Civil Engineer IV $108 Civil Engineer III $102 Civil Engineer II $90 Civil E ngineer I $83 Engineering Designer V $111 Engineering Designer IV $95 E ngineering Designer III $83 Engineering Designer II $78 Engineering Designer I $69 E ngineering Tech VI $107 E ngineering Tech V $94 E ngineering Tech IV $82 Engineering Tech III $72 E ngineering Tech II $64 E ngineering Tech I $56 Sr.PIC/Sr.PM LA/Mst Pln $225 PIC/Sr.PM LA/Master Plan $180 Landscape Architect V $115 Landscape A rchitect IV $105 Landscape Architect III $100 L andscape A rchhtect I I $90 Landscape Architect I $80 Landscape Technician III $89 Landscape Technician II $69 Landscape Technician I $62 Urban Designer V $159 Urban Designer IV $140 C:\Users\tome\Documents\Copy of Standard Rates by Category.xls 12/28/2016 Otak,Inc.Bill Rate Schedule Urban Designer III $118 Urban Designer II $111 PIC/Sr.PM Planner $225 Sr. PM,Planner II $174 Sr Proj.Mgr,-Planner I $149 Planner III $128 Planner II $100 Planner 1 $79 Planner Associate IV $94 Planner Associate III $82 Planner Associate II $75 Planner Associate I $61 Sr.GIS Specialist Plannr $89 GIS Specialist-Planner $76 Planning/GIS Intern $54 PIC/Scientist $180 Scientist V $135 Scientist IV $123 Scientist III $112 Scientist II $75 Scientist I $62 Environmental Specialist $115 PIC/PLS-Sr.Manager $195 PLS Sr.Manager $150 PLS-Project Manager $120 Sr PLS $115 Professional Land Surveyor $106 Survey Technician $86 Sry Tch II,Sr.Fld Pr Ch $85 Sr, Field Survey Tech II $75 Sr.Field Survey Tech 1 $60 Field Survey Tech $55 Contract Admin $100 Project Admin.Asst $68 Graphics Specialist $90 Bill Rates are based on current 2016 rates. Rates will be adjusted yearly at approximately 4%. All other direct costs and subconsultants will be charged at cost plus ten percent(10%). C:\Users\tome\Documents\Copy of Standard Rates by category.xls 12/28/2016 EXHIBIT B INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS Insurance The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 or its equivalent, with minimum limits of $2,000,000 per occurrence and $2,000,000 in the aggregate for each 1 year policy period. Stop Gap and Employer's Liability coverage shall be included. Products and Completed Operations coverage shall be provided for a period of 3 years following Substantial Completion of the work. The Commercial General Liability insurance shall be endorsed to provide the Aggregate per Project Endorsement ISO form CG 25 03 11 85. The City, King County and the King County Flood Control Zone District shall be named as Additional Insureds under the Contactor's Commercial General Liability insurance policy with respect to the work performed for the City, the District and the County. All endorsements adding Additional Insureds shall be issued on form CG 20 10 1185 or a form deemed equivalent, providing the Additional Insureds with all policies and endorsements set forth in this section. 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. 4. Professional Liability (Errors & Omissions) insurance appropriate to the Consultant's profession. EXHIBIT B (Continued) B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: 1. Commercial General Liability insurance shall be written with minimum limits of $2,000,000 per occurrence and $2,000,000 in the aggregate for each 1 year policy period. Products and Completed Operations coverage shall be provided for a period of 3 years following Substantial Completion of the work. 2. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of at least $1,000,000 per accident. 3. Professional Liability insurance shall be written with limits no less than $2,000,000 per claim and $2,000,000 policy aggregate limit. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability: 1. The Consultant's insurance coverage shall be primary insurance as respect the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Consultant's insurance and shall not contribute with it. 2. The Consultant's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent, King County Flood Control Zone District and King County shall be named as an additional insureds on all policies (except Professional Liability) as respects work performed by or on behalf of the Consultant and a copy of the endorsement naming the City, the Flood Control Zone District and King County as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Consultant's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. EXHIBIT B (Continued) D. Consultant's Insurance for Other Losses The Consultant shall assume full responsibility for all loss or damage from any cause whatsoever to any tools, Consultant's employee owned tools, machinery, equipment, or motor vehicles owned or rented by the Consultant, or the Consultant's agents, suppliers or contractors as well as to any temporary structures, scaffolding and protective fences. E. Waiver of Subrogation The Consultant and the City waive all rights against each other any of their Subcontractors, Sub-subcontractors, agents and employees, each of the other, for damages caused by fire or other perils to the extend covered by Builders Risk insurance or other property insurance obtained pursuant to the Insurance Requirements Section of this Contract or other property insurance applicable to the work. The policies shall provide such waivers by endorsement or otherwise. F. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. G. Verification of Coverage Consultant shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the Automobile Liability and Commercial General Liability insurance of the Consultant before commencement of the work. H. Subcontractors Consultant shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Consultant. A`C40RV CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDIYYYY) 2/21/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Peggy MacMillan -NAMEJD Fulwiler & Co. Insurance, Inc. PHONE (503)293-8325C Ne:(503)293-5418 5727 SW Macadam Ave -MAIL ADDRESS: p j macmillan@ dfulwiler.com PO Box 69508 INSURERS AFFORDING COVERAGE NAIC9 Portland OR 97239 INSURER A'Travelers Indemnity Cc of CT 25682 INSURED INSURER B Mravelers Indemnity Co of Am 25666 Otak Inc. INSURERC:Saif Corporation 36196 808 SW 3rd Ave Ste 300 INSURER D:Beazley Insurance Company Inc INSURERE:AGCS Marine Insurance Portland OR 97204 INSURER F: COVERAGES CERTIFICATE NUMBER:16/18 GEN USE REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADD SUBR POLICY NUMBER MMID LTR DYIYYYY) (MWDDIYYyYl LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A CLAIMS-MADE ❑X OCCUR PREMISES Ea occurrence $ 300,000 X WA Stop Gap Liability 6805H242469 12/9/2016 1/1/2018 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY[K JECT a LOC PRODUCTS-COMPIOPAGG S 2,000,000 OTHER: I Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea ccident S 11000,000 a A X ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED DA1502PO92 12/9/2016 1/1/2018 BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident Towing S X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 10,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED X RETENTIONS 10,000 CUP5C8570811247 12/9/2016 1/1/2018 $ WORKERS COMPENSATION OREGON X AND EMPLOYERS'LIABILITY STATUTE ERH ANY PROPRIETORIPARTNERIEXECUTIVE Y❑ NIA 967262 OTAK Architects Inc E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? C (Mandatory In NH) 487431 OTAK INC 4/1/2016 4/1/2017 E.L.DISEASE-EA EMPLOYE $ 11000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 14001000 D A&E Prof' 1 W/Pollution V10267160801 12/9/2016 1/1/2018 Limits per Claim/Agg/Ded $2m/$4m/$200K E Inland Marine NXI93070329 12/9/2016 1/1/2018 Mlsc Unscheduled ltems/Ded $3.00,000/$3.k DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) The City, King County and the King County Flood Control Zone District are included as additional insureds on the general and auto liability with regard to operations of the named insured subject to policy terms, conditions and exclusions per attached forms CGD381 & CAT4370808; It is further agreed that coveage is primary and non-contributory; Per project aggregate applies per attached form CGD379; Cancellation provisions apply per attached form ILT316; Waiver of subrogation applies per attached forms CGD381 (GL) , CAT3400808 (AL) & 430b(WC) CERTIFICATE HOLDER CANCELLATION (253)856-6500 NYoshitake@kentwa.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Public Works Department ACCORDANCE WITH THE POLICY PROVISIONS. 220 Fourth Avenue South KEnt, WA 98032 AUTHORIZED REPRESENTATIVE P MacMillan/TMAYDA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 onl4M1 Additional Named Insureds Other Named Insureds HLB Otak Inc., an Oregon Corporation OTAK Architects Inc, a Washington Corporation Otak Architects Inc., an Oregon Corporation Otak Engineering, Inc., an Oregon Corporation Otak International (Caymen Islands) Otak Nevada, LLC, an Oregon Limited Liability Co Otak, Inc. 401K Employee Savings Plan Otak, Inc., a Colorado Corporation Otak, Inc., an Washington Corporation OFAPPINF(02/2007) COPYRIGHT 2007,AMS SERVICES INC Policy 680 5H242469 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION It —WHO IS h. This insurance does not apply to "bodily AN INSURED: injury" or"property damage" caused by "your Any person or organization that you agree in a work" and included in the "products- "written contract requiring insurance"to include as completed operations hazard" unless the an additional insured on this Coverage Part,but: "written contract requiring insurance" a. Only with respect to liability for"bodily injury", specifically requires you to provide such coverage for that additional insured, and then "property damage"or"personal injury"; and the insurance provided to the additional b. If, and only to the extent that, the injury or insured applies only to such "bodily injury" or damage is caused by acts or omissions of "property damage"that occurs before the end you or your subcontractor in the performance of the period of time for which the "written of "your work" to which the "written contract contract requiring insurance" requires you to requiring insurance" applies, or in connection provide such coverage or the end of the with premises owned by or rented to you. policy period, whichever is earlier. The person or organization does not qualify as an 2. The following is added to Paragraph 4.a. of additional insured: SECTION IV — COMMERCIAL GENERAL c. With respect to the independent acts or LIABILITY CONDITIONS: omissions of such person or organization; or The insurance provided to the additional insured d. For "bodily injury", "property damage" or is excess over any valid and collectible other "personal injury" for which such person or insurance.whether primary, excess,contingent or organization has assumed liability in a on any other basis, that is available to the contract or agreement. additional insured for a loss we cover. However, if you specifically agree in the "written contract The insurance provided to such additional insured requiring insurance" that this insurance provided is limited as follows: to the additional insured under this Coverage Part e. This insurance does not apply on any basis to must apply on a primary basis or a primary and any person or organization for which non-contributory basis, this insurance is primary coverage as an additional insured specifically to other insurance available to the additional is added by another endorsement to this insured which covers that person or organizations Coverage Part. as a named insured for such loss, and we will not share with the other insurance, provided that: f. This insurance does not apply to the (1) The "bodily injury" or "property damage" for rendering of or failure to render any "professional services". which coverage is sought occurs:and g. In the event that the Limits of Insurance of the (2) The "personal injury" for which coverage is Coverage Part shown in the Declarations sought arises out of an offense committed; exceed the limits of liability required by the after you have signed that "written contract "written contract requiring insurance", the requiring insurance". But this insurance provided insurance provided to the additional insured to the additional insured still is excess over valid shall be limited to the limits of liability required and collectible other insurance, whether primary, by that "written contract requiring insurance". excess, contingent or on any other basis, that is This endorsement does not increase the available to the additional insured when that limits of insurance described in Section III — person or organization is an additional insured Limits Of Insurance. under any other insurance. CG D3 8109 15 ®2015 The Travelers Indemnity Company.Ali rights reserved. Page 1 of 2 Includes the copyrighted material of Insurance Services Office,Inc.,with its permission COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 8., Transfer 4. The following definition is added to the Of Rights Of Recovery Against Others To Us, DEFINITIONS Section: of SECTION IV — COMMERCIAL GENERAL "Written contract requiring insurance" means that LIABILITY CONDITIONS: part of any written contract under which you are We waive any right of recovery we may have required to include a person or organization as an against any person or organization because of additional insured on this Coverage Part, payments we make for "bodily injury", "property provided that the "bodily injury" and "property damage" or "personal injury" arising out of "your damage" occurs and the "personal injury" is work" performed by you, or on your behalf, done under a"written contract requiring insurance" with caused by an offense committed: that person or organization. We waive this right a. After you have signed that written contract; only where you have agreed to do so as part of b. While that part of the written contract is in the "written contract requiring insurance" with effect;and such person or organization signed by you before, and in effect when, the "bodily injury" or c. Before the end of the policy period. "property damage"occurs,or the"personal injury" offense is committed. Page 2 of 2 ®2015 The Travelers Indemnity Company.Ail rights reserved. CG D3 8109 15 Includes the copyrighted material of insurance Services Office,Inc.,with its permission COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ARCHITECTS, ENGINEERS AND SURVEYORS COVERAGE XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Broadened Named Insured K. Additional Insured —Lessor Of Leased Equipment B. Incidental Medical Malpractice L. Additional Insured — State Or Political C. Reasonable Force — Bodily Injury Or Property Subdivisions—Permits Relating To Premises Damage M. Additional Insured — State Or Political D. Non-Owned Watercraft— Increased To Up To 75 Subdivisions—Permits Relating To Operations feet N. Who Is An Insured — Newly Acquired Or Formed E. Aircraft Chartered With Crew Organizations F. Damage To Premises Rented To You O. Knowledge And Notice Of Occurrence Or Offense G. Malicious Prosecution — Exception To Knowing P. Unintentional Omission Violation Of Rights Of Another Exclusion Q. Waiver Of Transfer Of Rights Of Recovery H. Medical Payments— Increased Limit Against Others To Us When Required By Written I. Increased Supplementary Payments Contract J. Additional Insured — Owner, Manager Or Lessor R. Amended Insured Contract Definition — Railroad Of Premises Easement PROVISIONS Unless you are in the business or occupation A. BROADENED NAMED INSURED of providing professional health care services, "occurrence" also means an act or omission 1. The following is added to SECTION II —WHO committed in providing or failing to provide IS AN INSURED: first aid or "Good Samaritan services" to a Any organization, other than a partnership or person. joint venture, over which you maintain 2. The following is added to the DEFINITIONS ownership or majority interest on the effective Section: date of the policy qualifies as a Named Insured. However, coverage for any such "Good Samaritan services" means any additional organization will cease as of the emergency medical services for which no date during the policy period that you no compensation is demanded or received. longer maintain ownership of, or majority 3. The following is added to Paragraph 2.a.(1) of interest in, such organization. SECTION II—WHO IS AN INSURED: B. INCIDENTAL MEDICAL MALPRACTICE Unless you are in the business or occupation 1. The following is added to the definition of of providing professional health care services, "occurrence"in the DEFINITIONS Section: Paragraphs (1)(a), (b), (c) and (d) above CG D3 79 01 16 ©2016 The Travelers Indemnity Company.All rights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY does not apply to any "bodily injury" arising insured. This exclusion does not apply to out of any providing or failing to provide first "bodily injury" or "property damage" resulting aid or "Good Samaritan services" by any of from the use of reasonable force to protect your "employees", other than an employed any person or property. doctor. Any such "employees" providing or D. NON-OWNED WATERCRAFT — INCREASED failing to provide first aid or"Good Samaritan TO UP TO 75 FEET services" during their work hours for you will be deemed to be acting within the scope of 1. The following replaces Paragraph (2) of their employment by you or performing duties Exclusion g., Aircraft, Auto Or Watercraft, related to the conduct of your business. in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY 4. The following exclusion is added to INJURY AND PROPERTY DAMAGE Paragraph 2., Exclusions, of SECTION I — LIABILITY: COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE (2) A watercraft you do not own that is: LIABILITY in COVERAGES: (a) Less than 75 feet long; and Sale of Pharmaceuticals (b) Not being used to carry any person or "Bodily injury" or "property damage" arising property for a charge; out of the willful violation of a penal statute or 2. The following is added to Paragraph 2. of ordinance relating to the sale of SECTION II—WHO IS AN INSURED: pharmaceuticals committed by, or with the Any person or organization that, with your knowledge or consent of,the insured. express or implied consent, either uses or is 5. The following is added to Paragraph 5. of responsible for the use of a watercraft that SECTION III—LIMITS OF INSURANCE: you do not own that is: For the purposes of determining the (a) Less than 75 feet long; and applicable Each Occurrence Limit, all related (b) Not being used to carry any person or acts or omissions committed in the providing property for a charge; or failing to provide first aid or "Good Samaritan services"to any one person will be 3. The following is added to Paragraph 4.b., considered one"occurrence". Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY 6. The following is added to Paragraph 4.b., CONDITIONS: Excess Insurance, of SECTION IV — COMMERCIAL GENERAL LIABILITY This insurance is excess over any valid and CONDITIONS: collectible other insurance, whether primary, This insurance is excess over any valid and excess, contingent or on any other basis, that collectible other insurance, whether primary, is available to the insured for "bodily injury" excess, contingent or on any other basis, that that arises out of the use of a watercraft that is available to any of your "employees" for you do not own that is: "bodily injury" that arises out of providing or (a) Less than 75 feet long; and failing to provide first aid or"Good Samaritan (b) Not being used to cant' any person or services" to any person to the extent not property for a charge. subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. E. AIRCRAFT CHARTERED WITH CREW C. REASONABLE FORCE — BODILY INJURY OR 1. The following is added to Exclusion g., PROPERTY DAMAGE Aircraft, Auto Or Watercraft, in Paragraph The following replaces Exclusion a., Expected Or 2. of SECTION I — COVERAGES — Intended Injury, in Paragraph 2. of SECTION I — COVERAGE A BODILY INJURY AND COVERAGES — COVERAGE A BODILY PROPERTY DAMAGE LIABILITY in INJURY AND PROPERTY DAMAGE LIABILITY: COVERAGES: a. Expected Or Intended Injury Or Damage This exclusion does not apply to an aircraft that is: "Bodily injury" or"property damage" expected or intended from the standpoint of the (a) Chartered with crew to any insured; Page 2 of 6 0 2016 The Travelers Indemnity Company.All rights reserved. CG D3 79 0116 COMMERCIAL GENERAL LIABILITY (b) Not owned by any insured; and 2. The following replaces Paragraph 6. of (c) Not being used to carry any person or SECTION III—LIMITS OF INSURANCE: property for a charge. Subject to 5. above, the Damage To 2. The following is added to Paragraph 4.b., Premises Rented To You Limit is the most we Excess Insurance, of SECTION IV — will pay under Coverage A for damages COMMERCIAL GENERAL LIABILITY because of "property damage" to any one c premises while rented to you, or temporarily u CONDITIONS: occupied by you with permission of the This insurance is excess over any valid and owner, caused by fire; explosion; lightning; collectible other insurance, whether primary, smoke resulting from such fire, explosion, or excess, contingent or on any other basis, that lightning; or water. The Damage To Premises is available to the insured for use of an Rented To You Limit will apply to all damage aircraft that is: proximately caused by the same .° (a) Chartered with crew to any insured; "occurrence", whether such damage results from: fire; explosion; lightning; smoke (b) Not owned by any insured; and resulting from such fire, explosion, or (c) Not being used to carry any person or lightning; or water; or any combination of any property for a charge, of these. .� c F. DAMAGE TO PREMISES RENTED TO YOU The Damage To Premises Rented To You 1. The following replaces the last paragraph of Limit will be the higher of: Paragraph 2., Exclusions, of SECTION I — a. $1,000,000; or COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE b. The amount shown on the Declarations of LIABILITY in COVERAGES: this Coverage Part for Damage To Exclusions c. through n. do not apply to Premises Rented To You Limit. damage to premises while rented to you, or 3. The following replaces Paragraph a. of the temporarily occupied by you with permission definition of "insured contract" in the of the owner, caused by: DEFINITIONS Section: a. Fire; a. A contract for a lease of premises. b. Explosion; However,that portion of the contract for a c. Lightning; lease of premises that indemnifies any person or organization for damage to d. Smoke resulting from such fire, explosion, premises while rented to you, or 0 or lightning; or temporarily occupied by you with e. Water. permission of the owner,caused by: A separate limit of insurance applies to such (1) Fire; Q damage to premises as described in (2) Explosion; Paragraph 6. of Section III — Limits Of Insurance. This insurance does not apply to (3) Lightning; damage to premises while rented to you, or (4) Smoke resulting from such fire, temporarily occupied by you with permission explosion, or lightning; or of the owner, caused by: (5) Water, a. Rupture, bursting, or operation of pressure relief devices; is not an"insured contract"; b. Rupture or bursting due to expansion or 4. The following replaces Paragraph 4.b.(1)(b) swelling of the contents of any building or of SECTION IV— COMMERCIAL GENERAL structure, caused by or resulting from LIABILITY CONDITIONS: water; or (b) That is insurance for premises rented to c. Explosion of steam boilers, steam pipes, you, or temporarily occupied by you with steam engines, or steam turbines. the permission of the owner; CG D3 79 0116 0 2016 The Travelers Indemnity company_All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY G. MALICIOUS PROSECUTION — EXCEPTION TO insured, but only with respect to liability for"bodily KNOWING VIOLATION OF RIGHTS OF injury", "property damage", "personal injury" or ANOTHER EXCLUSION "advertising injury"that: The following is added to Exclusion a., Knowing a. Is "bodily injury" or"property damage" caused Violation Of Rights Of Another, in Paragraph 2. by an "occurrence" that takes place, or of SECTION I — COVERAGES — COVERAGE B "personal injury" caused by an offense that is PERSONAL AND ADVERTISING INJURY committed, after you have signed that LIABILITY: contract; and This exclusion does not apply to "personal injury" b. Arises out of the ownership, maintenance or y caused by malicious prosecution. use of that part of any premises leased to you Q. H. MEDICAL PAYMENTS—INCREASED LIMIT under that written contract. ZZ The following replaces Paragraph 7. of SECTION The insurance provided to such premises owner, o III—LIMITS OF INSURANCE: manager or lessor is subject to the following C 7. Subject to 5. above, the Medical Expense provisions: Limit is the most we will pay under Coverage a. The limits of insurance provided to such C. for all medical expenses because of premises owner, manager or lessor will be "bodily injury" sustained by any one person, the limits which you agreed to provide in the will be the higher of: written contract, or the limits shown on the and 00; or Declarations of this Coverage Part,whichever {a) $10will y are less. .. (b) The amount shown on the Declarations of b. The insurance provided to such premises this Coverage Part for Medical Expense =; Limit. owner, manager or lessor does not apply to: I. INCREASED SUPPLEMENTARY PAYMENTS (1) "Bodily injury" or "property damage" 1 caused by an "occurrence" that takes 1. The following replaces Paragraph 1.b. of place, or "personal injury" caused by an SUPPLEMENTARY PAYMENTS — offense that is committed, after you cease COVERAGES A AND B of SECTION I — to be a tenant in that premises; or COVERAGES: 1 (2) Structural alterations, new construction or b. Up to $2,500 for cost of bail bonds demolition operations performed by or on .N required because of accidents or traffic behalf of such premises owner, manager law violations arising out of the use of any or lessor. vehicle to which the Bodily Injury Liability c. The insurance provided to such premises Coverage applies. We do not have to furnish these bonds. owner, manager or lessor is excess over any 2. The following replaces Paragraph 1.d. of valid and collectible other insurance available SUPPLEMENTARY PAYMENTS to such premises owner, manager or lessor, COVERAGES A AND B of SECTION I — unless you have agreed in a written contract COVERAGES: for this insurance to apply on a primary or d. All reasonable expenses incurred by the contributory basis. insured at our request to assist us in the K. ADDITIONAL INSURED—LESSOR OF LEASED investigation or defense of the claim or EQUIPMENT "suit", including actual loss of earnings up The following is added to SECTION II —WHO IS to $500 a day because of time off from AN INSURED: work. Any person or organization that is an equipment J. ADDITIONAL INSURED — OWNER, MANAGER lessor and that you have agreed in a written OR LESSOR OF PREMISES contract to name as an additional insured on this The following is added to SECTION II —WHO IS Coverage Part is an insured, but only with respect AN INSURED: to liability for "bodily injury", "property damage", Any person or organization that is a premises "personal injury" or"advertising injury"that: owner, manager or lessor and that you have a. Is"bodily injury" or"property damage" caused agreed in a written contract to name as an by an "occurrence" that takes place, or additional insured on this Coverage Part is an "personal injury" caused by an offense that is Page 4 of 6 0 2016 The Travelers indemnity Company.All rights reserved. CG D3 79 0116 COMMERCIAL GENERAL LIABILITY committed, after you have signed that written M. ADDITIONAL INSURED — STATE OR contract; and POLITICAL SUBDIVISIONS — PERMITS b. Is caused, in whole or in part, by acts or RELATING TO OPERATIONS omissions of you or any person or The following is added to Paragraph 2. of organization performing operations on your SECTION II—WHO IS AN INSURED: ter' behalf, in the maintenance, operation or use Any state or political subdivision that has issued a c of equipment leased to you by such permit with respect to operations performed by equipment lessor. you or on your behalf is an insured, but only with respect to "bodily injury", "property damage", The insurance provided to such equipment lessor '1personal injury" or"advertising injury" arising out y is subject to the following provisions: of operations performed by you or on your behalf C a. The limits of insurance provided to such for which that state or political subdivision has equipment lessor will be the limits which you issued such permit. However, no such state or agreed to provide in the written contract, or political subdivision is an insured for: c the limits shown on the Declarations of this (1) "Bodily injury", "property damage", "personal Coverage Part,whichever are less; and injury" or "advertising injury" arising out of b. The insurance provided to such equipment operations performed for that state or political lessor does not apply: subdivision; or 2 "Bodily injury" or "property dama e" included .,� (1) To any bodily injury or property ( ) y g U damage" caused by an "occurrence" that hwithin azardthe "products — completed operations takes place, or "personal injury" caused by an offense that is committed, after the N. WHO IS AN INSURED — NEWLY ACQUIRED equipment lease expires; or OR FORMED ORGANIZATIONS (2) If the equipment is leased with an The following replaces Paragraph 4.a. of a' operator. SECTION 11—WHO IS AN INSURED: y c. The insurance provided to such equipment a. Coverage under this provision is afforded lessor is excess over any valid and collectible only: other insurance available to such equipment (1) Until the 180th day after you acquire or lessor, unless you have agreed in a written form the organization or the end of the contract for this insurance to apply on a policy period, whichever is earlier, if you primary or contributory basis. do not report such organization in writing — to us within 180 days after you acquire or L. ADDITIONAL INSURED STATE OR form it; or POLITICAL SUBDIVISIONS — PERMITS RELATING TO PREMISES (2) Until the end of the policy period, when that date is later than 180 days after you Q The following is added to Paragraph 2. of acquire or form such organizations, if you SECTION II—WHO IS AN INSURED: report such organization in writing to us Any state or political subdivision that has issued a within 180 days after you acquire or form permit in connection with premises owned or it. occupied by, or rented or loaned to, you, is an O. KNOWLEDGE AND NOTICE OF insured, but only with respect to "bodily injury", OCCURRENCE OR OFFENSE "property damage", "personal injury" or The following is added to Paragraph 2., Duties In "advertising injury" arising out of the existence, The Event of Occurrence, Offense, Claim Or ownership, use, maintenance, repair, Suit, of SECTION IV — COMMERCIAL construction, erection or removal of advertising GENERAL LIABILITY CONDITIONS: signs, awnings, canopies, cellar entrances, coal e. The following provisions apply to Paragraph holes, driveways, manholes, marquees, hoist a. above, but only for the purposes of the away openings, sidewalk vaults, elevators, street insurance provided under this Coverage Part banners or decorations for which that state or to you or any insured listed in Paragraph 1. or political subdivision has issued such permit. 2. of Section II—Who Is An Insured: CG D3 79 01 16 0 2016 The Travelers Indemnity Company.All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY (1) Notice to us of such "occurrence" or of an health insurer. This applies only if you offense must be given as soon as subsequently give notice to us of the practicable only after the "occurrence" or "occurrence" or offense as soon as offense is known to you (if you are an practicable after any of the persons individual), any of your partners or described in Paragraphs e. (1) or (2) members who is an individual (if you are above discovers that the "occurrence" or a partnership orjoint venture), any of your offense may result in sums to which the managers who is an individual (if you are insurance provided under the Coverage a limited liability company), any of your Part may apply. C, trustees who is an individual (if you are a P. UNINTENTIONAL OMISSION trust), any of your "executive officers" or The following is added to Paragraph 6., directors (if you are an organization other Representations, of SECTION IV — than a partnership, joint venture, limited COMMERCIAL GENERAL LIABILITY ,o liability company or trust), or any CONDITIONS: "employee" (such as an insurance, loss The unintentional omission of, or unintentional control or risk manager or administrator) error in, any information provided by you which authorized by you to give notice of an we relied upon in issuing this policy will not "occurrence" or offense. prejudice your rights under this insurance. Knowledge by any other"employee" of an However, this provision does not affect our right `ti "occurrence" or offense does not imply to collect additional premium or to exercise our that you also have such knowledge. rights of cancellation or nonrenewal in (2) If you are a partnership, joint venture, accordance with applicable insurance laws or limited liability company or trust, and regulations. none of your partners, joint venture Q. WAIVER OF TRANSFER OF RIGHTS OF p� members, managers or trustees are RECOVERY AGAINST OTHERS TO US WHEN individuals, notice to us of such REQUIRED BY WRITTEN CONTRACT o "occurrence" or offense must be given as The following is added to Paragraph 8., Transfer soon as practicable only after the of Rights of Recovery Against Others to Us, of "occurrence"or offense is known by: SECTION IV — COMMERCIAL GENERAL (a) Any individual who is: LIABILITY CONDITIONS: (i) A partner or member of any We waive any right of recovery we may have partnership or joint venture; against any person or organization because of (ii) A manager of any limited liability payments we make for injury or damage arising company; out of premises owned or occupied by or rented (iii)A trustee of any trust; or or loaned to you; ongoing operations performed by you or on your behalf, done under a written q (iv)An executive officer or director of contract with that person or organization; "your any other organization; work"; or "your products". We waive this right that is your partner, joint venture where you have agreed to do so as part of a member, manager or trustee; or written contract signed by you prior to loss. (b) Any "employee" authorized by such R. AMENDED INSURED CONTRACT DEFINITION partnership, joint venture, limited —RAILROAD EASEMENT liability company, trust or other 1. The following replaces Paragraph c. of the organization to give notice of an definition of "insured contract" in the "occurrence"or offense. DEFINITIONS Section: (3) Notice to us of such "occurrence" or c. Any easement or license agreement; offense will be deemed to be given as soon as practicable if it is given in good 2. Paragraph f.(1) of the definition of "insured faith as soon as practicable to your contract" in the DEFINITIONS Section is workers' compensation, accident, or deleted. Page 6 of 6 0 2016 The Travelers Indemnity Company.All rights reserved. CG D3 79 0116 COMMON POLICY CONDITIONS WASHINGTON All Coverage Parts included in this policy are subject to the following conditions. The conditions in this endorsement replace any c. Because of its physical condition, the similar conditions in the policy that are less favorable structure is in danger of collapse; to the insured. d. Because of its physical condition, a vaca- A. CANCELLATION tion or demolition order has been issued 1. The first Named Insured shown in the Decla- for the structure, or it has been declared rations may cancel this policy by mailing or unsafe in accordance with applicable law; delivering to us advance written notice of e. Fixed and salvageable items have been cancellation. removed from the structure, indicating an 2. We may cancel this policy or any Coverage intent to vacate the structure; Part by mailing or delivering to the first f. Without reasonable explanation, heat, Named Insured and the first Named Insured's water, sewer, and electricity are not fur- agent or broker written notice of cancellation, nished for the structure for 60 consecu- including the actual reason for the cancella- tive days; or tion, to the last mailing address known to us, g. The structure is not maintained in sub- at least: stantial compliance with fire, safety and a. 10 days before the effective date of can- building codes. cellation if we cancel for nonpayment of 4. If: premium; or b. 45 days before the effective date of can- cellation if we cancel for any other rea- b. A covered "auto" you own is of the "pri- son, vate passenger type"; and except as provided in paragraphs 3, and 4. c. The policy does not cover garage, auto- Wow. mobile sales agency, repair shop, service 3. We may cancel the Commercial Property station or public parking place operation Coverage Part, if made a part of this policy, hazards, by mailing or delivering to the first Named In- we may cancel the Commercial Auto Cover- sured and the first Named Insured's agent or age Part by mailing or delivering to the first = broker written notice of cancellation at least 5 Named Insured and the first Named Insured's days before the effective date of cancellation agent or broker written notice of cancellation, W for any structure where 2 or more of the fol- including the actual reason for cancellation, lowing conditions exist: to the last mailing address known to us: a. Without reasonable explanation, the a. At least 10 days before the effective date structure is unoccupied for more than 60 of cancellation if we cancel for nonpay- consecutive days, or at least 65% of the ment of premium; or r rental units are unoccupied for more than b. At least 10 days before the effective date 120 consecutive days unless the struc- of cancellation for any other reason if the ture is maintained for seasonal occu- policy is in effect less than 30 days; or pancy or is under construction or repair; c. At least 20 days before the effective date b. Without reasonable explanation, progress of cancellation for other than nonpayment toward completion of permanent repairs if the policy is in effect 30 days or more; to the structure has not occurred within or . 60 days after receipt of funds following d. At least 20 days before the effective date satisfactory adjustment or adjudication of loss resulting from a fire; of cancellation if the policy is in effect for 60 days or more or is a renewal or con- tinuation policy, and the reason for can- IL T3 16 09 07(Rev.09-08) Includes the copyrighted material of Insurance Services Office,Inc.with its permission. Page 1 of 4 007093 cellation is that your driver's license or B. CHANGES that of any driver who customarily uses a This policy contains all the agreements between { covered "auto" has been suspended or you and us concerning the insurance afforded. revoked during the policy period. The first Named Insured shown in the Declara- 5. We will also mail or deliver to any mortgage tions is authorized to make changes in the terms holder, pledgee or other person shown in this of this policy with our consent. This policy's terms policy to have an interest in any loss which can be amended or waived only by endorsement may occur under this policy, at their last mail- issued by us and made a part of this policy. ing address known to us, written notice of C. EXAMINATION OF YOUR BOOKS AND cancellation prior to the effective date of can- cellation. If cancellation is for reasons other than those contained in paragraph A.3. We may examine and audit your books and re- above, this notice will be the same as that cords as they relate to this policy at any time dur- mailed or delivered to the first Named In- ing the policy period and up to three years after- ] sured. If cancellation is for a reason con- ward• tained in paragraph A.3. above, we will mail D. INSPECTION AND SURVEYS or deliver this notice at least 20 days prior to 1. We have the right to: the effective date of cancellation. 6. Notice of cancellation will state the effective a. Make inspections and surveys at any date of cancellation. If the policy is cancelled, time; that date will become the end of the policy b. Give you reports on the conditions we ' period. If a Coverage Part is cancelled, that find; and date will become the end of the policy period c. Recommend changes. as respects that Coverage Part only. 2. We are not obligated to make any inspec- 7. If this policy is cancelled, we will send the lions, surveys, reports or recommendations j first Named Insured any premium refund due. and any such actions we do undertake relate If we cancel, the refund will be pro rata. If the only to insurability and the premiums to be first Named Insured cancels, the refund will charged. We-do not make safety inspections. be at least 90% of the pro rata refund unless We do not undertake to perform the duty of the following applies: any person or organization to provide for the a. If: health or safety of workers or the public.And (1) You are an individual; we do not warrant that conditions: (2) A covered auto you own is of the"pri- a. Are safe or healthful; or vate passenger type"; b. Comply with laws, regulations, codes or i (3) The policy does not cover garage, standards. automobile sales agency, repair 3. Paragraphs 1. and 2. of this condition apply shop, service station or public park- not only to us, but also to any rating, advi- ing place operations hazards; and sory, rate service or similar organization (4) The first Named Insured cancels, which makes insurance inspections, surveys, reports or recommendations. the refund will be not less than 90% 4. Paragraph 2. of this condition does not apply of the unearned portion not exceed- to any inspections, surveys, reports or rec- ing $100, plus 95% of any unearned ommendations we may make relative to certi- portion over $100 but not exceeding fication, under state or municipal statutes, or- $500 and not less than 97% of any dinances or regulations, of boilers, pressure unearned portion in excess of$500. vessels or elevators. The cancellation will be effective even if E. PREMIUMS we have not made or offered a refund. 8. If notice is mailed, proof of mailing will be 1. The first Named Insured shown in the Decla- sufficient proof of notice. rations: a. Is responsible for the payment of all pre- f miums; and Page 2 of 4 Includes the copyrighted material of Insurance Services Office,Inc.with its permission. IL T3 16 09 07(Rev.09-08) b. Will be the payee for any return premi- b. Other coverage acceptable to the insured ums we pay. has been procured prior to the expiration 2. We compute all premiums for this policy in date of the policy; or accordance with our rules, rates, rating plans, c. The policy clearly states that it is not re- premiums and minimum premiums. The newable, and is for a specific line, sub- premium shown in the Declarations was com- classification, or type of coverage that is puted based on rates and rules in effect at not offered on a renewable basis. the time the policy was issued. On each re- 3. If: newal, continuation or anniversary of the ef- fective date of this policy, we will compute the premium in accordance with our rates b. A covered "auto" you own is of the "pri- and rules then in effect. vate passenger type"; and F. TRANSFER OF YOUR RIGHTS AND DUTIES c. The policy does not cover garage, auto- UNDER THIS POLICY mobile sales agency, repair shop, service Your rights and duties under this policy may not station or public parking place operations be transferred without our written consent except hazards, in the case of death of an individual named in- the following applies to the nonrenewal of the sured. If you die, your rights and duties will be Commercial Auto Coverage Part in place of transferred to your legal representative but only GA.: while acting within the scope of duties as your a. We may elect not to renew or continue legal representative. Until your legal representa- tive is appointed, anyone having proper tempo- this policy by mailing or delivering to the rary custody of your property will have your rights first Named Insured and the first Named and duties but only with respect to that properly. Insured's agent or broker written notice at least 20 days before the end of the policy G. NONRENEWAL period including the actual reason for 1. We may elect not to renew this policy by nonrenewal. If the policy period is more mailing or delivering written notice of nonre- than one year, we will have the right not newal, stating the reasons for nonrenewal, to to renew or continue it only at an anni- •= the first Named Insured and the first Named versary of its original effective date. If we aw Insured's agent or broker at their respective offer to renew or continue and you do not last mailing addresses known to us. We will accept, this policy will terminate at the also mail to any mortgage holder, pledgee or end of the current policy period. Failure �— other person shown in this policy to have an to pay the required renewal or continua- interest in any loss which may occur under tion premium when due shall mean that this policy, at their last mailing address you have not accepted ouroffer. known to us, written notice of nonrenewal. b. We will not refuse to renew Liability Cov- We will mail or deliver these notices at least erage or Collision Coverage solely be- 45 days before the: cause an "insured" has submitted claims a. Expiration of the policy; or under Comprehensive Coverage or Tow- b. Anniversary date of this policy if this poI- Ing and Labor Coverage. icy has been written for a term of more c. if we fail to mail or deliver proper notice than one year. of nonrenewal and you obtain other In- 2. Otherwise we will renew this policy unless: surance, this policy will end on the effect ' a. The first Named Insured fails to pay the tive date of that insurance. renewal premium after we have ex- REF- pressed our willingness to renew, includ- H. BUSINESSOWNERS COVERAGE PART REF- pERENCES TO FORMS AND ENDORSEMENTS presse ing a statement of the renewal premium, In some instances the Common Policy Declara- to the first Named Insured and the first tions may list endorsements included in the Busi- Named Insured's agent or broker at least nessowners Coverage Part that reference: 20 days before the expiration date; 1. The Commercial Property Coverage Part; 2. The Commercial General Liability or Liquor Liability Coverage Part; or IL T3 16 09 07(Rev.09-08) Includes the copyrighted material of Insurance Services Office,Inc.with its permission. Page 3 of 4 007394 Property Forms referenced above apply to 3. Standard Property forms including, but not limited to, the following: the Businessowners Property Coverage Spe- a. Building and Personal Property Coverage cial Form in the same manner as they apply to the forms they reference. Form; b. Business Income Coverage Form; Endorsements referencing the Commercial General Liability Coverage Part apply to the c. Commercial Property Conditions; Commercial General Liability Coverage Form d. Condominium Association Coverage (included in the Businessowners Coverage Part) in the same manner as they apply to the Form; e. Condominium Commercial Unit-Owners form they reference. Coverage Form; I. INSURANCE UNDER TWO OR MORE COVERAGE PARTS f. Causes of Loss Basic Form; If two or more of this policy's Coverage Parts ap- g. Causes of Loss Special Form; and ply to the same loss or damage, we will not pay h. Causes of Loss Earthquake Form. more than the actual amount of the loss or dam- Endorsements referencing the Commercial age. Property Coverage Part or the Standard I t This policy consists of the Common Policy Declarations and the Coverage Parts and endorsements listed in that declarations form. In return for payment of the premium, we agree with the Named Insured to provide the insurance afforded by a Coverage Part forming part of this policy. That insurance will be provided by the company indicated as Insuring company in the Common Policy Declarations by the abbreviation of its name opposite that Coverage Part. The companies listed below (each a stock company) have executed this policy, but it is valid only if counter- signed on the Common Policy Declarations by our authorized representative. The Travelers Indemnity Company (IND) The Phoenix Insurance Company (PHK) CThe Charter Oak Fire Insurance Company (COF) Travelers Property Casualty Company of America(TIL) The Travelers Indemnity Company of Connecticut (TCT) The Travelers Indemnity Company of America (TIA) Travelers Casualty Insurance Company of America (ACJ) Secretary President Page 4 of 4 Includes the copyrighted material of Insurance Services Office,Inc.with its permission. IL T3 16 09 07 (Rev.09-013) A TRAVELERS J One Tower Square, Hartford, Connecticut 06183 ADDITIONAL LOCATIONS POLICY NO.: 680-1497P251-TCT-09 OFFICE PAC ISSUE DATE: 12-07-09 THIS SCHEDULE OF LOCATIONS AND BUILDINGS APPLIES TO THE COMMON DECLARATIONS FOR THE PERIOD 12-09-09 to 12-09-10 PREMISES LOCATION BUILDING NUMBER NUMBER OCCUPANCY ADDRESS 01 01 ENGINEERS i7355 BOONES FERRY ROAD LAKE OSWEGO OR 97035 02 01 ENGINEERS 10320 NE POINTS DRIVE, #400 KIRKLAND WA 98033 03 01 ENGINEERS 17990 SW MCEWAN AVENUE PORTLAND OR 97224 04 01 ENGINEERS 700 WASHINGTON STREET, #401 VANCOUVER WA 98660 05 01 ENGINEERS 36 N 4TH STREET CARBONDALE CO 81623 06 01 ENGINEERS 51 W 3RD STREET TEMPE AZ 85281 07 01 ENGINEERS 333 SW UPPER TERRACE DRIVE "�. BEND OR 97702 08 01 ENGINEERS 6 SOUTH 2ND STREET YAKIMA WA 98901 o 09 01 ENGINEERS 4253A HIGHWAY 101 NORTH o� GEARHART OR 97138 10 01 ENGINEERS 1715 B NORTH PACIFIC AVENUE m= LONG BEACH WA 98631 11 01 ENGINEERS 17437 BOONES ROAD, #200 LAKE OSWEGO OR 97035 12 01 ENGINEERS 1218 THIRD AVENUE, #300 SEATTLE WA 98101 ^~ 13 01 ENGINEERS 10445 NEAH-KAH-NNIE CREEK ROAD o MANZANITA OR 97130 o IL TO 20 02 05 Page 1 of 1 001395 BA1502PB92 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorse- a written contract or agreement that is signed and ment, the provisions of the Coverage Form apply executed by you before the"bodily injury"or"property unless modified by the endorsement. damage" occurs and that is in effect during the policy The following is added to the Section II — Liability Period is an "insured" for Liability Coverage, but only Coverage, Paragraph A.I. Who Is An Insured Pro- for damages to which this insurance applies and only to the extent that person or organization qualifies as vision: an "insured" under the Who Is An Insured provision Any person or organization that you are required to contained in Section II. include as additional insured on the Coverage Form in a.. o_ a_ 0 m o� .r. a o� CA T4 37 08 08 ©2008 The Travelers Companies,Inc. Page 1 of 1 000884 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorse- required of you by a written contract executed ment, the provisions of the Coverage Form apply prior to any "accident" or"loss", provided that the unless modified by the endorsement. "accident" or `loss" arises out of the operations Paragraph 'S. Transfer of Rights Of Recovery contemplated by such contract. The waiver ap- Against Others To Us of the CONDITIONS section plies only to the person or organization desig- is replaced by the following: nated in such contract. S. Transfer Of Rights Of Recovery Against Oth- ers To Us We waive any right of recovery we may have against any person or organization to the extent m as o o= a . o.— o= d= s� CA T3 40 08 08 m 2008 The Travelers Companies,Inc. Page 1 of 1 aoasae www.saif.com sai Fcorpora t i on Carrier No: 20001 Endorsement No: WC000313 Policy No; 487431 Agency: OTAK INC PEGGY MACMILLAN 808 SW 3RD AVE STE 300 J D FULWILER &COMPANY INC PORTLAND, OR 97204.2426 PO BOX 69508 PORTLAND, OR 97239 Waiver of Our Right to Recover From Others Endorsement We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Description: ALL OPERATIONS Contractor Name; PERSONS AND/OR ORGANIZATIONS WITH WHOM THE INSURED-EMPLOYER IS REQUIRED BY WRITTEN CONTRACT TO WAIVE SUBROGATION RIGHTS This endorsement does not alter the rights of an injured worker to pursue recovery from another party or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the schedule. The premium charge for this endorsement is based on one (1) percent of your manual premium. Effective Date: 04-01-2016 This endorsement is part of your policy. This endorsement amends and controls anything to the contrary. It is otherwise subject to all other terms of your policy. Countersigned 04-15-2016 at Salem, Oregon 430b Kerr arnett4Prsident and Chief Executive Officer 400 High St SE I Salem,OR 973121 P:800.285.8525