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PK18-196 - Original - Grindline Skateparks, Inc. - Contract - 05/09/2018
F Records Management Document CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to the City Clerk's Office. All portions are to The complleted„ If you have questions, please contact the City Clerk's Office at 253-856.-5725, ❑ Blue/Motion Sheet Attached ❑ Pink Sheet Attached Vendor Name: Grindline Skateparks, Inc. Vendor Number (]DE): 41442 Contract Number (City Clerk): I' Category: Contract Agreement_ Sub-Category (if applicable) Project Name: Skateparks General Maintenance Contract Execution Date: 5/4/2018 Termination Date: 09/02/2018 Contract Manager: Ben Levenhagen Department: Parks Contract Amount: $ 10,769.00 Approval Authority: ❑ Director ❑ Mayor ❑ City Council Other Details: General maintenance and repair of the City of Kent's skateoarks: Downtown Kent Lions Skate Park, West Fenwick Skate Park and Arbor Heights 360 Park. 1NT w.�� ....�. ` GOODS & SERVICES AGREEMENT between the City of Kent and Grindline Skateparks, Inc. THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Grindline Skateparks, Inc. organized under the laws of the State of Washington, located and doing business at 4619 141h Avenue SW, Seattle WA 98106, Contact: James Klinedinst; Phone: 206.932.6414, Cell: 206.819,9234, Fax: 206.932.6840 (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: In accordance with the April 11, 2018 Proposed Scope of Work attached and incorporated as Exhibit A, Vendor shall provide all necessary labor, materials and equiment to complete the work as follows and within the skatepark footprint: General Repair Work: Downtown Kent Lions Skate Park - located at West Smith and Interurban Trail, Kent WA - Weld end cap on ledge steel edging. West Fenwick Skate Park -located at 42nd Avenue South and Reith Road, Kent WA - Weld end caps and grind smooth. Arbor Heights 360 Skate Park - located at 11525 SE 240t' Street, Kent WA - Replace drain in Pool; Cracks - Route out and fill cracks with high end joint sealant, approximately 300 linear feet; Seams - Clean out, grind down where needed and fill with high end joint sealant, approximately 330 linear feet. Pool Coping Seams - Grind out and fill failed Seams with epoxy, various spails and voids to be filled throughout the park. 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 within 120 days from the date contract is signed. III. COMPENSATION. The City shall pay the Vendor an amount not to exceed TEN THOUSAND SEVEN HUNDRED SIXTY NINE DOLLARS AND NO CENTS ($10,769.00), 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: GOODS & SERVICES AGREEMENT - 1 ($20,000 or Less, incl. WSST) Vendor will submit an invoice to the City of Kent after work is completed and accepted. 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. A, DPfertiva nr Ilnauthnri�ari Wn_k 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 Pay men : Wver 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. GOODS & SERVICES AGREEMENT - 2 ($20,000 or Less, including WSST) I 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 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. GOODS & SERVICES AGREEMENT - 3 ($20,000 or Less, including WSST) 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, Vented i Duty to Com fete Er_=ted 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 Conn Mutes 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 Conskitutes Waiver. By failing to follow the procedures of this at� section, the Vendor completely waives any claims for protested work and accepts from the 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. GOODS & SERVICES AGREEMENT - 4 ($20,000 or Less, including WSST) 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. 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. Rec cy lablq ri I . 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_Brgach. 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. si nment. 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. GOODS & SERVICES AGREEMENT - 5 ($20,000 or Less, Including WSST) i 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 A.greervi�n . 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. I. Public Records Act. The Vendor 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 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 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. K. Ccunterrrarts and Signatures by Fa.x_a_ _Emaii. 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. VENDOR: CITY OF KENT (su""Grpature) n (signature) Print Name; �'7i✓ ` Ie'-T Gc z q Pr�nt qa' me: Julie Parascondola, CPRP Its: di'tc + 7z s✓ Its: Director - Parks, Recreation and (titre) Community Services Department DATE:.(� J / .. DATE: �.,. ,,:P' .: ,✓',w, NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: James Klinedinst, Project Manager Ben Levenhagen, Support Svcs Field Supervisor Grindline Skateparks, Inc. City of Kent 4619 14" Ave SW 220 Fourth Avenue South Seattle, WA 98106 Kent, WA 98032 GOODS & SERVICES AGREEMENT - 6 ($20,000 or Less, including WSST) (206) 932-6414 or (253) 856-5133 or (206) 819-9234 Cell (telephone) (206) 932-6840 (facsimile) (253) 508-9548 Cell] (telephone) (facsimile) (253) 856-6120 �. ATTEST: Kent City Clerk GOODS & SERVICES AGREEMENT - 7 ($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. j 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. 1 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: Title: _ Cl-c2/' �E'c�< f� -c........._ + C� Date: O E� c.....g__.......e__. 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 I 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 Page 1 of 2 CONCRETF SKATEPARK DESIGN & CONSTRUCTION PROPOSED SCOPE OF WORK: SUBMITTED TO: Name: Ben Levenhagen Project Name: Kent Skateparks Repair Work Title: Field Supervisor City: Kent Phone: 253.856,5133 State: WA Fax: Date: April 11, 2018 Grindline proposes to provide all necessary labor, materials, and equipment to complete the work detailed below within the skatepark footprint General Repair Work • Downtown Lions - Weld End Cap on Ledge Steel Edging •West Fenwick Skate- Weld End Caps and grind smooth •Arbor Heights- Replace Drain in Pool Cracks- Route out and Fill Cracks with high end joint sealant. Approx. 300 FL Seams- Clean out, grind down where needed and fill with high end joint sealant. Approx. 330 LF Pool Coping Seams- Grind out and Fill Failed Seams with Epoxy Various Spalls and Voids to be filled throughout the park Exclusions: • Water and power supply • Dewatering • Landscaping (including seeding and planting)/Irrigation (including sleeving) and/or restoration • Erosion control • Construction fence/staging area and final perimeter fencing • Permits • Performance/Payment Bond, If required add 2% to total bid. • Construction staking/surveying • Drain lines • Finish grading around skatepark perimeter • Non skatepark concrete • Site amenities. Including but not limited to benches, trash cans, shade strucutures, picnic tables • Material testing •Any other work outside of areas referenced above 4619 14TH AVE SW SEATTLE,WA 98106 206.932.6414(OFFICE) 206.932.6840(FAX) www.arindline.com I y, Page 2 of 2 CONCRETE SKATEPARK DESIGN & CONSTRUCTION We propose to complete the scoipe lasted above for: ARBOR HEIGHTS LUMP SUM TOTAL: $8,540.00 Not Including Sales Tax DOWNTOWN LIONS LUMP SUM TOTAL: $350.00 Not Including Sales Tax WEST FENWICK LUMP SUM TOTAL: $900.00 Not Including Sales Tax This proposal is valid for 60 days ReesspeeIctfullJ4-- y Submitted, I 4 - Matt Fluegge Senior Project Manager Cell: 206-612-3401 461914TH AVE SW SEAT TLEWA 9B106 w 206.932.6414(OFFICE) 206.932.6640(FAX) www.grindline.com EXHIEIT S INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS Insurance The Consultant 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 Consultant, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. q i PmQbile.Lj.4 lily 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. 2• Cginl Qen9LD_1_..LIabjIJt 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 Consultant'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. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of 'Washington, 4. EL9fsgnal Liability insurance appropriate to the Consultant's profession. B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: 1• Automobile Liabilltv insurance with a minimum combined single limit for bodily Injury and property damage of $1,000,000 per accident, 2• Qpmmercaal General UaOility insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000general EXHIBIT B (Continued) aggregate and a $1,000,000 products-completed operations aggregate limit. 3. Professional Lialaili insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit. 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 Consultant'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 Consultant's insurance and shall not contribute with it. 2. The Consultant'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 Consultant and a copy of the endorsement naming the City as additional insured shall be attached to the art fi a of In The City reserves the right to receive a certified copy of all required insurance policies. The Consultant'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 Consultant 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 Consultant 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 Consultant. Ac CERTIFICATE OF LIABILITY INSURANCE DATE'MMIDD"YYY) -- - 4/19/201B 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 endomement(s). PRODUCER NAMIII CONTACT Patricia Gallegos McDonald Insurance Group, Inc. PHONE (425)827-•7400 FAX {azy7 gx�-�a4z INC,No,loll. (INol: PO Box 3089 EWA1L ADDRESS.p g at @mcdonaldCourtsne..c 620 Kirkland Way, Ste 100 YNSUREROU AFFORDING COVERAGE NAICX Kirkland WA 98083-3089 INSURER A:Burlington Insurance Co 23620 INSURED INSURERS Western. National Mutual Insurance 15377 Grindline Skateparks, Inc. INSURER C:EYan s ton Insurance Co 4619 14th Ave. SW INSURER ID:Travelers Casualty & Surety Co INSURER IE:Admiral Insurance Cc 24856 Seattle WA 98106-1501 INSURER P: COVERAGES CERTIFICATE NUMBER:18-19 GL/AL/xS/WC/PRO REVISION NUMBER:. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSn Wvn POLICY NUMBER IMM/DGNYYYI IMMIDUNYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMSWADE X OCCUR DAMAGE TO RENTED 50,000 PREMISES(Ea occurrence) $ X $5,000 DED HI/PD/PI/AI 0361CRP0012023 1/12/2018 1/12/2019 DIED EXP(Any oneperson) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENE AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE 3 2,000,000 A POLICY X JEJGI LOC PRODUCTS-COMPIOP AGG S 2,000,000 X OTHER WA STOP GAP/EL 0361CRP0012023 1/12/2018 1/12/2019 ACCI]ENTGGG/ MPLOYEE S $lM/$1M/$1M AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000 (Ea acciden) B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDUL ( I ED CPPI005236-09 1/12/2018 1/12/2019 BODILY INJURY Peracclbenl S AUTOS AUTOS X HIRED AUTOS X NON-OWNNED PROPERTY DAMAGE AUTOS (Pereceldenl) $ UMBRELLA LIAB X... OCCUR EACH OCCURRENCE $ 2,000,000 L, X EXCESS LIAB CLAIMS-MADE AGGREGATE S 2,000,000 DED X REIEN9'ION$ 0 lrK1V5EUI.100795 1/12/2018 1/12/2019 $ D WORKERS COMPENSATION OB-5R023263-16-26-G 1/12/2018 1/12/2019 X PER X 0n1. AND EMPLOYERS'LIABILITY YEN h�ATUTF SIR ANY PROPRIETOR/PARTNERIEXECUTIVE UB-bK023263-18-26-G 1/12/2018 1/12/2019 EL EACH ACCIDENT $ 1,000,000 D OFFICERIMEMHER EXCLUDEDP NIA (Mandatory in NH) ALL STATES EXCLUDING: EL DISEASE-EA EMPLOYEE $ 1,000,000 If yes descuper under NO OR WA DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT S 1,000.000 E PROFESSIONAL LIABILITY E0000012696-09 1/12/2018 1/12/2019 EACH CLAIM $1,000,000 ARCHITECTS b ENGINEERS $25,000 DED PER CLAIM AGGREGATE $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RE: Consultant Services Agreeements with respect to the work performed. The City of Kent is additional insured for General Liability including ongoing and completed operations as required by written contract per forms CG2010 and CG2037. Primary and non-contributory provision for General Liabilty as required by written contract per form IFGG0094. Amendment - cancellation notice for General Liability per form IFG10155. Additional insured for Automobile Liability as required by written contract per form WNCA27. Primary and non-contributory provision for Automobile Liability as required by written contract per form WNCA71. (Continued on next page) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Parks Maintenance ACCORDANCE WITH THE POLICY PROVISIONS. Parks, Recreation S Community Services 220 Fourth Ave S AUTHORIZED REPRESENTATIVE Kent, WA 98032 Rob ©1988-2014 ACORD CORPORATION. All rights reserved, ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401) COMMENTS/REMARKS of cet I(,c,I I a 1, 1 on for A,j t oinnb i I e i rb i I i i,y pc;i form WW A4 I . All. Y D S a t t-�,l �h x c r,p t L 10 W NCA/ I , a i i<I W NC 1),/11, wt 1 1(J I Hive be t 0 1,d o I d Frain I t I r, i t I,,r)I ,+rl c e I,QfTlp,i y rl will b L vqd ('?d u r),,) 1 rrecoiCit . COPYRIGHT 2000, AMS SERVICES INC. POLICY NUMBER, 0361 CRP0012023 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON I OR ORGANIZATION This endorsement modifies insurance provided under the followings, COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations Or Oraanizationi l: Any person or organization for wham you are performing Any and All Locations. operations, but only if you have agreed, in a written contract, to add such person or organization as an additional insured on your policy for that location or part thereof, provided such written contract is fully executed prior to an "occurrence" in which coverage is sought under this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these Include as an additional insured the person(s) or additional insureds, the following additional exclu- organizalion(s) shown in the Schedule, but only sions apply. with respect to liability for "bodily injury", "property This insurance does not apply to 'bodily injury" or damage" or "personal and advertising injury' "property damage" occurring after: caused, in whole or In part, by: 1. Your acts or omissions, or 1. All work, including materials, is or equip- ment furnished in connection with such work, 2. The acts or omissions of those acting on your on the project (other than service, maintenance behalf, or repairs) to be performed by or on behalf of In the performance of your ongoing operations for the additional insureds) at the location of the the additional insured(s) at the locations) desig- covered operations has been completed, or nated above, 2. That portion of "your work" out of which the Injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project, CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 POLICY NUMBER, 0361CRP0012023 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations Any owner, lessee or contractor with whom you have Any and all of your completed operations. agreed, in a written contract, that such person or organization should be added as an additional Insured on your policy, provided such written contract is fully executed prior to an "occurrence" In which coverage is sought under this policy. Information required to complete this Schedule. if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury"or"properly dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT -- OTHER INSURANCE (PRIMARY AND NON-CONTRIBUTORY COVERAGE) This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Schedule of Additional Insured(s): Any person or organization named in an Additional Insured endorsement attached to this policy with whom you have agreed, in a written contract, that such person or organization should be provided primary and non-contributory coverage, but only when such written contract is fully executed prior to an "occurrence" in which coverage is sought under this policy. A. Paragraph C. of this endorsement replaces However, this endorsement: paragraph 4. Other Insurance of Section IV- 1. Applies only when you are required by Commercial General Liability Conditions, but contract, agreement or permit to provide only with respect to the insurance afforded to the primary and non-contributory coverage for the additional insured(s) scheduled above. additional insured, provided such written B. Paragraph C. of this endorsement replaces contract, agreement or permit is fully executed paragraph 4. Other Insurance of Section IV- prior to an 'occurrence" in which coverage is Products-Completed Operations Liability sought under this policy, and Conditions, but only with respect to the insurance p. Does not apply to any claim, loss or liability afforded to the additional insured(s) scheduled due to the sole negligence of the additional above, insured, C. Other Insurance Notwithstanding other valid and collectible All other terms and conditions of this Policy insurance available to the insured for a loss we remain unchanged. cover under the applicable Coverage Part to which this endorsement is modifying, this insurance is primary and non-contributory. IFG-G-0094 03 17 Includes copyrighted material of Page 1 of 1 ISO Properties, Inc., with its permission, WIN CA 27 06 16 BUSINESS AUTO ENHANCEMENT ENDORSEMENT The Business Auto Enhancement Endorsement is an optional endorsement that provides coverage enhancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is provided by this summary, refer to following endorsement for changes in your policy. SUMMARY OF COVERAGES PAGE Accidental Airbag Deployment Coverage 4 Auto Loan/Lease Gap Coverage 4 Blanket Additional Insured 2 Blanket Waiver of Subrogation 5 Broadened Definition of Insured includes; • Newly Acquired Organizations for up to 180 Days 2 • Employees as Insureds 2 • Subsidiaries in Which You Own 50% or More 2 Deductible Waiver for Glass Repair 3 Employee Hired Auto 2. 5 Fellow Employee Coverage 3 Hired Auto Physical Damage Coverage 4 Knowledge of Accident, Claim, Suit or Loss 5 Loss Of Use Expenses -Amended 3 Personal Effects 3 Rental Reimbursement Coverage 4 Supplementary Payments -Amended: • Bail Bonds up to $5,000 2 • Loss of Earnings up to $500/Day 2 Transportation Expense Limits—Amended 3 Unintentional Failure to Disclose Hazards 5 WIN CA 27 06 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 5 WIN CA 27 06 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BUSINESS AUTO ENHANCEMENT ENDORSEMENT This endorsement modifies the insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The SECTIONS of the Business Auto Coverage Form identified in this endorsement will be amended as shown below. SECTION II — COVERED AUTOS LIABILITY g. Any "employee" of yours is an "insured" while COVERAGE AMENDMENTS operating a covered "auto" hired or rented A. Who Is An Insured under a contract or agreement in the "employee's" name, with your permission, SECTION II — COVERED AUTOS LIABILITY while performing duties related to the conduct COVERAGE, A. Coverage, 1. Who Is An Insured of your business. is amended to add: B. Blanket Additional Insured d. Any legally incorporated subsidiary of yours in SECTION II — COVERED AUTOS LIABILITY which you own more than 50% of the voting COVERAGE, A. Coverage, 1. Who Is An stock on the effective date of this coverage Insured, paragraph c. is amended to add the farm. following: However, "insured" does not include any Any person or organization who is required under a subsidiary of yours that is an "insured" under written contract or agreement between you and any other automobile liability policy, or would that person or organization, that is signed and be an "insured" under such policy but for executed by you before the "bodily injury' or termination of such policy or the exhaustion on "property damage' occurs and that is in effect such policy's limits of insurance, during the policy period, to be named as an e. Any organization which is newly acquired or additional insured is an "insured" for Liability formed by you and over which you maintain Coverage, but only for damages to which this majority ownership. However, coverage under insurance applies and only to the extent that this provision: persons or organization qualifies as an "insured" under the Who Is An Insured provision contained in (1) is afforded only for the first 180 days after Section II. you acquire or form the organization or until the end of the policy period, C. Liability Coverage Extensions — Supplementary whichever comes first Payments (2) does not apply to "bodily injury" or SECTION II — COVERED AUTOS LIABILITY '.property damage" that results from an COVERAGE, A. Coverage, 2. Coverage "accident" that occurred before you formed Extensions, a. Supplementary Payments is or acquired the organization; amended by replacing subparagraphs (2) and (4) with the following: (3) does not apply to any newly acquired or formed organization that is a joint venture (2) Up to $5,000 for cost of bail bonds (including or partnership; and bonds for related traffic law violations) required because of an "accident" we cover. We do not (4) does not apply to an "insured" under any have to furnish these bonds. other automobile liability policy, or would be an "insured" under such a policy but for (4) All reasonable expenses incurred by the termination of such policy or the "insured" at our request, including actual loss exhaustion of such policy's limits of of earnings up to $500 a day because of time insurance. off from work. f. Any "employee" of yours is an "insured" while using a covered "auto' you don't own, hire or borrow in your business or your personal affairs. WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 5 D. Fellow Employee Coverage D. Glass Repair— Deductible Waiver SECTION II — COVERED AUTOS LIABILITY SECTION III — PHYSICAL DAMAGE COVERAGE, B. Exclusions, 5. Fellow COVERAGE, A. Coverage, 3. Glass Breakage — Employee, the following is added: Hitting A Bird Or Animal — Falling Objects Or Co-Employee Lawsuit Defense Cost Missiles, is amended by adding the following: Reimbursement No deductible will apply to glass breakage if such glass is repaired, in a manner acceptable to us, If a suit seeking damages for "bodily injury" to any rather than replaced. fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's" E. Hired Auto Physical Damage employment or while performing duties related to the conduct of your business, or a suit seeking SECTION III — PHYSICAL DAMAGE damages brought by the spouse, child, parent, COVERAGE, A. Coverage Is amended by adding brother or sister of that fellow "employee', is the following: brought against you, we will reimburse reasonable 5. Hired Auto Physical Damage costs that you incur in the defense of such matters. Any reimbursement made pursuant to If hired "autos" are covered "autos" for Liability this sub-section will be in addition to the limits of Coverage and if Comprehensive, Specified liability set forth in the Declarations. Causes of Loss. or Collision coverages are provided under this coverage form for any "auto' you own, then the Physical Damage SECTION III — PHYSICAL DAMAGE COVERAGE Coverages provided are extended to "autos" AMENDMENTS you hire of like kind and use, subject to the A. Transportation Expense—Limits Amended following: SECTION III — PHYSICAL DAMAGE a. The most we will pay for any one "loss" is COVERAGE, A. Coverage, 4. Coverage $50,000 or the actual cash value or cost to Extensions, a. Transportation Expenses is repair or replace, whichever is less, minus amended by replacing $20 per day/$600 maximum a deductible; limit with $50 per day/$1000 maximum. b. The deductible will be equal to the largest Physical Damage — Loss Of Use deductible applicable to any owned "auto" B. Hired Auto Ph Y 9 for that coverage. Any Comprehensive Expenses— Limits Amended deductible does not apply to "loss" caused SECTION III — PHYSICAL DAMAGE by fire or lightening; COVERAGE, A. Coverage, 4. Coverage c. Hired Auto Physical Damage coverage is Extensions, b. Loss of Use Expenses is excess over any other collectible amended by replacing the $20 per day/$600 insurance; and maximum limit with $50 per day/$750 maximum limit. d. Subject to the above limit, deductible and excess provisions we will provide C. Personal Effects Coverage coverage equal to the broadest coverage SECTION III — PHYSICAL DAMAGE applicable to any covered "auto"you own. COVERAGE, A. Coverage, 4. Coverage If a limit for Hired Auto Physical Damage is Extensions is amended by adding the following: indicated in the Declarations, then that limit replaces, and is not added to, the $50,000 limit c. Personal Effects indicated above. We will pay up to $500 for "loss" to personal effects, which are: (1) Owned by an"insured"; and (2) In or on your covered"auto." This coverage applies only in the event of the total theft of your covered "auto." No deductible applies to this coverage WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 5 F. Rental Reimbursement G. Accidental Airbag Deployment Coverage SECTION III — PHYSICAL DAMAGE COVERAGE SECTION III — PHYSICAL DAMAGE A. Coverage, is amended by adding the following: COVERAGE, A. Coverage is amended by adding f 6. Rental Reimbursement the following: 7. Accidental Airbag Deployment Coverage This coverage applies only to a covered "auto" of the private passenger or light truck type as We will pay to reset or replace factory installed follows: airbag(s) in any covered "auto" for accidental discharge, other than discharge due to a a. We will pay for rental reimbursement collision loss. expenses incurred by you for the rental of a private passenger or light truck type This coverage is applicable only if "auto" because of "loss" to a covered comprehensive coverage applies to the private passenger or light truck type covered"auto". "auto". Payment applies in addition to the otherwise applicable amount of each This coverage is excess over any other coverage you have on a covered private collectible insurance or reimbursement by passenger or light truck type "auto." No manufacturer's warranty. deductibles apply to this coverage. H. Auto Loan/Lease Gap Coverage b. We will pay only for those expenses incurred during the policy period beginning SECTION III PHYSICAL DAMAGE COVERAGE, 24 hours after the "loss" and ending, Item A., Coverage, is amended by adding the regardless of the policy's expiration, with following: the lesser of the following number of days: 6, Auto Loan/Lease Gap Coverage (1) The number of days reasonably This coverage applies only to a covered "auto" required to repair or replace the described or designated in the Schedule or in covered private passenger or light the Declarations as including physical damage truck type "auto". If "loss" is caused coverage. by theft, this number of days is added to the number of days it takes to In the event of a covered total "loss" to a locate the covered private passenger covered "auto" described or designated in the or light truck type "auto" and return it Schedule or in the Declarations, we will pay to you; or any unpaid amount due on the lease or loan (2) 30 days. for a covered "auto"less: c. Our payment is limited to the lesser of the a. The amount paid under the Physical following amounts: Damage Coverage Section on the policy; and (1) Necessary and actual expenses incurred, or b. Any: (2) $50 per day, up to a maximum of (1) Overdue lease/loan payments at the $1,000. time of the"loss'; d. This coverage does not apply while there (2) Financial penalties imposed under a are spare or reserve private passenger or lease for excessive use, abnormal light truck type "autos" available to you for wear and tear or high mileage; your operations. (3) Security deposits not returned by the e. If "loss" results from the total theft of a lessor; covered "auto" of the private passenger or light truck type, we will pay under this (4) Costs for extended warranties, Credit coverage only that amount of your rental Life Insurance, Health, Accident or reimbursement expenses which is not Disability Insurance purchased with already provided for under SECTION III — the loan or lease; and PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions. (5) Carry-over balances from previous loans or leases. For the purposes of this Rental Reimbursement coverage, light truck is defined as a truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as the maximum loaded weight the auto is designed to carry. WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission, Page 4 of 5 SECTION IV — BUSINESS AUTO CONDITIONS C. Unintentional Failure to Disclose Hazards AMENDMENTS SECTION IV — BUSINESS AUTO CONDITIONS, A. Duties In The Event Of Accident, Claim, Suit Or B. General Conditions, 2. Concealment, Loss Amended Misrepresentation Or Fraud, is amended by SECTION IV — BUSINESS AUTO CONDITIONS, adding the following paragraph: A. Loss Conditions, 2. Duties In The Event Of If you unintentionally fail to disclose any hazards Accident, Claim, Suit Or Loss, a. is amended by existing at the inception date of the policy, or adding the following: duringthe policy p y period in connection with any This condition applies only when the "accident" or additional hazards, we will not deny coverage under this Coverage Part because of such failure. "loss" is known to: (1) You, if you are an individual; D. Employee Hired Auto (2) A partner, if you are a partnership; SECTION IV — BUSINESS AUTO CONDITIONS, B. General Conditions, S. Other Insurance, (3) An executive officer or insurance manager, if paragraph b. is deleted and replace by the you are a corporation; or following: (4) A member or manager, if you are a limited b. For Hired Auto Physical Damage Coverage, liability company, the following are deemed to be a covered But, this section does not amend the provisions "autos"you own: relating to notification of police, protection or (1) Any covered "auto" you lease, hire, rent or examination of the property which was subject to borrow. the"loss". (2) Any covered "auto" hired or rented by your B. Blanket Waiver of Subrogation "employee" under a contract in that individual "employee's" name, with your Section IV — BUSINESS AUTO CONDITIONS, A. permission, while performing duties related Loss Conditions, 5. Transfer of Rights of to the conduct of your business. Recovery Against Others to Us, is amended by adding the following exception: However, any "auto" that is leased, hired, rented or borrowed with a driver is not a However, we waive any right of recovery we may covered"auto". have against any person or organization to the extent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 5 I McDonald Insurance Group, Inc. RO Box 3089 Kirkland, WA 98033 Applicable to ACORD 25 - Certificate of Liability This certificate of liability insurance does not necessarily imply that primary coverage or other additional insured requirements are provided for the additional insured(s) unless an endorsement is attached specifying these coverages. This certificate does not necessarily comply with all contract requirements between the named insured and the additional insured(s). All involved parties should have their attorney review the policy for actual coverage and compliance with their written agreement or contract. Applicable to ACORD 25, 27,28, and 24 This certificate is the "latest' ACORD 25 (January 2014) Certificate of Liability Insurance, or ACORD 27 (December, 2009) Evidence of Property Insurance or ACORD 28 (December 2009) Evidence of Commercial Property Insurance or ACORD 24 (September 2009) Certificate of Property Insurance . In order to issue certificates from our agency, these revisions listed above must be used. If you previously received an ACORD 25, 27, 28 or 24 with an earlier revision date, there are notable changes between the forms. Please note the following significant characteristics of the new ACORD forms. :• The cancellation clause refers back to the policy terms. •*e The ACORD form is copyrighted. Permission to alter it is not available. As Insurance Agents we receive authority from the insurance carriers that we represent to issue certificates. Carriers do not authorize us to include special language or alter the form even without the copyright concerns. The carriers also do not authorize us to complete special coverage forms provided by the certificate holder. McDonald Insurance Group, Inc— Po Box 3089 Kirkland, WA 98083 City of Kent Master Business License Application DATE° w�=-• T City of Kent Customer Service • 220 Fourth Avenue S. • Kent,WA 98032-5895 04/23/18 253-856-5210 • customerservice@KentWA.gov BUSINESS INFORMATION All licen-sesemre Decernher 31.Re-lssoe invoice mailed end of calendar vear. Legal Entity Name GRINDLINESKATEPARKS INC Trade Name Physical Address: 4619 14TH AVE SW City SEATTE State. WA ZIp. 98106 Mailing Address;4619 14TH AVE SW City_ SEATTLE State: WA ZIP: 98106 Phone: 206.932.6414 Email: INFORM@GRINDLINE.COM WA State UBI#: 602196010 WA State TRN (if applicable):__ Individual 13 Partnership 13 LLC El Corporation 13 Other Type of Business: (check all that apply) 0 Wholesale Trade 13 Retail Trade 13 Service ❑ Manufacturing ❑ Construction ❑ Govt. ❑ Transp./Commun./Utii. ❑ Finance/Insur./RE ❑ Education ❑ Health Industry ❑ Sales/Mktg. ❑ Other _ -- --- — Description of Business Ac tivuly:,SKATEPARK DESIGN & CONSTRUCTION Date when business activity began in KC3nt: TBD - 5/15/2018 -- _..... Owner(s)/OfficersName(s): R MARK HUBBARD Address 4619 14TH AVE SW City:,SEATTLE u State WA ZIP 98106 ----- - Phone: 2069326414 Email: MONK@GRINDLINE.COM Estimated Annual Gross Income in Kent(Check the box that applies to your business) 91 $0 - $200,000 13 $200,001 - $1,000,000 More than $1,000,000 Contact person: EMILY GIAQUINTA Phone: 2069326414 Email: emily@grindline.com THIS SECTION APPLIES TO BUSINESSES THAT HAVE A PHYSICAL LOCATION WITHIN CITY LIMITS COMMERCIAL_BUSINESSES NAICS Code: Square Footage: Do You Share a Location with Another Business? 13 No 13 Yes (If yes, please call C/S at 253-856-5201) If so please list other entity: _ ___.... Will your buslress engage in selling, giving away, distributing, dispensing, exchanging for anything of value, planting, growing, processing, packaging,storing, or any other act relating to marijuana as that term is defined in RCW 69.50,101? ❑ Yes ❑ No Do you have more than one location within the City of Kent? E3 Yes 13 No If yes, please list location(s): w . -------------- Does your business require a specialty license(i.e.Applicable if your business has Amusement Devices,Cabaret,or Pool&Billiard Tables)? 13 Yes 13 No If so please list: __.._._. . . .. Emergency Contact: --_ Phone: Phone _ _ Continued on back. COMMERCIAL BUSINESSES [WOi Does your business manufacture, process or package food or drink? 0 Yes E3 No Does your business prepare, serve or make available food or drink for consumption by the public? ❑ Yes E3 No Total number of employees_. (Use this number to determine license fee) Fee Schedule 6slU..M—BE R-Ol iMPI.OYCLS -- --OVhE,NlKj.LL_Y 1 0-24Employees $240.59 $190.59 25-49 Employees $340.59 $240.59 50-99 Employees $540.59 $340.59 100 or more employees $740.59 $440.59 IndependentContractor $101.00 $51.00 (Example:Someone leasing a chair at a licensed salon or barber shop) Non-Profit No Charge 501 (c)3 Required Relocation in Kent No Charge (New App. Prior Kent Address: NON-9E5I11NENT,BILSINES5 THIS SECTION IS FOR BUSINESSES WHICH DO NOT HAVE AN OFFICE OR PHYSICAL LOCATION IN THE CITY OF KENT. Fee Schedule Operating before July 1 $101.00 Operating after July 1 $51.00 RENTAL HOOUSINCi.fllNESS SECTION THIS SECTION IS ONLY FOR RENTAL PROPERTIES WHICH CONTAIN TWO OR MORE HOUSING UNITS Fee Schedule Opening July 1 2 to 10 units $101.00 $51.00 11 to 50 units $301.00 $151.00 51 and above $601,00 $301,30 TAX REGISTRATION By completing this application, you are also registering to file City of Kent business and occupation (B&O) tax returns. If your business activities are exempt from B&O tax, please write the reason(s) here: The City also levies a utility tax, admissions tax and gambling tax upon certain business activities. For tax forms or additional Information, visit us at KentWA.gov or contact the Tax Division at 253-856-6266. 1 hereby r,ertify that oie,,tatemerit;and information furnished by me on this applic atop are taut and complete to the ben,1 of my knowledge_ Jm acknowledfje that the st stements and inforrnation furnished by me on ibis arpliu)tlon are public records and are available for public irnpection pursuant to;Cate of Washington R(W 42,17.)60 1 understand that Iscuanr r,so the,luense Is conditioned upon complianc eatall tirnes with all applicable oidinance,,regulation and statute,of the City of Kent and State of Wa4lir gton,l or,i,suance of this burro ,s li ,n,e does not imply compliance with the Zoning,Unlfoun f ire anti Building Codes, Signature, Print Nanne: EM I LY G IAQ U I NTA ._.._...._� ........ CHIEF EXECUTIVE OFFICER 04/23/2018 Title:.... .......... __—,_. Date: ............................. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED...,.................................... FOR OFFICE USE ONLY: BLri Da[e He( I Amoun[Paid