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HomeMy WebLinkAboutPW17-156 - Change Order - #1 - Nature's Way Tree Service, LLC - Tree Removal - 04/26/2017 /o / /%/�///'i% Un Mir r M ON T / Document 'W'nsHIrr cror� �/i�i/;///////i CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor flame: Nature's Way Tree Service Vendor Number: D Edwards Dumber Contract 'Number: PW 1-1 - 1 - 00 This is assigned by City Clerk's Office Project Name: Tree Removal Description: El Tnterlocal Agreement ® Change Order ❑ Amendment ❑ Contract ❑ Other. Contract Effective Date: 4/26/17 Termination Date: 5/10/17 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: ,doe Codi a Department: PW Operations Contract Amount: $876.00 Approval Authority:. (CIRCLE ONE) Department Drec Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Remove an alder tree at 12206 SE 221st St. As of: 08/27/14 r . KEN T W A S H I N O T O N CHANGE ORDER NO. 1 NAME OF CONTRACTOR: Nature's Way Tree Service ("Contractor") CONTRACT NAME & PROJECT NUMBER: Tree Removal ORIGINAL CONTRACT DATE: March 27, 2017 This Change Order amends the above-referenced contract; all other provisions of the contract that are not inconsistent with this Change Order shall remain in effect. For valuable consideration and by mutual consent of the parties, the project contract 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, Contractor shall provide all labor, materials, and equipment necessary to: Remove one decayed alder tree at 12206 SE 2215t St. For a description, see the Contractor's bid which is attached as Exhibit A and incorporated by this reference. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are hereby modified as follows: Original Contract Sum, $1,916.25 (including applicable alternates and WSST) Net Change by Previous Change Orders $0 (incl. applicable WSST) Current Contract Amount $1,916.25 (incl. Previous Change Orders) Current Change Order $800.00 Applicable WSST Tax on this Change $76.00 Order Revised Contract Sum $2,792.25 CHANGE ORDER - 1 OF 3 Original Time for Completion 5/10/17 (insert date) Revised Time for Completion under n/a prior Change, Orders (insert date) Days Required (±) for this Change 0 calendar days Order Revised Time for Completion 5/10/17 (insert date) Pursuant to the above-referenced contract, Contractor agrees to waive any protest it may have regarding this Change Order and acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits, This Change Order, unless otherwise provided, does not relieve the Contractor from strict compliance with the guarantee and warranty provisions of the original contract, particularly those pertaining to substantial completion date. All acts consistent with the authority of the Agreement, previous Change Orders (if any), and this Change Order, prior to the effective date of this Change Order, are hereby ratified and affirmed, and the terms of the Agreement, previous Change Orders (if any), and this Change Order 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 contract modification, which is binding on the parties of this contract. 3. The Contractor will adjust the amount of its performance bond (if any) for this project to be consistent with the revised contract sum shown in section 2, above. IN WITNESS, the parties below have executed this Agreement, which will become effective on the last date written bellow. CONTRACTOR: CIT'Y OF KENT: By: By: Z�14 (signature) '-"(signature) Print Name: Print Name: L,4oihs A d6e_e Its— Its (title) title) DATE: Z-1-z' 7 DATE: lylh6"11-7- APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department NMure'S Way Tree Serve-Tree Remov COI/Codiga CHANGE ORDER - 2 OF 3 EXHIBIT A Estimate sheet Nature's Way Tree Service, LLC Customer Information Date 1019184th Ave Ct E 41312017 Lase Tapps WA 98391 City Of not 253-740-4669 Services Tours To Complete Price Pruning Tree evaluation Tree removal Other comments Removal of one decayed alder tree hanging over stied in wetland behind 12206221st Kent wa No clean up Sub total $800.00 TaX $76.00 Total $876.00 AcoRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DO 04/o�/z017 �--� l� 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 WANED,subject to the tenns 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 . PRODUCER NONTAMO CT DOII Young Young Insurance Agency, LLC PHONE 5253) 333-2425 1 FAxAC. EMAILADDRESS,don@youngins.net PO Sox 5340 INSURERS AFFORDING COVERAGE NAIC 1t Rent WA 98064— INSURERA:Wesco Insurance Company INSURED INSURER a Nature's Way Tree Service, LLC INSURERC: 1019 184th Ave Ct E INSURERD: INSURER E: Lake Tapps WA 98391- INSURER : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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, LTR TYPE OF INSURANCE a POLICY UMBER POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY y WPP1143553 4/07/2017 4/01/2010 EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY / / / / S 100,000 CLAIMS-MADE FXI OCCUR / / / / MED EXP one on 3 5,000 PERSONAL SADVINJURY 3 1,000,000 GENERAL AGGREGATE 3 2,000,000 GEMLAGGREGATE LIMIT APPLIES PER: / / / / PRODUCTS-COMPIOPAGO S 2,000,000 17 POLICY PRO LOC AUTOMOBILE LIABILITY / / / / COMBINED SINGLE OWN (Es l�ccldarffl ANY AUTO / / / / BODILY INJURY(Per person) $ ALL OWNED SCHEDULED / / / / BODILY INJURY(Per accidaM) 3 AUTOS NON-OWNED / / / / PROPERTYDAMAGE S OS HIRED AUTOS AUTOS UMBRELLA LIAR OCCUR / / / / EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE / / / / AGGREGATE S DED I I RETENTION S / / / / $ WORKERS COMPENSATION / / / / WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN OR I IMITS ANY PROPRIETORIPARTNEFWXECUTIVE F-1 N A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) / / / / E.L.DISEASE-EA EMPLOYE S If Yos.d acC under -POLICY LIMIT S O SCRIPTION OF OPERATI S be. / / / / E.L DISEASE DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,AddNlonal Remarks Schedule,If more apace Is required) City of Kent is listed as an Additional Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Rent AU OR11 REIRESEN TN 499 West Gowe Rent WA 98032- ACORD 25(2010105) 019 2010 ACORD CORPORATION. All rights reserved. INS025(201005).0t The ACORD name and logo are registered marks of ACORD TE A�" CERTIFICATE OF LIABILITY INSURANCE F °A 3rzlrzol" ' 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(les)must have ADDITIONAL INSURED provisions or 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). CONTACT PRODUCER Liberty Mutual Insurance NAME: PO Box 188065 PHONE 800-962-7132 Fax Not: 800-845-3666 Fairfield, OH 45018 ADDRESS* BusinessService Libe Mutual.com INSURERS AFFORDING COVERAGE NAIC R INSURER A: Ohio Securl Insurance Company 24082 INSURED INSURER B: Nature's Way Tree Services LLC 1019 184th Avenue Ct E INSURERC: Lake Tapps WA 98391 INSURER 0: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 34732251 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 I TYPE OF INSURANCE ADDL SUER POLICY NUMBER MMMIDCY EFF MMIDDDY E)W LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO CLAIMS-MADE OCCUR PREMISES Eaaocurrence S MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ iECTT LOC PRODUCTS-COMPIOPAGG s OTHER: $ A AUTOMOBILE LIABILITY BAS56527308 3/14/2017 3/14/2018 COMBINED SINGLE LIMIT $ 1,000.00 ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident) s UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEb I I RETENTIONS E WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY YIN STATUTE OERTH ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ if yyeess describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Romaft Schedule,may be attached If more space is required) Certificate Holder is listed as Additional Insured per form CA2048. CERTIFICATE HOLDER CANCELLATION Clt of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 49 W GOWe ACCORDANCE WITH THE POLICY PROVISIONS. Kent,WA 98032 AUTHORIZED REPRESENTATIVE 4/" v Robert Draggoo m 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 34732251 1 56527308 1 17-18 Master Certificate I Robert Draggoo 1 3/21/2017 9:21:16 AN (PDT) I Page 1 of 2 POLICY NUMBER:WPP1143553 03 COMMERCIAL GENERAL LIABILITY CG 2010 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations City of Kent 499 West Gowe Street, Kent,WA 98032 information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section li — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" pp y y caused, in whole or in part, by: property damage occurring after: 1. Your acts or omissions;or 1. All work, including materials, parts or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the 1. The insurance afforded to such additional injury or damage arises has been put to its intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 2010 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III—Limits Of Insurance; whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement;or Page 2 of 2 ©Insurance Services Office, Inc., 2012 CG 20 10 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 20 48 02 99 DESIGNATED INSURED ENDORSEMENT The endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement This endorsement identifies person(s)or organization(s)who are"insureds"under the WHO IS AN INSURED provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective Policy Number BAS56527308 Named Insured Nature's Way Tree Services LLC Countersigned by (Authorized Representative) SCHEDULE Name of Person(s)or Organizations) The Cityy of Kent 499 W Gowe Kent,WA 98032 (If no entry appears above, information required to complete this endorsement will be shown in the Dec- larations as applicable to this endorsement.) Each person or organization shown in the Schedule is an"insured"for LIABILITY COVERAGE,but only to the extent that person or organization qualifies as an "insured" under the WHO IS AN INSURED provision contained in SECTION II of the Coverage Form CA 20 48 02 99 copyright. Insurance Services Office, Inc., 1900 Page 1 of 1 34732251 1 56527308 1 17-18 Master Certificate I Robert Draggoo 1 3/21/2017 9:21:16 AM WTI I Page 2 of 2