HomeMy WebLinkAboutPW16-048 - Amendment - #1 - Shearer Design LLC - 72nd Ave S Extension Engineering Construction Support - 03/23/2017 /
Records M e
KENT
WA5HINGTON Document
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to City Clerks Office. All portions are to be completed.
f you have questions, please contact City Clerk's Office.
Vendor Name: Shearer Design LLC
Vendor Number:
JD Edwards Number
Contract Number; l " 0
This is assigned by City Clerk's Office
Project Name: 72`d Ave S. Extension
Description: ❑ Interlocal Agreement Cl Change Order Z Amendment El Contract
Ll Other:
Contract Effective lute: 2/10/16 Termination Date: /31/17
Contract Renewal Notice (days): 153
Number of days required notice for termination or renewal or amendment
Contract Manager: lien Langholz Department: Public Works
Contract Amount: 33,824, E
Approval Authority: (CIRCLE QNE) -DertmenMt_ .irector Mayor City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):
Time extension needed so Consultant can provide final inspection and documentation for
project,
As of: 08/2'7/14
IN
•
KENT
W.5-010.
AMENDMENT NO. 1
NAME OF CONSULTANT OR VENDOR: Shearer Design LLC
CONTRACT NAME & PROJECT NUMBER: 72"d Ave. S. Extension
ORIGINAL AGREEMENT DATE: February 10, 2016
This Amendment is made between the City and the above-referenced Consultant or
Vendor and amends the original Agreement and all prior Amendments. All other provisions of
the original Agreement or prior Amendments not inconsistent with this Amendment shall remain
in full force and effect. For valuable consideration and by mutual consent of the parties,
Consultant or Vendor's work is modified as follows:
1. Section I of the Agreement, entitled "Description of Work," is hereby modified to
add additional work or revise existing work as follows:
In addition to work required under the original Agreement and any
prior Amendments, the Consultant or Vendor shall:
No change is necessary to the scope of work, however an
amendment is needed to extend the time of completion to
August 31, 2017 so the Consultant can provide final inspection
and documentation for the project.
2. The contract amount and time for performance provisions of Section II "Time of
Completion," and Section III, "Compensation," are modified as follows:
Original Contract Sum, $33,820.80
including applicable WSST
Net Change by Previous Amendments $0
including applicable WSST
Current Contract Amount $33,820.80
including all previous amendments
Current Amendment Sum $0
Applicable WSST Tax on this $0
Amendment
Revised Contract Sum $33,820.80
AMENDMENT - 1 OF 2
Original Time for Completion 3/31/17
(insert date)
Revised Time for Completion under 11/a
prior Amendments
(insert date)
Add'l Days Required (±) for this 1 1-53 calendar days
Amendment
Revised Time for Completion 8/31/17
(insert date)
The Consultant or Vendor accepts all requirements of this Amendment by signing below,
by its signature waives any protest or claim it may have regarding this Amendment, and
acknowledges and accepts that this Amendment constitutes full payment and final settlement of
all claims of any kind or nature arising from or connected with any work either covered or
affected by this Amendment, including, without limitation, claims related to contract time,
contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless
otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the
guarantee and warranty provisions of the original Agreement.
All acts consistent with the authority of the Agreement, previous Amendments (if any),
and this Amendment, prior to the effective date of this Amendment, are hereby ratified and
affirmed, and the terms of the Agreement, previous, Amendments (if any), and this Amendment
shall be deemed to have applied.
The parties whose names appear below swear under penalty of perjury that they are
authorized to, enter into this Amendment, which is binding on the parties of this contract.
IN WITNESS, the parties below have executed this Amendment, which will
become effective on the last date: written below.
r"\
CON�I" T NT/VENDOR: CITY OF KENT:
By By;�
(signature) (signature)
Print Name: Uk-- �t-> Print Name: Timothy J. LaPorte, IP.E.
Its, 01 \--3 1-'-- Its Public 'Forks Director
(title) itle)
DATE: 2D�IL-) DATE: rZ'
I J f
APPROVED AS, TO FORM:
(applicable if Mayor's signature required)
Kent Law Department
t' r 0 i yn�77 A ,,S.F.t niCo,A,d I./La v 1 o I z
AMENDMENT - 2 OF 2
CORO® DATE(MMIDDIYYYY)
A
CC CERTIFICATE OF LIABILITY INSURANCE 11/11/2017
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 endorsements.
NT PRODUCER cMeA Call Wallace
Hall&Company PHONE 360-598-5028 FAX 360 598-3703
19660 10th Ave NE LAIC No
Poulsbo WA 98370 AE nDRE,,,swallace@hallandcompany.com
INSURERS AFFORDING COVERAGE NAIC 0
INSURER A:Hartford Casualty Insurance Company 29424
INSURED 12609 INSURERB:Travelers Casualty and Surety Co of 31194
Shearer Design LLC INSURER C:
3613 Phinney Ave N#B
Seattle WA 98103 INSURER D
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:916152832 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 ADDLISUHR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS
LTR POLICY NUMBER MWIDDIYYYY MMIDD/YYYY
A X COMMERCIAL GENERAL LIABILITY Y Y 52SBAIJ6571 2/9/2017 2/9/2018 EACH OCCURRENCE $2.000,000
DAMAGE TO RENTEIY
CLAIMS-MADE X�OCCUR PREMISES aoccurrence) $300.000
MEDEXP oneperson) $10,000
PERSONAL 8 ADV INJURY $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
JEC ❑LOC PRODUCTS-COMP/OP AGG $4,000,000 POLICY a
OTHER: $
A AUTOMOBILE LIABILITY Y Y 52SBAIJ6571 2/9/2017 2/9/2018 $
,E(,IMIIINED t 2,000,000
accident)
ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEAUTODULED BODILY INJURY(Per accident) $
X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE- $
AUTOS Par accident
S
A X UMBRELLA LIAR X OCCUR 52SBAIJ6571 2/9/2017 2/9/2018 EACH OCCURRENCE $3,000,000
EXCESS WAS CLAIMS-MADE AGGREGATE $3,000,000
DED RETENTION$ $
q WORKERS COMPENSATION 52SBAIJ6571 2/9/2017 2/9/2018 PTAT E X ERH WA Stop Gap
AND EMPLOYERS*LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $1,000,000
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH) E L.DISEASE-EA EMPLOYEE $1,000,000
If as.describe under
DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $1.000.000
B Professional Liab:Claims Made 106223080 1/11/2017 1/11/2018 $2.000.000 Per Claim
$2,000.000 Aggregate
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101.Additional Remarks Schedule,may ba attached If more space Is required)
The certificate holder is an additional insured per the attached.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
400 W Gowe ACCORDANCE WITH THE POLICY PROVISIONS.
Kent
Kent WA 98032
AUTHORIZEDnREPR NTATNE
C�2)
@ 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
Shearer Design LLC- The Hartford Policy#52SBAIJ6571
BUSINESS LIABILITY COVERAGE FORM
(b) Rented to, in the care, custody or b. Coverage under this provision does not
control of, or over which physical apply to:
control is being exercised for any (1) "Bodily injury" or "property damage'
purpose by you, any of your that occurred;or
"employees", "volunteer workers", (2) "Personal and advertising injury"
any partner or member(if you are arising out of an offense committed
a partnership or joint venture), or
any member (if you are a limited before you acquired or formed the
Ilabillty'company). organization.
b. Real Estate Manager 4. Operator Of Mobile Equipment
Any person(other than your"employee"or With respect to"mobile equipment" registered in
"volunteer worker"), or any organization your name under any motor vehicle registration
while acting as your real estate manager. law, any person is an insured while driving such
c. Temporary Custodians Of Your equipment along a public highway with your
Property permission. Any other person or organization
responsible for the conduct of such person is
Any person or organization having proper also an Insured, but'only with respect to liability
temporary custody of your property if you arising out of the operation of the equipment,and
die,but only: • only if no other insurance of any kind is available
(1) With respect to liability arising out of the to that person or organization for this liability.
maintenance or use of that property;and However,no person or organization is an Insured
(2) Until your legal representative has with respect to:
been appointed. a. 'Bodily injury" to a co-"employee" of the
d. Legal Representative if You Die person driving the equipment;or
Your Legal representative If you 'die, but b. "Property damage" to property owned by,
only with respect to duties as such. That rented to, in the charge of or occupied by'
representative will'have all your rights and you or the employer of any person who is
duties under this insurance, an insured under this provision.
e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft
Any subsidiary and subsidiary thereof, of With respect to watercraft you do not own that
yours which is a legally incorporated entity Is less than 51 feet long and is not being used
of which you own a financial interest of to carry persons for a charge, any person is an
more than 50% of the voting stock on the insured while operating such watercraft with
effective date of this Coverage Part. your permission. Any other person or
The insurance afforded herein for any organization responsible for the conduct of
subsidiary not shown in the Declarations such person Is also an insured, but only with
as a named insured does not apply to respect to liability arising out of the operation
injury or damage with respect to which an of the watercraft, and only If no other
Insured under this Insurance is also an insurance of any kind is available to that
Insured under another policy or would be person or organization for this liability.
an insured under such policy but For its However, no person or organization is an
termination or upon the exhaustion of its insured with respect to:
limits of insurance. a. "Bodily Injury" to a co"employee" of the
3. Newly Acquired Or Formed Organization person operating the watercraft;or
Any organ€zation you newly acquire or form, b. "Property-damage" to property owned by,
other than a partnership, joint venture or rented to, In the charge of or occupied by
limited liability company, and over which you you or the employer of any person who is
maintain financial interest of more than 50%of an insured under this provision.
the voting stock, will qualify as a Named S. Additional insureds When Required By
Insured If there is no other similar insurance Written Contract, Written Agreement Or
available to that organization. However. Permit
a. Coverage under this provision is afforded The person(s) or organization(s) identified In
only until the 180th day after you acquire Paragraphs a. through f. below are additional
or form the organization or the end of the insureds when you have agreed, In a written
policy period,whichever is earlier;and
Form SS 00.08 04 05 Page 11 of 24
The Hartford
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because'of a (ey Any failure to make such
permit Issued by a state or political inspections, adjustments, tests or
subdivision, that such person or organization servicing as the vendor has
be added as an additional Insured on your agreed to make or normally
policy, provided the injury or damage occurs undertakes to make in the usual
subsequent to the execution of the contract or course of business, in connection
agreement,or the Issuance of the permit, with the distribution or sale of the
A person or organization is an additional products;
insured under thls provision only for that (f) Demonstration, installation,
period of time required by the contract, servicing or repair operations,
agreement or permit. except such operations performed
However, no such person or organization is an at the vendor's premises inconnection with the sale of the
additional insured under this provision if such product;
person or organization Is included as an
additional Insured by an endorsement issued (g) Products which, after distribution
by us and made a part of this Coverage Part, or sale by you, have been labeled
including all persons or organizations added or relabeled or used as a
as additional insureds under the specific container, part or ingredient of any
additional Insured coverage grants in Section other thing or substance by or for
F.—Optional Additional Insured Coverages. the vendor;or
a. Vendors (h) "Bodily, injury". or "property
Any person damage" arising out of-the soles)or organ[zation(s}(referred to negligence of the vendor for its
below as vendor), but only with respect to. own acts or omissions or those of
"bodily injury" or "property damage" arising
out of"your products"which are distributed its employees or anyone else
or sold in the regular course of the vendor's acting on its behalf. However,this
business and only if this Coverage Part exclusion does not apply to:
provides coverage for "bodily injury" or (I) The exceptions contained In
"property damage" included within the Subparagraphs(d)or(f);or
"products-completed operations hazard". (ii) Such inspectiohs, adjustments,
(1) The insurance afforded to the vendor tests or servicing as the vendor
Is subject to the following additional has agreed to make or normally
exclusions: undertakes to make in the usual
This insurance does not apply to: course of business, inconnection with the distribution
(a) "Bodily injury" or "property or sale of the products.
damage" for which the vendor is (2) This insurance does not apply to any
obligated to pay damages by insured person or organization from
reason of the assumption of whom you have acquired such products,
liability in a contract or agreement. or any Ingredient, part or container,
This exclusion does not apply to entering into, accompanying or
liability for damages that the containing such products.
vendor would have In the absence
of the contract or agreement; b. Lessors Of Equipment
(b) Any express warranty (1) Any person or organization from
unauthorized by you; whom you lease equipment; but only
with respect to their liability for"bodily
(c) Any physical or chemical change injury", "property damage" or
In the product made Intentionally "personal and advertising Injury"
by the vendor; caused, in whole or In part, by your
(d) Repackaging, except when maintenance, operatfon or use of
unpacked solely for the purpose of equipment leased to you by such
Inspection, demonstration, testing, person or organization.
or the substitution of parts under
instructions from the manufacturer,
and then repackaged in the
original container;
Page 12 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(2) With respect to the Insurance afforded e. Permits issued By State Or Political
to these additional insureds, this Subdivisions
insurance does not apply to any (1) Any state or political subdivision, but
"occurrence" which takes place after only with respect to operations
you cease to lease that equipment performed by you'or on your behalf for
c. Lessors Of Land Or Premises which the state or political subdivision
(1) Any person or organization from has issued a permit.
whom you lease land or premises, but (2) With respect to the Insurance afforded
only with respect to liability arising out to these additional insureds, this
of the ownership, maintenance or use insurance does not apply to;
of that part of the land or premises (a) "Bodily injury, "property damage"
leased to you. or "personal and -advertising
.(2) With respect to the insurance afforded injury" arising out of operations
to these additional insureds, this performed for the state or
insurance does not apply to: municipality;or
(a) Any "occurrence" which takes (b) "Bodily injury"or"property damage"
place after you cease to lease that included within the "products-
land or be a tenant in that completed operations hazard".
premises;or f. Any Other Party
(b) Structural alterations, new (1) Any other person or organization who
construction or demolition is not an insured under Paragraphs a.
operations performed by or on through e. above, but only with
behalf of such person or respect to liability for "bodily injury",
organization. "property damage" or "personal and
d. Architects,Engineers Or Surveyors advertising injury"caused,in whole or
(1) Any architect, engineer,or surveyor,but in part, by your acts or omissions or
only with respect to liability for "bodily the acts or omissions of those acting
Injury", "property damage" or "personal on your behalf:
and advertising injury" caused, In whole (a) In the performance of your
or In part, by your acts or omissions or ongoing operations;
the acts or omissions of those acting on (b) In connection with your premises
your behalf owned by or rented to you;or
(a) In connection with your premises; (c) In connection with"your work"and
or included within the "products-
(b) In the performance of your completed operations hazard",but
ongoing operations performed by only if
you or on your behalf. (i) The written contract or written
(2) With respect to the insurance afforded agreement requires you to
to these additional insureds, the provide 'such coverage to
following additional exclusion applies: such additional insured; and
This insurance does not apply to (11) This Coverage Part provides
"bodily injury", "property damage" or coverage for,"bodily Injury" or
"personal and advertising injury" "property damage" included
arising out of the rendering of or the within the "products-
failure to render any professional completed operations hazard".
services by or for you,including: (2) With respect to the insurance afforded
(a) THe preparing, approving, or to these additional. Insureds, this
failure to prepare or approve, insurance does not apply to:
maps, shop drawings, opinions, "Bodily injury", "property damage" or
reports, surveys, field orders, "personal and advertising injury"
change orders, designs or arising out of the rendering of, or the
drawings and specifications;or failure to render, any professional
(b) Supervisory, inspection, architectural, engineering or surveying
architectural or engineering services,including:
activities.
Form SS 00 08 04 05 Page 13 of 24
j
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or This General Aggregate limit does not
failure to prepare or approve, apply to "property damage" to premises
maps, shop drawings, opinions, while rented to you or temporarily
reports, surveys, field orders, occupied by you with permission of the
change orders, designs or owner, arlsing out of fire, lightning or
drawings and specificatlons;or explosion.
(b) Supervisory, inspection, 3. Each Occurrence Limit
architectural or engineering Subject to 2.a. -or 2.4 above, whichever
activities. applies, the most we will pay for the sum of all
The limits of insurance that apply to additional damages because of all "bodily injury",
Insureds are described in Section D. — Limits "property damage"- and medical expenses
Of Insurance. arising out of any one "occurrence" is the
How this insurance applies when other Liability and Medical Expenses Limit shown in
insurance Is available to an additional Insured the Declarations.
is described in the Other Insurance Condition ' The most we will pay for all medical expenses
In Section E.—Liability And Medical Expenses because of "bodily injury" sustained by any
General Conditions. one person is the Medical Expenses Limit
No person or organization is an insured with shown In the Declarations.
respect to the conduct of any current or past 4. Personal And Advertising Injury Limit .
partnership, joint venture or limited liability Subject to 2.15. above,the most we will pay for
company that is not shown as a Named Insured In the •sum of all damages because of all
the Declarations. "personal and advertising injury" sustained by
D. LIABILITY .AND MEDICAL EXPENSES any one person or organization Is the Personal
LIMITS OF INSURANCE and Advertising Injury Limit shown in the
Declarations.
1. The Most We Will Pay
5. Damage To Premises Rented To You Limit
The Limits of Insurance shown in the The Damage To Premises Rented To You
Declarations and the rules below fix the most Limit Is the most we will pay under Business
we will pay regardless of the number of: Liability Coverage for damages because of
a. Insureds; "property damage"to any one premises,while
b. Claims.made or"suits"brought;or rented to you,or in the case of damage by fire,
c. Persons or organizations making claims or lightning or explosion, while rented to you or
bringing"suits". temporarily occupied by you with permission of
2. Aggregate Limits the owner.
The most we will pay for: In the case of damage by fire, lightning or
explosion,the Damage to Premises Rented To
a. Damages because of "bodily injury" and You Limit applies to all damage proximately
"properly damage" included in . the caused by the same event, whether such
"products-completed operations hazard"is damage results from fire,lightning or explosion
the Products-Completed Operations or any combination of these.
Aggregate Limit shown in the Declarations. 6. HowLimits Apply To Additional Insureds
b. Damages because of all other "bodily The most we will pay on behalf of a person or
Injury", "property damage" or "personal organization who is an additional insured
and advertising injury", including medical under this Coverage Part is the lesser of
expenses, is the General Aggregate Limit a. The limits of insurance specified in a
shown in the Declarations. written contract, written agreement or
This General Aggregate Limit applies
permit issued by a state or political
separately to each of your "locations" subdivision;or
owned by or rented to you. b. The Limits of Insurance shown in the
"Location" means premises involving the Declarations.
same or connecting lots, or premises Such amount shall be a part of and not in
whose connection is interrupted only by a addition to the Limits of Insurance shown in
street, roadway or right-of-way of a the Declarations and described in this Section.
railroad.
Page 14 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
If more than one limit of Insurance under this (1) Immediately send us copies of any
policy and any endorsements attached thereto demands; notices, summonses or
applies to any claim or"suit",the most we will pay legal papers received in connection
under this policy and the endorsements is the with the claim or"suit";
single highest limit of liability of all coverages (2) Authorize us to obtain records and
applicable to such claim or "suit". However, this other Information;
paragraph does not apply to the Medical Expenses (3) Cooperate with us In the investigation,
limit set forth in Paragraph 3.above. settlement of the claim or defense
The Limits of Insurance of this Coverage Part apply against the"suit`;and
separately to each consecutive annual period and to
any remaining period of less than 12 months,starting (4} Assist us, upon our request, in the
with the beginning of the policy period shown In the Enforcement of any right against any
Declarations, unless the policy period Is extended person or organization that may be
after Issuance for an additional period of less than 12 liable the insured because of injury
months. In that case, the additional period will.be or damage to which this insurance
deemed part of the last preceding period for purposes may also apply.
of determining the Limits of Insurance, d. Obligations At The insured's Own Cost
E. LIABILITY AND MEDICAL EXPENSES No insured will, except at that Insured's own
GENERAL CONDITIONS cost, voluntarily make a payment, assume
any obligation, or Incur any expense, other
1. Bankruptcy than for first aid,without our consent.
Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance
the Insured's estate will not relieve us of our if we cover a claim or "suit" under this
obligations under this Coverage Part. Coverage Part that may also be covered
2. Duties in The Event Of Occurrence, by other insurance available to an
Offense,Claim Or Suit additional Insured, such additional Insured
a. Notice Of Occurrence Or Offense must submit such claim *or "suit" to the
You or any additional insured must see to other insurer for defense and indemnity.
- it-that we are notifled as soon as However, this provision does not apply to
practicable of an "occurrence" or an the extent that you have agreed in a
offense which may result In a claim. To written contract, written agreement or
the extent possible, notice should Include: Permit that this Insurance Is primary and
non-contributory with the additional
(1) How, when and where the"occurrence" Insured's own insurance.
or offense took place; f. Knowledge Of An Occurrence,Offense,
(2) The names and addresses of any Claim Or Suit
Injured persons and witnesses;and Paragraphs a. and b. apply to you or to
(3) The nature and location of any injury any additional insured only when such
or damage arising out of the "occurrence", offense, claim or "suit" is
"occurrence"or offense. known to:
b. Notice Of Claim (1) You or any additional insured that is
If a claim is made or "sult" is brought an Individual;
against any insured, you or any additional (2) Any partner, if you or an additional
insured must: insured is a partnership;
(1) Immediately record the specifics of the (3) Any manager, if you or an additional f
claim or "suit" and the date received; €nsur�d is a limited liability company;
and (4) Any "executive officer" or insurance
(2) Notify us as soon as practicable. manager, if you or an additional
You or any additional insured must see to insured is a corporation;
it that we receive a written notice of the (5) Any trustee, if you or an additional
claim or"suit"as soon as practicable, insured is a trust;or
c. Assistance And Cooperation Of The (6) Any elected or appointed official, If you
Insured or an additional insured Is a political
You and any other involved insured must: subdivision or public entity.
Form SS 00 08 04 05 Page 15 of 24
BUSINESS LIABILITY COVERAGE FORM
This Paragraph f. applies separately to (3) We have Issued this policy in reliance
you and any additional insured. upon your representations.
3. Financial Responsibility Laws b. Unintentional Failure To Disclose
a. When this policy is certified as proof of. Hazards
financial responsibility for the future under If unintentionally you should fall to disclose
the provisions of any motor vehicle all hazards relating to the conduct of your
financial responsibility law, the insurance business at the Inception date of this
provided by the policy for "bodily injury" Coverage Pan:, we shall not deny any
liability and "property damage" liability will coverage under this Coverage Part
comply with the provisions of the law to because of'such failure.
the extent of the coverage and limits of 7, Other Insurance
insurance required by that law.
b. With respect to "mobile equipment" to If other valid and collectible insurance is
which this Insurance applies, we will available for a loss we cover under this
pp Coverage Part, our obligations are limited as
provide any liability, uninsured motorists, follows:
underinsured motorists, no-fault or other
coverage required by any motor vehicle a. Primary Insurance
law. We will provide the required limits for This Insurance Is primary except when b.
those coverages, below applies. If other insurance is also
4. Legal Action Against Us primary, we will share with all that other
No person or organization has a right under insurance by the method described in c.
below.
this Coverage Form:
b• Excess Insurance
a. To join us as a party or otherwise bring us
into a suit asking for damages from an
This insurance is excess over any of the
insured;or other insurance, whether primary, excess,
b. To sue us on this Coverage Form unless contingent or on any other basis:
all of its terms have been fully complied (1) Your Work.
with. That is Fire, Extended Coverage,
A person or organization may sue us to recover Builder's Risk, Installation Risk or
on an agreed settlement or on a final judgment similar coverage for"your work";
against an.Insured; but we will not be liable for (2) Premises Rented To You
damages that are not payable under the terms of That is fire, lightning or explosion
this insurance or that are in excess of the insurance for premises rented to you
applicable limit of Insurance. An agreed or temporarily occupied by you with
settlement means a settlement and release of permission of the owner,
liability signed by us, the insured and the
claimant or the claimant's legal representative. (3) Tenant Liability
5. Separation Of insureds That is insurance purchased by you to
cover your liability as a tenant for
Except with respect to the Limits of insurance, "property damage" to premises rented
and any rights or duties specifically assigned to you or temporarily occupled by you
in this policy to the first Named Insured, this with permission of the owner;
insurance applies:
a. As If each Named Insured were the only (4) Aircraft,Auto Or Watercraft
Named Insured; and If the loss arises out of the maintenance
b. Separately to each insured against whom or use of aircraft,"autos"or watercraft to
a claim is made or"suit"is brought. the extent not subject to Exclusion g. of
Section A.—Coverages.
6. Representations (5) Property Damage To Borrowed
a. When You Accept This Policy Equipment Or Use Of Elevators
By accepting this policy,you agree: If the loss arises out of "property
(1) The statements in the Declarations damage" to borrowed equipment or
are accurate and complete; the use of elevators to the extent not
(2) Those statements are based upon subject to Exclusion k.of Section A.—
representations you made to us;and Coverages.
Page 16 of 24 Form SS 00 08 04 05
BUSINESS LIABILITY COVERAGE FORM
(6) When You Are Added As An When this Insurance is excess over other
Additional Insured To Other insurance, we will pay only our share of
insurance the amount of the. loss, if any, that
That is other insurance available to exceeds the sum of
you covering liability. for damages (1) The total amount that all such other
arising out of the premises or insurance would pay for the loss in the
operations,or products and completed absence of this insurance;and
operations, for which you have been (2) The total of all deductible and self-
added as an additional Insured by that insured amounts under all that other
insurance;or Insurance.
(7) When You Add Others As An We will share the remaining loss,if any,with
Additional Insured To This any other insurance that is not described in
insurance this Excess Insurance provision and was not
That is other Insurance available to an bought specifically to apply in excess of the
additional insured. Limits of Insurance shown In the
However, the following provisions Declarations of this Coverage Part
apply to other insurance available to c. Method Of Sharing
any person or organization who is an If all the other Insurance permits
additional insured under this Coverage contribution by equal shares,we will follow
Part: this method also. Under this approach,
(a) Primary Insurance When each insurer contributes equal amounts
Required By Contract until it has paid its applicable limit of
This insurance is primary if you Insurance or none of the loss remains,
have agreed in a written contract, whichever comes first.
written.agreement or permit that If any of the other insurance does not permit
this insurance be primary. If other contribution by equal shares, we will
insurance is also primary, we will contribute by limits. Under this method,each
share with all that other Insurance insurers share Is based on the ratio of its
by the method described In- c. applicable limit of insurance to the total
below. applicable limits of Insurance of all insurers.
(b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against
To Other Insurance When Others To Us
Required By Contract a. Transfer Of Rights Of Recovery
If you have agreed in a written if the insured has rights to recover all or
contract, written agreement or part of any payment, including
permit that this insurance Is Supplementary Payments, we have made
primary and non-contributory with under this Coverage Part, those rights are
the additional insured's own transferred to us. The insured must do
Insurance, this insurance is nothing after loss to impair them. At our
primary and we will not seek request, the Insured will bring "suit" or
contribution from that other transfer those rights to us and help us
Insurance. enforce them. This condition does not
Paragraphs(a)and (b)do not apply to apply to Medical Expenses Coverage.
other insurance to which the additional b. Waiver Of Rights Of Recovery (Waiver
Insured has been added as an Of Subrogation)
additional Insured. if the insured has waived any rights of
When this,insurance is excess, we will recovery against any person or
have no duty under this Coverage Part to organization for all or part of any payment,
defend the insured against any"suit"if any including Supplementary Payments, we
other insurer has a duty to defend the have made under this Coverage Part, we
Insured against that "suit". If no other also waive that right, provided the insured
Insurer defends, we will undertake to do waived their rights of recovery against
so, but we will be entitled to the insured's such person or organization in a contract,
rights against all those other insurers. agreement or permit that was executed
prior to the injury or damage.
Form SS 00 08 04 05 Page 17 of 24
COMMON POLICY CONDITIONS
Ali coverages ofthis policy are subject to the following conditions.
A. Cancelfation (5) Failure to;
1. The first Named Insured shown in the (a) Fumish necessary heat, water,
Declarations may cancel this policy by mailing sewer service or electricity for 30
or delivering to us advance written notice of consecutive days or more, except
cancellation. during a period of seasonal
a2. We may cancel this policy by mailing or unoccupancy;or
delivering to the first Named Insured written (b) Pay property taxes that are owing
notice of cancellation at least: and have been outstanding for
H a. 5 days before the effective date of more than one year following the
cancellation if any one of the following date due, except •that this
NV conditions exists at any building that is provision will not apply Where you
rl Covered Property frl this policy: are in a bona fide dispute with the
o taxing authority regarding payment
ca (1) The building has *been vacant or o#such faxes.
Ln unoccupied 60 or more consecutive
Cq
days.This does not applyfo: b. 10 days before the effective date of .
cancellation if we cancel for nonpayment
(a) Seasonal uneccupancy;or of premium.
(b) Buildings in the course of c. '30 days before the effective date of
Sao construction, renovation or cancellation if we cancel for any other
-_-- addition. reason.
Butldings with 65% or more of the rental 3. We will mail or deliver our notice to the first
units or floor area vacant or unoccupied Named Insured's last mailing address known
are considered unoccupied under this to us.
provision. 4. Notice of cancellation will state the effective
(2) After damage by a Covered Cause of date of cancellation. The policy period will end
Loss, permanent repairs to the on that date.
� building:
5. if this policy is canceled, we will send the first
(a) Have not started;and Named insured any premium refund due.
� (b) Have not been contracted for,
Such refund will be pro rats. The cancellation
within 30 days of Initial payment of will be effective even if we have not made or
loss. offered a refund.
S. If notice is mailed, proof of mailing will be
(3) The building has: sufficient proof of notice.
(a) An outstanding order to vacate; 7. if the first Named Insured cancels this policy,
(b) An outstanding demolition order; we will retain no less than $100 of the
or premium.
(c) Been .declared unsafe by B. Changes
governmental authority. This policy contains all the agreements between you
(d) Fixed and salvageable items have and us concerning the Insurance afforded. The first
l� been or are being removed from the Named insured shown In the Declarations is
building and are not being replaced. authorized to make changes In the terms of this policy
1 This does not apply to such removal with our consent. Tills policy's terms can be
that is necessary or incidental to any amended or waived only by endorsement issued
renovation or remodeling. by us and made a part of this policy.
Form SS 00 05 12 06 Page I of 3
0 2006,The Hartford
COMMON POLICY CONDITIONS
4
C. Concealment,Misrepresentation Or Fraud I. Premiums
This policy is void in any case of fraud by you as it 1. The first Named Insured shown In the
relates to this policy at any time. It is also void If you Declarations:
or any other Insured,at any time,intentionally conceal a, is responsible for the payment of all
or misrepresent a material fact concerning: premiums;and
1. This policy; b. Will be the payee for any return premiums
2, The Covered Property;. we pay.
3. Your interest In the Covered Property;or 2. The premium shown in the Declarations was
4. A claim underthis policy. computed based on rates in effect at the time
the policy was Issued. If applicable, on each
0. Bxa[mination Of Your Stooks And Records renewal, continuation or anniversary of the
We may examine and audit your books and effective date of this policy, we will compute
records as they relate to the policy at any time the premium In accordance with our rates and
during the policy period and up to three years rules then In effect.
afterward. 3. With our consent,you may continue this policy
E. Inspections And Surveys In force by paying a continuation premium for
We have the right but are not obligated to: each successive one-year period. The
premium must be:
1. Make Inspections and surveys at anytime: a. Paid to us prior to the anniversary date;and
2. Give you reports on the conditions we find;and b. Determined in accordance with Paragraph
3. Recommend changes. 2.above.
Any Inspecflons, surveys, reports or Our forms then In effect will apply. If you do
recommendations relate only to Insurability and the not pay the continuation premium, this policy
premiums to be charged. We do not make safety will expire on the first anniversary date that we
I Inspections. We do not undertake to perform the duty have not received the premium.
of any person or organization to provide for the health 4. Changes in exposures or changes in your
or safety of any person. And we do not represent or business operation, acquisition or use of
warrant that conditions: locations that are not shown in the Declarations
4. Are safe or healthful;or may occur during the policy period, if so,we may
2. Comply with laws, regulations, codes or require an additional premium. That premium will
standards. be determined in accordance with our rates and
This condition applies not only to us, but also to rules then In effect,
any rating, advisory, rate service or similar J, Transfer Of Rights Of Recovery Against Others
organization which makes insurance inspections, To Us
surveys, reports or recommendations. Applicable to Property Coverage:
F. Insurance Under Two Or More Coverages If any person or organization to or for whom we
If two or more of this policy's coverages apply to make payment under this policy has rights to
the same loss or damage, we will not pay more recover damages from another, those rights are
than the actual amount of the loss or damage. transferred to us to the extent of our payment.
G. Liberalization That person or organization must do everything
necessary to secure our rights and must, do
If we adopt any revision that would broaden the nothing after loss to impair them. But you may
coverage under this policy without additional waive your rights against another party In writing:
premium within 45 days prior to or during the policy 1. Prior to a loss to your Covered Property.
period, the broadened coverage will immediately
apply to this policy, 2. After a loss to your t;avered property only if, at
time of loss,that party is one of the following:Fl. Other Insurance-property Coverage
If there is other Insurance covering the same loss a. Someone insured by this insurance;
or damage, we will pay only for the amount of b. A business firm:
covered loss or damage in excess of the amount (1) Owned or controlled by you;or
due from that other insurance, whether you can That owns or controls you;or
collect on It or not. But we will not pay more than (2)
the applicable Limit of Insurance.
Page 2 of 3 Form S5 00 0812 06
COMMON POLICY CONDITIONS
c. Yourtenant. L. Premium Audit
You may also accept the usual bills of lading or a. We will compute all premiums for this policy In
shipping receipts limiting the liability of carriers. accordance with our rules and rates.
This will not restrict your Insurance, b. The premium amount shown In the
K. Transfer Of Your Rights And Duties Under This Declaratlons is a deposit premium only. At the
Policy close of each audit period we will compute the
Your rights and duties under this policy may not be earned premium for that period. Any
additions!premium found to be due as a result
transferred without our written consent except in
of the audit are due and payable on notice to
the case of death of an individual Named Insured.
the first Named Insured. If the deposit
If you die,your rights and duties will be transferred premium paid for the policy term is greater
co to your legal representative but only while acting than the earned premium, we will return the
to, within the scope of duties as your legal excess to the first Named Insured.
a representative. Until your legal representative is c. The first. Named Insured must maintain all
appointed, anyone having proper temporary
01 custody of your property will have your rights and records related to the coverage provided by
this policy and necessary to tinarize the
rq duties but only with respect to that property. premium audit, and send us copies of the
0 same upon our request.
oe
0
w
N
N
0
aOur President and Secretary have signed this policy, Where required by law,the Declarations page has also been
ii countersigned by our duly authorized representative.
l�
Egg
aordd0.Hunt,Seafty Juan Ahdrade,President
Fong SS 00 05 12 06 Page 3 of 3
SUPER STRETCH SUMMARY
SUMMARY OF COVERAGE LIMITS
This is a summary of the Coverages and the Limits of Insurance provided by the Super Stretch Coverage form
SS 04 74 which is included in this policy. No coverage is provided by this summary. Refer to coverage form
SS 04 74 to determine the scope of your insurance protection.
�r
The Limits of Insurance for the following Additional Coverages are in addition to any other limit of insurance provided
ri under this policy:
Ln Blanket Coverage Limitof Insurance:$150,000
n Blanket Coverages
Accounts Receivable-On/Off Premises
Ln Computers and Media
o Debris Removal
aPersonal Property of Others
o Temperature Change
# Valuable Papers and Records-On/Off Premises
Coverage Limit
a�
Brands and Labels Up to Business Personal Property Limit
Claim Expenses $10,000
Computer Fraud $5,000
Employee Dishonesty(including ER[SA) $25,000
Flne Arts $25,000
Forgery $25,000
Laptop Computers-Worldwide Coverage $10,000
Off Premises Utility Services—Direct Damage $25,000
Outdoor Signs Full Value
Pairs or Sets Up to Business Personal Property Limit
Property at Other Premises $10,000
Salespersons'Samples $ 5,000
Sewer and Drain Back Up included Up to Covered Property Limits
Sump Overflow or Sump Pump Failure $25,000
Tenant Building and Business Personal Property $20,000
Coverage-Requlred by Lease
Transit Property in the Care of Carriers for Hire $10,000
Unauthorized Business Card Use $ 5,000
a
Form SS 8415 09 07 Page 1 of 2
0 2007,The Hartford
. 11
The-Llmlts of insurance for the following Coverage Extensions are a replacement of the Limit of Insurance provided
under the Standard Property Coverage Form or the Special Property Coverage Form,whichever applies to the policy:
Coverage Limit
Newly Acquired'or Constructed Property—180 Days
Building $1,000,000
Business Personal Property $500,000
Business income and Extra Expense $500,000
Outdoor Property $25,000 aggregate/$1,000 per item
Personal Effects $25,000
Property Off-Premises $25,000
The following changes apply only if Business income and Extra Expense are covered under this policy.- The Limits of
Insurance for the following Business Income and Extra Expense Coverages are in addition to'eny,other Limit of
Insurance provided under this policy:
Coverage Limit
Business Income Extension for Off-Premises utility Services $25,000
Business Income Extension for Web Sites $50,000/7 days
Business Income from Dependent Properties $50,000
The following Limit of insurance for the following Business Income Coverage is a replacement of the Limit of
insurance provided under the Standard Property Coverage Form or the Special Property Coverage Form, whichever
applies to the policy:
Coverage Limit.
Extended Business income 90 Days
The following changes apply to Lass Payment Conditions:
Coverage Limit
Valuation Changes
Commodity Stock Included
"Finished Stock" included
Mercantile Stock-Soid Included i
I
I
I
I
I
• i
Page 2 of 2 Form SS 84 15 09 07
PUBLIC WORKS DEPARTMENT
Timothy J. LaPorte, P.E.
Public Works Director
400 West Lowe
Kent, WA 98032
'W N Fax: 253-856-6500
K" ENT
W A S H IN G T O N Phone: 253-856-5500
LETTER OF TRANSMITTAL,
DATE: March 24, 2017
TO: David Shearer
Shearer Design LLC
3613 Phinney Ave. N. #13
Seattle, WA 98103
RE: 72 nd Ave. S. Extension
Copies Description
1 original Amendment No. 1
Enclosed is your executed copy of Amendment No. I for the above referenced project.
Please note that invoices should be emailed to accountspayableakentwa.gov.
If you should have any questions, please contact me.
Copies to: Andrew Dacuag
Ken Langholz Public Works Operations
220 4t' Ave, S.
Kent, Washington 98032
Phone: 253-856-5653
Fax: 253-856-6600
Email: ADacuag@KentWa.gov