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HomeMy WebLinkAboutPW16-225 - Amendment - #2 - Ott-Sakai and Associates, LLC - S 228th St UPRR Grade Separation - 12/19/2017 Records M e rin ,,,,,, //fr)I y lr %" KET /;; 1 / Document //'�WOW /IR/,/i 41/f�Wi�l/r7 i as/ �!(�f/Pf�����/ 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: Ott-Sakai and Associates LLC Vendor Number: JD Edwards Number Contract Number: V V� I C) 3 This is assigned by City Clerk's Office Project Name: S. 228`h St. UPRR Grade Separation Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 12/19/17 Termination Date: 12/31/18 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Susanne Smith Department: Engineering Contract Amount: $9,680.15 _ Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Provide a cost estimate analysis for the project. AS of: 08/27/14 �KETJT AMENDMENT NO. 2 NAME OF CONSULTANT OR VENDOR: Ott-Sakai and Associates, LLC CONTRACT NAME & PROJECT NUMBER: S. 228t" St. UPRR Grade Separation ORIGINAL AGREEMENT DATE: May 27, 2016 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of "he original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: Provide a cost estimate analysis for the project. For a description, see the Consultant's Scope of Work which is attached as Exhibit A and incorporated by this reference. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are modified as follows: _..............._ _... Original Contract Sum, $9,948.00 including applicable WSST Net Change by Previous Amendments $u including applicable WSST Current Contract Amount $9,948.00 including all previous amendments ............._.... ..............-- ...._........ ................._.... ....... . Current Amendment Sum $9,680.15 _. _......m.. ... ._-........_ Applicable WSST Tax on this $0 Amendment Revised Contract Sum $19,628.15 AMENDMENT - 1 OF 2 Original Time for Completion 12/31/16 (insert date) .m........._ _.._... _....---- .-.--- Revised Time for Completion under 12/31/17 prior Amendments (insert date) Add'I Days Required (f) for this 365 calendar days Amendment Revised Time for Completion 12/31/18 (insert date) r The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. —. ..-_ _ .....- ---......-----.._ _ ............_.. CONSULTANT/VENDOR: CITY OF KENT: By: B ;:Z4�� Keyi-v 'r ur� / (sNgrr J. L Print Name: Print Name: Timothy. LaPorte, P.E. _ Its f'eAVC Opt L- Its Public Works Director__ (title) DATE: . 2ot� DATE: ✓' _. _.....a.._ _.................. ------ _......_ APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department Ott-Sskel-229"'UP Grade Sep Amd 1/Sml[fi AMENDMENT - 2 OF 2 EXHIBIT A South 228th Street Grade Separation at BNSF Railway- Estimate of hours Ott-Sakai and Associates, LLC 9/29/2017 206-255-25D9 1.The cost estimate will be based on the 70%design drawing and specification 2.We propose to take the owner's cost estimate and populate the unit prices to provide an opinion of cost.During this process we will review major Items such as bridge structure components, retained fill,and significant utilities. Contracts pevlew and Construction Administrator, Coordination, Classification Consultant Accounting ac Janiece Kevin Sakai,Bill Personnel Bing Ma Christaln Ott Rate 196,80 $159,91 $21526 100%Independent Design Cast Estimate Accounting,Admin 1 f Site Visit 4 Meetings 0 Unit Price Input and Analysis of Maior Bid Iten 40 4 Cost Esimate Total Hours 44 1� 4 49 I TOTAL AMOUNT $8,659.20 $159.91 $861.04 $9,680.15 Client#: 1045900 WILLIOTT2 ACORD,, CERTIFICATE OF LIABILITY INSURANCE DA,061m2°17 '. 4/06/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS r•ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED _-PRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the pn0oy(les)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 USI Kibble&Prentice PIR --- - - ----- tK91 Na 9A!) 206 441-6300 PAX 610.362-8530 601 Union Street,Suite 1000 - --- AoLrRless PL.CertRegDost@usi.com ,. l Nor. Seattle,WA 98101 ....._... __ _.... .._ INSURER)S)AFFORDING COVERAGE NAICq ,INVSORERA-Travelers Indemnity Co. of Amer 25666 iesuRED Ott-Sakai&Associates INSURER B.Navigators Insurance Company 42307 -- -- - ---- --- 14915 88th Place NE INSURER C Kenmore,WA 98028 INSURER D 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 WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. —. L R. TYPE OF INSURANCE ADDL 9UBR. ... ..____. GOLICY EKF POLIGy EXP -,... ........— _. ...., „-._ <3 _ ......,,,,.. _lN4R wvD POLICY RUMBER (MMlODIYYYVI 9MMlDgIYYYY( LIMITS A COMIIMERCIAL GENERAL LIABILITY 6800JOB7853 410512017 04105/201 EACH OCCURRENCE s1,000,040 V CI—AIMS—MADE X�OCCUR � qi � a „Lr°nn..ai $1,000,000 MED FxPrgm nna persam _ st0r400 _ PERBpNAL&ADV INJURY $1,000.000 ._ ., _.. ..., r GEN LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2000.000 POLICY ... f LOC PRODUCTS-COMP/OP AGO s2 000,000 j OTHER .. .. ,,. _— ,..... auTOMDSILE LIABILITY 6800J087853 0410512017 0410512011 COMBINED SiNGLk.LIMIT 11 000 000 - 1Eaarcrdontj ....... _ ANY AUTO ROPILY INJURY(Per person) $ —_ ALL OWNED SCHEDULED BODILY INJURY Par acatlenl $ AUTOS NAUTOSON-OWNED i ) NON OWNED PRO'aPRTY 6AMAC>E .. ... X HIRED AUTOS X AUTOS jeer icplpunt], $ ' I ,..... UNIERELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE rI ..... ., AGGREGATE $ ❑ED 1 ,,,,,RETENTIONS ._. .,.,.,...., A WORKERS COMPENSATION 6800J087853 D4/05/2017 04/051201 �srnnlTP X�°a'" AND EMPLOYERS LIABILITY ANY CERMr ETORIPARTNbED? CUTIVE Y!N (WA Stop Gap) E I.EACH ACCIDENT $1 000.000 OFFICEILMEMDLR EXCLUUEU7 ` N,.� NIA .___ _ _ (Mandatory in end E.L.DISEASE-EA EMPLOYEE 11,000,000 If yes,decenleeate,in under -- -- ------ - - - ----- DESCRIPTIONOFOPERATIONSbeI EL DISEASE-POLICY LIMIT $1,000,000 B Professional CM77DPL0478431V 4/0512017 04/05/201 $1,000,000 per claim Liability $2,000,000 annl aggr, DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) RE: Cosnutlant Services Agreement-S.228th Street-UPPR Grade Separation. The General Liability policy includes an automatic Additional Insured endorsement that provides Additional .Insured status to the City of Kent only when there is a written contract that requires such status,and only with regard to work performed on behalf of the named insured. CERTIFICATE HOLDER CANCELLATION City of Kent Engineering SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 400 West Gowe ACCORDANCE WITH THE POLICY PROVISIONS. Kent,WA 98032 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD #S20255238/M20254043 DYBZP Client#: 1045900 WILLIOTT2 ACORDTN CERTIFICATE OF LIABILITY INSURANCE D ATE(MMIDDIYYYY) '''.. 1 013 0/2 01 7 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 CONIACT NAME: USI Kibble &Prentice PR PRONE _ I NR1,...610-362-8530IAIC.No E. (AID 601 Union Street, Suite 1000 E-MAIL' - ADDRESS PL.CertRequest@ausl.com Seattle,WA 98101 INSURERIS)AFFORDING COVERAGE III INSURERA na.omrs Indemnity no,of Amer 25666 _ _ _ ._........_..... . ....... .........._......._.. .._.. ........ ...... ....._ ...._.___ INSURED INSURER B.N-1got—losmarron.ropro, 42307 Ott-Sakai &Associates ..-,--------.—__ _-__....,,_....-.m........................._-_ INSURER C 14915 88th Place NE . . ...____— .................... .... .... ...._.. INSURER D Kenmore,WA 98028 _. ......... ...._.._.,_,,,,...._-...___.�.._... ._._. ...- ........._...__m INSURER E: IN5URFR F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: ]HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMEDABOVE FORTHE POLICYPERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR. ...... ..- .. MDDL 9UaR -... POLICY EFF POLICY ESP .- ." .................. .....- TR TYPE OF INSURANCE IN,. wvn POLICY NUMBER {MMIDDIVYYVI IMMIDDPIYYYI LIMITS __. U �_ ......-..._... .LIMA. ........, A X COMMERCIAL GENERAL LIABILITY 6800J087853 04/05/2017 04105/2018 EACH OCCURRENCE $1.000.000 CLAIMS MADE X OCCUR PRANI p FN9TL1 D MA 'y d,r den $1 goo."DD..- -.--_, MED EXP IAre one oorsonl $10.000 PERSONAL&ADVINJURY $1.000.000 . . ...- _...._.. - - GENL AGGREGATE LIMIT APPLIES PER. GENERAL I AGGREGATE $2000000 ry ViO J..J-.. .—.. POLICY ❑X IECT I ] LDC PRODUCTS-COMPIOP AGG s2 000.000, OTHER_ $ A AUTOMOBILE LIABILITY 6800J087853 D4/0512017 04/0512018 coMrmNEu SINGLE uMn 1 000 000 AE ANY AUTO BODILY INJURY(Per person) $ 'm ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) S NON OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS or pepslanll, - ,.,,...., _ __ -..-. .... ...... _ .... .. UMBRELLA LIAB __---_r OCCUR EACH OCCURRENCE 5 {Ihl ,. .. .. .. ___. .... EXCESS LIAB CLAIMS MADE AGGREGATE 9 OFO .I RETENTION$ WORKERS COMPENSATION 11 A '6800J087853 D4/0512017 04/05/2018 �ST^T..Lg4 1 X °a"-_ AND EMPLOYERS LIABILITY ANY PROPER TORIPAR rNERfEXECUTIVE YIN I NA (WA Stop Gap) EL EACH ACCIDENT S1000000 OFFCEH,MkMtdLH LXOWY)t.[)f _._._. ,_,.,.-..,.. ....._, (Mandatory In NH) E L.DISEASE EC EMPLOYEE___ $10,00,1 000 _ (yes,describe under DESCRIPTION OF OPERATIONS below EL„DISEASE-POLICY LIMIT 51.000.000 B Professional CM17DPLO478431V D4/05/2017 04/05/2018 $1,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RE: Cosnutlant Services Agreement-S.228th Street-UPPR Grade Separation. The General Liability policy includes an automatic Additional Insured endorsement that provides Additional Insured status to the City of Kent only when there is a written contract that requires such status, and only with regard to work performed on behalf of the named insured. CERTIFICATE HOLDER CANCELLATION Cityof Kent Engineering SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 9 9 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 400 West Gowe ACCORDANCE WITH THE POLICY PROVISIONS. Kent, WA 98032 AUTHORIZED REPRESENTATIVE ~a. 4- ©19BB-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #521821812/M20254043 TJMJV This page has been left btank intentionally. --� DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/30/17 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer Nubia to the certificate holder in lieu of such endorsement(s). PRODUCER 1 nrAc; Scott. McGrew SCOTT MCGREW AGENCY vHQNE (425)882-2828 �'' (425) 881-3050 2509 152nd Ave NE Ste C -5MA.L,. ,.smcgreW armersagent.com Redmond, WA 98052 INSIIRFRI$1 AFFORDING COVERAGE NAICC NSITA,,l. Mid Century Insurance Company 21687 INSURED IMSURF,Rr Ott-Sakai & Associates LLC lull OF,c - P.O. Box 247 INSHRFR n Mountlake Terrace, WA 98043 raCIIRE,F- COVERAGES CERTIFICATE. NUMBER:... REVISION NUMBER: THIS L TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EHC W SIONS AND CONDITIONS OF SUCH POLICIES..LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMSINS A-1111" .. LTa TYPE OF INSURANCE Nsn unrn POI Ir'YNIIMBFR "UY p1U 1V LIMITS COMMERCIAL GENERAL LIABILITY PACH OCCIIRRENOE A CLAIMS-MADE O OCCUR °. °'22olutplil MFD FXP Mucccouersom s PERSONAL&ADV INJURY A GEN'LAGGREGATE LIMITAPPLIESPER. GFNERAL AGGREGATE $ Vfjp➢Q:Y® PRO- El JECT LOD PRODUCTS-COMP/OP AGGOTHER R 3 AUTOMOBILE LIABILITY l. . IGI.V 1NtiBUMIT $ANYAU , TO K A -- AUTOS ONLY AUTOBHE Y Y -- OWNED SCDULED 604780065 11/20/1611/20/18 BODILY INJUBY(Per aeeidenp 3,�,,,,�„,,.,,,.... HIRED NON OWNED A A $ X AUTOS ONLY x AUTOS ONLY rl $ UMBRELLA HAS OCCUR EACH CCCLIRRENCE R EXCESS LAB Cl AIMS MADEAGGREGATE $ nFn RFTFNTI(1NA Q WORKERS COMPENSATION AND EMPLOYERS LIABILITY y�ry STATUTE FR ANY PROPRIETORIPARTNERIE%ECUTIVE 1�1 F,I„F„Af:H ACPIr)FNT $ OFFICERIMEMBER EXCLUDED? Iffi NIA )Mandatory in NH) E L DISEASE-EA EMPLOYEE $ If pG,Mkscrideunder IFIRDTIONOFOPFRATIGNSt,almv nSGp S`E_FILI`YIIMIT A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACERB 101,Additional Remarks Schedule,may he attached if more space Is teethed) City of Kent named as additional insured as respects named insureds business auto '.operations. RE: Consultant Services Agreement - S. 228th Street - VPPR Grade Separation. CERTIFICAIEJ CANCELLATION City of Kent Engineering Public Works Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 400 West GO We THE EXPIRATION DATE THEREOF FA, NOTICE FALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Kent, WA 98032 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 680-0J087a53-17-47 EFFECTIVE DATE: 04/05/2017 ISSUE DATE: 02/16/2017 LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS BY LINE OF BUSINESS IL TO 19 02 05 COMMON POLICY DECLARATIONS MP TO 01 02 05 SUSINESSOWNERS COVERAGE PART DECLARATIONS IL T8 01 01 01 FORMS ENDORSEMENTS AND SCHEDULE NUMBERS IL T3 16 05 12 COMMON POLICY CONDITIONS - WASHINGTON IL T3 20 09 97 EARLIER NOTICE OF CANCELLATION/NONRENEWAL PROVIDED BY US BUSINESSOWNERS MP Tl 30 02 05 TABLE OF CONTENTS - BUSINESSOWNERS COVERAGE PART - DELUXE PLAN MP PO 06 09 15 ARCHITECTS, ENGINEERS AND SURVEYORS PROPERTY ENHANCEMENT MP PO 07 09 15 ARCHITECTS, ENGINEERS AND SURVEYORS FLOOD ENDORSEMENT MP PO 08 09 15 ARCHITECTS, ENGINEERS AND SURVEYORS EARTHQUAKE ENDORSEMENT MP Tl 02 02 05 BUSINESSOWNERS PROPERTY COVERAGE SPECIAL FORM MP T1 05 02 05 AMENDATORY PROVISIONS - OFFICES MP T3 25 01 15 FEDERAL TERRORISM RISK INSURANCE ACT DISCLOSURE _ MP T3 50 11 06 EQUIPMENT BREAKDOWN - SERVICE INTERRUPTION LIMITATION MP T3 56 02 08 AMENDATORY PROVISIONS - GREEN BUILDING AND BUSINESS PERSONAL PROP COV ENHANCEMENTS �..� CP 01 60 12 98 WASHINGTON CHANGES - DOMESTIC ABUSE MP T4 31 07 16 WASHINGTON CHANGES o� COMMERCIAL GENERAL LIABILITY CG D4 69 07 14 TOT AGG LIMIT OTHER THAN PROJECTS CG TO 34 11 03 TABLE OF CONTENTS - COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG 00 01 10 01 CG 00 01 10 01 COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG D2 55 11 03 AMENDMENT OF COVERAGE - POLLUTION - CG D3 09 11 03 AMENDATORY ENDR- PRODUCTS-COMPLETED OPERATIONS HAZARD CG D3 81 09 15 BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND c� SURVEYORS) a CG D4 71 Ol 15 AMENDMENT OF COVERAGE B - PERSONAL AND ADVERTISING INJURY LIABILITY GN 00 13 11 97 EXTENSION OF COVERAGE - BODILY INJURY GN 01 13 11 03 EMPLOYERS OVERHEAD LIABILITY C CG D2 03 12 97 AMEND - NON CUMULATION OF EACH OCC CG D2 06 06 04 AMD OF EXPECTED OR INTENDED INJY EXL - ADD OF PROP DMGE TO EXC FOR RESNBLE FORCE CG D3 79 01 16 ARCHITECTS, ENGINEERS AND SURVEYORS COVERAGE XTEND ENDORSEMENT IL T8 01 01 01 PAGE: 1 OF 3 010064 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY„ BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II - WHO IS its of insurance described in Section III - Lim- AN INSURED: its Of Insurance. Any person or organization that you agree in a It. This insurance does not apply to "bodily inju- "written contract requiring insurance"to include as ryork" "property ncldaamdage" caused by "your an additional insured on this Coverage Part, but: n the "products- completed operations hazard" unless the a. Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and "written contract requiring insurance"covespecrage cally requires you to provide such coverage III If, and only to the extent that, the injury or for that additional insured, and then the insur- damage is caused by acts or omissions of ance provided to the additional insured ap- you or your subcontractor in the performance plies only to such "bodily injury' or "property of "your work" to which the "written contract damage"that occurs before the end of the pe- requiring insurance" applies, or in connection riod of time for which the "written contract re- with premises owned by or rented to you. quiring insurance" requires you to provide The person or organization does not qualify as an such coverage or the end of the policy period, whichever Is earlier. additional insured 2. The following is added to Paragraph 4.a. of SEC- c. With respect to the independent acts or orris- TION IV - COMMERCIAL GENERAL LIABILITY sions of such person or organization; or CONDITIONS: d. For "bodily injury", "property damage" or "per- The insurance provided to the additional insured sonal injury" for which such person or organi- is excess over any valid and collectible other in- zation has assumed liability in a contract or surance, whether primary, excess, contingent or agreement. on any other basis, that is available to the addi- The insurance provided to such additional insured tional insured for a loss we cover. However, if you is limited as follows: specifically agree in the "written contract requiring e. This insurance does not apply on any basis to insurance" that this insurance provided to the ad- any person or organization for which cover- ditional insured under this Coverage Part must age as an additional insured specifically is apply on a primary basis or a primary and non- added by another endorsement to this Cover- contributory basis, this insurance is primary to age Part. other insurance available to the additional insured f. This insurance does not apply to the render- which covers that person or organizations as a ing of or failure to render any "professional named insured for such loss, and we will not services". share with the other insurance, provided that: g. In the event that the Limits of Insurance of the (1) The "bodily injury" or "property damage" for Coverage Part shown in the Declarations ex- which coverage is sought occurs; and ceed the limits of liability required by the "writ- (2) The "personal injury" for which coverage is ten contract requiring insurance", the insur- sought arises out of an offense committed; ance provided to the additional insured shall after you have signed that"written contract requir- be limited to the limits of liability required by ng insurance". But this insurance provided to the that "written contract requiring insurance". This endorsement does not increase the lim- additional insured still is excess over valid and collectible other insurance, whether primary, ex- cess, contingent or on any other basis, that is CG D3 81 09 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 2 Includes the copyrighted material of Insurance services Office, Inc.,with its permission COMMERCIAL GENERAL LIABILITY available to the additional insured when that per- fore, and in effect when, the "bodily injury" or son or organization is an additional insured under "property damage" occurs, or the "personal injury" any other insurance. offense is committed. 3. The following is added to Paragraph 8., Transfer 4. The following definition is added to the DEFINI- Of Rights Of Recovery Against Others To Us, TIONS Section: of SECTION IV - COMMERCIAL GENERAL LI- "Written contract requiring insurance" means that ABILITY CONDITIONS: part of any written contract under which you are We waive any right of recovery we may have required to include a person or organization as an against any person or organization because of additional insured on this Coverage Part, provid- payments we make for "bodily injury", "property ed that the "bodily injury" and "property damage" damage" or "personal injury" arising out of "your occurs and the "personal injury" is caused by an work" performed by you, or on your behalf, done offense committed: under a "written contract requiring insurance" with a. After you have signed that written contract; that person or organization. We waive this right only where you have agreed to do so as part of b. While that part of the written contract is in ef- the "written contract requiring insurance" with feet; and such person or organization signed by you be- c. Before the end of the policy period. Page 2 of 2 ©2015 The Travelers Indemnity Company.All rights reserved. CG D3 81 09 15 Includes the copyrighted material of Insurance services Office, Inc.,with its permission POLICY NUMBER: 604780065 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply un modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is Indicated below. Endorsement Effective: 10/30/2017 Countersigned By Named Insured. Ott-Sakai & Associates LLC S&T- M &n (Authorized Representative) SCHEDULE Name of Persons or Organization s : CITY OF KENT (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown In the Schedule Is an "Insured"for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained In Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1