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PW18-080 - Original - Tire Disposal & Recycling LLC - 2018 Recycling Events - 02/22/2018
/ „ 1 . ............... // / 0 R qc�:: c ke 3- r d s M le E, T Document WASHPNOTON CONTRACT COVED 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 Tire Disposal & Recycling LLC Vendor Number: JD Edwards Number Contract Number: evy r " This is assigned by City Clerk's Office Project Name: 2018 Recycl�inq Events Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment x Contract ❑ Other: Contract Effective bate: 2/22/18 Termination Date: 10/30/18 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Tony Donati Department: Engineering Contract Amount: $2,400.00 Approval Authority: X Department Director ❑ Mayor ❑ City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Provide tire collection services for two Recycling Events, As of: 08/27/14 • KENT GOODS & SERVICES AGREEMENT between the City of Kent and Tire Disposal & Recycling LLC THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Tire Disposal & Recycling LLC organized under the laws of the State of Delaware, located and doing business at PO Box 83478, Portland, OR 97283, Phone: (503) 240-1919, Contact: Mark Hope (hereinafter the "Vendor"). AGREEMENT I. DESCRIPTION OF WORK. Vendor shall provide the following goods and materials and/or perform the following services for the City: The Vendor shall provide tire collection services for two City of Kent 2018 Recycling Events. For a description, see the Vendor's Scope of Work which is attached as Exhibit A and incorporated by this reference. Vendor acknowledges and understands that it is not the City's exclusive provider of these goods, materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and services through other sources. II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete the work and provide all goods, materials, and services by October 30, 2018. III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Two Thousand, Four Hundred Dollars ($2,400.00), including applicable Washington State Sales Tax, for the goods, materials, and services contemplated in this Agreement. The City shall pay the Vendor the following amounts according to the following schedule: Vendor shall be paid per recycling event after submittal of invoice. If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. GOODS &SERVICES AGREEMENT - 1 ($20,000 or Less, ind. WSST) A. Defective or Unauthorized Work. The City reserves its right to withhold payment from Vendor for any defective or unauthorized goods, materials or services. If Vendor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services from other sources, and Vendor 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 Agreement price specified above. The City further reserves its right to deduct these additional costs incurred to complete this Agreement with other sources, from any and all amounts due or to become due the Vendor. B. Final Payment: Waiver of Claims. VENDOR'S ACCEPTANCE OF FINAL PAYMENT SHALL CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR FINAL PAYMENT IS MADE. 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 Vendor 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 Vendor maintains and pays for its own place of business from which Vendor's services under this Agreement will be performed. C. The Vendor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Vendor's services, or the Vendor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Vendor 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 Vendor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Vendor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Vendor maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. VI. CHANGES. The City may issue a written amendment for any change in the goods, materials or services to be provided during the performance of this Agreement. If the Vendor determines, for any reason, that an amendment is necessary, Vendor must submit a written amendment request to the person listed in the notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days of the date Vendor 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 Vendor'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 Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the amended work upon receiving either a written amendment from the City or an oral order from the City before actually receiving the written amendment. If the Vendor fails to require an GOODS & SERVICES AGREEMENT - 2 ($20,000 or Less, including WSST) amendment within the time allowed, the Vendor waives its right to make any claim or submit subsequent amendment requests for that portion of the contract work. If the Vendor disagrees with the equitable adjustment, the Vendor must complete the amended work; however, the Vendor may elect to protest the adjustment as provided in subsections A through E of Section VII, Claims, below. The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. An amendment that is accepted by Vendor 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. VII. CLAIMS. If the Vendor disagrees with anything required by an amendment, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Vendor may file a claim as provided in this section. The Vendor 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 Vendor 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 Vendor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Vendor'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 Vendor'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 Vendor is asserting a schedule change or disruption. B. Records. The Vendor 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 Vendor'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. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor 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 Vendor 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 Vendor completely waives any claims for protested work and accepts from the GOODS & SERVICES AGREEMENT - 3 ($20,000 or Less, including WSST) City any written or oral order (including directions, instructions, interpretations, and determination). VIII. LIMITATION OF ACTIONS. VENDOR 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 VENDOR'S ABILITY TO FILE THAT SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. IX. WARRANTY. Vendor warrants that it will faithfully and satisfactorily perform all work provided under this Agreement in accordance with the provisions of this Agreement. In addition to any other warranty provided for at law or herein, this Agreement is additionally subject to all warranty provisions established under the Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants goods are merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance with their specifications and Vendor's representations to City. The Vendor shall promptly correct all defects in workmanship and materials: (1) when Vendor knows or should have known of the defect, or (2) upon Vendor's receipt of notification from the City of the existence or discovery of the defect. In the event any part of the goods are repaired, 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 Vendor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the correction. X. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor 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. Vendor 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. XI. INDEMNIFICATION. Vendor 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 Vendor'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 Vendor's work when completed shall not be grounds to avoid any of these covenants of indemnification. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'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 Vendor 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 Vendor's part, then Vendor 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 Vendor's part. The provisions of this section shall survive the expiration or termination of this Agreement. GOODS & SERVICES AGREEMENT - 4 ($20,000 or Less, including WSST) XII. INSURANCE. The Vendor 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. XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor 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 Vendor's own risk, and Vendor 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. XIV. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in 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 XI 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 Vendor. 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 Vendor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Vendor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. GOODS & SERVICES AGREEMENT - 5 ($20,000 or Less, including WSST) I. Pubhc Records Act. The Vendor acknowledges that the City is a public agency subject to th:e I'll 11111-- ...............------------ Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes, emails, and other, records prepared or gathered by the Consultant in its performance of this Agreement may be subject to public review and disclosure, even if those records are not produced to or possessed by the City of Kent. As such, the Vendor, agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act, J. City BV5iness License- - Required, Prior to commencing the tasks described in Section 1, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. K. Cokint-trparts and-...5tgnatures,by i ax or. Email. This Agreement may be executed in any number of counter-parts, 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 iin 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. VENDOR: CITY OF KENT: By: By: Print Name Print Name: Michael Mactutis, P.E. Its:--- Its: Environmental Engineering Manager DATE:_____�, ...... DATE ........................ ................---------- -—__ ....... NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Mark Hope Timothy J. LaPorte, P.E. Tire Disposal & Recycling LLC City of Kent PO Box 83483 220 Fourth Avenue South Portland, OR 97283 Kent, WA 980�32 (503) 240-1.919 (telephone) (253) 856-5500 (telephone) (503) 240-1992 (facsimile) (253) 856-6500 (facsimile) ... . ........................... rtr D"%.[-,R,v yd GOODS &SERVICES AGREEMENT - 6 ($20,000 or Less, including WSST) DECLARATION ,CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who: perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2, During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3, During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. By: e, For: C ........... Title: Date: EEO COMPLIANCE DOCUMENTS - 1 of 3 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 of 3 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 of 3 EXHIBIT A Tire Disposal& Tire,Disposal&Recycling 1,1.0 PO ox Recycling LLC Port land,)470 OR 97293 Phone: (503)240-1919 FAX: (503)20-1992 February 1,2018 Scope of Work Tire Collection at Recycling Event Hogan Park off Russell Rd Kent,WA Tire Disposal&Recycling LLC will provide to the City of Kent in 2018 at the March 17th& October 20th(funds permitting)recycling events,scrap tire collection services to include the following: 1. One laborer to accept tires from the public,one 28'trailer pup for the laborer to load tires into,from approximately 8:30am-4:30pm or as otherwise determined and not to exceed 8 hours. The trailer will be removed at the end of the day Rate: $489,00 2. Haul away the tires collected during the event for recycling,recovery and/or disposal. Rate: $1.00 per passenger car/light truck tire off the rim $3.00 per passenger car/light truck tire on the rim $5.00 per semi truck tire off the rim $15.00 per semi truck tire on the rim 3. If requested,the TDR employee will be available to collect tire drop off fees and report them back to the City. This service agreement is capped at$2400.00 and charges are not to exceed this amount unless approved by a representative of the City of Kent. Any tire quantities that exceed this limit will be turned away. Alisa Bacon,Bookkeeper 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 ANII. 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. CASMR-02 TCHII. CERTIFICATE OF LIABILITY INSURANCE DATE(MMI TE(MMI D s I 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 rights to the certificate holder In lieu of such endorsement(s). -- PRODUCER License III OD21146 ,NAME'CT Partners Service Group San Francisco,CA-Equity Risk Partners-HUB International California PHONE,Extl:(415 874-7168 FAX 415 874-7170 466 Montgomery Street f _. (NC.No):( ) Suite 1200 R ffi�ss;psg@equityrisk.com San Francisco,CA 94104 _ -.- ___ INSUREA(S)AFFORDING COVERAGE NAICrJ INSURER A:General.Casualty Company of Wisconsin 24414 INSURED INSURER B: Castle Tire Disposal,LLC INSURER C: _ P.O.BOX 83478 INSURER i Portland,OR 97283 INSURERE: _ INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 1$ TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I$SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID C-I AIMS INSR 'ADDL SUBR POLICY EFF POLICY EXP TYPE OFENSURANCE POLICY NUMBER LIMITS IR._--- .[NSU.YYYD.;_-----._._-- ----_-------(A1MIDDmYYt (MM(DDrYYYY1 A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OECCURRENCE ,E CLAIMS-MACE X OCCUR CCI 1257396 01/3012018 0710112018 PREMISES RtNttlOccurrD0oco1 . S 100,000 MED EXP(Anyone persm) S 5,000 _ PERSONAL_&ADV INJURY s 1,000,000 GL4'L AGGRCOATC LIMIT Af r`LIL,,PI R GENERAI Anf7RFrATF 5 2.000,000 X POLICY Ppa LOC PRCDUCTS-COMPIOP.AGG.S 21000,000 OTHER. .- _._.----.. _---- S C�OMBINED SINGLE LIMIT 1,000,000 s A AUTOMOBILE LIABILITY (Ea eccidenq ANY AUTO CBA1267395 01/30120i8 07/0112018 BODILY INJURY(Per person) ,s OWNED SCHEDULED AUTOS ONLY AUTOS BODILY BODILY INJURY(Por aocident) s X ,AUTOS ONLY X A101T0 ONLY ..SP.'. Rl4AMAGE s A X UMBRELLA UAB X OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS MADE CCU1257395 01130/2018 0710112018 AGGREGATE S 1,000,000 DED RETENTION s WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY YIN STATUTE H TUTE ER ANY PRROR��PRIETgOgRIPARTNEIRJEXECUTIVE E L EACH ACCIDENT S 9cnCdot 04-NH)EXCLUDED? N I A EL DISEASE-EAE_M_PL_OYEE:S Ues describe urner SORIPTION OF OPERATIONS below .__ EL DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES JACORD 101,Additional Remarks Schedule,may be attached It mores ace Is required) Certificate Holder Is Additional Insured on the General Liability and Auto Liability policies as required by written contract.Waiver of subrogation applies in favor of the additional insureds with respect the General Liability and Auto policies as required by written contract.The Umbrella policy follows form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPTION DATE THEREOF, City of Kent;clo Nancy Yoshtake ACCORDANCE WITH THE POLICY P OVISIONSCE WILL BE DELIVERED IN 400 West Gowe Kent,WA 98032 ------- --— AUTHORIZED REPRESENTATIVE 0"Az/aat- ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY#: CCI 1257395 COMMERCIAL GENERAL LIABILITY CG 8156 03 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES, CUSTOMERS OR CONTRACTOR'S -- COMPLETED OPERATIONS -- AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN AGREEMENT WITH YOU This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON OR ORGANIZATION DESIGNATED PROJECT NAME OR NUMBER BLANKET BASIS AS REQUIRED BY WRITTEN CONTRACT A. Section II —Who is an Insured Is amended to B. Additional Conditions Include as an additional insured any person or 1. The written contract or written agreement organization, including any person or organization must be: shown In the schedule above, for whom you are performing operations when you and such person a. Currently In effect or becoming effective or organization have agreed in writing In a during the term of this policy;and contract or agreement (as set forth In Paragraph b. Executed prior to the "bodily Injury", B. below) that such person or organization be "property damage" or "personal and added as an additional insured on your policy. advertising injury". Such person or organization Is an additional 2. The Limits of Insurance applicable to the Insured only with respect to liability for "bodily Injury", "property damage", or "personal and additional insured are those specified in the written contract or agreement or in the advertising injury"caused In whole or in part by. Declarations of this policy, whichever is less. 1. "Your work" performed for that additional These Limits of Insurance are inclusive of and Insured, and not, in addition to, the Limits of Insurance 2. included in the "products-completed oper- shown in the Declarations. ations hazard". Includes copyrighted material of Insurance Services Office, Inc. CG 81 56 03 with its permission. Page 1 of 2 09 C. With respect to the Insurance afforded to these D. As respects the coverage provided by this additional Insureds, the following additional endorsement, Paragraph 4.a. Section IV exclusions apply: Commercial General Liability is deleted and This Insurance does not apply to: replaced by. 1. "Bodily injury", "property damage" or 4. Other Insurance "personal and advertising Injury"arising out of a. This insurance is primary except when b. the rendering of, or the failure to render, any below applies. If this insurance is primary, professional architectural, engineering or our obligations are not affected unless surveying services, Including but not limited any of the other insurance is also primary. to: Then, we will share with all that other a. The preparing, approving or failing to insurance by the method described In c. prepare or approve, maps, shop below. When required by written contract drawings, opinions, reports, surveys, field or agreement with the additional insured, orders, change orders, or drawings and this insurance is primary and we will not specifications; or share under Paragraph c. below with the b. Supervisory, inspection, architectural or additional insured. engineered activities. Includes copyrighted material of Insurance Services Office, Inc. O Page 2 of 2 with its permission. CG 8156 03 09 Policy#CBA 1257396 COMMERCIAL AUTO CA 7010 01110 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ rr CAREFULLY. CHANGES IN COMMERCIAL AUTO COVERAGE FORM This endorsement modifies Insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. BROADENED WHO IS AN INSURED (4) All reasonable expenses Incurred by Paragraph A.I.Who Is an Insured of SECTION the Insured"at our request, Including It — LIABILITY COVERAGE Is amended to In- actual loss of earnings up to $500 a clude the follovrtng: day because of time off iron Work. d. Any °employee" of yours is an Insured" C. FELLOW EMPLOYEE COVERAGE while using a coved "auto' you don't Paragraph B.& Fellow Employee Exclusion own, hire or borrow In your business or contained In SECTION fl—LIABILITY COVER- your personal affairs. AGE does not apply N the "bodily it LW results of yours Is an "Insured" from the use of a covered "auto"you own or hire e. Any employee"while using an 'auto" hired or rented un- that is not a bus, motorcycle or van used to der a contract,or agreement In that*am- transport emptoyees ployss's' name, with your permission, This Fellow Employee Coverage Is excess over while performing duties misted to the any other cogectibie Insurance. conduct of your business. D. POLLUTION LIABILITY— BROADENED COW I. Each person or Organization to whom ERAGE FOR COVERED AUTOS you are required by a written contract or 1. Liability Coverage is changed as follows: agreement to provide additional Insured Ex- status Is an "insured" under Liability Cov- a. Paragraph 8 the Pollution Fac erage, but only to the extent that person COVEciuslon in SECTION ONN II -- L.IABIUTY or organization qualifies as an "Insured" sumed under applies only to tiabenMty as- under the Who Is an Insured Provision earned under a contract or agreement. contained In Section II of the coverage b. With respect to the cmWW afforded by form. The written contract or agreement Paragraph 1.a.Above, Exdusian B8.Care, must be In effect during the policy period Custody or Control of SECTION II — shovm In the Declarations and must have LIABILITY does not apply. been executed prior to the 'bodily injury' 2. Changes In Definitions or"property damage." For the purposes of this endorsement, Para- B. LIABILITY COVERAGE EXTENSIONS SUP- graph D. of SECTION V—DEFINITIONS Is PLEMENTARY PAYMENT'S replaced by the following: Paragraphs A.2.a. (2) and A.2.a. (4) Coverage D. "Covered pollution cost or expense" Extensions — Supplementary Payments of means any cost or expense arising out of: SECTION 11 — LIABILITY COVERAGE are de- 1. Any request,demand, order or states leted and replaced with the following: tiny or regulatory requirement that (2) Up to $5,000 for the cost of ball any"Insured"or others test for, moni- bonds (Including bonds for related tor, dean up, remove, contain, treat, traffic law violations) required be- debv* or neutralize, or In any way cause of an "ac oldent"we cover.We respond to, or assess the effects of do not have to furnish these bonds. •pollutants':or Indudes copyrighted material of Insurance Services Office, Inc., CA 7910 0110 with its permission. Page 1 of 6 1 2. Any Balm or "suit by or on behalf of a 2. Unless you notify us to add overage to your governmental authority for damages be- policy,the Coverage under this provision is af- Cause of testing for, monitoring, cleaning forded only until: up, removing,containing, treeing,detoxi- a. The 120th d after lying or neutralizing, or In any way re- you acquire or form sponding to or assessing the effects of the organization,or "pollutants". b. The and of the policy period,whichever is "Covered pollution cost or " _ earlier. Include an cost or expense�g out of Bee F. EXTENDED TOWING actual, alleged or threatened discharge, dis- Paragraph A.2. Towing of SECTION lit — p�l"pole�e,migration, release or escape PHYSICAL DAMAGE COVERAGE Is deleted • and replaced with the tbifawtng: a. Before the "pollutants"or any pry We will pay for tawing and labor costs each time a ty In which the "pollutants" are con- covered "auto° Is disabled.All labor must be per- tained are moved from the ply formed at the place of disablement.If the"auto"Is where they are acxepled by the "in- of the private passenger type,there will be no de- sured'for movement Into or onto the ductible. if the "auto° Is other than a private pes- cov+ered"auto";or anger type,a$100 deductible will apply. b. After the "pollutants" or any property The most we WU pay under this EXTENDED In which the "pollutants" are con- TOWING c ovemge Is$750 per occurrence. twined are moved from the covered G. PHYSICAL DAMAGE COVERAGE "auto" to the place where they are fi- EXTENSIONS nally delivered, disposed of or aban- doned by the"insured-. Paragraph A.4. — Coverage Extensions of Paragraphs a. and b. above do not apply SECTION III — PHYSICAL DAMAGE COVER- to"accidents"that occur away from prom- AGE is amended as follows: Ism owned by or rented to an "Ensured" a. Transportation Expenses with respect to"pollutants"not In or upon The amount we will pay for temporary a Covered"auto"EW*. transportation expense Is Increased to (1) The "pollutants" or any property $50 per day to a maximum of$3,000. In which the"pollutants"are con- b. Loss of Use Expenses tained are upset, overturned or The amount we will pay for loss of use is damaged as a result of the Increased to $75 per day and to a maxi- maintenance or use of a covered mum limit of$1,000. "auto";and (2) The&charge, drspersai, seepW H. RENTAL REIMBURSEMENT migration, reuse or escape of the 1. This overage applies only to a covered"auto" 'poEhrtants" is Caused dire* by described or designated In the Schedule or In such upset avertum of damage. the Declarations as Carrying physical damage This Pollution Liability Coverage Is subject to an Coverage, Annual Aggregate Limit of Liability of$100,000. 2. We will pay for rental reimbursement expens- E. NEWLY ACQUIRED OR FORMED es Incurred by you for the rental of an °auto" ORGAMZATIONS because of "loss" to a covered "auto". Pay- ment applies In addition to the otherwise ap- Throughout this policy, the words you and your pticable amount of coverage you have on also refer to any organization you newly acquire or each covered"auto form, other than a partnership, joint venture (w onlyg, We vAll pay y for those expenses incurred limited liability company, and over which you during the policy period beginning 24 hours maintain ownership or majority Interest, but only If after the 'doss' and ending, regardless of the there Is no similar insurance available to that or- ganization. poly expiration, with the lesser of the foi- Hawaver lowing number of days: r: 1. The coverage does not apply to an "accident" which occurred before you acquired or formed the organization. Includes copyrighted material of Insurance Services Of oe, Inc., Page 2 of 0 with its permission. CA 7910 0110 a. The number of days reasonably required 2. Exclusions to repair or replace the covered "auto". If The exclusions that apply to SECTION III— Roes" Is caused by thett, this number of PHYSICAL DAMAGE, ocept for the exclu- days Is added to the number of days it slon relating to Audlo, Visual and Data Elec- takes to locate the covered"auto'and re- trork Equipment,also apply to coverage Pro- turn it to you;or vided by this endorsement. In addition, the b. 30 days. following exclusions apply. 4. Our payment Is limited to the lesser of the fol- We will not pay, under this endorsement, for [awing amounts: either any electronic equipment or accesso- a. Necessary and actual expenses Incurred; ries used with such electronic equipment that or Is: a. Necessary for the norrnal operation of the b. $50 per day gyred °auto' or the monitoring of the 5. This coverage does not apply white there are covered"auto's"operating system;or spare or reserve "sutos° avalable to you for b. Bath: your operations. 0. If°toss° results from the total theft of a cov- (1}.housing integral part of the same unit erect 'auto'of the private passenger type,via housing any sound reproducing the e will pay under this coverage only that amount equipment designed solely for the re- of your rental reimbursement eximrmw which production of sound li the sound re- of not already provided for under the pare- producing equipment ' permanently graph A4. Coverage Extension in SECTION installed in the covered'auto°;and [tl—PMYS1C&DAMAGE COVERAGE (2).Permanently installed In the opening No Deductible applies to this coverage. of the dash or console normally used 1. AIRBAG COVERAGE by the manufacturer for the tnstalla- tlon of a radio. Exclusion 0.3. In SECTION III — PHYSICAL 3. Limit Of Insurance DAMAGE COVERAGE Is amended to add: With respect to coverage under this en- This exension does not apply to the accidental dorsemert,the Limit Of Insurance provWcn discharge of an fig. of SECTION Ili — PHYSICAL DAMAGE J. AUDIO, VISUAL AND DATA ELECTRONIC COVERAGE Is replaced by the following: EQUIPMENT a. The most we will pay for all Ross" to au- 1. Coverage dio, visual or data electronic equipment a. We will pay with respect to a covered°au- and any accessories used with this to"described in the Schedule for"toes"to equipment as a result of any one "awl- any electronic equipment that receives or dento Is the lesser of transmits audio, visual or data signals (1).The actual cash value of the dam- and that Is not designed solely for the re- aged or stolen property as of the time production of sound. This coverage ap- of the Ross"; piles only If the equipment Is permanently (2).The cost of repaMng or replacing the Installed in the covered'auto" at the time damaged or stop property with oth- of the Ross'or the equipment Is remove- or property of like kind and quaW,or ble from a housing unit which is perms- (3}.$1,500. neatly installed In the covered *auto" at the time of the °toes". and such equip- b. An adjustment for depredation and phys- ment Is designed to be solely operated by ical condition will be made In determining use of the power from the°autoW electri- actual cosh value at the time of the"lose. cal system,In or upon the covered'auto". c. if a repair or replacement results In better b. We will pay with respect to a covered"au- than like kind or quality,we will not pay for to°described In the Schedule for Ross"to the amount of betterment any accessories used with the electronic 4. Deductible equipment described to Paragraph 1.e. No deductible apples to this coverage. above. However, this does not include tepee, records or discs. The Insurance provided by this extension Is ex- cow over any other collectible Insurance. Includes copyrighted material of insurance Services Office. Inc., CA 7910 0110 With its permission. Page 3 of 6 K TAPES,RECORDS AND DISCS COVERAGE 2. "Personal et{ects" as used in this extension Exclusion BA.a. of SECTION III — PHYSICAL means tangible property that Is worn or car- DAMAGE COVERAGE is deleted and replaced rim by the "insured°. "Personal eflacts"does by the t1lowing: not Include toots,jewelry, money, securities, Tapes, records, discs or other similar au- radar or laser detectors, or tapes, records, a. Te P discs or similar audio,visual or data electronic dio, visual or data electronic devices de- equipment. signed for use with audio, visual or data No Deductible applies to this extension. electronic equipment except when the tapes, records, discs or other similar au- The Insurance provided by this extension is ex dio,visual or data electranlo devices: cess over any other oollectible insurance. (1) Are your property or that of a family N. LOANILEASE PAYOFF COVERAGE member,and The SECTION IU—PHYSICAL.DAMAGE COVER- (2) Are in a covered "auto"at the time of AGE Is amended by the addition of the followng: DIME• in the event of a total "loss° to a covered "auto' (a).The most we will pay far"loss" Is shown In the Declamations,we vA pay any unpaid $200. No Physical Damage Cow amount due on the lease or loan for a covered stage deductible applies to this "auto',less: coverage. 1. The amount paid under the Physical Damage This extension provides coverage only to a cov- Coverage Section of the policy;and ered"auto". 2. Any. L. PHYSICAL. DAMAGE DEDUCTIBLE—SINGLE a, Overdue leasedoan payments at the time DEDUCTIBLE AND GLASS REPAIR of the"loss"; Paragraph D. Deductible In SECTION III -- b. Ftnanclal penalties Imposed under a PHYSICAL DAMAGE COVERAGE Is deleted lease for excessive use, abnormal wear and replaced by the following: and tear or high mileage. D. Deductible c. Security deposits not returned by the For each owed "auto!"our obligation to pay lessor; for, repair, return or replace damaged or sto- d. Costs for extended warrantles, Credit Life len property will be reduced by the applicable Insurance, Health, Accident or Disability deductible shown In the Declarations. Any Insurance purchased with the ban or Comprehensive Coverage deductible shown lease;and in the Decthratlons does not apply to 'loss" caused by lire or lightning. e. Carry-over balances from previous loans When two or more covered "autos" sustain or leases. "loss" In the same occurrence, the total of all 0. CUSTOM SIGNS AND DECORATIONS the"loss" for all the Irridved covered "autos" In the event of a total loss to a vehicle Insured for will be reduced by a single deductible,which auto physical damage coverage on this policy, In will be the largest of all the deductibles apply- addition to the ACV of the vehicle,we will pay the Ing to all such wined"autos." actual cost to repair or replace signage or custom No deductible applies to glass damage N the PclM detells up to$6,000. glass is repaired rather than replaced. P. HIRED AUTO PHYSICAL DAMAGE M. PERSONAL EFFECTS COVERAGE If hired "autos" are covered "autos" for Liability 1. If you purchase Comprehensive Coverage on age and If Physical Damage Coverage of this policy for a stolen owned "auto", we will Comprehensive, Specified Causes of Loss, or pay up to $600 for 'personal effects" stolen Collision are provided under this Coverage Form with the *auto. for any"auto"you own,then the Physical Damage Coverage's provided are extended to "autos"you hire of like Idnd and use subject to the following limit: The most we will pay for any one loss Is the lesser of the following: 1. $60,000 per accident, Includes copyrighted material of Insurance Services OfRce, Inc., Page 4 of 6 with its permission. CA TO 10 0110 2. Actual Cash Value,or Any unintentional fa€€ure to disciase all exposures 3. The cost of repair. or hazards adding as of the of eclive date of the The deductible will be equal to the largest deduct- In theme Auto period a Form or at anytime rsedur- Ible applicable to any owned"auto'for that cover- y policy peers e f not such exposure or adverse- a e. Na deductible applies to"loss"caused t� !Y atiect the coverage for such exposure or haz 9 by ard. However, you must report the undisclosed or lightning. This Hired Auto Phyalcat Damage pure or hazard to us as soon as reasonably coverage Is excess over any other collectible €n- a after its discovery. surenoe. Subject to the above limit, deductible T. EXTENDED EMPLOYEE HIRED AUTO PHYSM and excess provisions, we will provide coverage equal to the broadest coverage applicable to any CAL DAMAGE covered°auto"you own. Paragraph 8.6.b. Other Insurance of SECTION 4 DUTIES IN EVENT OF ACCIDENT, CLAIM, IV—BUSINESS AUTO CONDITIONS Is deleted SUIT OR LOSS and replaced by the following: Subparagraphs A.2.a. of SECTION IV— BUSI• b. For Hired Auto Physical Damage Cover- NESS AUTO CONDITIONS Is deleted and re- age, the following are deemed to be cov- placed by ered"autos"you own: a. In the event of "accident", dalm, "sutt° or 1. Any covered "auto" you lease, hire, "lass°, you, your insurance manager or any rent or borrow;and other person you designate must ghre us or 2. Any covered°auto"hired or rented by our authorized representative prompt notice your °employee° under a contract In of such "accident or"loss". Include: that Individual "employee's" name, (1) How, when and where the "accident° or with your permission, while perform- ""occurred; Ing duties related to the conduct of (2) The"insuredle name and address;and your business. S To the extent possible, the names and However, any "auto" that Is leased, hired, rented ( ) p or borrowed with a driver is not a covered'"auto". addresses of any injured persons and U. POLICY PERIOD,COVERAGE TERRITORY witnesses. Knowledge of an "accident" or "loss° by your Paragraph B.I. Policy Period, Coverage Terri. agent savant or"employee"shall not be oonsid- tory of SECTION IV—BUSINESS AUTO CON- ered knowledge by you unless you, your Ineur DITIONS Is deleted and replaced by: ance manager or any other person you designate 7. Policy Period, Coverage Territory has received notice of the "accident" or loss" Under this Coverage Form, we ever "acci- f m your agent,servant,or"employee." dents"and"losses"occurring: R. WAIVER OF SUBROGATION a. During the policy period shown In the SECTION IV — BUSINESS AUTO CONDI- Dedwatlons;and TIONS—A. 5. Transfer of Rights of Recovery b. Within the coverage territory. Against Others to Us Is amended as totlows: The caverage tenibry Is: This condition does not apply to any person or or- gantzatlon to which you waived this condition by a. The United States of America; written contract or agreement, but only to the ex b. The territories and possessions of the tent that subrogation Is waived prior to the °acd- United States of America; dent" or "loss" under a contract with that person c. Puerto Woo; or organization. S. UNINTENTIONAL FAILURE TO DISCLOSE d. Canada;and ADS e. Anywhere In the world if: Paragraph 0.2. Concealment, Mlarepresen- (1) A covered -auto" is leased, hired, tation Or Fraud In SECTION IV — BUSI- vented or borrowed for a period of 30 NESS AUTO CONDITIONS Is amended by days or less;and adding the following: Includes copyrighted material of Insurance Services Office, Inc., CA 7910 0110 with its per mrlssion. Page 5 of 6 (2) The "Insured's" responsibility to pay V. DEFINITION OF BODILY INJURY AMENDED damages Is determined In a "sult" on Paragraph C. of SECTION V—DEFINITIONS Is the merits, In the United States of amended to Include: America, the tat � and passes- " fiy lnjury" Includes mental anguish or other sloes of the Unitediced States of America, mental Injury resulting Puerto Rico, or Canada or in a set- g from "boduy Injury." How- dement we agree to. ever, no overage is provided for mental anguish We also cover"loss"to,or"accidents"involving,a or mental Injury absent physical injury. covered "auto" while being transported betweo None of the extensions provided under this cov- any of these places. erage endorsement apply ff coverage Is more specifically Identified elsewhere In the policy or endorsements, for which a premium charge Is made or a higher limit Is Identified. Under no cir- cumstances Is any limit provided under this ex- tension to be combined with a limit provided elsewhere in the pollcy or endorsements. Includes copyrighted material of Insurance Services Office, Inc., Page 6 of 6 with its permission. CA T910 0110 Client#: 175025 TIREDISP1 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM10DfYYYY) 613 012 01 7 -'4,S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS ATIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES or-LOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Therese Pritchett NAME: Propel Insurance PHO ko Ell:800 499-0933 �- AlC we No; 866 577-1326 Medford Workers Compensation a DD Riess: therese.pritchett@propelinsurance.com P O Box 936 INSURER(S)AFFORDING COVERAGE NAIC a Medford,OR 97501 INSURER A:SAIF Corporation 36196 INSURED �Tire Disposal&Recycling, LLC INSURER a — PO Box 83478 �INSURER C: ---- ------ _.----- Portland,OR 97283 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. LTRTYPE OF INSURANCE ADDLSUB POLICY EFF POLICY EXP __ INSR WVD POLICY NUMBER MM1D MMIDICOUXY LIMITS COMMERCIAL GENERAL LIABILITY EACH�OECCpURRENCE S CLAIMS-MADE OCCUR PREMISES fEaEor r ante) S MED EXP(Any one person) 8 PERSONAL&ADV INJURY 8 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE 8 PRO- POLICY JECT LOC PRODUCTS•COMPIOP AGG 8 OTHER: S AUTOMOBILE LIABILITY Ee BINEDaccideitSINGLE LIMIT S ANY AUTO _ i BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY Per accident) 8 AUTOS _ AUTOS ( 1 NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS _(Per accident)_ S ' S UMBRELLA LIAR HOCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS•MAOE AGGREGATE $ DED I I RETENTIONS 1 $ A IWORKERS COMPENSATION $70553 710112017 07/01/201 X PER orH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $500 000 OFFICER/MEMBEREXCLUDED? N!A (Mandatory in and E L DISEASE-EA EMPLOYEE S500 000 If yes, IPTI be under I E L DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS below �I I j I DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION City of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN c/o Nancy Yoshitake ACCORDANCE WITH THE POLICY PROVISIONS. 400 West Gowe Kent,WA 98032-6019 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 #S27657821M2765776 TMPOO This page has been left blank intentionally M �s .;h ll • S y.. k "t-s