HomeMy WebLinkAboutPK17-352 - Original - Stripe Rite Inc. - Sealcoating & Restriping of Service Club Ballfields Parking Lot - 06/02/2017 w / /r�/`l'�%/M
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CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to City Clerks Office. All portions are to be completed.
If you have questions, please contact City Clerk's Office.
Vendor Name: Stripe Rite, Inc,
Vendor Number: 34801
JD1 Edwards Number
Contract Number: =
This is assigned by City Clerk's Office
Project Name: Service Club Ballfields-Sealcoatinq and Restriping of Parking Lot
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment X❑ Contract
❑, Other:
Contract Effective Date: 05/31/2017 Termination Date: 09/29/2017
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Justin Oliver Department: Park Maintenance-East Hill
Contract Amount: $25,411.30
Approval Authority: ❑ Department Director X0 Mayor 0 City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):.
Sealcoating and restriping of parking lot at Service Club Ballfie-1ds located at 14 98 SE
288t" Street, Kent 'I�,rA 98942 as . . ....... _-- _-_ ._ ..._
and marked as Exhibit A attached.
As of. 08/'27/14
I�KENT
PUBLIC WORKS AGREEMENT
between City of Kent and
Stripe Rite Inc.
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Stripe Rite Inc, organized under the laws of the State of Washington, located
and doing business at 1813 137'h Ave. E., Sumner, WA 98390; P: 253-863-2987, F; 253-863-3120,
contact: Jake Bateman, (hereinafter the "Contractor").
AGREEMENT
The parties agree as follows:
I. DESCRIPTION OF WORK.
Contractor shall perform the following services for the City in accordance with the following
described plans and/or specifications:
------------
Sealcoating and restriping of parking lot at Service Club Ballfields located at 14608 SE 288 1h
St, Kent 'WA 98042 as per attached Bid Number 17-2323 dated' April 24, 2017 marked as
Exhibit A attached.
Contractor 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 such services are performed,
11. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in
Section I above immediately upon execution of this Agreement. Upon the effective date of this
Agreement, the Contractor shall complete the work described in Section I within 120 days, .
III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed TWENTY
FIVE THOUSAND FOUR HUNDRED ELEVEN DOLLARS AND 30 CENTS ($2S,411.30)], including any
applicable Washington State Sales Tax, for the work and services contemplated in this Agreement. The
City shall pay the Contractor fifty percent (50%) of the Contract amount upon completion and acceptance
of the work by the City, or at such earlier time as the City may determine is appropriate, The City will pay
the remaining Contract amount upon fulfillment of the conditions listed below and throughout this
Agreement,
A. No Payment and Performance Bond, Because this contract, including applicable sales
tax, is less than $35,000, and pursuant to Chapter 39.08 RCW, the Contractor, in
lieu of providing the City a payment and performance bond, has elected to have the
City retain the final fifty percent (50%) of the Contract amount for a period of thirty
(30) days after the date of final acceptance, or until receipt of all necessary releases
from the State Department of Revenue, the State Department of Labor & Industries,
and the State Employment Security Department, and until settlement of any liens
filed under Chapter 60.28 RCW, whichever is later.
PUBLIC WORKS AGREEMENT - 1
(Over$20K, under$35K, and No Performance Bond)
B. Defective or Unauthorized Work. The City reserves its right to withhold payment
from Contractor for any defective or unauthorized work. Defective or unauthorized
work includes, without limitation: work and materials that do not conform to the
requirements of this Agreement; and extra work and materials furnished without the
City's written approval. If Contractor is unable, for any reason, to satisfactorily
complete any portion of the work, the City may complete the work by contract or
otherwise, and Contractor shall be liable to the City for any additional costs incurred
by the City. "Additional costs" shall mean all reasonable costs, including legal costs
and attorney fees, incurred by the City beyond the maximum Contract price specified
above. The City further reserves its right to deduct the cost to complete the
Contract work, including any Additional Costs, from any and all amounts due or to
become due the Contractor.
C. Final Payment: Waiver of Claims. THE CONTRACTOR'S ACCEPTANCE OF FINAL
PAYMENT (EXCLUDING WITHHELD RETAINAGE) SHALL CONSTITUTE A WAIVER OF
CONTRACTOR'S CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND
IDENTIFIED BY CONTRACTOR AS UNSETTLED AT THE TIME FINAL PAYMENT IS MADE
AND ACCEPTED.
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:
A. The Contractor 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 Contractor maintains and pays for its own place of business from which
Contractor's services under this Agreement will be performed.
C. The Contractor has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed before the City
retained Contractor's services and is a service other than that furnished by the City,
or the Contractor is engaged in an independently established trade, occupation,
profession, or business of the same nature as that involved under this Agreement.
D. The Contractor 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 Contractor has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by Contractor's
business, and has obtained a Unified Business Identifier (UBI) number from the
State of Washington.
F. The Contractor has a valid contractor registration pursuant to Ch. 18.27 RCW or an
electrical contractor license pursuant to Ch. 19.28 RCW.
G. The Contractor maintains a set of books dedicated to the expenses and earnings of
its business.
V. TERMINATION. The City may terminate this Agreement for good cause. "Good cause"
shall include, without limitation, any one or more of the following events:
A. The Contractor's refusal or failure to supply a sufficient number of properly skilled
workers or proper materials for completion of the Contract work.
PUBLIC WORKS AGREEMENT - 2
(Over$20K, under$35K, and No Performance Bond)
B. The Contractor's failure to complete the work within the time specified in this
Agreement.
C. The Contractor's failure to make full and prompt payment to subcontractors or for
material or labor.
D. The Contractor's persistent disregard of federal, state or local laws, rules or
regulations.
E. The Contractor's filing for bankruptcy or becoming adjudged bankrupt.
F. The Contractor's breach of any portion of this Agreement.
If the City terminates this Agreement for good cause, the Contractor shall not receive any further
money due under this Agreement until the Contract work is completed. After termination, the City may
take possession of all records and data within the Contractor's possession pertaining to this project which
may be used by the City without restriction.
VI. PREVAILING WAGES. Contractor shall file a "Statement of Intent to Pay Prevailing
Wages," with the State of Washington Department of Labor & Industries prior to commencing the Contract
work. Contractor shall pay prevailing wages in effect on the date the bid is accepted or executed by
Contractor, and comply with Chapter 39.12 of the Revised Code of Washington, as well as any other
applicable prevailing wage rate provisions. The latest prevailing wage rate revision issued by the
Department of Labor and Industries is attached.
VII. CHANGES. The City may issue a written change order for any change in the Contract work
during the performance of this Agreement. If the Contractor determines, for any reason, that a change
order is necessary, Contractor must submit a written change order request to the person listed in the
notice provision section of this Agreement, section XV(D), within fourteen (14) calendar days of the date
Contractor knew or should have known of the facts and events giving rise to the requested change. If the
City determines that the change increases or decreases the Contractor's costs or time for performance,
the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with
the Contractor on all equitable adjustments. However, if the parties are unable to agree, the City will
determine the equitable adjustment as it deems appropriate. The Contractor shall proceed with the
change order work upon receiving either a written change order from the City or an oral order from the
City before actually receiving the written change order. If the Contractor fails to require a change order
within the time specified in this paragraph, the Contractor waives its right to make any claim or submit
subsequent change order requests for that portion of the contract work. If the Contractor disagrees with
the equitable adjustment, the Contractor must complete the change order work; however, the Contractor
may elect to protest the adjustment as provided in subsections A through E of Section VIII, Claims, below.
The Contractor accepts all requirements of a change order by: (1) endorsing it, (2) writing a
separate acceptance, or (3) not protesting in the way this section provides. A change order that is
accepted by Contractor as provided in this section shall constitute full payment and final settlement of all
claims for contract time and for direct, indirect and consequential costs, including costs of delays related
to any work, either covered or affected by the change.
VIII. CLAIMS. If the Contractor disagrees with anything required by a change order, another
written order, or an oral order from the City, including any direction, instruction, interpretation, or
determination by the City, the Contractor may file a claim as provided in this section. The Contractor shall
give written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the
events giving rise to the claims, or within fourteen (14) calendar days of the date the Contractor knew or
should have known of the facts or events giving rise to the claim, whichever occurs first . Any claim for
damages, additional payment for any reason, or extension of time, whether under this Agreement or
otherwise, shall be conclusively deemed to have been waived by the Contractor unless a timely written
claim is made in strict accordance with the applicable provisions of this Agreement.
PUBLIC WORKS AGREEMENT - 3
(Over$20K, under$35K, and No Performance Bond)
At a minimum, a Contractor's written claim shall include the information set forth in subsections A,
items 1 through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN
THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN
ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED
BY THAT DELAY.
A. Notice of Claim. Provide a signed written notice of claim that provides the following
information:
1. The date of the Contractor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions in this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that estimate
was determined; and
5. An analysis of the progress schedule showing the schedule change or
disruption if the Contractor is asserting a schedule change or disruption.
B. Records. The Contractor shall keep complete records of extra costs and time incurred as a
result of the asserted events giving rise to the claim. The City shall have access to any of
the Contractor's records needed for evaluating the protest.
The City will evaluate all claims, provided the procedures in this section are followed. If the
City determines that a claim is valid, the City will adjust payment for work or time by an
equitable adjustment. No adjustment will be made for an invalid protest.
C. Contractor's Duty to Complete Protested Work. In spite of any claim, the Contractor shall
proceed promptly to provide the goods, materials and services required by the City under
this Agreement.
D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the
Contractor also waives any additional entitlement and accepts from the City any written or
oral order (including directions, instructions, interpretations, and determination).
E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this
section, the Contractor completely waives any claims for protested work and accepts from
the City any written or oral order (including directions, instructions, interpretations, and
determination).
IX. LIMITATION OF ACTIONS. CONTRACTOR MUST, IN ANY EVENT, FILE ANY LAWSUIT
ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE
THE CONTRACT WORK IS COMPLETE OR CONTRACTOR'S ABILITY TO FILE THAT CLAIM OR SUIT SHALL BE
FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD.
X. WARRANTY. Contractor warrants that it will faithfully and satisfactorily perform all work
provided under this Agreement in accordance with the provisions of this Agreement. The Contractor shall
promptly correct all defects in workmanship and materials: (1) when Contractor knows or should have
known of the defect, or (2) upon Contractor's receipt of notification from the City of the existence or
discovery of the defect. In the event any parts are repaired or replaced, only original replacement parts
shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for
that portion of the work shall extend for an additional year beyond the original warranty period applicable
to the overall work. The Contractor shall begin to correct any defects within seven (7) calendar days of its
receipt of notice from the City of the defect. If the Contractor does not accomplish the corrections within
a reasonable time as determined by the City, the City may complete the corrections and the Contractor
shall pay all costs incurred by the City in order to accomplish the correction.
PUBLIC WORKS AGREEMENT - 4
(Over$20K, under$35K, and No Performance Bond)
XI. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any sub-contract, the Contractor, its sub-contractors, or any person acting on behalf of the
Contractor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation,
national origin, or the presence of any sensory, mental, or physical disability, discriminate against any
person who is qualified and available to perform the work to which the employment relates.
Contractor shall execute the attached City of Kent Equal Employment Opportunity Policy
Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the
attached Compliance Statement.
XII. INDEMNIFICATION. Contractor 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 Contractor'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 Contractor'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 Contractor and the City, its officers,
officials, employees, agents and volunteers, the Contractor's duty to defend, indemnify, and hold the City
harmless, and Contractor's liability accruing from that obligation shall be only to the extent of the
Contractor's negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL
INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES
FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER.
In the event Contractor 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 Contractor's part, then
Contractor 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 Contractor's part.
The provisions of this section shall survive the expiration or termination of this Agreement.
XIII. INSURANCE. The Contractor shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit B, attached and incorporated
by this reference.
XIV. WORK PERFORMED AT CONTRACTOR'S RISK. Contractor 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 Contractor's own risk, and Contractor shall be responsible for any loss of or damage to
materials, tools, or other articles used or held for use in connection with the work.
XV. MISCELLANEOUS PROVISIONS.
PUBLIC WORKS AGREEMENT - 5
(Over$20K, under$35K, and No Performance Bond)
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
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred
in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or
award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section XII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at
the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written
notice hereunder shall become effective three (3) business days after the date of mailing by registered or
certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this
Agreement or such other address as may be hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written consent
of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment,
the terms of this Agreement shall continue in full force and effect and no further assignment shall be
made without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of the City
and Contractor.
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 Contractor agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable to
Contractor'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 Contractor 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 Contractor 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 Contractor agrees to cooperate fully with the City in satisfying
the City's duties and obligations under the Public Records Act.
J. City Business License Required. Prior to commencing the tasks described in Section I,
Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of
the Kent City Code.
PUBLIC WORKS AGREEMENT - 6
(Over$20K, under$35K, and No Performance Bond)
K. Counterparts and Signatures by Fax or Email. This Agreement may be executed in any
number of counterparts, each of which shall constitute: an original, and all of which will together constitute
this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page
to the other by fax or email and that signature shall have the same force and effect as if the Agreement
bearing 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.
CONTRACT R: CITY OF KE ...........
By: By:
(Signat (signature)T
Print ame: PI N a e!ri , zette Cooke
Its I s v Ma or
(title)
DATE: 5/tct q
DATE:
NOTICES TO-iE SENT TO: NOTICES TO BE SENT TO:
CONTRACTOR: CITY OF KENT:
lake Bateman Justin Oliver, Project Manager
Stripe Rite Inc City of Kent
1813 137t" Avenue E. 220 Fourth Avenue South
Sumner, WA 98390 Kent, WA 98032
253-261-8611 (cell) (253) 455-2457 (cell)
253-863-29,87 (telephone)
253-863-3120 (facsimile) (253) 856-5135 (telephone)
(253) 630-0670 (facsimile)
APPROVED AS TO FORM:
Kent' L [)apartment
[In this N21d,you may ef9er the electrOMC fileodth where the CoiltrACE has been saved
PUBLIC WORKS AGREEMENT - 7
(Over$20K, under$35K, and No Performance Bond)
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 1, 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:
Title:
Date:--.. q
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
Scope,wf work for Service Club Sea|umadmg and Resthpin&
Work tobe performed at Serv�ce Club @aNfie|ds �ocated at: l4GO8SE288th St, Kent, VVA98O4Z
VVorNtmbeperformedbetweenJu|y1nm, Z017and ]u|V13m, 2O17, |fweatherdoesnotpenmitwnrktm
bccomp|eteddurinQthattime,]m[y31p—AugustZ~'vxiObethebackupvvindovv.
• Prepare Iot for mea|coating
• Apply two coats mfA-1OOCommercial Grade Sealer mrequivalent
= ResLripe parking lot to match previous existing layout.
AH work is to be performed to normal practices of the trades and manufacturer specifications of all
materials used. Prevailing wage must be included inbid.
The Contractor shall cleanup, remove and properly dispose mfany and all job related debris and
materials from the job site.
Project area is shown in picture below. Exact size specifications to he confirmed by City nfKent project
manager on site with contractor.
_ 1`813 137th Ave E
Sumner WA 98390 BID PROPOSAL BY-fake Bateman
Ph (253)863-2987 SEND CONTRACT MD/OR SIGN AND REnMN
TREE Fax (253)863.3120 TO ACCEPT BID
www stnpente com
1akeQstrtpente coin SCHEDULING:PLEASE CALL: (253)8B3-2987
Bid Number. V-2323
April 24,2017
COMPANY NAME PROJECT
CITY OF KENT PARKS DEPT SERVICE CLUB SEALCOATING AND RESTRIPING
220 FOURTH AVE SOUTH 14608 SE 288TH ST
KENT,WA 98032 KENT,WA 98042 Ph: 253-455-2457
Email: JOliver®kentwa.gov Rep's Name: JUSTIN Fax:
Office: 253-455-2457 Fax: Email: JOliver0kentwa-gov Prevailing: Yes
Sales Tax argeM U CW&W on File on
ITEM# EST QTY UNITS ITEM DESCRIPTION UNIT PRICE TOTAL
129,712 S.F. CLEAN LOT AND APPLY SEAL COAT $ 0.14 $ 18,159.68
'MATERIAL IS SPECIAL ASPHALT RESURF_ACER XLR8
`TO BE INSTALLED PER MANUFACTURER SPECIFICATIONS
299 EACH RESTRIPE PARKING STALL:WHITE $ 9.50 $ 2,840.50
2 EACH RESTRIPE 12"(STAFF)STENCIL:WHITE 35.00 $_ $ 70.00
- -- - -
2 EACH RESTRIPE 12"(BUS PARKING)STENCIL:WHITE $ 40.00 $ 80.00
4 EACH RESTRIPE 18"(NO PARKING FIRE LANE)STENCIL:WHITE $ 50.00 $ 200.00
11 EACH RESTRIPE HANDICAP STENCIL:WHITE ON BLUE WITH WHITE BORDER 825.00
288 S.F. RESTRIPE CROSSWALK:_WHITE(2'X8'BLOCKS) $ 2.00 $ 576.00
2 -- EACH RESTRIPE BUS PARKING STALL:WHITE _- - _- S— 25.00 § - 50.00
- - - - —
200 L.F. RESTRIPE CURB:RED $ 1.50 $ 300.00
'ALL PAVEMENT MARKINGS WILL BE DONE WITH WSDOT SPEC
- - -- - PAINT - -- - -
Total(Sales Tax Not Included) $ 23,101.18
'ANYTHING NOT CLEARLY STATED ABOVE SHALL BE EXCLUDED FROM BID!
'EXCLUDES PRELIMINARY SPOTTING AND LAYOUT, +►o% y�Ia t2
REMOVAL OF TEMP TAPE AND CORE DRILLING! 2Sr4,lt_30
BID PROPOSAL GOOD FOR 30
Bid Proposal Terms:
This bid proposal is based on( )mobilizahonts) If additional mobilizations are required due to scheduling conflicts that are out of Stripe Rrte's control,a
mobl6zation fee of S850 00-11 be charged each time for pavement marlung signs precast and S750 00 for extruded curb and seal coat
Excludes permits.layout.referencing,traffic control.sales tax and any other items not specifically mentioned in this bid proposal
Scheduled work may be cancelled by unfavorable weather Stripe Rite,Inc..shall solely determine unfavorable weather Conditions as Stripe Rite.Inc bears
the responsibility for installation and is in the best position to judge weather conditions
Stripe Rite.Inc shall not bear any financial responsibility for delays caused by strikes.weather conditions.delay in obtaining materials or other causes beyond its
control
Payment terms are as follows Within 30 days of receipt of invoice All past due Invoices shall bear interest at 18%per antrum until pad or the maximum rate allowed
by law
In the event that it becomes necessary to employ an attorney to enforce the rights of any part of this signed bdlcontract or any modification hereof the prevailing parry
shall be entitled to recover their collection costs.attorneys fees,and court fees.etc regardless if actual suit Is brought.
Customer Authonzation Title Date
TRAFFIC
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A TRAFFIC SAFETY SOLUTIONS COMPANY
Highways, Roads
TRAFFIC PAINT
Ennis-Flint manufactures and SUpplies a full line of-traffic
paints are both waterborre arid solvent based formulations
engineered to meet your specification whether Federal,
State, local, or commercial based.
WATERBORNE TRAFFIC PAINT
Environmental) friend) and lasting y y' g pavement markings,waterborne traffic paint is
based on proven acrylic emulsion technologies.Formulated for use in a wide range
of applications from streets and highways to parking lots,waterborne traffic paints
can be applied from temperatures as low as 35"F to as high as 120T.Waterborne
paints are suitable for application an both bituminous and concrete substrates and
can be sprayed with airless or conventional spray equipment.
STANDARD DRY DURASHEEN
r
■ Law VOC formula,non-flammable M Specifically for use where dirt
N Reduces and cleans up with water pickup is an issue
w
0 Excellent atomization and
■ Excellent atammzatlon and
application characteristics application characteristics
sill Dries to a durable,abrasion-resistant 0 Performs equally well on both
/ finish In temperatures of 50T and
rising asphalt and concrete surfaces
® Most commonly used for curbs.
;6
FAST DRY on roadways and parking lots
■ 'Worker and environmentally friendly
e Proven waterborne acrylic durability EXTENDED SEASON
'r • Minimizes traffic control when restriping N Developed for use from early
less antler standard c minutes or Specialized til late Fall
0 Dries to no trac
conditions at '15Spring
' formula eliminates
wet mils(vs.25 min.std.)
switching to solvent systems in
HIG,FI BUILD cold climates
y Eliminates hazardous waste and
IMMV increased durability through renter
N/ lr 0/ai Mil,
film build (,30 mil) rn�nirnizes exposure to chemicals
M [dries to"no track"in 3 min,or less 8 "No track"in less than 10 minutes at
All under standard conditions at 30 mils temperatures of 35 F and rising
is , r�� 1 yt�" ■ Flexible paint film to withstand road N 12 month shelf life
expansion/contraction
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r enhanced retroreflectivity
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to parkinglast eli e ti n,
choose from the very adle.
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SOLVENT BASED TRAFFIC PAINT
Solvent based traffic paints are co-polymer based and formulated for use on streets '
and highways,rural roads,and parking lots.
j
Solvent based formulas are especially suitable for colder ambient applications where. I
waterborne cannot be used, Suitable for application on bituminous and concrete
e
substrates, a 15 mil application can be applied at temperatures near freezing, for
faster drying times,it can be heated(maximum of 1 5 T)and sprayed with airless or
conventional spray equipment.
Solvent based paints are classified as High VOC and Low VOC..
High VOC> 150 g/l typically 450 g/I
•Chlorinated Rubber
Regular Dry Alkyd w
Acrylic Copolymer
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Low VOC c 150 g/I
Acrylic Copolymer(Low VOC)
PRODUCT BENEFITS
• Versatile quick dry times with excellent durability -,
• Applies with ease at ambient temperatures as low as 40'F
• Designed to be used with or without glass beads
• Available in both Zone Markings and Low VOC formulations
• Allows for traffic markings in the colder"shoulder"season
■ Dries to no pickup in 10 iminutes or less when applied at 15 mils
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TX Corporate Office
NC Corporate ice
5910 N.Central Expressway 115 Todd Court
Suite 1050 Thomasville,NC 773,60
D,allas,'TX 75706 Phone: 336,475.6600
Phone: 800.3 1.8118 sales@flinttrading.com
CO2012,Ennis-Flint MKT-00004
Page I of I
State of Washington
Department of Labor & Industries
Prevailing Wage Section - Telephone 360-902--5335
PO Box 44540, Olympia, WA 98504-4540
Payment Receipt
Your payment has been processed and your for-ai has been subryfltt(-.5cl.
Transaction 5/19/2017
Date
Transaction Id 105758280
Project Name Service Club Ballfields
Form Filed Intent
Form Id 835186
Payment Type VISA 5623
Amount Billed $40.00
5/19/20 17
Page 1of1
State of Washington
Department of Labor & Industries
Prevailing Wage Section - Telephone 360-902-5335
PO Box 44540, Olympia, WA 98504-4540
Washington State Prevailing Wage
The PREVAILING WAGES listed here include both the hourly wage rate and
the hourly rate of fringe benefits. On public works projects, worker's wage
and benefit rates must add to not less than this total. A brief description of
overtime calculation requirements are provided on the Benefit Code Key.
Journey Level Prevailing Wage Rates for the Effective Date: 5/11/2017
Countv Trade Job Classification Waeel Ho lidavlovertime Note
King Traffic Control Stripers Journey Level $44.85 7A 1 1 K
https://fortress.wa.gov/Ini/wagelookup/prvWagelookup.a... 5/11/2017
STRIPE RITE: INC Page 1 of 1
srAfFOFwiwltMGF M
Department of Labor& Industries
Certificate of Workers' Compensation Coverage
May 9, 2017
WA UBI No. 601 048 084
L&I Account ID 477,182-01
Legal Business Name STRIPE RITE INC
Doing Business As STRIPE RITE INC
Workers'Comp Premium Status. Account is current.
Estimated Workers Reported Quarter 1 of Year 2017"51 to 75
(See Description Below) Workers"
Account Representative Employer Services Help Line, (360)
902-4817
Licensed Contractor? Yes
License No. STRIPR1121JM
License Expiration 04/17/2019
What does "Estimated Workers Reported" mean?
Estimated workers reported represents the number of full time position requiring at least 480
hours of work per calendar quarter. A single 480 hour position may be filled by one person, or
several part time workers.
Industrial Insurance Information
Employers report and pay premiums each quarter based on hours of employee work already
performed, and are liable for premiums found later to be due. Industrial insurance accounts have
no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RCW
S 1.._12.050 and 51_.l 6.1 90).
https:Hsecure.ini.wa.gov/verify/Details/liabilityCertifiicate.aspx?UBI=601048084&E.IC=Sl*... 5/9/2017
EXHIBIT B
INSURANCE REQUIREMENTS FOR
SERVICE CONTRACTS
Insurance
The Contractor shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Contractor, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
1. Commercial General Liability insurance shall be written on
ISO occurrence form CG 00 01 and shall cover liability
arising from premises, operations, independent contractors,
products-completed operations, personal injury and
advertising injury, and liability assumed under an insured
contract. The City shall be named as an insured under the
Contractor's Commercial General Liability insurance policy
with respect to the work performed for the City using ISO
additional insured endorsement CG 20 10 11 85 or a
substitute endorsement providing equivalent coverage.
2. Automobile Liability insurance covering all owned, non-
owned, hired and leased vehicles. Coverage shall be written
on Insurance Services Office (ISO) form CA 00 01 or a
substitute form providing equivalent liability coverage. If
necessary, the policy shall be endorsed to provide
contractual liability coverage.
3. Workers' Compensation coverage as required by the
Industrial Insurance laws of the State of Washington.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Commercial General Liability insurance shall be written with
limits no less than $2,000,000 each occurrence, $2,000,000
general aggregate and a $2,000,000 products-completed
operations aggregate limit.
2. Automobile Liability insurance with a minimum combined
single limit for bodily injury and property damage of
$1,000,000 per accident.
EXHIBIT B (Continued)
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
insurance:
1. The Contractor's insurance coverage shall be primary insurance as respect
the City. Any Insurance, self-insurance, or insurance pool coverage
maintained by the City shall be excess of the Contractor's insurance and
shall not contribute with it.
2. The Contractor's insurance shall be endorsed to state that coverage shall
not be cancelled by either party, except after thirty (30) days prior
written notice by certified mail, return receipt requested, has been given
to the City.
3. The City of Kent shall be named as an additional insured on all policies
(except Professional Liability) as respects work performed by or on behalf
of the contractor and a copy of the endorsement naming the City as
additional insured shall be attached to the Certificate of Insurance. The
City reserves the right to receive a certified copy of all required insurance
policies. The Contractor's Commercial General Liability insurance shall
also contain a clause stating that coverage shall apply separately to each
insured against whom claim is made or suit is brought, except with
respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than A:VII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Contractor before commencement of the work.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Contractor.
Client#: 25674 STRIRITE
YYYY)
ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(M2017 M1001 5111 MIDDI
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 NAME: T Shamel Di Vona
Propel Insurance PHONE (F
(A/C,No,Exq:253.310.4047 Alc 66 No: 8 577-1326
vona
Tacoma Commercial Insurance E-MAIL Sharnel.Di ro elinsurance.com
1201 Pacific Ave,Suite 1000 ADDREss: @P P
Tacoma,WA 98402 INSURE S AFFORDING COVERAGE NAIC p
INSURER A:Continental Western Ins.Co. 10804
INSURED Stripe Rite Inc. INSURER8:Evanston Insurance Company 35378
`
1813137th Ave E INSURER C
INSURER D:
Sumner,WA 98390
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT NTH 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 IINDDLSU 0 POLICY NUMBER POLICY
OO EFF MMIDDIIYYYY LIMITS
A X COMMERCIAL GENERAL LIABILITY X X CPA6113651 1411112017 04/111201 EpACH OCCURRENCE $1,000,000_
NTED
CLAIMS-MADE I X OCCUR PREMISES aEocccurrrence) __ $500,000 _
X PD Ded:$1,000 MED EXP(Any one person) S 1 O OOO
PERSONAL 6 ADV INJURY S1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 2,000,000
POLICY i7 ECOT _ LOC PRODUCTS-COMP/OP AGG S 2,000,000
OTHER $
A AUTOMOBILE LIABILITY X I'i X CPAS013651 4/11/2017 04111/2018(Ea Md DSINGLE LIMIT
Ea acnaent $1,000,000
X ANY AUTO BODILY INJURY(Per person) S
ALL OWNED I�SCHEDULED BODILY INJURY(Per accident) $ ^
_ AUTOS H AUTOS ___
X HIRED AUTOS X NON-0WNED PROPERTY DAMAGE 9
` i AUTOS (Per accudeni) _
X A000110/13 — S - -
A X UMBRELLA LIAB X I OCCUR X X CPA6013651 4111/2017'I0411 1/2 01 8 EACH OCCURRENCE $10 000 000
EXCES5LIA8 CLAIMS-MADE, AGGREGATE $10 OOO OOO
DED X RETENTION$0 _ $
WORKERS COMPENSATION WA Stop Gap Only: PER
AND EMPLOYERS'LIABILITY
A ANY PROPRIETORJPARTNERJEXECUTIVE Y!N CPA6013651 4/1112017 04/11/2018 E L.EACH ACCIDENT__ $1,000,000
OFFICERIMEMBER EXCLUDED? N I A —
(Myandatory In NH) E L DISEASE-EA EMPLOYEE $1 000,000
ESCRIPTION OF OPERATIONS below _ �—
If as,describe under
D j El.DISEASE-POLICY LIMIT $1,000,000
B Contractor's 17CPLOWE00525 /1112017',04111/2016 $2,000,000 CPL&TPL
Pollution Liab $5,000 deductible
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
RE: Service Club Sealcoating&Restriping.
The City of Kent is additional insured per the attached endorsement.
CERTIFICATE HOLDER CANCELLATION
CI of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Parks,Recreation&Community Services ACCORDANCE WITH THE POLICY PROVISIONS.
220 Fourth Ave South
Kent,WA 98032 AUTHORIZED REPRESENTATIVE
-.-._-V—..,.,,—
01988-2014 ACORD CORPORATION.All rights reserved.
ACORD 25(2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S27027741M2662386 KTROO
This page has keen left:blank intentionally.
COMMERCIAL GENERAL LIABILITY
CL CG 04 92 09 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY ULTRA PLUS ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SUMMARY OF COVERAGE EXTENSIONS
Provision Name Of Coverage Extension Included or Limit of
Insurance
A. Miscellaneous Additional Insureds Included
B. Expected Or Intended Injury Or Damage Included
C. Knowledge Of Occurrence Included
D. Legal Liability—Damage To Premises Rented To You (Fire, Lightning, $300,000
Explosion, Smoke, Or Leakage From Automatic Fire Protective Systems)
E. Medical Payments $10,000
F. Mobile Equipment Redefined Included
G. Newly Formed Or Acquired Organization, Partnership Or Limited Liability Included
Company And Extended Period Of Coverage
H. Who Is An Insured—Amendment Included
I. Non-Owned Watercraft (Increased to maximum length of less than 51 Included
feet
J. Supplementary Payments—Increased Limits
1. Bail Bonds $ 3,000
2. Loss Of Earnings $ 1,000
K. Unintentional Omission Or Unintentional Error In Disclosure Included
L. Waiver Of Transfer Of Rights Of Recovery Against Others Included
M. Liberalization Clause Included
N. Incidental Medical Malpractice Included
The above is a summary only. Please consult the specific provisions that follow for complete information on the
extensions provided.
The provisions of the Commercial General Liability additional insured on your policy, provided
Coverage Part apply except as otherwise provided in that:
this endorsement. This endorsement applies only if a. The written contract or written agreement
such Coverage Part is included in this policy.
is:
A. MISCELLANEOUS ADDITIONAL INSUREDS (1) Currently in effect or becoming
1. Section II —Who Is An Insured is amended effective during the term of this
to include as an insured any person or policy; and
organization (referred to as an additional (2) Fully executed by you and the
insured below) described in Paragraphs additional insured prior to the "bodily
A.1.c.(1) through A.1.c.(8) below when you injury", "property damage" or "per-
and such person or organization have agreed sonal and advertising injury".
in writing in a contract or agreement that
such person or organization be added as an
CL CG 04 92 09 16 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 7
with its permission
b. The insurance afforded by this provision performed by or on behalf of
does not apply to any person or such additional insured.
organization included as an additional (4) Lessor Of Leased Equipment
insured by a separate endorsement
issued by us and made a part of this Any person(s) or organization(s)
policy or coverage part. from whom you lease equipment but
c. Only the following persons or organi- only with respect to liability for"bodily
zations are additional insureds under this injury", "property damage" or "per-
provision, with coverage for such sonal and advertising injury" caused,
additional insureds limited as provided in whole or in part, by your
herein: maintenance, operation or use of
equipment leased to you by such
(1) Managers Or Lessors Of Premises person(s) or organization(s).
A manager or lessor of premises but A person's or organization's status
only with respect to liability arising as an additional insured under this
out of the ownership, maintenance or endorsement ends when their written
use of that part of the premises contract or written agreement with
leased to you and subject to the you for such leased equipment ends.
following additional exclusions: This insurance does not apply to any
This insurance does not apply to: "occurrence" which takes place after
(a) Any "occurrence" which takes the equipment lease expires.
place after you cease to be a (5) State, Municipality, Governmental
tenant in that premises. Agency Or Subdivision Or Other
(b) Structural alterations, new con- Political Subdivision — Permits Or
struction or demolition operations Authorizations Relating To
performed by or on behalf of Premises
such additional insured. Any state, municipality, govern-
(2) Mortgagee,Assignee Or Receiver mental agency or subdivision or
other political subdivision subject to
A mortgagee, assignee, or receiver the following additional provisions:
but only with respect to their liability
as mortgagee, assignee, or receiver (a) This insurance applies only with
and arising out of the ownership, respect to:
maintenance, or use of a covered (i) The following hazards for
premises by you. which the state, municipality,
This insurance does not apply to governmental agency or
structural alterations, new con- subdivision or other political
struction or demolition operations subdivision has issued a
performed by or on behalf of such permit or authorization in
additional insured. connection with premises
you own, rent or control and
(3) Owners Or Other Interests From to which this insurance
Whom Land Has Been Leased applies:
An owner or other interest from (1.1) The existence,
whom land has been leased to you maintenance, repair,
but only with respect to liability construction, erection
arising out of the ownership, mainte- or removal of adver-
nance or use of that part of the land tising signs, awnings,
leased to you and subject to the canopies, cellar
following additional exclusions: entrances, coal holes,
This insurance does not apply to: driveways, manholes,marquees, hoist away
(a) Any "occurrence" which takes openings, sidewalk
place after you cease to lease vaults, street banners
that land. or decorations and
(b) Structural alterations, new con- similar exposures; or
struction or demolition operations
CL CG 04 92 09 16 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 7
with its permission
(1.2) The construction, erec- The insurance afforded the
tion or removal of vendor does not apply to:
elevators; or
(i) "Bodily injury" or "property
(1.3) The ownership, main- damage" for which the
tenance or use of any vendor is obligated to pay
elevators covered by damages by reason of the
this insurance. assumption of liability in a
(ii) Operations performed by you written contract or written
or on your behalf for which agreement. This exclusion
does not apply to liability for
the state, municipality, damages that the vendor
governmental agency or would have in the absence of
subdivision or other political subdivision has issued a the written contract or written permit or authorization. agreement;
(b) This insurance does not apply to (ii) Any express warranty unau-
"bodily injury", "property dam- thorized by you;
age" or"personal and advertising (III) Any physical or chemical
injury" arising out of operations change in the product made
performed for the state, munici- intentionally by the
pality, governmental agency or vendor;
subdivision or other political
subdivision. (iv) Repackaging, except when
unpacked solely for the
(6) Controlling Interest purpose of inspection,
Any person(s) or organization(s) with demonstration, testing, or the
a controlling interest in the Named substitution of parts under
Insured but only with respect to their instructions from the manu-
liability arising out of: facturer, and then
repackaged in the original
(a)Their financial control of you; or container;
(b) Premises they own, maintain or (v) Any failure to make such
control while you lease or occupy inspections, adjustments,
these premises. tests or servicing as the
This insurance does not apply to vendor has agreed to make
or normally undertakes to
structural alterations, new con- make in the usual course of
struction or demolition operations business, in connection with
performed by or for such person(s)or organization(s). the distribution or sale of the
products;
(7) Co-Owner Of Insured Premises (vi) Demonstration, installation,
A co-owner of a premises co-owned servicing or repair opera-
by you and covered under this tions, except such operations
insurance but only with respect to the performed at the vendor's
co-owner's liability as co-owner of premises in connection with
such premises. the sale of the product;
(8) Vendors (vii) Products which, after distri-
(a) Any person(s) or organization(s) bution or sale by you, have
(referred to as vendor), but only been labeled or relabeled or
with respect to "bodily injury" or used as a container, part or
"property damage" arising out of ingredient of any other thing
"your products" which are or substance by or for the
distributed or sold in the regular vendor; or
course of the vendor's business.
CL CG 04 92 09 16 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 7
with its permission
(viii)"Bodily injury" or "property 3. With respect to the insurance afforded to the
damage" arising out of the additional insureds within this Provision A.
sole negligence of the Miscellaneous Additional Insureds, the
vendor for its own acts or following is added to Section III — Limits Of
omissions or those of its Insurance:
employees or anyone else The most we will pay on behalf of the
acting on its behalf. How- additional insured is the amount of insurance:
ever, this exclusion does not
apply to: a. Required by the written contract or
(1.1) The exceptions written agreement; or
contained in Sub- b. Available under the applicable Limits Of
paragraphs (iv) or (vi); Insurance shown in the Declarations;
or
whichever is less.
(1.2) Such inspections, ad-
tests or This endorsement shall not increase the
justments, the applicable Limits Of Insurance shown in the
servicing tests
vendor has agreed to Declarations.
make or normally B. EXPECTED OR INTENDED INJURY OR
undertakes to make in DAMAGE
the usual course of
business, Exclusion 2.a. Expected Or Intended Injury of
business, in con-n with the Section I — Coverage A — Bodily Injury And
nectiodistribution it sale a Property Damage Liability is deleted and
the products. replaced by the following:
(b) This insurance does not apply to a. Expected Or Intended Injury Or Damage
any insured person or organi- 'Bodily injury"or"property damage"expected
zation, from whom you have or intended from the standpoint of the
acquired products, or any insured. This exclusion does not apply to
ingredient, part or container, "bodily injury" or "property damage" resulting
entering into, accompanying or from the use of reasonable force to protect
containing such products. persons or property.
2. With respect to coverage provided by this C. KNOWLEDGE OF OCCURRENCE
Provision A. Miscellaneous Additional
Insureds, the following additional provisions Paragraph 2.a. Duties In The Event Of
apply: Occurrence, Offense, Claim Or Suit of Section
IV — Commercial General Liability Conditions
a. Any insurance provided to an additional is deleted and replaced by the following:
insured designated under Paragraphs
A.1.c.{1} through A.1.c.(8) above does a. You must see to it that we are notified as
not apply: soon as practicable of an 'occurrence" or an
offense which may result in a claim only
(1) To "bodily injury" or "property when the 'occurrence" or offense is known
damage" included within the to:
products-completed operations
hazard"; or (1) You, if you are an individual;
(2) To "bodily injury", "property damage" (2) A partner, if you are a partnership;
or "personal and advertising injury" (3) A manager, if you are a limited liability
arising out of the sole negligence of company; or
such additional insured.
(4) An "executive officer' or the "employee"
b. The insurance afforded to such additional designated by you to give such notice, if
insured only applies to the extent you are an organization other than a
permitted by law. partnership or a limited liability company.
c. The insurance afforded to such additional To the extent possible, notice should include:
insured will not be broader than that
which you are required to provide by the (i) How, when and where the 'occurrence"
written contract or written agreement. or offense took place;
CL CG 04 92 0916 Includes copyrighted material of Insurance Services Office, Inc., Page 4 of 7
with its permission
(ii) The names and addresses of any injured you, or in the case of damage by fire,
persons and witnesses; and lightning, explosion, "smoke", or leakage
(iii) The nature and location of any injury or from automatic fire protective systems,
damage arising out of the "occurrence" while rented to you or temporarily
or offense. occupied by you with permission of the
owner.
D. LEGAL LIABILITY — DAMAGE TO PREMISES This limit will apply to all damage
RENTED TO YOU (Fire, Lightning, Explosion, proximately caused by the same event,
Smoke, Or Leakage From Automatic Fire whether such damage results from fire,
Protective Systems) lightning, explosion, "smoke", leakage
If damage to premises rented to you is not from automatic fire protective systems, or
otherwise excluded from this policy or coverage other covered causes of loss or any
part, then the following provisions apply: combination thereof.
1. Under Section I — Coverage A — Bodily 4. Subparagraph b.(1)(a)(ii) of Paragraph 4.
Injury And Property Damage Liability, the Other Insurance of Section IV —
last paragraph (after the exclusions) is Commercial General Liability Conditions
deleted and replaced by the following: is deleted and replaced by the following:
Exclusions c. through n. do not apply to dam- (ii) That is fire, lightning, explosion, "smoke"
age by fire, lightning, explosion, "smoke", or or leakage from automatic fire protective
leakage from automatic fire protective systems insurance for premises rented to
systems to premises while rented to you or you or temporarily occupied by you with
temporarily occupied by you with the permission of the owner;
permission of the owner. A separate limit of 5. Subparagraph a. of Definition 9. "Insured
insurance applies to this coverage as contract" of Section V — Definitions is
described in Section III — Limits Of deleted and replaced by the following:
Insurance.
2. The paragraph immediately after Sub- a. A contract for a lease of premises,
paragraph j.(6) of Paragraph 2. Exclusions However, that portion of the contract for
of Section I — Coverage A — Bodily Injury a lease of premises that indemnifies any
And Property Damage Liability is deleted person or organization for damage by
and replaced by the following: fire, lightning, explosion, "smoke" or
leakage from automatic fire protective
Paragraphs (1), (3) and (4) of this exclusion systems to premises while rented to you
do not apply to "property damage" (other or temporarily occupied by you with
than damage by fire, lightning, explosion, permission of the owner is not an
"smoke", or leakage from automatic fire "insured contract".
protective systems) to premises, including 6. As used in this Provision D. Legal Liability —
the contents of such premises, rented to you Damage To Premises Rented To You:
for a period of seven or fewer consecutive
days. A separate limit of insurance applies to "Smoke" does not include smoke from
Damage To Premises Rented To You as agricultural smudging, industrial operations
described in Section III — Limits Of or"hostile fire".
Insurance. E. MEDICAL PAYMENTS
3. Paragraph 6. of Section III — Limits Of If Coverage C — Medical Payments is not
Insurance is deleted and replaced by the otherwise excluded from this policy or coverage
following: part, the Medical Expense Limit is changed,
6. Subject to Paragraph 5. above, the subject to the terms of Section III — Limits Of
greater of: Insurance, to the greater of:
a. $300,000; or a. $10,000; or
b. The Damage To Premises Rented b. The Medical Expense Limit shown in the
To You Limit shown in the Declarations.
Declarations, F. MOBILE EQUIPMENT REDEFINED
is the most we will pay under Coverage Subparagraph f.(1) of Definition 12. "Mobile
A for damages because of "property equipment" of Section V—Definitions is deleted
damage to premises while rented to and replaced by the following:
CL CG 04 92 09 16 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 7
with its permission
(1) Equipment with a gross vehicle weight of partnership or limited liability company
1,000 pounds or more and designed primarily are the same or similar to the operations
for: of insureds already covered under this
(a) Snow removal; insurance;
(b) Road maintenance, but not construction (v) Coverage only applies for those limited
or resurfacing; or liability companies who have established
a date of formation as recorded within
(c) Street cleaning; the filed state articles of organization,
G. NEWLY FORMED OR ACQUIRED ORGANIZA- certificates of formation or certificates of
TION, PARTNERSHIP OR LIMITED LIABILITY organization; and
COMPANY AND EXTENDED PERIOD OF (vi) Coverage only applies for those part-
COVERAGE nerships who have established a date of
Paragraph 3. of Section II —Who Is An Insured formation as recorded within a written
is deleted and replaced by the following: partnership agreement or partnership
certificate.
3. Any organization you newly acquire or form, H. WHO IS AN INSURED—AMENDMENT
other than a joint venture, and over which
you maintain ownership or: The last paragraph of Section 11 — Who Is An
a. Majority interest of more than 50% if you Insured is deleted and replaced by the following:
are a corporation; No person or organization is an insured with
b. Majority interest of more than 50% as a respect to the conduct of any:
general partner of a newly acquired or a. Current partnership or limited liability
formed partnership; and/or company, unless otherwise provided for
c. Majority interest of more than 50% as an under Paragraph 3. of Section II — Who Is
owner of a newly acquired or formed An Insured;
limited liability company; b. Current joint venture; or
will qualify as a Named Insured if there is no c. Past partnership, joint venture or limited
other similar insurance available to that liability company;
organization. However, for these organiza- that is not shown as a Named Insured in the
tions:
Declarations.
(i) Coverage under this provision is afforded I. NON-OWNED WATERCRAFT
only until the next anniversary date of
this policy's effective date after you Subparagraph (2) of Exclusion 2.g. Aircraft,
acquire or form the organization, Auto Or Watercraft of Section I — Coverage A
partnership or limited liability company, — Bodily Injury And Property Damage Liability
or the end of the policy period, whichever is deleted and replaced by the following:
is earlier; (2) A watercraft you do not own that is:
(ii) Section I — Coverage A — Bodily Injury
And Property Damage Liability does (a) Less than 51 feet long; and
not apply to "bodily injury" or "property (b) Not being used to carry persons or
damage" that occurred before you property for a charge.
acquired or formed the organization, J. SUPPLEMENTARY PAYMENTS —INCREASED
partnership or limited liability company; LIMITS
(iii) Section I — Coverage B — Personal
And Advertising Injury Liability does Section I — Supplementary Payments —
not apply to "personal and advertising Coverages A And B is changed as follows:
injury" arising out of an offense 1. The limit shown in Paragraph 1.b. for the
committed before you acquired or formed cost of bail bonds is changed from $250 to
the organization, partnership or limited $3,000; and
liability company;
2. The limit shown in Paragraph 1.d. for loss of
(iv)Coverage applies only when operations earnings because of time off from work is
of the newly acquired organization, changed from $250 a day to$1,000 a day.
CL CG 04 92 09 16 Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 7
with its permission
K. UNINTENTIONAL OMISSION OR UNINTEN- M. LIBERALIZATION CLAUSE
TIONAL ERROR IN DISCLOSURE The following is added to Section IV —
The following provision is added to Paragraph 6. Commercial General Liability Conditions:
Representations of Section IV — Commercial If we adopt a mandatory attachment form change
General Liability Conditions: which broadens coverage under this edition of
However, the unintentional omission of, or the Commercial General Liability CG0001 for no
unintentional error in, any information given or additional charge, and those changes are
provided by you shall not prejudice your rights intended to apply to all insureds under this edition
under this insurance. of CG0001, that change will automatically apply
This provision does not affect our right to collect to your insurance as of the date we implement
additional premium or to exercise our right of the change in your state. This liberalization
clause does not apply to changes implemented
cancellation or non-renewal. through introduction of a subsequent edition of
L. WAIVER OF TRANSFER OF RIGHTS OF the Commercial General Liability form CG0001.
RECOVERY AGAINST OTHERS N. INCIDENTAL MEDICAL MALPRACTICE
The following is added to Paragraph 8. Transfer
1. Paragraph 2.a.(1)(d) of Section II — Who Is
Of Rights Of Recovery Against Others To Us An Insured does not apply to a physician,
of Section IV — Commercial General Liability nurse practitioner, physician assistant, nurse,
Conditions: emergency medical technician or paramedic
We waive any right of recovery we may have employed by you if you are not in the
against any person or organization because of business or occupation of providing medical,
payments we make for injury or damage arising paramedical, surgical, dental, x-ray or
out of your ongoing operations or"your work"and nursing services.
included in the "products-completed operations 2. This provision is excess over any other valid
hazard" when you have agreed in a written and collectible insurance whether such
contract or written agreement that any right of
recovery is waived for such person or insurance is primary, excess, contingent or
organization. This waiver applies only to the on any other basis. Any payments by us will
follow Paragraph 4.b. of Section IV —
person(s) or organization(s) agreed to in the
written contract or written agreement and is Commercial General Liability Conditions.
subject to those provisions.
This waiver does not apply unless the written
contract or written agreement has been executed
prior to the"bodily injury" or"property damage".
However, if any person or organization is
separately scheduled on a separate waiver of
transfer of rights of recovery which is attached to
this policy, then this waiver does not apply.
CL CG 04 92 09 16 Includes copyrighted material of Insurance Services Office, Inc., Page 7 of 7
with its permission
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f
COMMERCIAL GENERAL LIABILITY
CL CG 05 29 09 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY ULTRA PLATINUM
ENHANCEMENT COVERAGES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
A. The following coverage is added: paragraph 2.a.above, the words caused in
ADDITIONAL INSURED - OWNERS, LESSEES whole or in part by are replaced by the
OR CONTRACTORS - AUTOMATIC STATUS words arising out of.
INCLUDING PRIMARY NON-CONTRIBUTORY c. The insurance afforded to such additional
1. Section II -Who is An Insured is amended to insured only applies to the extent
include as an additional insured any person(s) permitted by law; and
or organization(s) for whom you are required d. If coverage provided to the additional
by virtue of a written contract or agreement insured is required by a contract or
that such person(s) or organization(s) be agreement, the insurance afforded to such
added as an additional insured on your policy. additional insured will not be broader than
2. The insurance provided to the additional that which you are required by the contract
insured is limited as follows: or agreement to provide for such
additional insured.
a. Such person or organization is an
additional insured only with respect to e. This insurance ends at the earliest of the
liability for "bodily injury", "property following times:
damage" or "personal and advertising (1) When any Named Insured(s) work
injury"caused in whole or in part by: called for in the written contract has
(1) Acts or omissions of the Named been completed
Insured; or (2) When all of any Named Insured(s)
(2) The acts or omissions of those acting work done at a job site has been
on behalf of the Named Insured; completed if the written contract calls
for work at more than one job site
in the performance of the Named Insureds (3) When that part of any Named
work for the additional insured(s) specified Insured(s) work done at a job site has
in the written contract provided the been put to its intended use by any
contract or agreement requires you to person or organization other than the
provide the additional insured such Named Insured or those acting on the
coverage and is: Named Insured(s)behalf.
i. Currently in effect or becomes Work that may need service, maintenance,
effective during the term of this correction, repair or replacement, but is
policy; and otherwise complete, will be treated as
ii. Was executed prior to the "bodily completed
injury", "property damage" or f. This insurance does not apply to any
"personal and advertising injury". additional insured scheduled on your
b. If the written contract specifically requires policy by separate endorsement.
you to provide additional insured coverage g. For purposes of paragraph A. of this
via the 10/01 edition of CG2010 (aka CG endorsement, the terms "you" and "your"
20 10 10 01) or via the 11/85 edition of refer to the Named Insured shown in the
CG2010 (aka CG 20 10 11 85), then in Declarations.
CL CG 05 29 09 16 Includes copyrighted material of Insurance Services Page 1 of 3
Office, Inc., with its permission
3. Exclusions b. Available under the applicable Limits of
With respect to the insurance afforded to these Insurance shown in the Declarations;
additional insureds, the following additional whichever is less.
exclusions apply to "bodily injury", "property This endorsement shall not increase the
damage" or "personal and advertising injury" applicable Limits of Insurance shown in the
arising out of:
Declarations.
a. The rendering of or failure to render any 5. Other Insurance
professional services by you or on your
behalf, but only with respect to either or For purposes of this endorsement, the
both of the following operations: following is added to the Section IV -
(1) Providing engineering, architectural or Commercial General Liability Conditions, 4.
surveying services to others in your Other
capacity as an engineer, architect or Insurance condition and supersedes any
surveyor; and provision to the contrary:
(2) Providing, or hiring independent This insurance is excess of all other
professionals to provide, engineering, insurance available to an additional
architectural or surveying services in insured whether on a primary, excess,
connection with construction work you contingent or any other basis. But, if
perform required by a written contract or written
agreement to be primary and
b. Subject to Paragraph c. below, noncontributory, this insurance will be
professional services include: primary to and will not seek contribution
(1) Preparing, approving, or failing to from any insurance on which the additional
prepare or approve, maps, shop insured is a Named Insured.
drawings, opinions, reports, surveys, No other coverage or limit in the policy
field orders, change orders, or applies to loss or damage insured by this
drawings and specifications; and coverage.
(2) Supervisory or inspection activities B. The following coverage is added:
performed as part of any related CONTRACTUAL LIABILITY -RAILROADS
architectural or engineering activities.
c. Professional services do not include 1. With respect to operations performed for a
Railroad within 50 feet of railroad property, the
services within construction means, definition of "insured contract" in Section V -
methods, techniques, sequences and procedures employed by you or performed Definitions is replaced by the following:
by or for the construction manager, its 9. "Insured Contract"means:
employees or its subcontractors in
connection with your ongoing operations. a. A contract for a lease of premises.
However, that portion of the contract
This exclusion applies even if the claims for a lease of premises that
against any insured allege negligence or other indemnifies any person or
wrongdoing in the supervision, hiring, organization for damage by fire to
employment, training or monitoring of others premises while rented to you or
by that insured, if the "occurrence" which temporarily occupied by you with
caused the "bodily injury" or "property permission of the owner is not an
damage", or the offense which caused the "insured contract";
"personal and advertising injury", involved the
rendering of, or the failure to render, any b. A sidetrack agreement;
professional architectural, engineering or c. Any easement or license agreement;
surveying services.
d. An obligation, as required by
4. Limits of Insurance ordinance, to indemnify a municipality,
With respect to the insurance afforded to these except in connection with work for a
additional insureds, the following is added to municipality;
Section III - Limits Of Insurance: e. An elevator maintenance agreement;
If coverage provided to the additional insured f. That part of any other contract or
is required by a contract or agreement, the agreement pertaining to your business
most we will pay on behalf of the additional (including an indemnification of a
insured is the amount of insurance: municipality in connection with work
a. Required by the contract or agreement; or performed for a municipality) under
Page 2 of 3 Includes copyrighted material of Insurance Services CL CG 05 29 0916
Office, Inc., with its permission
which you assume the tort liability of pay settlements or judgments will be reduced, and
another party to pay for "bodily injury" may be exhausted, by defense expenses.
or property damage" to a third person The following is added to paragraph 14. "Personal
or organization. Tort liability means a and advertising injury"SECTION V-
liability that would be imposed by law DEFINITIONS OF COMMERCIAL GENERAL
in the absence of any contract or LIABILITY COVERAGE FORM:
agreement.
Paragraph f. does not include that part h. "Non-employment discrimination" means
of any contract or agreement: violation of a person's civil rights with
(1) That indemnifies an architect, respect to such person's race, color,
engineer or surveyor for injury or national origin, religion, gender, marital
damage arising out of: status, age, sexual orientation or
preference, physical or mental condition,
(a) Preparing, approving or failing or any other protected class or
to prepare or approve maps, characteristic established by any federal,
shop drawings, opinions, state or local statutes, rules or regulations.
reports, surveys, field orders, "Non-employment discrimination"does not
change orders or drawings include violation of civil rights arising out of
and specifications; or past, present or prospective employment.
(b) Giving directions or Any obligation to the insured to pay "non-
instructions, or failing to give employment discrimination" liability damages
them, if that is the primary on your behalf applies only to the amount of
cause of the injury or damage; damages in excess of $5,000 deductible as
(2) Under which the insured, if an the result of any one offense regardless of the
architect, engineer or surveyor, number of persons or organizations who
assumes liability for an injury or sustain damages because of the offense.
damage arising out of the The most we will pay for all damages for"non-
insured's rendering or failure to employment discrimination" is $15,000 annual
render professional services, aggregate. No other liability to pay sums or
including those listed in Paragraph perform acts or services is covered.
(1) above and supervisory, Supplementary Payments -Coverage A and
inspection, architectural or
engineering activities. B do not apply to non-employment
discrimination.
2. Other Insurance D. AGGREGATE LIMITS OF INSURANCE
For purposes of this endorsement, the The General Aggregate Limit under SECTION III -
following is added to the Section IV- LIMITS OF INSURANCE applies separately to
Commercial General Liability
Conditions, 4. Other Insurance condition each of your:
and supersedes any provision to the 1. Projects away from premises owned by or
contrary: rented to you.
This insurance is excess of all other 2. "Locations"owned by or rented to you,
insurance that is Railroad Protective
Liability or similar coverage for"your work" "Location" means premises involving the same
performed for a Railroad. But, if required or connecting lots, or premises whose
by a written contract or written agreement connection is interrupted only by a street,
to be primary and noncontributory, this roadway, waterway or right-of-way of a
insurance will be primary to and will not railroad.
seek contribution from any insurance on When paragraph B. Construction Project
which the Railroad is a Named Insured. General Aggregate Limit on form CL CG 00 20 is
No other coverage or limit in the policy a part of this policy, then this endorsement
applies to loss or damage insured by this CL CG 05 29 paragraph D. Aggregate Limits Of
coverage. Insurance does not apply.
C. The following coverage is added:
NON-EMPLOYMENT DISCRIMINATION
LIABILITY
This coverage contains a DEFENSE WITHIN
LIMIT provision: The limit of liability for "Non-
employment discrimination" coverage available to
CL CG 05 29 09 16 Includes copyrighted material of Insurance Services Page 3 of 3
Office, Inc., with its permission
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l`
s'
COMMERCIAL GENERAL LIABILITY
CL CG 20 71 09 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES,
CONTRACTORS OR OTHERS - COMPLETED OPERATIONS
- AUTOMATIC STATUS, INCLUDING PRIMARY
NONCONTRIBUTORY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. SECTION II -WHO IS AN INSURED is amended For purposes of this endorsement, throughout
to include as an additional insured any person(s) the policy, the terms "you" and "your" refer to
or organization(s) when you are obligated by the Named Insured shown in the Declarations.
virtue of a written contract or agreement that
such person or organization(s) be added as an B. Exclusions
additional insured to your policy. With respect to the insurance afforded to these
Such person(s) or organization(s) is an additional additional insureds, the following additional
insured only with respect to liability for "bodily exclusions apply to "bodily injury" and "property
injury" or "property damage" or "personal and damage"arising out of:
advertising injury"caused, in whole or in part by: 1. The rendering of or failure to render any
(1) Acts or omissions of the Named Insured; professional services by you or on your behalf,
or but only with respect to either or both of the
following operations:
(2) The acts or omissions of those acting on
behalf of the Named Insured; a. Providing engineering, architectural or
surveying services to others in your
and included in the "products-completed capacity as an engineer, architect or
operations hazard" surveyor; and
This insurance applies only when you are required b. Providing, or hiring independent
to add the additional insured by virtue of a written professionals to provide, engineering,
contract or agreement, provided the contract or architectural or surveying services in
agreement is: connection with construction work you
1. Currently in effect or becomes effective during perform.
the term of this policy; and This exclusion applies even if the claims against
2. Was executed prior to the "bodily injury" or any insured allege negligence or other
wrongdoing in the supervision, hiring,
property damage" or "personal and employment, training or monitoring of others by
advertising injury". that insured, if the"occurrence"which caused the
However: "bodily injury"or"property damage",or the offense
a. The insurance afforded to such additional which caused the "personal and advertising
insured only applies to the extent permitted by injury", involved the rendering of, or the failure to
law; and render,any professional architectural,engineering
or surveying services.
b. If coverage provided to the additional insured 2. Subject to Paragraph 3. below, professional
is required by a contract or agreement, the services include:
insurance afforded to such additional insured
will not be broader than that which you are a. Preparing, approving, or failing to prepare
required by the contract or agreement to or approve, maps, shop drawings,
provide for such additional insured. opinions, reports, surveys, field orders,
change orders, or drawings and
specifications; and
CL CG 20 71 09 16 Includes copyrighted material of Insurance Services Page 1 of 2
Office, Inc., with its permission
b. Supervisory or inspection activities D. Other Insurance
performed as part of any related For purposes of this endorsement, the following is
architectural or engineering activities. added to the Section IV - Commercial General
3. Professional services do not include services Liability Conditions, 4. Other Insurance
within construction means, methods, condition and supersedes any provision to the
techniques, sequences and procedures contrary:
employed by you or performed by or for the This insurance is excess of all other insurance
construction manager, its employees or its available to an additional insured whether on a
subcontractors in connection with your primary, excess, contingent or any other basis.
ongoing operations. But, if required by a written contract or written
C. Limits of Insurance agreement to be primary and noncontributory, this
With respect to the insurance afforded to these insurance will be primary to and will not seek
additional insureds, the following is added to contribution from any insurance on which the
Section III -Limits Of Insurance: additional insured is a Named Insured.
If coverage provided to the additional insured is No other coverage or limit in the policy applies to
required by a contract or agreement, the most we loss or damage insured by this coverage.
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
Page 2 of 2 Includes copyrighted material of Insurance Services CL CG 20 7109 16
Office, Inc., with its permission
COMMERCIAL AUTO
CL CA 01 49 02 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT
- PLATINUM
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to the coverages provided by this endorsement, the provisions of the Business Auto Coverage Form
apply unless modified by this endorsement.
A. NEWLY ACQUIRED OR FORMED ORGANIZA- ganization is liable for"bodily injury" or"prop-
TIONS erty damage": because of the conduct of an
The following is added to Paragraph A.1. Who Is "insured" under Paragraphs a. or b. under
An Insured of Section II - Covered Autos Liability Paragraph A.1. Who Is An Insured of Section
Coverage: II - Covered Autos Liability Coverage, caused
by an"accident"and resulting from the owner-
Any organization you newly acquire or form,other ship, maintenance or use of a covered "auto";
than a partnership,joint venture or limited liability
company or any organization excluded either by 2. The written contract or agreement described
this Coverage Part or by endorsement, and over above must have been executed prior to the
which you maintain ownership or majority interest accident' that caused the bodily injury" or
property damage"and be in effect at the time
of more than 50 percent will qualify as a Named of such"accident";
Insured. However:
1. This insurance does not apply to any newly ac- 3. The insurance afforded to any such additional
quired or formed organization that is an "in- "insured"does not apply to any"accident"be-
sured" under any other automobile policy or yond the period of time required by the written
would be an "insured" under such policy but contract or agreement described above;
for its termination or the exhaustion of its Limit 4. The most we will pay on behalf of such addi-
of Insurance. tional "insured(s)" is the lesser of:
2. Coverage does not apply to "bodily injury" or a. The Limits of Insurance specified in the
"property damage" that occurred before you written contract or agreement described
acquired or formed the organization. above;or
3. Coverage under this provision is afforded only b. The Limits of Insurance shown in the Dec-
until the 180th day after you acquire or form larations.
the organization or the end of the policy pe- This provision shall not increase the Limit of
riod, whichever is earlier. Insurance shown in the Declarations in this
B. ADDITIONAL INSURED BY CONTRACT OR policy or coverage part;and
AGREEMENT
5. The following changes are made to Paragraph
The following is added to Paragraph A.1., Who Is S. Other Insurance of B. General Conditions
An Insured of Section 11 - Covered Autos Liability under Section IV- Business Auto Conditions:
Coverage: a. The following is added to Paragraph 5.a.:
When you have agreed in a written contract or If required by the written contract or
agreement to include a person or organization as
an additional "insured", such person or organiza- agreement described above, the insur-
tion is included as an "insured" subject to the fol- ance afforded to the additional insured un-
Iowing: der this provision will be primary to, and
will not seek contribution from, the addi-
1. Such person or organization is an additional tional insured's own insurance.
"insured"only to the extent such person or or- b. Paragraph 5.c. is deleted in its entirety.
CL CA 01 49 02 15 Includes copyrighted material of Insurance Services Page 1 of 5
Office, Inc., with its permission
6. Paragraph A.1.c. under Section II - Covered 2. We will also pay reasonable and necessary
Autos Liability Coverage is deleted in its en- expenses to facilitate the return of the stolen
tirety. "auto" to you.
7. The definition of"insured contract"under Sec- 3. It is agreed and understood and it is our stated
tion V- Definitions is amended to add the fol- intent that expenses incurred by you under the
lowing: Transportation Expenses Coverage Exten-
An "insured contract" does not include that sion will not also be covered or paid under the
part of any contract or agreement: Rental Reimbursement Coverage provided by
this endorsement or any rental reimbursement
That pertains to the ownership, maintenance coverage added by separate endorsement to
or use of an "auto" and which indemnifies a this policy.
person or organization for other than the vicar- H. EXTENDED COVERAGE- AIRBAGS
ious liability of such person or organization for
"bodily injury"or"property damage"caused by The following is added to Exclusion B.3.a.of Sec-
your operation or use of a covered"auto". tion III - Physical Damage Coverage:
However, a person or organization is an addi- However, this exclusion does not apply to the un-
tional "insured"under this provision only to the intended discharge of an airbag.
extent such person or organization is not This coverage is excess over any other collectible
named as an "insured" by separate endorse- insurance or warranty providing such airbag cov-
ment to this policy.
erage.
C. EMPLOYEES AS INSUREDS I. AUTO LOAN/LEASE GAP COVERAGE
The following is added to Paragraph A.1. Who Is The following is added to Section III - Physical
An Insured Section II - Covered Autos Liability Damage Coverage, Paragraph C. Limits of Insur-
Coverage:
ance.
Any "employee" of yours is an "insured" while us- 4. In the event of a total "loss" to a covered
ing a covered "auto" you don't own, hire or borrow "auto", we will pay any unpaid amount due on
in your business or your personal affairs. the lease or loan for a covered "auto", less:
D. INCREASED COVERAGE - BAIL BONDS a. The amount under the Physical Damage
The Supplementary Payments Coverage Exten- Coverage section of the policy; and
sion of Section II - Covered Autos Liability Cover- b. Any:
age is amended as follows:
The Limit of Insurance in paragraph A.2.a.(2) is (1) Overdue lease/loan payments at the
increased to$5,000. time of the "loss";
E. INCREASED COVERAGE - LOSS OF EARN- (2) Financial penalties imposed under a
INGS lease for excessive use, abnormal
wear and tear or high mileage;
The Supplementary Payments Coverage Exten- (3) Security deposits not returned by the
sion of Section II - Covered Autos Liability Cover- lessor;
age is amended as follows:
The Limit of Insurance in paragraph A.2.a.(4) is (4) Costs for extended warranties, Credit
increased to$1,000. Life Insurance, Health, Accident or
Disability Insurance purchased with
F. FELLOW EMPLOYEE COVERAGE the loan or lease; and
The Fellow Employee Exclusion contained in Sec- (5) Carry-over balances from previous
tion 11-Covered Autos Liability Coverage does not loans or leases,
apply. This coverage is excess over any other col-
lectable insurance. J. GLASS REPAIR - NO DEDUCTIBLE
G. COVERAGE EXTENSION-TRANSPORTATION The following is added to Paragraph D. Deductible
EXPENSES of Section III - Physical Damage Coverage:
Paragraph A.4.a. Transportation Expenses of Any Comprehensive Coverage deductible shown
Section III - Physical Damage Coverage is in the Declarations does not apply to "loss" to
amended as follows: glass when you elect to patch or repair rather than
replace the glass.
1. The Limits of Insurance are increased to $75 K. INCREASED COVERAGE - ELECTRONIC
per day to a maximum of$2,500. EQUIPMENT
Page 2 of 5 Includes copyrighted material of Insurance Services CL CA 01 49 02 15
Office, Inc., with its permission
The$1,000 limit indicated in Paragraph C.1.b.un- The following is added to Paragraph A.4. Cover-
der Section III - Physical Damage Coverage is in- age Extensions of Section III - Physical Damage
creased to$2,500. Coverage:
L. EXTENDED COVERAGE - PERSONAL PROP- If hired "autos" are covered "autos" for Covered
ERTY Autos Liability Coverage and if Physical Damage
The following is added to Paragraph A.4. Cover- Coverage is provided for any"auto"you own,then
age Extensions of Section III - Physical Damage the Physical Damage coverages provided are ex-
Coverage: tended to "autos" you lease, rent, hire or borrow
from someone other than your"employees", part-
Physical Damage Coverage on a covered "auto" ners or members of their households subject to the
may be extended to "loss" to your personal prop- following:
erty or, if you are an individual, the personal prop- 1. The most we will pay in any one "loss" is the
erty of a family member, that is in the covered lesser of:
"auto" at the time of"loss" and caused by an "ac-
cident" and resulting from the ownership, mainte- a. The actual cash value of the"auto";
nance or use of a covered "auto".
b. The cost to repair or replace the"auto";or
The insurance provided by this coverage exten- c. $100,000,
sion is excess over any other collectible insur-
ance. The most we will pay for any one"loss"un- 2. Paragraph 1.above is subject to a deductible.
der this coverage extension is$500. However,our The deductible shall be equal to the amount of
payment for"loss"to personal property will only be the highest deductible shown for any owned
for the account of the owner of the property. "auto" of the same classification for that cov-
Under this provision, personal property does not erage. In the event there is no owned "auto"
include and we will not pay for"loss" of currency, of the same classification, the highest deduct-
coins, securities or contraband. ible for any owned "auto" will apply for that
coverage.
No deductible applies to this coverage extension. No deductible will apply to "loss" caused by
M. TOWING fire or lightning.
Paragraph A.2. Towing of Section III - Physical 3. Hired Auto Physical Damage Coverage is
Damage Coverage, is replaced by the following: subject to the following:
If a private passenger type "auto" or light truck a. If symbol 8 is shown in the Covered Auto
"auto"(0-10,000 Lbs.GVW)is provided both Com- section of the Declarations page for any of
prehensive and Collision Coverage,we will pay up the Physical Damage coverages,then the
to $150 for towing and labor costs incurred each Hired Auto Physical Damage coverage
time such "auto" is disabled. If a medium, heavy described in this endorsement does not
or extra-heavy truck or extra-heavy Truck-tractor apply.
"auto"(greater than 10,000 Lbs. GVW)is provided b. Other than indicated in Paragraphs a. di-
both Comprehensive and Collision Coverage, we rectly above, coverage provided under
will pay up to $250 for towing and labor costs in-
curred each time such "auto" is disabled. How- this provision will excess over any
ever, the labor must be performed at the place of other collectible insurance or coverage.
disablement. 4. In addition to the limit set forth in Paragraph 1.
N. FIRE EXTINGUISHER RECHARGE above we will pay up to $500 per day, to a
maximum of$3,500 per"loss"for:
The following is added to Paragraph A.4. Cover-
age Extensions of Section IV - Physical Damage a. Any costs or fees associated with the
"loss"to a hired "auto";and
Coverage:
When fire extinguishers are kept in your covered b. Loss of use of the hired"auto", provided it
"auto"and any are discharged in an attempt to ex- is the consequence of an "accident" for
tinguish a fire, we will pay the lesser of the actual which you are legally liable, and as a re-
cost of recharging or replacing such fire extin- sult of which a monetary loss is sustained
guisher(s). by the leasing or rental concern.
No deductible applies to this coverage However, Paragraph AA.b. Loss of Use Ex-
penses under Section III- Physical Damage Cov-
O. HIRED AUTO PHYSICAL DAMAGE COVER- erage of the Business Auto Coverage Form does
AGE not apply.
P. RENTAL REIMBURSEMENT COVERAGE
CL CA 01 49 02 15 Includes copyrighted material of Insurance Services Page 3 of 5
Office, Inc.,with its permission
We will pay for rental reimbursement expenses in- (3) Your members or managers, if you
curred by you for the rental of an "auto" because are designated in the Declarations as
of"loss"to a covered "auto". a limited liability company;
1. Payment applies in addition to the otherwise (4) Your executive officers if you are des-
applicable amount of each coverage you have ignated in the Declarations as an or-
on the covered "auto". ganization other than an individual,
2. No deductible applies to this coverage. partnership, joint venture or limited li-
ability company; and
3. We will pay only for those expenses incurred
during the policy period beginning 24 hours af- (5) The spouse of any person named in
ter the"loss"and ending, regardless of the ex- Paragraphs 1.a.(1). through i.a piration date of the policy, with the lesser of while a resident of the same housse-
e-
the following number of days: hold;
a. The number of days when the covered Except:
"auto" has been repaired or replaced, or (a) Any "auto" owned by that individ-
b. 45 days. ual or by any member of his or
her household.
4. Our payment is limited to the lesser of the fol- (b) Any"auto" used by that individual
lowing amounts: or his or her spouse while working
a. Necessary and actual expenses incurred; in a business of selling, servicing,
or repairing or parking "autos".
b. Not more than$75 for any one day; 2. Changes In Auto Medical Payments And
5. We will pay up to an additional $300 for the Uninsured And Underinsured Motorists
reasonable and necessary expenses you in- Coverages
cur to remove your materials and equipment The following is added to Who Is An Insured:
from the covered"auto"and replace such ma- Any individual named in 1.a above and his or
terials and equipment on the rental "auto". her"family members" are "insured"while "oc-
6. This coverage does not apply while there are cupying" or while a pedestrian when being
spare or reserve "autos" available to you for struck by any"auto" you don't own except:
your operations. Any "auto" owned by that individual or by any
7. If"loss"results from the total theft of a covered "family member".
"auto" of the"private passenger type", we will 3. Changes In Physical Damage Coverage
pay under this coverage only that amount of
your rental reimbursement expenses which is Any private passenger type "auto" you don't
not already provided for under the Physical own, hire or borrow is a covered "auto" while
Damage Coverage Extension of the Business in the care,custody or control of any individual
Auto Coverage Form or any endorsements named in Q.1.a. above or his or her spouse
thereto while a resident of the same house-hold ex-
However, this provision does not apply to the cept:
extent that rental reimbursement is provided a. Any"auto" owned by that individual or by
by separate endorsement to this policy. any member of his or her household; or
Q. DRIVE OTHER CAR COVERAGE b. Any"auto"used by that individual or his or
1. The following is added to Section 11 - Covered her spouse while working in a business of
Autos Liability Coverage: selling, servicing,repairing or parking"au-
tos".
a. Any "auto" you don't own, hire or borrow 4. The most we will pay for the total of all dam-
is a covered "auto" for Liability Coverage ages under Covered Autos Liability Uninsured
while being used by: Motorists Coverage and Underinsured Motor-
(1) You, if you are designated in the Dec- ists Coverage is the Limit Of Insurance shown
larations as an individual; in the Declarations as applicable to owned
(2) Your partners or members, if you are "autos".
designated in the Declarations as a 5. Our obligation to pay for, repair, return or re-
partnership or joint venture; place damaged or stolen property under Phys-
ical Damage Coverage, will be reduced by a
deductible equal to the amount of the highest
Page 4 of 5 Includes copyrighted material of Insurance Services CL CA 01 49 02 15
Office, Inc., with its permission
deductible shown for any owned private pas- prejudice the coverage provided to you. However,
senger type "auto" applicable to that cover- this provision does not affect our right to collect
age. If there are no owned private passenger additional premium or exercise our right of cancel-
type "autos", the deductible shall be $250 for lation or nonrenewal.
Comprehensive Coverage and$500 for Colli- U. LIBERALIZATION
sion Coverage. No deductible will apply to
"loss" caused by fire or lightning. If we revise this endorsement to provide greater
6. Additional Definition coverage without additional premium charge, we
will automatically provide the additional coverage
As used in this DRIVE OTHER CAR Provi- to all endorsement holders as of the day the revi-
sion: sion is effective in your state.
"Family member" means a person related to
the individual named in 1.a. by blood, mar-
riage or adoption who is a resident of the indi-
vidual's household, including a ward or foster
child.
R. KNOWLEDGE OF AN ACCIDENT,CLAIM, SUIT
OR LOSS
The following is added to Paragraph A.2. of Sec-
tion IV - Business Auto Conditions:
Your obligation to provide prompt notice of an "ac-
cident", claim, "suit" or'loss" is satisfied if you or
a person designated by you to be responsible for
insurance matters is notified of, or in any manner
made aware of an"accident",claim, "suit"or"loss"
and provides us such notice as soon as practica-
ble
S. WAIVER OF SUBROGATION BY CONTRACT
OR AGREEMENT
The following is added to Paragraph A.5 of Sec-
tion IV- Business Auto Conditions:
We waive any right of recovery we may have
against a person or organization because of pay-
ments we make for "bodily injury" or "property
damage" when you and such person or organiza-
tion have agreed in writing in a contract or agree-
ment to waive such right of recovery, provided:
1. Such written contract or agreement was:
a. Made prior to the "accident" or "loss" resulting in
the covered "bodily injury" or "property damage";
and
b. Was in effect at the time of the covered "bodily in-
jury"or"property damage".
2. The covered "bodily injury" or "property damage"
must arise out of the operations specified in such
written contract or agreement.
3. At our request you must provide us with a copy of
the aforementioned written contract or agreement.
T. UNINTENTIONAL OMISSIONS
The following is added Paragraph B.2. of Section
IV- Business Auto Conditions:
If you fail to disclose any hazards existing at the
inception date of this policy, such failure will not
CL CA 01 49 02 15 Includes copyrighted material of Insurance Services Page 5 of 5
Office, Inc.,with its permission
}
This page has been Wtblank intentionally.
City of Kent
Business License
KENT
W•S-/IN GT_N
STRIPE RITE INC
1813 137TH AVE E
SUMNER, WA 98390
Please tear at pe.-P-rat.cn
-------------------------------------------------
BUSINESS LICENSE andusets� 1-flhe sales =
and use lax must he coded
LICENSE MUST BE PAID ANNUALLY BY No 1715 for all qualified
JANUARY Ist TO AVOID PENALTY sales%%ithin the cay of
KENTIssuance or License Does Not Imply Licensee's pent
W e S M I N G T-N Compliance with State and Local I.8%s
THIS LICENSE MUST BE POSTED IN A CONSPICUOUS Year : 2017
PLACE.NOT TRANSFERABLE OR ASSIGNABLE
NAME AND ADDRESS OF BUSINESS
BLOC-21005 89
STRIPE RITE INC MAYOR
1813 137TI-I AVE E The City of Kent
SUMNER. WA 98390
u^_n Iru Mr so
'REQUESTFOR MAYO,R'S SIGNATURE
1 ENT
Routing Information:
(ALL,REQUESTS f+J'IUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT)
Approved by Directo,
Originator: Janice A Applegate; (Jars) Phone (Originator): 253-856-51
Date Sent 5 / Date Required: 06/ 1/2017
Return Signed Document tO:Ja 'Alppl gate Contract Termin,atioln Date: 09/29/2017 '
VENDOR NAME, gate Finance Notified:
Stripe Flute Inc. (ONY required on ro'ntranta 5 2 2 1 7
Mtn 1000 and over or on any rant)
DATE OF COUNCIL APPROVAL: ��+iel Cute Risk Manager Notified:5/ / 17�
(Required on anon-Qi Standard contrants/A reerments
Has this Document been Sped icall Account Number: P 5 1 7411 530
Authorized in the Budget? YE NO
Brief Explanation of Document:
Contract between, the City f Kentand Stripe Rite Inc. for sealcoating and restriping of
parking lot at Service Oub, Baffields located at 14608' E 288th t., Kent WA 98042 as
per attached Rid Numbeir 1 - 8 dated April 4, 2017 marked as Exhibit A attached.
A46E>ust Be Routed Through The Law Department
MAY 30 2oj� ( this area to be compl6eted by the Law Department)
Received:Approval ofDept.:
' Lew
�LawWjMN[W
a'te or a ed
Shaded Areas, To Be icom,pleted By Administration Staff
eceived
e mrrr ndations and bmrn ,nts.
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