HomeMy WebLinkAboutPK17-130 - Original - Integrity Structural Engineering PLLC - Three Kent Parks Timber Light Pole & Bridge Inspections - 03/17/2017 21i///i
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CONTRACT COVER SKEET
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: Integrity Structural Engineering PLLC
Vendor Number:
JD Edwards Number
Contract Number: n ` hb
This is assigned by City Clerk's Office
(Project Name: Timber Light Pole and Bridge Inspections at. Three Kent Parks
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment 0 Contract
❑ Other:
Contract Effective Date: 3/17/17 Termination Date: 4/30/17
Contract Renewal Notice (Days): 0
Number of days required notice for termination or renewal or amendment
Contract Manager: Lynn Osborn/EL Department: Parks Planning & Dev.
Contract Amount: 4,230.00
Approval Authority: Z Department Director ❑Mayor ❑City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):
Inspect timber light poles atKent Memorial and Hagan Parks, and inspect timber
pedestrian bridge at Mill Creek Earthworks Park, and provide recommendations
Division Contract #PPD17-11
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KENT
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
Integrity Structural Engineering PLLC .
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Integrity Structural Engineering organized under the laws of the State of
Washington, located and doing business at 4124 Interlake Ave. North, Seattle, WA 98103 (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:
As described in attached Exhibit A, consultant will conduct inspections and analytical
evaluations and provide structural engineering recommendations for timber light poles at
Kent Memorial Park and Hogan Park and a timber pedestrian bridge at Mill Creek Earthworks
Park.
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 April 30, 2017.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed
$4,230.00, 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.
]. City Business License Reguired. 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 Sig nature ab Fax ar Ema"l. This Agreement may be executed in any
number of counterparts, each of which shall constitute an original, and all of which will together constitute
this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page
to the other by fax or email and that signature shall have the same force and effect as if the Agreement
bearing the original signature was received in person.
IN WITNESS, the parties below execute this Agreement, which shall become effective on
the last date entered below. All acts consistent with the authority of this Agreement and prior
to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed
to have applied.
CONSULTANT: CITY OF KENT:
7
By: B Y*
(signature) ((signature)
Print Name: 7 22 41� Print Name: Hope Gibson
Its: Its: Parks Planning & Development
a7 Manager
DATE:— Xf-S
DATE:—
NOTICES TO ENT T0: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Kenneth Wilson Brian Levenhagen
Integrity Structural Engineering City of Kent
4124 Interlake Ave N 220 Fourth Avenue South
Seattle, WA 98103 Kent, WA 98032
(206) 547-1379 (telephone) (253) 856-5116 (telephone)
integrityse@att.net
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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 equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
By:
For: 57,41l 7 v,t4fk LAItg-,)-rA, iW ,,P1C C
Title: 't L 111A 61-'4
Date: 3 L511 -
EEO COMPLIANCE DOCUMENTS - 1
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered into on
the (date) between the firm I represent and the City of
Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 3
Exhibit A
INTEGRITY
i STRUCTURAL
ENGINEERING
PLLC 4124 INTERLAKE AVENUE NORTH SEATTLE,WA 98103
TEL:(206)547.1379 FAx:(206)547-1381 EMAIL:INTEGRmSE@ATT.NET
March 14, 2017
Mr. Brian Levenhagen, Park Planner
City of Kent Parks Planning & Development Services
220 4th Avenue S.
Kent, WA 98032
Dear Mr. Levenhagen:
Re: Proposal for Professional Structural Engineering Services
Kent Parks&Timber Bridge Inspection,Analytical Evaluation, and Recommendations
Thank you for your calls, our discussions, and the emailed figures regarding the athletic field
timber poles at Hogen Paris(24400 Russel Road) and Kent Memorial Park(850 Central Ave).
Integrity Structural Engineering's (ISE)scope of work is to perform an immediate visual inspection
from the ground for each timber pole and through timber sounding, measurement of checks/splits,
and local drilling at the base(only)establish pole general conditions and viability. Inspection of
the timber pedestrian bridge and poles at Earthworks Park is also included. The results will be
compiled into a brief letter format report. The letter report will include a key map to locate each of
the inspected poles, a tabulation of the specific conditions and measurements at each pole, as
well as my professional opinion of the pole's condition, estimated remaining service life, or
recommendation for further evaluation. A second phase evaluation, if requested,would be a
hands-on study of the entire length of selected poles via rented 85-foot manlift, and the
completion of calculations for general and critical pole conditions to assess the demands and
existing capacity(using DL and code values for wind&seismic).
Phase 1 project specific work breakdown tasks are:
❑ Coordinate and perform one (1) site visit to inspect and assess the conditions for
approximately sixty-nine (69)timber poles at three fields and one timber bridge.
❑ Create key map,field sketches, and take measurements for report use and calculations.
❑ Investigate conditions with recommendations generalized for continued monitoring,
repair/remediation, or replacement.
❑ Prepare a brief letter report to summarize inspection, conditions found, provide
photographic documentation, and my professional structural engineering
recommendation. Submit one(1)draft and final PDF report via email.
ISE's fee for this phase of the project is billed at a time and materials basis with a not to exceed
fee of$4,230 as shown in the attached. Due to the critical conditions conveyed via today's
photograph, I am available to complete the full day inspection on Monday March 20th. Immediate
critical findings, if any, would be conveyed via email by Tuesday March 21th. The engineering
stamped letter format report would be provided for your use on Monday March 30th. Thank you
for the opportunity to present this proposal and please feel free to call me with any questions.
Sincerely,
� —�-
Kenneth M. Wilson, PE SE
Bridge Consultant/WSDOT Bridge Inspector#D2038
Encl: Cost Estimate Spreadsheet
Page 1 of 2
Exhibit A, "Continued
Kent Parks 3/14/17
Lighting Pole Engineering Inspection
PM/Br Total Hrs ISE,
Task Engr PLLC
Kent Parks Athletic Field Timber Pole Evaluation
I Inspection, Condition Assessment, and Letter Report
a. Parks Dept Coordination, Technical Discussions, Admin. 2 2
b. Preparation, Travel, and Site Visit with Pole Inspection, 13 13�
Measurements, Observations
c. Report Sketches, Pole location Key Map, and Photographic Figures 5 5
d. Brief Letter Report Preparation, Professional Recommendations, and 8 8
Transmittal
Subtotal Task 1 28 28
Kent Parks Athletic Field Timber Pole Evaluation
I Inspection,Condition Assessment,and Letter Report 28 28
28 28
Billing Rate $14850
Fee $ 4,158 $ 4,1581
labor cost= $ 4,158
Mileage $ 43 direct costs= $ 72
Courier, mad $ - ISE, PLLC = $ 4,230,
Equipment Rental(Heitz Equipment Proposal) $ -
Reproduction $ 29
ISE, PLLC Direct Expenses Subtotal.- 1 $ 72
Hour and Task Estimate Page 2 of 2 ISE, PLLC
EXHIBIT B
INSURANCE REQUIREMENTS FOR
CONSULTANT SERVICES AGREEMENTS
Insurance
The Consultant shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Consultant, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Consultant shall obtain insurance of the types described below:
1. Automobile Liability insurance covering all owned, non-
owned, hired and leased vehicles. Coverage shall be written
on Insurance Services Office (ISO) form CA 00 01 or a
substitute form providing equivalent liability coverage. If
necessary, the policy shall be endorsed to provide
contractual liability coverage.
2. Commercial General Liability insurance shall be written on
ISO occurrence form CG 00 01 and shall cover liability
arising from premises, operations, independent contractors,
products-completed operations, personal injury and
advertising injury, and liability assumed under an insured
contract. The City shall be named as an insured under the
Consultant's Commercial General Liability insurance policy
with respect to the work performed for the City using ISO
additional insured endorsement CG 20 10 11 85 or a
substitute endorsement providing equivalent coverage.
3. Workers' Compensation coverage as required by the
Industrial Insurance laws of the State of Washington.
4. Professional Liability insurance appropriate to the
Consultant's profession.
EXHIBIT B (Continued)
B. Minimum Amounts of Insurance
Consultant shall maintain the following insurance limits:
1. Automobile Liability insurance with a minimum combined
single limit for bodily injury and property damage of
$1,000,000 per accident.
2. Commercial General Liability insurance shall be written with
limits no less than $2,000,000 each occurrence, $2,000,000
general aggregate and a $1,000,000 products-completed
operations aggregate limit.
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
insurance:
1. The Consultant's insurance coverage shall be primary insurance as
respect the City. Any Insurance, self-insurance, or insurance pool
coverage maintained by the City shall be excess of the Consultant's
insurance and shall not contribute with it.
2. The Consultant's insurance shall be endorsed to state that coverage shall
not be cancelled by either party, except after thirty (30) days prior
written notice by certified mail, return receipt requested, has been given
to the City.
3. The City of Kent shall be named as an additional insured on all policies
(except Professional Liability) as respects work performed by or on behalf
of the Consultant and a copy of the endorsement naming the City as
additional insured shall be attached to the Certificate of Insurance. The
City reserves the right to receive a certified copy of all required insurance
policies. The Consultant's Commercial General Liability insurance shall
also contain a clause stating that coverage shall apply separately to each
insured against whom claim is made or suit is brought, except with
respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than ANII.
EXHIBIT B (Continued)
E. Verification of Coverage
Consultant shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Contractor before commencement of the work.
F. Subcontractors
Consultant shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Consultant.
DATE(MWDWYYYY►
A�o® CERTIFICATE OF LIABILITY INSURANCE
3/3/2017
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 Kim Grahn
NAME:
Shipley ai Pease Insurance PHONE 1j; (206)519-5371 ---- A�Nol,(503)282-3345
P O Box 928 E-MAIL SS:kim@shipley:Lns.com
INSURERS AFFORDING COVERAGE___ _ NAIC#
Woodinville WA 98072 INSURERA:Phoenix Insurance PHX 25623
INSURED INSURERB:Travelers Casualty b Surety Company , 31194
Integrity Structural Engineering, PLLC INSURERC: _
4124 Interlake Ave N. INSURERD:
INSURER E
Seattle WA 98103 INSURER F:
COVERAGES CERTIFICATE NUMBER:CL1611400103 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.POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE AODL'i UBRj POLICY EFF POLICY EXP LIMITS
LTR POLICY NUMBER MMID MWDDlYYYY
X COMMERCIAL OENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
A —;CLAIMS-MADE X OCCUR !,, _P_REAIISES�Ea occun'encel !$ 1,000,000
R Y 680008H725288 11/7/2016 11/7/2017 'MED EXP(Any one person) $ 50,000
_J i PERSONAL&AOV INJURY j$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER 4,000,000
I GENERAL AGGREGATE _;$ _ _ _
POLICY X JECT LOC L PRODUCTS-COMP/OP AGG j$ 4,000,000
— — --
OTHER: $
AUTOMOBILE LIABILITY Ee 1 COMBINED SINGLE LIMIT $ 2,000,000
ANY AUTO BODILY INJURY(Per person) $
A AU OS SCHEDULED 6110008H725288 11/7/2016 11/7/2017 BODILY INJURY $
_ X Y
X HIRED X NON-OWNED PROPERTY DAMAGE $
_ AUTOS LPer acci n� —_
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAR — CLAIMS-MADE' AGGREGATE $
OED RETENTION$ $
lCDORIG9Ea6p(E60iiiXD(ONC
- STATUTE_ _ ERH
ANXEMPLOYERS'LIABILITY YINI -
ANY PROPRIETOR/PARTNER/EXECUTIVE ^- NIA
A E.L.EACH ACCIDENT $ 1,000,000
ED?'OFFICER/MEMBER EXCLUD -- --- -- --- -- -
A (Mandatory In NH) 680008H725288 11/7/2016 11/7/2017 E.L.DISEASE-EA EMPLOYE $ 1,000,
000
If yes,describe under
DESCRIPTION OF OPERATIONS below I WA Stop Gap E.L.DISEASE-POLICY LIMIT I $ 11000,000
B ' Professional Laibility 105365387 11/7/2016 11/7/2017 Each Claim 2,000,000
Aggregate 2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
City of Kent is Additional insured per CGD037 04/05, CGD381 09/07 and CGD379 09/07 attached. Forms
extend Waiver of Subrogation, Primary and Non-Contributory wording.
CERTIFICATE HOLDER CANCELLATION
Bjlevenhagen@kentwa.gov
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Parks Department ACCORDANCE WITH THE POLICY PROVISIONS.
220 Fourth Ave S
Kent, WA 98032 AUTHORIZED REPRESENTATIVE
Stan Pease/KG
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
IN S025 rn1l4nl%
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
OTHER INSURANCE - ADDITIONAL INSUREDS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS lb. The "personal injury" or "advertising injury" for
COMMERCIAL GENERAL LIABILITY CONDITIONS which coverage is sought arises Out of an of-
(Section IV), Paragraph 4. (Other Insurance), is fense committed
amended as follows: subsequent to the signing and execution of that
1. The following is added to Paragraph a. Primary contract or agreement by you.
Insurance: 2. The first Subparagraph (2) of Paragraph b. Ex-
However, if YOU specifically agree in a written con- cess Insurance regarding any other primary in-
tract or written agreement that the insurance pro- surance available to you is deleted.
vid'ed to an additional insured Under this 3. The following is added to Paragraph b. Excess
Coverage Part must apply on a primary basis, or Insurance, as an additional subparagraph under
a primary and non-contribu:tory basis, this insur- Subparagraph (I):
ance is primary to other insurance>that is avail- That is available to the insured when the insured
able to such additional insured which covers such is added as an additional insured under any other
additional insured as a named insured, and we policy, including any umbrella or excess policy,
will not share with that other insurance, provided
that:
a. The "bodily injury" or "property damage" for
which coverage is sought occurs-, and
CG DO 37 04 05 Copyright 2005 The St. Paul Travelers Companies, Inc. Ali rights reserved. Page 1 of 1
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
A. The following is added to WHO IS AN INSURED INSURANCE (Section 111) for this Coverage
(Section 11): Part.
Any person or organization that you agree in a B. The following is added to Paragraph a. of 4.
""contract or agreement requiring insurance" to in- Other Insurance in COMMERCIAL GENERAL
clude as an, additional insured on this Coverage LIABILITY CONDITIONS (Section IV),
Part, but only with respect to liability for"bodily in- However, if you specifically agree in a "contract or
jury", "property damage" or "'personal injury" agreement requiring insurance" that the insurance
caused, in whole or in part, by your acts or omis- provided to an additional insured under this Cov-
sions or the acts or omissions of those acting on erage Part must apply on a primary basis, or a
your behalf- primary and non-contributory basis, this insurance
a. In the performance of your ongoing opera- is primary to other insurance that is available to
tions; such additional insured which covers such addi-
b. In connection with premises owned by or tionaf insured' as a named insured, and we will not
rented to you; or share with the other insurance, provided that:
c. In connection with "your work" and included (1) The "bodily injury" or "property damage" for
within the "products-completed operations which coverage: is sought occurs; and
hazard". (2) The "personal injury" for which coverage is
Such person or organization does not qualify as sought arises out of an offense committed;
an additional insured for "bodily Injury", "property after You have entered into that "contract or
damage" or "personal injury" for which that per- agreement requiring insurance". But this insur-
son or organization has assumed liability in a con- ance still is excess over valid and collectible other
tract or agreement. insurance, whether primary, excess, contingent or
The insurance provided to such additional insured on any other basis, that is available to the insured
is limited as follows: when the insured is an additional insured under
d. This insurance does not apply on any basis to any other insurance,
any person or organization for which cover- C. The following is, added to Paragraph 8. Transfer
age as an additional insured specifically is Of Rights Of Recovery Against Others To Us
added by another endorsement to this Cover- in COMMERCIAL GENERAL LIABILITY CON-
age Part, DITIONS(Section IV):
e. This insurance does not apply to the render- We waive any rights of recovery we may have
ing of or failure to render any "professional against any person or organization because of
services", payments we make for "bodily injury", "property
f. The limits of insurance afforded to the addi- damage" or "personal injury" arising out of "your
tional insured shall be the limits which you work performed by you, or on your behalf, under
agreed in that "contract or agreement requir- a "contract or agreement requiring insurance" with
ing insurance" to provide for that additional that person or organization. We waive these
insured, or the limits shown in the Declara- rights only where you have agreed to do so as
tions for this Coverage Part, whichever are part of the "contract or agreement requiring insur-
less. This endorsement does not increase the ance" with such person or organization entered
limits of insurance stated in the LIMITS OF into by you before, and in effect when, the "bodily
CG D3 81 09 07 @ 2007 The Travelers Companies,Inc: Page I of 2
Includes the copyrighted material of Insurance Services Office,Inc.,with its permission
00r:387
COMMERCIAL GENERAL LIABILITY _
injury" or "property damage" occurs, or the "per- erage Part, provided that the "bodily injury" and
sonal injury"offense is committed. "property damage" occurs, and the "personal in-
D. The following definition is added to DEFINITIONS jury"is caused by an offense committed:
(Section V): a. After you have entered into that contract or
"Contract or agreement requiring insurance" agreement;
means that part of any contract or agreement un- b. While that part of the contract or agreement is
der which you are required to include a person or in effect; and
organization as an additional insured on this Cov- c. Before the end of the policy period.
Page 2 of 2 ®2007 The Travelers Companies,Inc. CG D3 81 09 07
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
XTEND, ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
GENERAL DESCRIPTION OF COVERAGE Provisions A. — T. and V. of this endorsement broaden coverage.
Provisions U. and W. of this endorsement miay limit coverage. The following listing is a general coverage
description only. Limitations and exclusions may apply to these coverages. Read all the PROVISIONS of this
endorsement carefully to determine rights, duties, and what is and is not covered.
A. Broadened Named Insured N. Additional Insured — Architect, Engineer Or
B. Incidental Medical Malpractice Surveyor
C. Reasonable Force — Bodily Injury Or Property O. Who Is An Insured — Newly Acquired Or Formed
Damage Organizations
D. Non-Owned Watercraft — Increased To Up To 75 P. Who Is An Insured — Unnamed Partnership Or
feet Joint Venture— Excess
E. Aircraft Chartered With Crew Q. Per Project General Aggregate Limit
F. Extension Of Coverage — Damage To Premises R. Knowledge And Notice Of Occurrence Or
Rented To You Offense
G. Malicious Prosecution — Exception To Knowing S. Ununtentional Omission
Violation Of Rights Of Another Exclusion T. Waiver Of Transfer Of Rights Of Recovery
H. Medical Payments Limit Against Others To Us When Required By Con-
1. Increased Supplementary Payments tract Or Agreement
U. Amended Bodily Injury Definition
J. Additional Insured _ Owner, Manager Or Lessor
Of Premises V. Amended Insured Contract Definition — Railroad
Easement
K. Additional Insu�red—Lessor Of Leased Equipment W. Amended Property Damage Definition —Tangible
L. Additional Insured — State Or Political Subdivi- Property
sions —Permits Relating To Premises X. Additional Definition — Contract or Agreement
M. Additional Insured — State Or Political Subidivi- Requiring Insurance
sions— Permits Relating To Operations
PROVISIONS coverage for any such additional organization
A. BROADENED NAMED INSURED will cease as of the date, if any, during the
policy period, that you no longer are the s6e
1. The Named Insured in Item 1. of the Com- owner of, or maintain the majority ownership
mon Policy Declarations is amended as fol- interest In, such organization.
lows:
The person or organization named in Item 1. 2. This Provision A. does not apply to any per-
of the Common Policy Declarations and any son or organization for which coverage is ex-
cluded by another endorsement to this Cov-
organization, other than a partnership, joint erage Part.
venture, limited liability company or trust, of B. INCIDENTAL MEDICAL MALPRACTICE
which you are the sole owner or in which you
maintain the majority ownership interest on 1. The following is added to Paragraph 1. Insur-
the effective date of the policy. However, ing Agreement of COVERAGE A BODILY
CG D3 79 09 07 d 2007 The Travelers Companies,Inc, Pagel of
COMMERCIAL GENERAL LIABILITY
INJURY AND PROPERTY DAMAGE LI- C. REASONABLE FORCE — BODILY INJURY OR
ABILITY in COVERAGES (Section 1): PROPERTY DAMAGE
"Bodily injury" arising out of the rendering of, The Expected Or Intended Injury Exclusion in
or failure to render, "first aid" or "Good Sa- Paragraph 2. Exclusions of COVERAGE A
maritan services" to a person, other than a BODILY INJURY AND PROPERTY DAMAGE
co-"employee" or "volunteer worker", will be LIABILITY in COVERAGES (Section 1) is de-
deemed to be caused by an "occurrence". leted and replaced by the following:
For the purposes of determining the applica- Expected Or Intended Injury Or Damage
ble limits of insurance, any act or omission
together with all related acts or omissions in "Bodily injury" or "property damage" expected or
the furnishing of the services to any one per- intended from the standpoint of the insured. This
son will be deemed one "occurrence". exclusion does not apply to "bodily injury" or
"property damage" resulting from the use of rea-
2. As used in this Provision B.: sonable force to protect any person or property.
a. "First aid" means medical or nursing ser- D. NON-OWNED WATERCRAFT — INCREASED
vice, treatment, advice or instruction; the TO UP TO 75 FEET
related furnishing of food or beverages;
the furnishing or dispensing of drugs or 1• The exception contained in Subparagraph (2)
medical supplies or appliances; of the Aircraft, Auto Or Watercraft Exclu-
sion in 2. Exclusions of COVERAGE A
b. "Good Samaritan services" means those BODILY INJURY AND PROPERTY DAM-
medical services rendered or provided in AGE LIABILITY in COVERAGES (Section 1)
an emergency and for which no remu- is deleted and replaced by the following:
neration is demanded or received.
3. Paragraph 2.a.(1)(d) of WHO IS AN IN- (2) A watercraft you do not own that is:
SURED (Section 11) does not apply to any of (a) Less than 75 feet long; and
your "employees", who are not employed as (b) Not being used to carry persons or
a doctor or nurse by you, but only while per- property for a charge;
forming the services described in Paragraph 2. Only as respects the insurance provided by
1. above and while acting within the scope of this Provision D., WHO IS AN INSURED
their employment by you. Any such "employ- (Section II) is amended to include as an in-
ees" rendering "Good Samaritan services" sured any person who, with your expressed
will be deemed to be acting within the scope or implied consent, either uses or is respon-
of their employment by you. sible for the use of the watercraft.
4. The following exclusion is added to Para- 3. The insurance provided by this Provision D.
graph 2. Exclusions of COVERAGE A BOD- shall be excess over any valid and collectible
ILY INJURY AND PROPERTY DAMAGE other insurance available to the insured,
LIABILITY in COVERAGES (Section 1): whether primary, excess, contingent or on
Sale of Pharmaceuticals any other basis, except for insurance pur-
"Bodily injury" or "property damage" aris- chased specifically by you to apply in excess
ing out of the willful violation of a penal of the Limits of Insurance shown in the Decla-
statute or ordinance relating to the sale of rations for this Coverage Part.
pharmaceuticals committed by or with the E. AIRCRAFT CHARTERED WITH CREW
knowledge or consent of the insured. 1. The following is added to the exceptions con-
k. The insurance provided by this Provision B. tained in the Aircraft, Auto Or Watercraft
shall be excess over any valid and collectible Exclusion in Paragraph 2. Exclusions of
other insurance available to the insured, COVERAGE A BODILY INJURY AND
whether primary, excess, contingent or on PROPERTY DAMAGE LIABILITY in COV-
any other basis, except for insurance pur- ERAGES (Section I):
chased specifically by you to apply in excess Aircraft chartered with crew, including a pilot,
of the Limits of Insurance shown in the Decla- to any insured.
rations for this Coverage Part.
Page 2 of 8 0 2007 The Travelers Companies,Inc. CG D3 79 09 07
COMMERCIAL GENERAL LIABILITY
2. This Provision E. does not apply if the char- any one premises while rented to you, or
tered aircraft is owned by any insured. temporarily occupied by you with permission
3. The insurance provided by this Provision E. of the owner, caused by: fire; explosion; light-
shall be excess over any valid and collectible ning; smoke resulting from such fire, explo-
other insurance available to the insured, sion, or lightning; or water. The Damage To
whether primary, excess, contingent or on Premises Rented To You Limit will apply to
any other basis, except for insurance pur- all "property damage" proximately caused by
chased specifically by you to apply in excess the same "occurrence", whether such dam-
of the Limits of Insurance shown in the Decla- age results from: fire; explosion; lightning;
rations for this Coverage Part. smoke resulting from such fire, explosion, or
F. EXTENSION OF COVERAGE — DAMAGE TO
lightning; or water; or any combination of any
of these causes.
PREMISES RENTED TO YOU
1. The last paragraph of COVERAGE A BOD- The Damage To Premises Rented To You
ILY INJURY AND PROPERTY DAMAGE Limit will be the higher of:
LIABILITY in COVERAGES (Section 1) is a. $1,000,000; or
deleted and replaced by the following: b. The amount shown for the Damage To
Exclusions c. through n. do not apply to dam- Premises Rented To You Limit in the
age to premises while rented to you, or tem- Declarations for this Coverage Part.
porarily occupied by you with permission of 4. Paragraph a. of the definition of"insured con-
the owner, caused by: tract" in DEFINITIONS (Section V) is deleted
a. Fire; and replaced by the following:
b. Explosion; a. A contract for a lease of premises. How-
c. Lightning; ever, that portion of the contract for a
lease of premises that indemnifies any
d. Smoke resulting from such fire, explo- person or organization for damage to
sion, or lightning; or premises while rented to you, or tempo-
s. Water, rarily occupied by you with permission of
A separate limit of insurance applies to this the owner, caused by: fire; explosion;
coverage as described in LIMITS OF IN- lightning; smoke resulting from such fire,
SURANCE (Section III). explosion, or lightning; or water is not an
"insured contract';
2. The insurance under this Provision F. does 5. This Provision F. does not apply if coverage
not apply to damage to premises while rented for Damage To Premises Rented To You of
to you, or temporarily occupied by you with COVERAGE A BODILY INJURY AND
permission of the owner, caused by: PROPERTY DAMAGE LIABILITY in COV-
a. Rupture, bursting, or operation of pres- ERAGES (Section 1) is excluded by another
sure relief devices; endorsement to this Coverage Part.
b. Rupture or bursting due to expansion or G. MALICIOUS PROSECUTION — EXCEPTION TO
swelling of the contents of any building or KNOWING VIOLATION OF RIGHTS OF AN-
structure, caused by or resulting from wa- OTHER EXCLUSION
ter; or The following is added to the Knowing Violation
c. Explosion of steam boilers, steam pipes, Of Rights Of Another Exclusion in 2. Exclu-
steam engines, or steam turbines. sions of COVERAGE B PERSONAL INJURY,
3. Paragraph 6. of LIMITS OF INSURANCE ADVERTISING INJURY AND WEB SITE IN-
(Section III) is deleted and replaced by the JURY LIABILITY of the WEB XTEND LIABILITY
following: Endorsement:
Subject to 5. above, the Damage To Prem- This exclusion does not apply to "personal injury"
ises Rented To You Limit is the most we will caused by malicious prosecution.
pay under Coverage A for the sum of all
damages because of "property damage" to
CG D3 79 09 07 0 2007 The Travelers Companies,Inc. Page 3 of 8
COMMERCIAL GENERAL LIABILITY
H. MEDICAL PAYMENTS LIMIT (2) Any structural alterations, new con-
The Medical Expense Limit shown in the Declara- struction or demolition operations
tions for this Coverage Part is increased to performed by or on behalf of such
$10,000. additional insured; or
I. INCREASED SUPPLEMENTARY PAYMENTS (3) Any premises for which coverage is
Paragraphs 1.b. and 1.d. of SUPPLEMENTARY excluded by another endorsement to
this Coverage Part.
PAYMENTS — COVERAGES A AND B in COV-
ERAGES (Section I) are amended as follows: 3. This Provision J. does not apply on any
basis to any person or organization for
1. In Paragraph 1.1b., the amount we will pay for
which coverage as an additional insured
the cost of bail bonds is increased to $2500.
specifically is added by another en-
2. In Paragraph 1.d., the amount we will pay for dorsement to this Coverage Part.
loss of earnings is increased to $500 a day. K. ADDITIONAL INSURED — LESSOR OF
J. ADDITIONAL INSURED — OWNER, MANAGER LEASED EQUIPMENT
OR LESSOR OF PREMISES 1. WHO IS AN INSURED (Section II) is
1. WHO IS AN INSURED (Section II) is amended to include as an insured:
amended to include as an insured: Any person or organization that you have
Any person or organization that you have agreed in a contract or agreement to include
agreed in a contract or agreement to include as an additional insured on this Coverage
as an additional insured on this Coverage Part, but:
Part, but: a. Only with respect to liability for "bodily in-
a. Only with respect to liability for "bodily in- jury" or"property damage" that occurs, or
jury" or"property damage" that occurs, or "personal injury" caused by an offense
"personal injury" caused by an offense committed, after you have entered into
committed, after you have entered into that contract or agreement; and
that contract or agreement; and b. Only if the "bodily injury", "property dam-
b. Only if the "bodily injury", "property dam- age" or "personal injury" is caused, in
age" or "personal injury" is caused, in whole or in part, by acts or omissions of
whole or in part, by acts or omissions of you or any person or organization per-
you or any person or organization per- forming operations on your behalf, in the
forming operations on your behalf, and maintenance, operation or use of equip-
arises out of the ownership, maintenance ment leased to you by such additional in-
or use of that part of any premises leased sured.
to you under that contract or agreement. 2. The insurance provided to such additional
2. The insurance provided to such additional insured under this Provision K. is subject to
insured under this Provision J. is subject to the following provisions:
the following provisions: a. The limits of insurance afforded to such
a. The limits of insurance afforded to such additional insured shall be the limits
additional insured shall be the limits which you agreed to provide in the con-
which you agreed to provide in the con- tract or agreement, or the limits shown in
tract or agreement, or the limits shown in the Declarations for this Coverage Part,
the Declarations for this Coverage Part, whichever are less; and
whichever are less; and b. The insurance afforded to such additional
b. The insurance afforded to such additional insured does not apply:
insured does not apply to: (1) To any "bodily injury" or "property
(1) Any "bodily injury" or "property dam- damage" that occurs, or "personal in-
age" that occurs, or "personal injury" jury" caused by an offense commit-
caused by an offense committed, af- ted, after the equipment lease ex-
ter you cease to be a tenant in that pires; or
premises;
Page 4 of 8 0 2007 The Travelers Companies,Inc. CG D3 79 09 07
COMMERCIAL GENERAL LIABILITY
(2) If the equipment is leased with an N. ADDITIONAL INSURED — ARCHITECT, ENGI-
operator. NEER OR SURVEYOR
3. This Provision K. does not apply on any basis 1. The following is added to Paragraph 2. of
to any person or organization for which cov- WHO IS AN INSURED (Section 11) to include
erage as an additional insured specifically is as an insured:
added by another endorsement to this Cov- Any architect, engineer or surveyor engaged
erage Part. by or for you that you agree in a "contract or
L. ADDITIONAL INSURED — STATE OR POLITI- agreement requiring insurance" to include as
CAL SUBDIVISIONS — PERMITS RELATING an additional insured on this Coverage Part,
TO PREMISES but only with respect to liability for "bodily in-
The following is added to Paragraph 2. of WHO jury", "property damage" or "personal injury"
IS AN INSURED (Section 11) to include as an that is caused, in whole or in part, by acts or
insured: omissions of you or any person or organiza-
tion acting on your behalf in connection with
Any state or political subdivision that has issued a your premises or"your work".
permit in connection with premises owned or oc-
cupied by, or rented or loaned to, you, but only 2. This Provision N. does not apply on any basis
with respect to "bodily injury", "property damage", to any person or organization for which cov-
"personal injury" or "advertising injury" arising out erage as an additional insured specifically is
of the existence, ownership, use, maintenance, added by another endorsement to this Cov-
repair, construction, erection or removal of adver- erage Part.
tising signs, awnings, canopies, cellar entrances, O. WHO IS AN INSURED—NEWLY ACQUIRED
coal holes, driveways, manholes, marquees, hoist OR FORMED ORGANIZATIONS
away openings, sidewalk vaults, elevators, street 1. Paragraph 4.a. of WHO IS AN INSURED
banners or decorations for which that state or (Section II) is deleted and replaced by the
political subdivision has issued such permit. following:
M. ADDITIONAL INSURED — STATE OR POLITI- a. Coverage under this provision is afforded
CAL SUBDIVISIONS — PERMITS RELATING only until the 180th day after you acquire
TO OPERATIONS or form the organization or the end of the
The following is added to Paragraph 2. of WHO policy period, whichever is earlier. Any
IS AN INSURED (Section II) to include as an such newly acquired or formed organiza-
insured: tion that you report in writing to us within
Any state or political subdivision that has issued a 180 days after you acquire or form the
permit, but only with respect to "bodily injury", organization will be covered under this
"property damage", personal injury' or "advertis-
provision until the end of the policy pe-
ing injury" arising out of operations performed by riod, even if there are more than 180
you or on your behalf for which that state or po- days remaining until the end of the policy
litical subdivision has issued such permit. How- period;
ever, no such state or political subdivision is an 2. This Provision O. does not apply to any or-
insured for: ganization for which coverage is excluded by
1. "Bodily injury", "property damage", "personal another endorsement to this Coverage Part.
injury" or "advertising injury" arising out of P. WHO IS AN INSURED— UNNAMED PART-
operations performed for that state or political NERSHIP OR JOINT VENTURE—EXCESS
subdivision; or 1. The last paragraph of WHO IS AN INSURED
2. "Bodily injury" or "property damage" included (Section II) is deleted and replaced by the
within the "products — completed operations following:
hazard". No person or organization is an insured with
respect to the conduct of any current or past
partnership, joint venture or limited liability
company that is not shown as a Named In-
sured in the Common Policy Declarations.
CG D3 79 09 07 0 2007 The Travelers Companies,Inc. Page 5 of 8
COMMERCIAL GENERAL LIABILITY
However, this exclusion does not apply to Any payments made under Coverage A for
your liability with respect to your conduct of damages and under Coverage C for medical
the business of any current or past partner- expenses shall reduce the Per Project Gen-
ship or joint venture: eral Aggregate Limit for that "project", but
a. That is not shown as a Named insured in shall not reduce:
the Common Policy Declarations, and a. Any other Per Project General Aggregate
b. In which you are a member or partner Limit for any other"project";
where each and every one of your co- b. The General Aggregate Limit; or
ventures in that joint venture is an archi- c, The Products-Completed Operations Ag-
tectural, engineering, or surveying firm. gregate Limit.
2. This Provision P. does not apply to any per- The limits shown in the Declarations for this
son or organization for which coverage is ex- Coverage Part for Each Occurrence, Dam-
cluded by another endorsement to this Cov- age To Premises Rented To You and Medical
erage Part_ Expense are also subject to the Per Project
3. The insurance provided by this Provision P. General Aggregate Limit when the Per Pro-
shall be excess over any valid and collectible ject General Aggregate Limit applies.
other insurance, whether primary, excess, 3. As used in the Provision Q.:
contingent or on any other basis, which is
available covering your liability with respect "Project" means an area away from premises
to your conduct of the business of any current owned by or rented to you at which you are
or past partnership or joint venture that is not performing operations pursuant to a contract
shown as a Named Insured in the Common or agreement. For the purposes of determin-
Policy Declarations and which is issued to ing the applicable aggregate limit of insur-
such partnership or joint venture. ance, each "project" that includes premises
involving the same or connecting lots, or
Q. PER PROJECT GENERAL AGGREGATE LIMIT premises whose connection is interrupted
1. Paragraph 2. of LIMITS OF INSURANCE only by a street, roadway, waterway or right-
(Section 111) is deleted and replaced by the of-way of a railroad shall be considered a sin-
following: gle "project".
The General Aggregate Limit is the most we R. KNOWLEDGE AND NOTICE OF OCCUR-
will pay for the sum of: RENCE OR OFFENSE
a. Damages under Coverage B; and The following is added to Paragraph 2. Duties In
b. Damages from "occurrences' under Cov- The Event of Occurrence, Offense, Claim Or
erage A and for all medical expenses Suit of COMMERCIAL GENERAL LIABILITY
caused by accidents under Coverage C CONDITIONS (Section IV):
which cannot be attributed only to opera- Notice of an "occurrence" or of an offense which
tions at a single "project". may result in a claim must be given as soon as
2. The following is added to LIMITS OF IN- practicable after knowledge of the "occurrence"
SURANCE (Section III): or offense has been reported to you, one of your
"executive officers" (if you are a corporation), one
A separate Per Project General Aggregate of your partners who is an individual (if you are a
Limit applies to each "project" for all sums partnership), one of your managers (if you are a
which the insured becomes legally obligated limited liability company), one of your trustees
to pay as damages caused by "occurrences" who is an individual (if you are a trust), or an
under Coverage A and for all medical ex- "employee" (such as an insurance, loss control or
penses caused by accidents under Coverage risk manager or administrator) designated by you
C which can be attributed only to operations to give such notice.
at a single "project", and that limit is equal to
the amount of the General Aggregate Limit Knowledge by any other"employee" of an "occur-
shown in the Declarations for this Coverage hav e" offense does not imply that you also
Part. have succ h knowledge.
Page 6 of 8 0 2007 The Travelers Companies,Inc. CG D3 79 09 07
COMMERCIAL GENERAL LIABILITY
Notice of an "occurrence" or of an offense which 4. "Your products".
may result in a claim will be deemed to be given We waive these rights only where you have
as soon as practicable to us if it is given in good agreed to do so as part of a contract or agree-
faith as soon as practicable to your workers' com- ment entered into by you before, and in effect
pensation, accident, or health Insurer. This ap- when, the "bodily injury" or "property, damage"
plies only if you subsequently give notice of the
11 occurrence" or offense to us as soon as practi- occurs, or the "personal injury':' offense or "adver-
cable after you, one of your "executive officers" fising Injury"'offense is committed.
(if you are a corporation), one of your partners U, AMENDED BODILY INJURY DEFINITION
who is an individual (if you are a partnership), The definition of "bodily injury" in DEFINITIONS
one of your managers (if you are a limited liability (Section V) is deleted and replaced by the follow-
company), one of your trustees who is an individ- ing:
ual (if you are a trust), or an "employee" (such as "Bodily injury" means,
an insurance, loss control or risk manager or ad-
ministrator) designated by YOU to give, such notice a. Physical harm, including sickness or disease,
discovers that the "occurrence" or offense may sustained by a person;
involve this policy. lb. Mental anguish, injury or illness, or emotional
S. UNINTENTIONAL OMISSION distress, resulting at any time from such
1. The following is added to Paragraph 6. Rep- physical harm, sickness or disease; or
resentations of COMMERCIAL GENERAL c. Care, loss of services or death resulting at
LIABILITY CONDITIONS (Section IV): any time from such physical harm, sickness
or disease.
The unintentional omission of, or uninten-
tional error in, any information provided by V. AMENDED INSURED CONTRACT DEFINITION
you which we relied upon in issuing this pol- — RAILROAD EASEMENT
icy shall not prejudice your rights under this 1. Subparagraph c. of the definition of "insured
insurance. contract" in DEFINITIONS (Section V) is de-
l. This Provision S. does not affect our right to leted and replaced by the following:
collect additional premium or to exercise our c. Any easement or license agreement;
right of cancellation or nonrenewal in accor- 2. Subparagraph f,(I) of the definition of "in-
dance with applicable insurance laws or regu- sured contract" in DEFINITIONS (Section V)
lations. is deleted.
T. WAIVER OF TRANSFER OF RIGHTS OF W. AMENDED PROPERTY DAMAGE DEFINITION
RECOVERY AGAINST OTHERS TO US WHEN —TANGIBLE PROPERTY
REQUIRED BY CONTRACT OR AGREEMENT
The definition of "properly damage" in DEFINI-
The, following is added to Paragraph 8. Transfer TIONS (Section V) is deleted and replaced by
of Rights of Recovery Against Others, to U's of the following,-
COMMERCIAL GENERAL LIABILITY CONDI-
TIONS (Section 1IV)- "Properly damage" means:
We waive any rights of recovery we may have a. Physical injury to tangible property, including
against any person or organization; because of all resulting loss of use of that property. All
payments we make for "bodily injury", "property such loss of use shall be deemed to occur at
damage", "personal injury"' or "advertising injury" the time of the physical injury that caused it;
arising out of: or
1. Premises owned by you, temporarily occu- b. Loss of use of tangible property that is not
pied by you with permission of the owner, or physically injured. All such loss of use shall
leased or rented to you; be deemed to occur at the time of the "occur-
rence" that caused it.
2. Ongoing operations performed by you, or on
your behalf, under a contract or agreement For the purposes of this insurance, tangible prop-
with that person or organization; erty does not include data.
3. "'Your work"; or
CG D3 79 09 07 0 2007 The Travelers ComOnies,Inc Page 7 of 8
COMMERCIAL GENERAL LIABILITY
X. The following definition is added to SECTION V— and "property damage" occurs, and the "personal
DEFINITIONS: injury" is caused by an offense committed:
"Contract or agreement requiring insurance" a. After you have entered into that contract or
means that part of any contract or agreement agreement;
under which you are required to include a person b. While that part of the contract or agreement
or organization as an additional insured on this is in effect; and
Coverage Part, provided that the "bodily injury"
c. Before the end of the policy period.
Page 8 of 8 0 2007 The Travelers Companies,Inc. CG D3 79 09 07