HomeMy WebLinkAboutPK18-210 - Original - MRF Enterprises, Inc. - Milfoil Removal & Maintenance/Lake Meridian - 05/22/2018 VENT
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 be completed.
If you have questions, please contact the City Clerk's Office at 253-856-5725.
❑ Blue/Motion Sheet Attached
❑ Pink Sheet Attached
Vendor Name: MRF Enterprises, Inc.
Vendor Number (JDE): 1066539
. ..............
Contract Number (City Clerk): yp%
Category: Contract Aqreement
Sub-Category (if applicable): Choose an item.,
Project Name: Milfoil Removal & Maintenance/Lake Meridian
Contract Execution Date; 5122/2018 Termination Date: 9/30/2018
Contract Manager: Ben Levenhagen Department: Parks
Contract Amount:
Approval Authority: XL Director E] Mayor ❑ City Council
Other Details: Divino services for the initial removal and subseauent weekly
17..... ...............-
maintenance of milfoil at Lake Meridian, located at 14800 S.E. 272n' Street, Kent WA.
---- ---------
RECOVED
MAY 413 2018
CITY or KF_NT
CITY GLUiK
GOODS & SERVICES AGREEMENT
between the City of Kent and
MRF Enterprises, Inc.
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and MRF Enterprises, Inc. organized under the laws of the State of Washington,
located and doing business at 6712 112`h Avenue East, Puyallup, WA 98372; Contact: Michael Ferguson,
Phone: 253-301-7274 (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:
............ _ ....... .. _,
Diving services for the initial removal and subsequent weekly maintenance of milfoil at Lake
Meridian, located at 14800 S.E. 272od Street, Kent, WA as described in attached Exhibit A.
Includes all diver equipment, supplies and air fills, all travel to and from the dive site and
any non-diving surface hours. De Watering location to be provided by the Parks Department.
Parks Department will dispose of all wood spoils and weeds and debris place in dewatering
location by divers.
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 September 30, 2018. .
III. COMPENSATION. The City shall pay the Vendor an amount not to exceed TWELVE
THOUSAND FIVE HUNDRED DOLLARS AND NO CENTS ($12,500.00), 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 will submit the first invoice upon completion of the initial dive and monthly invoices
after the work is completed from which the City will pay. Invoices to be submitted to:
AccountsPayable@KentWA.gov.
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, Incl. WSST)
A.
The {]iV reserves its right to withhold payment from
Vendor for any defective or unauthorized goods, materials
or services. If Vendor
oris unable
,
hor any reason, to complete any part of this Agreement, the City may obtain the goods,nateria|s or services from other sources, and Vendor shall be liable to the City for anyadditional costs incurred by the City. "Additional cuSt»" - laMmean all reasonable costs,including legal costs and attorney fees, incurred by the City beyond the maximum
Agreanemt price specified above, The City further reserves its to deduct theseadditional costs incurred to complete this Agreement with
other sources, from any and all
amounts due nrtu become due the Vendor.
D. VENDOR'S ACCEPTANCE OF FINAL PAYMENT SHALL
CONSTITUTE WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE
AND IDENTIFIED 8Y 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
andi//�
accordance vvithCh. 51�08RCVV, the pardes rnakethe ho||ovviny 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.
D. The Vendor maintains and pays for its own place of business from which Vendor's
services under this Agreement will beperformed.
C. The Vendor has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed behmnG the City
retained Vendor's services, or the Vendor is engaged in an independently established
bade, occupation, profession, m, 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 (U8l1 number from the
��tatmoyVVashinyt0n, '
F. The Vendor maintains a set of books dedicated to the expenses and earnings of its
business.
V. lrERMDMUAl[IOhU. Either party may terminate this Agn8unoent with orvvithoutcause upon
Providing the other party thirty (38) days written notice at its address set Agreement,
on the signature block f
this Agreement.
»
1NI^ CHANGES. The City may issue a written amendment for any change in the guwds
noaber|a|yor services tobe provided duhngthe pe�annanc* of this /\gneenMenL If the Vendor dmtennioe /
for any reason/ that an amendment is necessary, Vendor rnuotsuhnni\ a written amendment request
�
"^ to person listed in the notice provision Section of this Agreement, section XV(D)^ within fourteen (14)cm/eodar days of the date Vendor knew or should have known of the facts and events giving rise to thereque«ted 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 v"/l| attempt, in good faith, to
roach agreement with the Vendor on all equitable adjustments. Hvvvever, if the !
agree, the, City */i|| determine the equitable adjustment as it deems appropriate,
mn� unable !o
proceed w"iththe anuendedvvorkupon receiving, either a written anoendnnentrrnno ,`^�(�|�' ''� vc//"v/ �//o//
f/pnn t|�e C|t7 before attua|ly rece{vin# the vvr|iten onnendnnent I[ �h / V «nc City oral order
� e endurfa|1storequircan
GOODS & SERVICES AGREEMENT 2
($2V,000or Less, including N/S37)
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, 8-QLQrds. 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 ko Gamglete 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, f�aHure to Protest Constitutes 1Naiver. 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 Praeedures Constitutes wNaiver. 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. Rec 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 Dis�uts and Governin❑ 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; pro i. d, 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. Modifi ti4n. 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 wit _ flaws. 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. Publio Records Acj,. 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. CAi Bu�s5Lice n& R=UjLgd. 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. Counterparts and Signatures by Fax or Email:. This Agreement may be executed in any
number of counterparts, each of which shall constitute an original, and all of which will together constitute
this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page
to the other by fax or email and that signature shall have the same force and effect as if the Agreement
bearing the original signature was received in person.
IN WITNESS, the parties below execute this Agreement, which shall become effective on
the last date entered below. All acts consistent with the authority of this Agreement and prior
to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed
to have applied.
_.-_....— --- -----.------ ..... ___... _—._....__.....
VENDOR: CITY OF KENT
By
�Y w_ ^ame: Julie Parndo R .
rratu�cy j
Print me' /47,zC,tP& f �"- .1...>frwa.".., �" P
Its: �;, rr ✓
(rime) Its: Director - Parks, Recreation and
DATE:,_—_er / Community Services Department
au DATE: -C✓ � � a
NOTICES TO BE SENT TO: FWCITICES TO BE SENT
VENDOR: CITY OF KENT:
Michael R. Ferguson Ben Levenhagen, Support Svcs Field Supervisor
City of Kent
MRF Enterprises, Inc. 220 Fourth Avenue South
6712 - 112th Avenue East Kent, WA 98032
Puyallup, WA 98372
(253) 856-5133 or
(253) 508-9548, Cell (telephone)
(253) 301-7274 (telephone) (253) 856-6120 (facsimile)
(facsimile)
ATTEST
Kent City Clerk
(Li tbls field,you may en@r[he eleRronlc fllepath rvheie 1h,mntraR has been--dI
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.
>v
Title /ramp
Date: ._,.�slwl .....`..
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
them ,,,__ (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
r�xtin'rdCC'Pu9Ykc%kaq,.gp,t
4l191&12,-U Rai
MRF Entarpriaec, Inc
671211 Ave East
PWalkhp WA M372
United Vales
City of Kad Estimate a LTE201
Ben Lwenhagen Estimate Date ADrR 19, 20te
220 Fourth Avenue South
Keotm 96032 Estill tm T (UM) SSA30.00
Kenn 00schption unit CW Quantity Lire TOW
SingleLM Diver IPj Orm Diver, 5 hOurs of diving, Includes a8 divcr 50.004 2,00t1.D0
Rate eqUiPffwrd, Supplies and aw Us,An travel 1n
and from dive sift, and any n -di ' g gurkee
houre.DeUVatering wGation to be provided by
Parka m t- Parks Department Mll
dispose of ON vmedr and debris placed in
dewuatering location by ofivom.
Price does not inCfUde taxes, per . additions!
insured cOMcmte,or ea required by City
other than at is specjfIcally dordiked.
LM Additional Diver Additional diver per day; 5 hoare of n _ 250.00 8 2,0130.00
Includes all diva equipment,s d air
Eh--AN travel to and tom dive site, and any
no ing surface hours.DeWetwIng b
to be provided by Perks Department, Parks
Department vAl dispose of an wmeds and debris
Placed in dewaterjng location by dKws
Price does not include texts, permrgs, addibanal
insured aerOPicats, or any fees
LM Surface Support Noe er surlaim support. 250.E 4 l 00
dady
Additional Insured Requirement of Organization for contract 130.00 1 130.00
Certmeate
btobel 6,130m
Kwd 1 5W00
Eelk"atio Total f ) 5
S J!YRPPCPt2CEpfi4rg0Yn C- g.YYC3YYC<Meda.(;p1Y'/$ rS1fMABC'YipkEan�CCa@®5Ya!5Ji
Pago 1 04 2
FXNWIS: hike Fo 9gu
471ena,12*4t Pt1
Tarms
Ful PaymvH Due LIPW compwrce6on of Work_
Notes
Quote for the Initd Remov&a Of Labe Murrdian re�WM area.
Based on 60 hours Of underwafK, scuba dyer hlandfl8cking.Hours map be completed by a kin
dive team or smalpor deployments of the team to total 60 hours al rrnr9erwoter work.
�1imr(unM[Pnsaxinr.-lwlraiP.frcsMontra�nnrlyhowFslims[a7esrvaefew-176571
Pa"2 oft
r'01iMWE:Mae�N yUi011
4n3.MA, 19:55 PM
MRF Enterprises, Inc
6712 112th Ave East
Puyallup V4A 90372
United States
City of Kent EsSmete>Y LTE2018 1
Ben Levenhagen Estimate Dale
220 Fourth Avenue South
Apt 19, 201®
Kent M 95032 Estmate Total(U$D) SGAW t D
Ram Destrption Unit Cost Quantity Line Total
LM Weeldy One Diver;upto 5 hours of diving. Includes al SW-00 12 6.000.00
Maintdlance Dive dyer egeiPmenL supphes and air fipt.All travel
to and from dive site, and any non-diving
surface hours ANweed spoils will ba bagged
and left at dewatering location%or disposal by
City Personal.
Subtotal 6,000.00
Kent ID% 600-00
Estimate Tow(USU) $4,W0-00
Tema
City will be invoiced monthly for work completed. MordwY payments will be expected with each
Invoice,
Notes
This is the quote for the Maintenance Ptan.
In the latter I quoted S4000 Plus W. This was a mdetake on my pari a3 I underqueted by
$1800.00- Please Contact ne if This is a problem. I aPpologice for any inconvenience-
and-I IA S75
Pape I nl 1
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 arose 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. Autamr-bile 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.
2. C—Ommercial General Liabil_i 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 Commercial General Liability
insurance shall be endorsed to provide the Aggregate per Project
Endorsement ISO form CG 25 03 11 85. 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.
3. W"orkq_rs` Com.Qnsation 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. Automobile Liability insurance with a minimum combined
single limit for bodily injury and property damage of
$1,000,000 per accident.
2. Coommerrial General Linbility insurance shall be written with
limits no less than $1,000,006 each occurrence, $2,000,000
general aggregate and a $2,000,000 products-completed
operations aggregate limit.
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 Crtifte of Insurances The
City reserves the right to receive a certified copy of all required insurance
policies. The Contractor's Commercial General Liability insurance shall
also contain a clause stating that coverage shall apply separately to each
insured against whom claim is made or suit is brought, except with
respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than A:VII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Contractor before commencement of the work.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Contractor.
Faa:RSa7p6Ei000
CERTIFICATE OF LIABILITY INSURANCE '
THIS CeRTIFICATF I3 rESUE.D AS A MATTER OF INFORMATION ONLY AND CON FtRS MO R44M i VPOM THE D'ERTTFtCA TE MOLD9R..TM
CERTIFICATt DOES NOT AFPIRMATIVeLy OR NEOATNELY AMEND,EXTEND OR ALTER Ttlt COVERAf39 AFFORDED BY THE POLVCISS..
BELOW: Tivs CtRnF.CATE OF INSSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(%AUT14ORIZEO
REPRESENTATIVE ON PROOUCER,AND THE CERTIFICATE HOLDER,
IMPORTANT:. N ma cart hal Weldor 11 d4 ADOTTIONAL INSURED,IMe D011400t)must haae AD'WYI NAI,INSURED PrOvM4lorla or he olNtaread..
If SUBROOAT10N IS WAEVED,subject to the terms and C"ditlons of the poucp,com mut polkisa may naulre an eodarsenmeat. A statement on
tMla cartf9cada dean a ooMar n ma to the c"ffcae holder In leu of auoh wWanemana s
rRaOaeaR Cam Tnhml on
Quench Irwaurance Brokaw,LTD . y6,�g rd ' {2139 6aaMt2Ap
3926 South Orchard Street eeY c 9!06 aoan2¢M-Inacam
Tacoma,WA 98468 rl..sRgg=_IalArraworewn ._.... ' .. e, a.
..._..... ....._ ,.. ._...._..�_ �rw.n1Kh. CSt all Spawalty.Ins Co ._.
� wsJgF° ,Maua¢ag Co
__,_tsnarlafty
BOTTOM$UP AQUATIC WEED CONT CO_
ROL NVJRFR,r
6712 112TH AVE E Araawano;
PUYALLUP,WA$8372
m✓Slmi� i
COVtRA0E8 CERTIFICATE NUMR£R: 00000a 1Aa0t,2 R VIS9DN NUMBER 11 _..
T'*15-01 ENT I r `1,AW AIL PCUC'IES IF INwUel'e 5,Lis f495 E�,tUV H+A4'6 aPFrtl fSUS Fn Tq THE..NS4NLl;M.thA:kG Ma47^tE FCR THE rot 57 pfot 00
'01nCAWL0 NO M IST+d nimn ANly ofQUIRCIVE t,iLMM N,COtdDYTIQV^F ANY.-OV" AC"'MR 1' kE�P'b'U,LIME1 AIF*7FaF'er C MIzeCAr'HIS
r'" �••• ,,•, I rNCAmNl 6YTHE"OCt;5 bt56.141009EWFIN i!aUPoAI:T 7Q A..,THE 7_RM^u.
®CR't .Ira AND
E3lDMONS O VaY aEPTMIN6.Twt h.s.iliAriCF.^sF upon C0.A�pAS
MAAcLMAR as X x " ixuna�-•.
I. J IbNa Alin C.Cltl'DII Cry$rpF$:,y„riwOL wJ B'a LN':�a EHC+hRA Y,RA4 IhA.'C JkCtR OR4Cl[S:EDa
"PEW ca � Ytrf Y✓NI& �^_ _ WADw...�_.. .. �....
A . X —. r, Y Y VBA U6282.00 �o2,nnela 9 I r,I CLRa ,ra a .. 1,Q p;OQO
e ?swLr �I ± _l9Q.QQA
kr"rW la�grrra r. .� 5,000
R.y_" .-�D'S,a�Q '
f CM'L:.%a A$WM1 L..!la...l'A4 41V k� �..
CCCy rmM'irnl r r.' n r..rr; s 2.Qb0,Q,✓�,Q
,i i.c rrixvey>nrs, t 2.ODD.060
AJTa.o.�.c wmurr �' I LD rt. T I
nwA.ro ` Kouv wJvv,rw.,...,1 s
BRED �N Po3 I. n —
_:Nlb°CN M4YCk ° � NV'SYdY I"L0..W' iPdt p.Y5{anNll D
A6C —•" n•IAtiNIfi7
A4?C6 di.Y
vmvrvUJ JA� 6K,rofa(�AA¢Tp�v. b
P 1 N - .
DCCLF
-0 a 11PM�
B r.oaw*Aa aeWP'EsaAT4CN VBA4458J7... 0312Z'201a 0a129'2020 a
AA6laaetOYRw F:,Artav „"- ry
AMXPAUpIaeYryemAnflwr'e£xM Pert alAll lr EA D'I Va
CA Icortw sw aYcx�evxo, ._ - �'.A f eso vAC[ucxr 4 1 Q00,QAQ
1 laNmaaNen sal 1..6.., .
�r•�+"� �b+*;awn'.t, � ..^ors .Cwluytry�s. ., 1 Q4Q0 coo
'+..a AeMIM2:rr Y
OQ DOQ
xa5aT0.a'g4 CA aFanAI1tMII r LaaA"VDYY I 41,IC4a5 fAmSTar,in,AadtanP kw'mvmu am+Aa,✓,a,mxy wATAflµe T a&iMrPwe Yn rwm.[uw}
City of Kent Parka,Rooraetion and Community Sarvhaas OIWIt are named as Additional Inuarsd on VIE all Why,polity wHh ...
M 3090e to work gsarformeD£or the c"Iflceta holder. Policy Inofluctas camplelad operations,pat proJOst,wafwr of
auDt029110PS,and Is primary and non-contributory, Emdataamsnta to follow.
i
I I
CERTlFCATE E1R LANCE TI -{,
aNOULD ANY on In AWVC 06 SCROD(!O,`OLLUIE.a as CANCELLro REFCNF '1
City of Heat Parks,. THE EXPIRATION DATE THEREOF,NOTCr WILL at DELIVERED IN
RFOraatlOn.And C011VAInity Servlcsa DNPHOn ACCORDANCE WITH THE ADI,ICY PAOV410ma.
120 ath Avenue 30,
KENT,WA 96032 AuaeFaso+varsaRTA�.s _ —_
� CpT
rD 1aaS-20i6ACORO CORPORATNON. Allrlomsrgerved.
ACORD 26 f2016,102I The A CORD name and M90 Ara rapisoared marks of ACORD
PdnRW by CAT an a.pnl:W.7010 40.02.22PM
M "VBA 606982"60 COVINGTON SPECIALTY INSURANCE COMPANY
This E-7domamort Ch8ngos The Policy. PteasO R6ad It Camfrrf(y,.
CONTRACTOR COVERAGE EXTENSION ENDORSEMENT
BLANKET ADDITIONAL INSURED - OWNERS, LESSEES, OR
CONTRACTORS; PRIMARY AND NONCONTRIBUTORY;
BLANKET WAIVER OF TRANSFER OF RIGHTS OF
RECOVERY AGAINST OTHERS TO US
TN,' cnyorserent moc:(ia 'nsurancs prcrccd under tro fulloivrlg,
COAgMERCfAL GENERAL LIABILITY COVERAGE PART
A- 1-11 'Me oxtant of C tVersc{C atlt
afrdrrlg h(dl'Is pr F Il,!VC� S 7 ..We"HCJ IS F h!INSURED is' tcrtdod I GnCtutie
as ar „y9 Y on*° il7a red any rv,rer. le$2ae or Ccnl char for Whanl gvu are .erfornilog ocgr�apcars or w;or lrrg
at'h�le emiar.s vrBnw9 YOU 1 rwa gte J u .vr°Ctl In a nr rift t Or agree Ono:hat 9u n p9r5C11 of nr,yanpzatlon
be added as.an 7JCtYlonal sn u-c[r,) or you t d'vcr tut my wrth ra�pe.t ,a li abdIx for 'ho" y i u ", ";pr �e;y
r;amage';w"ge onat a"rd a vurvginC� lrJury' aaLSOd, tin rrhOEtl or m y}art. ay:
.. ``'eu;aBlS C:Ot"14'sSILL93;or
2. The acts r crosslons c-f thcso arcing 6+1 your behalf:
In the perlomlanc'o cf JG+Jr crlgc;nc OaCrator$ or th'a addfiCra7 inBUred(S)daSi;.rIJC:: 8J0';e.
Hm'veve
a insurance ado°cad n s ch a d;tiora'insu-e0 only aPdies to`Ica exfeal[pormi@ted cy la'&;and
2. Ir rorora -au prov"dod to 00 add'utirml instrmd 's rotl.firec Afaoh tjp
a"or lorr a Conn act or aryroara ent, tl o istiirance
to adu,Yi ar ° nsvr�c Nlli n^7i o@ hraadnr H"%-,flat which you Ore reao;lroc' by the Ca t'.rae^_orat+gr'ee11"C t to provida fo, 3uC!R scditlorrlal in3trrec.
Any ent'ty f"rrafing tro he spgc'IiCaih/ Ilsled as addWonN Insurad per trio terms a this Contract or agrcc`narl'
may bo li irr tha syh dc$u t eiCrv✓r
pI NaMO of Peraor. o°Organlzat€or:
I
Clq of Knat Flar",
Raereakom and Cerrrrvumkry Somkm Owlalam
+ 220 ath Avomvp 3a,
KENT.WA 2M2
4
El lh ro sticf.o tho Irsu-anco a."arded to these acaL Gaal irsu;sys, Ino follow-IQ additionar wxdusions aapryy
°sr>'apc ly dranl.srge"or'persaral and adJeerfia'ng,njury`arising crat Of lht runde.7ng of or the
failure to render, any crtpfoaM,lorrol arahitectura;,engineer,nJ Cr sv vcy°rig scrvicf s,inGuding:
Tip- ru,1arrdp, a;crS,ti hrw a ra ifsg to preparo ur apprcva, maps, Shop dravV",. , orin;cn-, reports,
tr eyso tYeld ortlors, r par go orders er drawings arti spec:T,asCons;or
b. 5cfpenls0rt, inspaclicil, afC.hite,:rural or engineerng aetivilzes.
Clailnla% '°503" danlaQus a7ainp Oot o` the aa�, ®missWnd and'e•r rligere the av`dltlor,a:v`:n ve rfsj. vp
PoIICY No,: V9A481699 GO^^+13A tifiU'4 1215 `
Pa e 1 Of 2
C M!r r sUcGP to d ie r9outan o aJftcu.€ to irate 2. ova il�FVn �r�r� the
e t ia �r 'nsurcca the rc4lnv.Tr�43 Ms n 3q rr,
9eckPor,IPI—Limits at tnsurzrnce: 7 Ina.firrnc*shcml In ve alvrAIC 5;
It ccvva o w;ov4ttle<i ".a t" 41'IedUOMOI Ir�sa:n:J ,s, vhfchovsrfs loss.
rnc�Atrllrl y c eP+llt�ack ah^ai, re�grnq .# ,h®ma�s? wo o`P dx Or'c'k7rsvRna'n1 shell notl +nc�ross awl nsa cn 19uMa,( p( ^hp Oddl'ftr j O the
insumej s th, uprllcab,:9 L..NIs q1 drs grsriCo `1 wNi the
amasr�tcdlr war smo: N'dFvVZlfl.
1 �ecpulrcc�'��rtx�curdrnc rs=a.Orr7�°r�:.�tl;cr
Pago 2 of a C+Insunrrx 9s
ti,'430RAIra,2V9 C0 20 10 04 13
YBA 606902-00
COMIAERCIAL GENERAL LIABILITY
THIS 5NDOPSE17EN? CHANGES THE PbLlCY. cc 2a 10 W, 13
1. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
r' xdccsament—odl4es,smJrar,,prrnided.tnde y^o'oflr�r:°:0
CC*44MERCIX GFN17 RA ,i I3iL:Y Cp`/ERACr PART
SCNRDLILE
Name ofAddlfloraat In3ured Persor(s} `""`----"^----
—_ _�..
�...... �'orp.anl'zcIpn(s; —.- -.. �onxllarr'a otCaverad0aeoar;Parrs
CAY or Kom,Part,
Paena46apn and a mMunley BuYYl4mu.UMI44n
210 41h A"e",840
KENT,WA sum i
P
—P_ aAa�', nat uP Grn aCc^ wtll be ahwm q ry li^, ;aat rrv'1anx.�
N„ secfrarl d -• VARaq 7s Ae Inst.rsd is Etre x to B, 'J4Y(t; ros(acG Co Pha, as rErnr
IncrslrMtt ca ery dadtlomsd heLf,aa9 U`o pereurc(sj Cr r~^Jdaticrod inetorr th0 rar�ederto VI e
a'guntzatlan(s) shrr�tt ,ra the ;CMe t tad a°.r
Al eaped Ro Reh vY'rr^1 c�rllV Id;u{„ p r aau s ra w zply:
au n'rhr.(e ut P a and strove t9mrAng Ir un"" 1 rc �t m0 c# nat aPrh?to tWlIy,njUj'j,b or
Your acts cr ernlsaicn3;or I. All Vona P klr rBn�;1NSn.
2- "fnu nets cr omfss ona of€hc5e ort;n� on ,,,r equtr<rent farrrrehedCir: eonnoet nr vait,
teh11r, vm vt or. wo prrfcct gNher 'nEn 4e�1ca,
lr^ I'ttt p4"Gaff11N9 Ghl of Nt.t crgoltIg operatiare` a'1 tJa A,�7+A O+ repr,Jrs, to�^ ,Worm,'
'gyp Of
rhp EdJ11d0Fra1 . ,yi:rec%R,i at Mr_ gar Cf the 8»f ikonw nEp Cat ar At ❑re
ceS4 1114d attewv, t r tocaron(«t ,'a.atlail Of the �,ever�,y eper&fEcr;x a freer
Ccw'nNO'ed;or
1, Tc eer. 2. That corticn of
t• The InstCfan^ ar'crcled la t§a:t,dt ar''ditVpptaf it1�'ur� 0�` dattror4Ged PS�iugs bee�rl PQ to its
kjw,Enc.' xN }as tr Chu a:Ae^1I permllkvJ Ly b #,Crr¢°erl� LOG -W anA peraer ar drganYeaRficn
Wher ttwr, nrK?,yr curt Roto"cc xut ,"fYF¢ al
2. If ccyeAVO prWeeri N iho e4cf'{ir7anat Jnrpjfcc San e-994 dauf l p parforanhsg Vps*,or s rC^ a
requrod trtr a aMttat' or Vroarrept !110 6rrn1304 eam x par,of tC.d ffiarrae airry''o,;T,
tnrV,anric ittInrctco 10 94NY1 ad ho CgxrrGa
el rinl be ,1,,Ouee,' tt�ar1 h a och YOU arE
oyudrsd Lv he wn,so' a' e; oarrcent to
prr!}e fCr su^„h arJrY9edcarYl Ineuracf
GG M 10 041.3 0;nsurarxe 3arvtcca Cffica, Irw:.,2092
Page 1 of 2
OOMMERUAL GENERAL IJASILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. is
PRIMARY AND NONCONTRIBUTORY
OTH R INSURANCE CONDITION
Th,is'cnd xsemrrt r«X16La insurance Txrovlded JVe^Ore PrAvowg;
COY,K.E'P IAL Gf-'NERAL'_'AIJIL,7v COVERIA(3E PART
PRCCL' T r..Jtdsx;_CTEt GRz'.f 4T,4'NSLIA811j wCOVER/�GCPART
;>*n o:^eare'np, ,� ae�fiad �� the ut9vpr Crrsursotoe
ac 4ea,iee :�re' s�a�r�r° >:Jvrart ony r,^a°y7n1Cm to tae >a,Ormmed lar aorta y do cOn[roat ort
arWae^T?pt t r��n Iuaa v , rer,Cd w��nr^.
ilrrar/ n v Qj id nor ok i
primer/And 1I017contrlilLttony Insurance c ncrPl•u:won
rrMl5cr l ot'har ss�.r, ,ae gv lirtrw4e to C:as
'-^Is ➢n�rr rnce^ ix pc(tr ar, td un�l tiq+� ^�� se"it adgpC[.+cr�a
Ccrzfl,;J�Jd'cr? KM'bY�„tlty 4t)+8f n"Rtft'Gr w•aV?Sahle
'o an ncci°rwt^n' drrsuuec" trr:d�^r yv.r t:utcy
f} Tra W-Ullonal Irztj%,j !C, u llamad Irauved
;; er
f
I
i
CO 20 0104 13 k surm cc rJ rs®FFlcc, Ire., +.?
Pace i of 1
{
POLY:Y Nls!4F3ER= VBA 606982 09 COMMERCIAL OGNERAL LIABILITY
CO 24 04 06 09
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
't is o±t Ysar enr mcdiFteaa Irst" ce providm u^.eor the 1wowin6;
1NERO1 . '3F:NEF2Ai.C,iAL'L'%Y CC�df_t Ar3E PAW,
^R ^.! SIC<a1Gi,CTEC L!P€I? T QAt C.'ANLITY--0'vTiRAGE PjV7-r
SCHEDULE
game Of Parson Or Organization; C(fij wac ar '
. ' Mont ._. _
Mannar Amd Dtv w
220 as A"ma So,
4 KENT.WA W22
r
_. .... _ .
�r+rkL4'+aa r iyreJ to,rai'rd e®'h s fiCk7a7a.^uie "nrid vI urtr Nri1 ca
Tl c C1iaw tn0 ie 2c !'aa in PararrU h 0. Transfer Of
Rfgbt:t Cf Romiery Against 60:9:s To Lit of
SusC!10n iV-CnndINCnV
lira w�� "any reds[cw"'FP")vraaY Nwe r,s�y�?Y wc^ufi�sirv-,k
hhe 1-eufi' of c;,V-rf7nticl,,, sherm+ in t%c sach,edkli"
attrve bccausw W DW,11relYs wo made %v ",arJL y or
darxr,�o ar:' frg Oiat Of y,:r DrTg,,)hjp ope:^otlicns cr
Y'i.."Ork"C%faC J"de't� Cwlfac; with t;m;:eraor
ar Ciytarfza,lca7 aril it e;ud e rp Ohs rnrduva..
4uir^Dared openitvana haz'ar '. ThIC wl'vvr appt4s
or y S'iJ t pe i, C,. da p i an she yr In ihw
6J..0 4.i0 obove.
I
00 24 04 06 09 0 htUtanoe Seek-uu offce, Lnc„2008
Pape 1 of 1 0
� j
vBA445832 _
COMMERCIAL GENERAL LIABILITY
CG 98?0 12 08
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONSTRUCTION PROJECT(S) -GENERAL AGGREGATE LIMIT
(PER PROJECT)
This e:�da-semenl mcdiries insi:.rarce prcrrided Uncer the fonowirq
COMMERCAAL,GFNt_RAL:.IABILITY COVERAGL PART
A. Fflr aid srun+s nwheCta Iho tnsttrod benoules lega.ly ubltygatad to pay aS dama;ge%caused fly roccerra nces'
wk$or Section I-Coverage A-Bodily Injury And Property Darnage Llabdtity„and to all Inetlfcut
expenses caused by acciCelina urger Sactlon I'.—Coverage C Madicat Payntants,Which ca.l;be
adiribured only to ango°ng cparat!orrs�as a singta ccnS0.tl;auF+un project away ttv n prwc'josus mwned bw or
rented to ynV:
t• !e Sapara(e unforr
arrd that imitit is Pri"ut Gancrol Aggregate LIrstl;t plies to each Construction pre cct,.
l [s aq:aal to tnc 81mlO 11,of the Garaarr4 A
U9ragatn LIn»PI ahrywn in the D�Ciaratfnr.S.
2. The"ClInSINCt"or Prl)Az, C+Sres a;Aggregate h,anjt is the me^st we aviil pay for di'�sum C!old
'orraga.g t'rada-Cavoraage A,oxcarA uarragrts because od"badiry it*gory` c °°prep su 01 a li
irx nded In The`°prodaacts Cum laced ope a;101S tuoxard are tar met w l Cxl:unaeS 6k;ader
Cl"r-190 C r09wdIa$$of the m ilt iLer 0 '
4. Cialrna M000 cr"sr„r:ls b'CL91"t;ur
C• ^'er Sons or cigar izadruraS mofk:ant; cilil or bringing 'suns'.
3. 'ad p 1ynls c midi 6atatCr Cowa1'arpn Ate�r darnagas 01' under'Coverage C'or modical expenses SI#aald
"aduCa Nna OC'7sUYrrCiran Project Gerera(Ailgragalu Limit for than Corn ucto4n proJarct.vtlCta paymSnis
el
shall not redo the Genaretl Aggregate Lint shown In tlno Daclaratioras roar dial;thayv reduce any other
r,%Cna�4r+,J-I!dn ProjI Genefel Aggr'gate Llmlt tof ar'y 0MV r0rk-8rtaasfion projecf°
4. Tf:e'imits a"wvn in the D++daral'ro's for Eat:h DCCaueende,hire Carnegie and Medic«LXpanae tmr,.firua
� 4o r t�General regWe lmat shown(r r Daaafatcns.CC �IC5xhnds wo besao'lect To tho app cil ' nlrclact General; Lim E. For no Saxns wnyah the In surge becomes egalty cnhgated Icy pay as donaagea Caaused by"cccurremes,
�ndgr Sactl0in I--Coverage A-Bodlly InjuryAnd Property Damage LlabI ty° and(or ale rnedcc ai
organics CaJ5q,d bd oWidenr3 under Section t_CoveraI C Medical Payments, whlCh cannot be
athbul000naa/to cngoing opeEaaions at a air9le caraafrualor proyeCt lil born pre'wlbas awnod try er
rent+.�d to yo
1. Any psyn+Crils mado unde Cove'eretje A for "magas or Lmder Covurag�e,C roar mryddCai expselasasa:
SCbflIP mihCo the arlRCunt a vallabt°n Undur the General Aggregate w_mior Ina Prrodutts-ConaprlBtact
2 GPoraticnb ANregaale Limit,Wnichover ds opeilcablo,and
;r"a.:.h payments shall not iedv"e auly CCrrsiructaon F*cwt Ganara!P�grugate Lima.
C. Whher•Coverage for Ilaukty arising CA of Pha "prudtarIXd CfmrpletoC vaarattc¢as ha2a,`d' is Provided,any
CamptKpef tnngahaao MMVtte CCylharredllat$ Genp.ater peGarY CloYladgruflr h^PBIarMnot
rad�ra'CO Iha General AQ9tegK0 Limit Itur the Consitructiut Proliect General Aggregi4fu;.9mit.
D. If the appidaaolie prpje�p has boor rj ahandaned,daiaypc,or ahnnaoi,ne d and than restarted.Cr
l tare auliaerraeo Contracting PM,as dew ills from Plana. 'bluepnnts.dealgcs spacttk,'afiona or t�rvaatahltx
the me,jC;t Wili 4til be Cae..rnei to be Ole Sanoe C<ocs:nr lion prC,jaey.
E The provisions of Section III -Limits Of Insurance nor otherMse,,joclfud by tolls eradCrsurnr!nt Shall
continue tc apply.
CG 88 7012 as rnar,,yes�0}z!A6Arrr.rnalal5af o'isc r.
raentwa,��x:.,M Ili paciom!ur Page 1 of 1
I For P4044181de Ass lea nce
F*port a mlarn, pet COve( 99 d dedLJ=blQ irdwmatior rcqjm-. a !ow f,OTTI the accident
SC" GC--'GdLeffi or Worm;" or rewve a renta cw .�ihg
JSAA's Mobile Apo o,
6V CNINN 212-531-USAA (8722), OLr m0t+lu zlhcne shortcjt numbcy 03722 or
600-53 JSAA
tg I C
Automobile lnmw&Me Werfifflemion Card
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K"P a COPY of the Ida in yow vatiticle ad all times.
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Vehicle Coverage and Deductibles
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201$RAM 1400 CRCA9 4X.4 7SLT Ywr Deduc6hA o tivw•ew'bgriaum
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2013 RAM 1100 C RCAB 47f4 SLY Ca'rprage DwUned
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7015 LEXI.W RX 360 4D 4X4 Your DadwrNlbk prerntumr
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2009 FORD EXPL 40 4X4 E® Your Deducutwe Premum
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2013 RAM $NO CRCAB 4A4 SLT CO rsge D"Rined
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VI M1 5 RAM 1$00 C PICA 8 04 SLY Coveinge DRmfi,,wd
2006 FORT)IlXPL 411E 4AA LB Colvarm9c Duclinod
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Boddy rrtjpV L�abil:t NAlp Pay�•Ap RD Prornwin
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2015 LEXUZ RX 3&0464X4 Cavcaago D*cAwKd
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E-XPRE.SS AI N�-AL REPORT WITH CH,?INt c.ES
BUSINESS INFORMATION
Ii;clireSs\Artie.
SIRF EN7-F. RISES.1NC:_
'HI\llSil�;
602 1%618
Buuness TpyX-'
`® 4 PROFIT(:0 RATIG\
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6?72 112TH AN-E E, PU}'ALLIIP, %VA.9 3^'12MI. USA
r''BCival otbor .mailiu," Addals.:
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ken.liction
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PERPETUAL
IrWtisr Dale
`Arlie of Hnsicwsc
REGISTERED AGENT
Ragi$tercrl AUent w,me Slre*1 Addre$j, — -- _
I i('1 LlT;. It I&"iki.[_"S(-.}. Wailing Addrrzy
`: tmlv5 1P'I F{ °t`v'z; F.I'!. \L!,! I', ',i.-A, `A33^m-,85E t 'Ur1-:1)STA J Fe
PRINCIPAL OFFICE
2SX 1-7r4
ima,!
►I I KE F E RGL SY],\'3?(WGhI,%M.0(7.19
6712 11.21'H AVE E. PL'I ALLUP, WA. 72-2&'01. USA
I"his c7ur:wrtcut iv.a nui�ic rr.kv¢u. !�rx ruorr-illj;nnrva.fi,:�rsi:
Mailing Addmsr
GOVERNORS
F-n4iv Name Fib Nume
1,451 Name
NATURE OF BUSINESS
oI'IIIlk s E.:RGICF.S
11 SSTV klANA!,FJii:17 k Rl_-Vl AATlf N S{,R41s_.IIc
EFFECTIVE DATE
CONTROLLING INTEREST
LAJCS 4'tNf(NO CUnfpenY Own M31 pDfUplrt\"d17BCIuAifl®ICb�Cile m¢crc.L.j m '" ••••••••14'aslEinYtCYt'� —
RETURN ADDRESS FOR THIS FILING
MIKE FERctTSON
-jnt l
Il KL"FERGI[So Nr, dtG&IAIL.CoW
AkI ros
6712 1 UTH AVE F,PUIrALI.I,p, W'A,98370 2SSI, USA
AUTHORIZED PERSON
1\DIN7DUAL
HIKE
I as l'Nam,
FERG USCI\
lire
'l ui*<ux�./;u„2;nt is LrrcM1\ r.cceutcd tnrlcr n�>!law Au<I;, ;n rLe bc.t t,l'mg�kno�ladgc. true alai t"�-t
'Elxit dmunonr it a puhuc mcxmi I ct rmfe irdfrurR 90�m risil
011E � yy�e� ''E?JAdlVRIIN�NJ"Idiyllpr,���rvr {
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January 1 , 2018 0 . 9000
Y
a 12-OS-17 July 1 , 2013 - June 30, 2016
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6 60,2 194 618
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TOM MRF ENTERPRISES INC
6712 712TH AVE E 9S4,842-01 16368392 �u
p uraLLuv WA
98372 MINE
KENT ANDERSON
T
(360)902-6963
What vent into calculating Your 2018 workers' comp rates?
1. Chinge In L!I avcrage 'baia' rate: ;'.b$ average rate d6creasc for Pole; rates SpeCIrIC LO your
r ndustry earl be found on our "041 to at Ini .va.gov
2. (;n0nges in industry costs: Changes in Claim coitt compered to puma COl tretetl for your
indu&dry frisk clast'I In which somee or or all
worKearlcetl, of your employees
3. Yuur Lxpilrienee factor:
based on Lhe medical , wogs roplceencnt and dl to Dlliiy pencfrp
ror worker claims on your account, during the eYperiencc pari Coats
ad
listed above,
4. A c101N-frco discount:
You earned a TD# claim-free discount in your Experience Factor.
Learn how Lo kccp Lhe d,aceunt at wv,Lnl .ra.gov/ClsiohreeDiscounL.
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mama
ina [ h/sandbi 11 Mervr MC
3.aas2 1.4Nf 6.6a03 0.1030¢, $4.22{3{
a{04-Sa freer eeeh/]snml lido/Struot S0.16325 µ,�0
14M 16 3.2651 3.63e4 6.0423 6,1036 03.7Y42S $0.60766 04.{710
Wsaets/Ferrsas lac 1.0%31 6.6236 0.0113 6.1030
.. 4a6S07Fer mi: Alumtic ?:ant Raisin 01.27700 00.63020 41,6132
4904-so elarlsel evil" NOe s 4 6-6260 0.3947 B.IIa67 G.1a16 sl.713Sa IIL.23410 tO.foss
6ftsmn e.a2ta l.alR •.0603 0,16]0 Sl.6a3{0 06.06610 00.1436
6602-16 Portable Cli�lna/vashlM NOC
0,{µ6 6.60" 0.1036 vio.""t 00,316N il.zia4
1.0400 aP19J� ✓y'' ldffi.
•.. a .woo .laoa a
101). Liam
factor fecte,. factor
FADE 1 or 7 ON: 1?3,660
HVSUNESS I WENSE NO'1'1('F,
100
KENTh^r !,icentjr!k
Dec D�jcare J,WLan 1, 2�: Decnike 2f,j�
Amounti)uv 5101.00
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253-307-2872
M IND Ifflamirg I III jjj,jjj�N ill PAN din u 2150570
ONE 101HU ifil pqrmikD: 174314
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h. LMPIA.�ftl,nt Kent Locrfiop al of !0,'3
7. TRNP: _42-1535222 Til�,; Part Time:
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