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HomeMy WebLinkAboutL11-082 - Amendment - #8 - Aquatic Management Group, Inc. - Kent Pool Sub-Lease Agreement - 05/25/2018 CITY CLERK T CITY OF KENT 220411 Avenue South Kent, WA 98032 Fax: 253-856-6725 PHONE: 253-856-5725 Lease Agreement Cover Sheet This document is to be used in lieu of the Contract Cover Sheet SECTION 1 - CONTRACT PROC'ESSING AND TENANT SET-UP: Contract Number: Lll-082-008 1. Responsible Department/Division: Parks and Recreation Dept Admin 2. Contact Person and Title: Phung Huynh, Accountant Telephone Extension: 5102 3. Tenant (Customer) Name: Aquatic Management Group Inc 4. Tenant (Customer) Number: 160465 5. General Ledger Account Number: 10006221.56250 6. King County Tax Parcel Number: 202205-9066 7. Address of Parcel: 25316 101" Ave SE Kent WA S. Type of Lease: Sub-lease (Operating Agreement) Addendum No 7 9. Council Authorization Date: 5/11/2011 10. Mayor Signature Date: 5/27/2011 SECTION 2 - LEASE DURATIQN AND IMPORIANT DATES, 11. Lease Start Date: 5/26/2018 12. Tenant Lease Option Renewal Notification Due Date: Annual 13. Lease Termination Date: 5/2fA/2019 14. Lease Duration: Annual SECTION 3 RENT DETERMINATION AND DUE DATE: 15. Rent: $125,000 (New) 16. Rent Due Date: Annual 17. Calculation of Rental Increase(s): N/A Lease Agreement Cover Sheet—Page 1 of 2 i SECTION 4 — LEASEHOLD EXCISE TAX: 18. Is this lease subject to leasehold excise taxes? ® YES (go to Question 19) ❑ NO, reason:_ 19. Are leasehold excise taxes for this tenant centrally assessed, i.e. directly collected from the tenant by the Washington State Department of Revenue? YES (attach written verification received directly from DOR or indirectly through the tenant, e.g. DOR notification letter) NO (go to Question 20) 20. Does Lease Rent include Leasehold Excise Tax? (Leasehold taxes must be broken out on the invoice and coded: Business unit.32500.0303) ❑ YES Calculate the leasehold excise tax (Stated Rent divided by 1.1284) ® NO Calculate the leasehold excise tax (Stated Rent times .1284) SECTION 5 — APPLICABLITY OF UTILITIES: 21. Applicability of Utilities — Check all that utilities that are affected and indicate provider (e.g. City of Kent), Account Number or basis of exclusion. E Does Not Apply water: E] Sewer: ❑ Drainage: ❑ Garbage: Electricity/Natural Gas: MONETARY PENALTIES ....EREK;HANES 22. Monetary Penalties: N/A 23. Late Interest: N/A SECTION 7 — OTHERLEASE CONSIDERATIONS: Special lease considerations, e.g. non-monetary rent, etc ® None (check box if no considerations) Lease Agreement Cover Sheet—Page 2 of 2 +" ` `1' N AMENDMENT NO. EIGHT to Kenta! Sub Lease Agreement NAME OF CONSULTANT OR VENDOR: AnuatiC M iall �rrrC�»t Group—(AM b CONTRACT NAME C PROJECT NUMBER Kong Ppol ORIGINAL AGREEMENT DATE: new 2C, 2011. This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of he Onginal Agreement or pros Amendments not inconsistent v ith this Amendment -hull remain in full 'urce and effect. For valuable consideration and by mutual consent of the parties, Consultant orVendors work is modified as follows, 1. Section I of the Agreement, enb0cd 'Dcscrlptior: of Work,' is hereby modifno to add additional work or revise existing work ,as follows: In addition to wore required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: As set in the terms of the agreement dated March 26 2011, the current sublease agreement with AMG is schedueld to expare annually. This Arnerdmient extends the agreement to May 25, 2019 and increase, the argreernent by $20,000 for operational expenses. 2. The contract amount and time for performance provisions of Section II "Tirre of Compieticn," and Section 111, "C'pmpen5ation," are modified as follows: ' L?ri ., u...... glnal Contract Sum, $75 tltllM 4Vtl including applicable WS r Nit Change by Previous Ame�sdments $10,tlCIl1.o __...__...._ inrJu&ng appOcaWe 4M55T Current Contract Amount $te7w,Gp(pDs0 including ari previou-i amen dmea ts j Current Amendment Sum $20,000.00 Applicable WS T Tax on this $ a. 4 Amendment Rev;sed Guntract Sum $1 5,000,00 ..........._... _ AP` ES NC M!4 NT 1 OF G Original T"Ime for Completion 5/25/2012 (insert date) P,evlsed Time for Completion under 5125/2018 prior Amendmelars (tnaa,�t date) Add`i Gays Reclurred (�} for this +365 calendar days Amendment Revised T€me for Completion 5/2512019 ('insert date) The Consultant or Vendor ar opts all rmuiremen7s of this Amendment by signing below, by its signaz ure waives any protest or dam 4t may have regarding this Amendment, and acknowledgcs and accepts that this Arno+ndme;raC Cvtinstitutes full payment and final settlement of all claims of any kind or nature arising from or Connected with any work e'ather covered or affer-ted by this Amendrnen C, Including, without imitators, Claims related to contract lu-me, contract acceleration, orrsmte or Home office overhead, or lost profits. This Amendment, unless otherwise provided, doe, not relieve the Consultant or Vender from strict compliance a+rith the guarantee and warranry profits€on,5 of the original Agreement. Ail aces consistent with the aauthorlty of the Agreement, previous Amendment-, (if any), and this Amendment, prior to the effective date of this Anterrdmont„ are hereby ratified and affirmed, and the terms of the Agreement, previous Annendm„nLs (If any), and this Amendment shall be deemed to have applied. The partles whose names appear "- low swear under penalty of perjury that they are authorized to enter Into this Arnendineril, '„which Is LindinG can the porties of Roes contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below.. �CONSUL"l'AFIT/VENDORc CITY OF KENT By: V r�razm eu vt�� c n'rc/ l ✓ w� ]tsnt Name � p�lrrrf'Nao�e' �, '"'r ;�";,a ,r tTC- " e _ _._ ._. DATE: _ PPROVA AS TO FORM: I i Kent Law (department AMENDL 11:N`r - 21 OF 2 AQUAMGM-01Q, CERTIFICATE OF LIABILITY INSURANCE D 0411712018 V) 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. .............. ............................ y �................ ....._._. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the polic (ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). ......._w _ .....e... ..... .. PRODUCER Hub International Northwest LLC PHONE -- PAX 12100 NE 195th Street,Suite 200 inrc NQ.E.1L(425)489-4500 {A+c_a+ (426)485-8489 Bothell,WA 98011 kAQss now,info_Chuibinternational.com - INSURER{SI,AFFbRDING COVERAGE, .. -------NA➢CH ....... INAill Great American Insurance Com Danv 19691 INSURED IN9IRFR R ___ Aquatic Management Group Inc. Igsl„IRFR r• PO Box 129 INCIIRFP rl. — •• T Kent,WA 98011-0129 INSURER,E: INSURER F: __ _.. ..........__ .... _COVERAGES CERTIFICATE NUMBER: .... REVISION NUMBER„ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 POOL,SURF POLICY EFF POLICYEXPI LIMITS .o TYPE OFINSURANCE ncn wvn POIJCV NUMBER rMMlnnrwvvl _...._____RA r _,a ,u..._._ 1,000,000 A X COMMERCIAL GENERAL LIABILITY FAOH OGCIIRRFNCF S . culMs MADE X OCCUR MAC0686137 04 04115/2018 0411512019 D"MACE TO RENTED a 1,000,000 _._,� D,...MISLS ten=wcanceE X Abuse&Molestal MFn FxP lAnv or.r—rA x 20,000 PERSONLS AADVINJURY a 1,000,000 GEl AGGREGATE LpIMI I APPLIES PER GENERALAGGREGATE R 21000000 I"),IG'Y JELQT j X^� LOC PRODUCTS-COMPIOP ADS R 2,000,000 OTHER' $ GOM[BINEDSINGLELOMir 1,000000 A AUTOMOBILE LIABILITY (LagFd[eno 11 _ R ANY AUTO MAC068613704 04/1512018 0411512019'' DODILY INJURY(Peroerson) -- OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per actin r X HI X NOryry.'p.Wry[��py� Pif°a RTY?AMAGE ¢ _. AuO's ONLY AUBai"ykrJLY ,,,--- _ e UMBRELLA LIAO OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE "I AGGREGATE P DEDJJ RETENTION$ .,WORKERS CO. ........ .........___.... A WORRERS COMPENSATION CTATI ELF X OR AND EMPLOYERS'LIABILITY y+N MAC068613704 04/1512018 04115/2019 � I 1,000,000 ANY PROPRIETORIPARTNERIEXECUTIVE l E L EACH ACCIDENT c (,1�FICFRJ IJSl EXCLUDED? NIA 1,000,000 IMAnoialory rl NHl EL DISEASE_ EA EMPLOYEE_ $ It yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below w E L DISEASE POLICY LIMIT $ _ ............................................ ......... _.. ...._. __.. .m ------------- BE SCRIPTION Of IRATIONS(LOCATIONS I VEHICLES (ACORD 101,Addll as Remarks Schedule,may he aHa ched if more space Ie required) Certificate holder is an ouldl{ionai insured per forme.attached.. _ ...._............ ..........m _ 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 Y ACCORDANCE WITH THE POLICY PROVISIONS. 220 4th Ave.South Kent,WA 98032 .....,..........._ ......................... AUTHORIZED REPRESENTATIVE /4,1 .......... ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Ad.1nistrative Offices 301 E 4th Street riREA 4MERICAN. Cincinnati Off 45202-4201 CG 82 24 INSURANCE GROUP 513 369 5000 ph (Ed. 12 01) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SOCIAL SERVICE AGENCY GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following provision is added to SECTION (2) With respect to the insurance af- II - WHO IS AN INSURED forded the Additional Insured identified in Paragraph A.(1) of 5. AUTOMATIC ADDITIONAL INSURED(S) this endorsement, the following additional provisions apply: a. Additional Insured - Manager or Lessor of Premises (a) This insurance applies only to liability arising out of the (1) This policy is amended to include ownership, maintenance or as an insured any person or or- use of that portion of the ganization (hereinafter called Ad- premises leased to you. ditional Insured) from whom you lease or rent property and which (b) The Limits of Insurance ap- requires you to add such person plicable to the Additional In- or organization as an Additional sured are the lesser of those Insured on this policy under: specified in the written con- tract or agreement or in the (a) awritten contract, or Declarations for this policy and subject to all the terms, (b) an oral agreement or con- conditions, and exclusions tract where a Certificate of for this policy. The Limits of Insurance showing that per- Insurance applicable to the son or organization as an Additional Insured are inclu- Additional Insured has been sive of and not in addition to issued; the Limits of Insurance shown in the Declarations. but the written or oral contract or agreement must be an "insured (c) In no event shall the cov- contract," and, erages or Limits of Insurance in this Coverage Form be in- (i) currently in effect or be- creased by such contract. come effective during the term of this policy, and (d) Coverage provided herein Is excess over any other valid (ii) executed prior to the "bodily and collectible insurance injury," "property damage," available to the Additional In- "personal and advertising in- sured whether the other in- jury." surance is primary, excess, Includes copyrighted material of Insurance Service Office with its permission. Copyright, Insurance Services Office, Inc., 2001 CIS 82 24 (Ed. 12/01) XS (Page 1 of 4) contingent or on any other tomarily provided by the basis unless a written con- policy forms specified in and tractual arrangement specifi- required by the contract. tally requires this Insurance to be primary. (c) In no event shall the cov- erages of Limits of Insurance (3) This insurance does not apply to: in this Coverage Form be in- creased by such contract. (a) Any "occurrence" or offense which takes place after you c. Additional Insured - Contractual cease to be a tenant in that Obligations premises. (1) This policy is amended to include (b) Structural alterations, new as an Insured any person or or- construction or demolition ganization (hereinafter called Ad- operations performed by or ditional Insured) that you are re- on behalf of the "Additional quired by a written "insured con- Insured." tract" to include as an Insured, b. Additional Insured Funding subject to all of the following provisions: Sources (a) Coverage is limited to liability (1) This policy is amended to include arising out of: as an Insured any Funding Source which requires you in a written (i) your ongoing oper- contract to name the Funding ations performed for Source (hereinafter called Addi- such Additional Insured; tional Insured) as an Insured but or only with respect to liability aris- ing out of your premises, "your (ii) that Insured's financial work" for such Additional Insured, control of you, or or acts or omissions of such Ad- ditional Insured in connection with (Ili) the maintenance, opera- the general supervision of "your tion or use by you of work" and only to the extent set equipment leased to forth as follows: you by such Additional Insured; or (a) The Limits of Insurance ap- plicable to the Additional In- (iv) a state or political sub- sured are the lesser of those division permit issued specified in the written con- to you. tract or agreement or in the Declarations for this policy (b) Coverage does not apply to and subject to all the terms, any "occurrence" or offense: conditions, and exclusions for this policy. The Limits of (i) which took place be- Insurance applicable to the fore the execution of, Additional Insured are inclu- or subsequent to the sive of and not in addition to completion or expira- the Limits of Insurance tion of, the written "in- shown in the Declarations. sured contract", or (b) The coverage provided to (ii) which takes place after the Additional Insured(s) is you cease to be a ten- not greater than that cus- ant in that premises. Includes copyrighted material of Insurance Service Office with its permission, Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12/01) XS (Page 2 of 4) (c) With respect to architects, work" done under a contract for that engineers, or surveyors, person or organization and included in coverage does not apply to the "products-completed operations "Bodily Injury," "Property hazard." Damage," "Personal and Ad- vertising Injury" arising out 3. NON-OWNED OR CHARTERED WATER- of the rendering or the fail- CRAFT ure to render any profes- sional services by or for you Section I - Coverages, Coverage A, Item including: 2.g.(2) is replaced with: (i) the preparing, approv- (2) A watercraft you do not own that is: ing, or failing to pre- pare or approve maps, (a) less than 51 feet long; and drawings, opinions, re- ports, surveys, change (b) not being used to carry persons or orders, designs or property for a charge. specifications; and 4. BROADENED PERSONAL AND ADVERTISING (ii) supervisory, inspection, INJURY or engineering services. Unless "Personal and Advertising Injury" is ex- If an Additional Insured endorsement is at- cluded from this policy: tached to this policy and specifically names a person or organization as an Insured, then the SECTION V - DEFINITIONS Item 14. is re- coverage in Section II - WHO IS AN placed by: INSURED 5. Automatic Additional Insured(s) does not apply to that person or organization. 14. "Personal and Advertising Injury" means injury, including consequential "bodily in- 2. BLANKET WAIVER OF SUBROGATION jury," arising out of one or more of the following offenses: SECTION IV - COMMERCIAL GENERAL a. false arrest, detention or imprison- LIABILITY CONDITIONS, Item 8. is replaced merit, with: It. malicious prosecution; 8. Transfer of Rights of Recovery Against Others to us and Blanket Waiver of c. the wrongful eviction from, wrongful Subrogation entry into, or invasion of the right of private occupancy of a room, dwelling a. If an Insured has rights to recover all or premises that a person occupies by or part of any payment we have made or on behalf of its owner, landlord or under this Coverage Part, those rights lessor; are transferred to us. The Insured must do nothing after loss to impair them. d. oral, written, televised, videotaped, or At our request, the Insured will bring electronic publication of material, in "suit" or transfer those rights to us and any manner, that slanders or libels a help us enforce them. person or organization or disparages a person's or organization's goods, pro- b. If required by a written "insured con- ducts or services, tract", we waive any right of recovery we may have against any person or e. oral, written, televised, videotaped, or organization because of payments we electronic publication of material, in make for injury or damage arising out any manner, that violates a person's of your ongoing operations or "your right of privacy, or Includes copyrighted material of Insurance Service Office with its permission, Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12/01) XS (Page 3 of 4) f. mental injury, mental anguish, humili- Subject to 5. above, the Damage to Prem- ation, or shock, if directly resulting ises Rented to You Limit is the most we from Items 14.a. through 14.e. will pay under Coverage A for damages because of "property damage" to your g. the use of another's advertising idea in building, or to personal property of others your "advertisement"; or in your care, custody and control while at premises rented to you or temporarily h. infringing upon another's copyright, occupied by you with permission of the trade dress or slogan in your "adver- owner, arising out of any one fire. tisement." The Damage to Premises Rented To You 5. MENTAL INJURY, MENTAL ANGUISH, Limit is replaced by the following Damage HUMILIATION, OR SHOCK INCLUDED IN to Premises Rented To You Limit. BODILY INJURY DEFINITION The Damage to Premises Rented To You Section V - Definitions, Item 3. is replaced Limit is the greater of: with: (1) $300,000; or 3. "Bodily injury" means physical injury, sick- ness, or disease, including death of a per- (2) the amount shown in the Declarations son. "Bodily injury" also means mental in- for Damage to Premises Rented to jury, mental anguish, humiliation, or shock You Limit. if directly resulting from physical injury, sickness, or disease to that person. B. This provision is subject to all the terms of SECTION III - LIMITS OF INSURANCE. 6. MEDICAL PAYMENTS C. This provision 5. does not apply if Damage to Premises Rent to You Liability of COV- A. The Medical Expense Limit in Paragraph 7. of SECTION III - LIMITS OF INSURANCE y the A {SECTION his excluded either b is replaced by the following Medical Ex- by the provisions of the Coverage Part or by endorsement. pense Limit. The Medical Expense Limit provided by 8. SUPPLEMENTARY PAYMENTS this policy shall be the greater of: A. In the SUPPLEMENTARY PAYMENTS - a. $10,000; or COVERAGES A and B provision, Item 1.b., and 1.d are replaced with: b. The amount shown in the Declarations 1.b. Up to $500 for cost of bail bonds for Medical Expense Limit. required because of accidents or traf- fic law violations arising out of the use B. This provision 7. is subject to all the terms In- of SECTION III - LIMITS OF INSURANCE. any vehicle which the Bodily In- juu ry Liability Coverage applies. We do not have to furnish these bonds. C. This provision 7. does not apply if COVERAGE C. MEDICAL PAYMENTS is 1.d. All reasonable expenses incurred by excluded either by the provisions of the the Insured at our request to assist us Coverage Part or by endorsement. in the Investigation or defense of the claim or "suit," including actual loss of 7. DAMAGE TO PREMISES RENTED TO YOU earnings up to $500 a day because of LIMIT time off work. A. SECTION III - LIMITS OF INSURANCE, This endorsement does not change any other Item 6. is replaced with: provision of the policy. Includes copyrighted material of Insurance Service Office with its permission, Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12/01) XS (Page 4 of 4) ,...ram AQUAMGM-01 TM CERTIFICATE OF LIABILITY INSURANCE D04/1712018ATE Y, o4rl�rzole THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ....................._._. _............................ .... IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this c . _...........____ ...... .. PRODUCER CONTACT Hub International Northwest LLC PHONE "" """' FAX 12100 NE 195th Street,Suite 200 INC,N E.tl (425)489-4500 1�(ATc No,(425)485-8489 Bothell,WA 98011 ,noW.IhtD NlUbinterRational.com NSURER(SI AFFORDING COVERAGE NAIDO INSURER A Great American Insurance Companv 16691 INSURED INSURER B Aquatic Management Group Inc. INSURER c PG BOX 129 INSURER n Kent,WA 98035-0129 .. ...._-...-.., ..__ ........ _........ ______ INSURER E NSURER F COVERAGES CERTIFICATE NUMBER;_ REVISION NUMBER: ................_. __--- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADDLSUBR POLICYEFF POLICYE�YP LIMITS IrR TYPE OF INSURANCE CI ¢ f n POLICV NUMBER a e aua aliuin . ..wwAoa. ..... ._ ..y..__.......... - 1,000,000 A X COMMERCIAL GENERAL LIABILITY FACHnrrIIRRFNCE $ DAMAGE RENTED TO 1,000,000 CLAMS MADEXI OCCUR MAC0686137 04 0411512018 04/15/2019 rnn..F9 rT r S X Abuse&Molestation ME n FXP rAn �mml s 20,006 RERCS)NAI n Anb IN wRY s -- 1,000,000 GENE AGGREGATE LIMIT APPLIES PER CENFRAI ArCRFCATF S 2000OOO PDI ICY L_I PE O � X � LOC PRQE)UQTS. rnrnwnP Arr_, s _ 2,000 000 OTHER 9 A CDMPIN'HD SWwr 1CUMIT 1,000,000 AUTOMOBILE LIABILITY tEp&N�SISiI'111 A ANY AUTO MAC068613704 OV1512018 0411512019 Rnrory INJIJRY!'Pe.r rsori a _.._._ OWNED ,........_.. SCHEDULE❑ AUTOS ONLY AUTOS Rnnll Y IN,IIIRY_(P r damn S X44 ��pp ... ryry +1 `1 PROPERTY AtdI .. AVRTOS ONLY X 5{7 EW Per,ecCld41 s UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESSLIAR CLAIMS-MADE AGGREGATE x DED 1 RETENTION$ ¢ A WORKERS COMPENSATION cTATUTF I X OeH AND EMPLOYERSLIABILITY YIN iMAC068613704 0411512018 0411512019 1000000' ANY PRO PRI ETOMPARTN ERIEXEC UTIVE WE L EACH ACCIDENT R e u�ERIME NH)EXCLUDED? ` ._� NIA 1,000,000 EL DISEASE EA EMPLOYEE; R u yes,describe under 1,000,000 OFSf.RIPTION OF OPERATIONS below EL DISEASE POLL.V LIMIT ._...________ .. _.... ........ —._.._ DESCRIPTION OF OPERATHONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached Ir more space is scolded) Certificate holder is an:additional insured per attached form. .___................................... ®, CERTIFICATE.HOLDER __._,...... ,,,m CANCELLATION....._ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE HI hline School District Facilities Service Dept THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g P ACCORDANCE WITH THE POLICY PROVISIONS. 17810 8th Ave S Burien,WA 98148 - -- AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD •^" � A3d0ministrative Offices GREAT Cih E pe Street fL11ERIC . cincinnatiOR 45202-4201 CG 82 24 INSURANCE GROUP 513 369 500D ph (Ed. 12 01) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SOCIAL SERVICE AGENCY GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following provision is added to SECTION (2) With respect to the insurance af- II - WHO IS AN INSURED forded the Additional Insured identified in Paragraph A.(1) of 5. AUTOMATIC ADDITIONAL INSURED(S) this endorsement, the following additional provisions apply: a. Additional Insured - Manager or Lessor of Premises (a) This insurance applies only to liability arising out of the (1) This policy is amended to include ownership, maintenance or as an insured any person or or- use of that portion of the ganization (hereinafter called Ad- premises leased to you. ditional Insured) from whom you lease or rent property and which (b) The Limits of Insurance ap- requires you to add such person plicable to the Additional In- or organization as an Additional sured are the lesser of those Insured on this policy under: specified in the written con- tract or agreement or in the (a) a written contract; or Declarations for this policy and subject to all the terms, (b) an oral agreement or con- conditions, and exclusions tract where a Certificate of for this policy. The Limits of Insurance showing that per- Insurance applicable to the son or organization as an Additional Insured are inclu- Additional Insured has been sive of and not in addition to issued; the Limits of Insurance shown in the Declarations. but the written or oral contract or agreement must be an "insured (c) In no event shall the cov- contract," and, erages or Limits of Insurance in this Coverage Form be in- (i) currently in effect or be- creased by such contract. come effective during the term of this policy; and (d) Coverage provided herein is excess over any other valid (ii) executed prior to the "bodily and collectible insurance injury," "property damage," available to the Additional In- "personal and advertising in- sured whether the other in- jury." surance is primary, excess, Includes copyrighted material of Insurance Service Office with its permission. Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12/01) XS (Page 1 of 4) contingent or on any other tomarily provided by the basis unless a written con- policy forms specified in and tractual arrangement specifi- required by the contract. cally requires this insurance to be primary, (c) In no event shall the cov- erages of Limits of Insurance (3) This insurance does not apply to: in this Coverage Form be in- creased by such contract. (a) Any "occurrence" or offense which takes place after you c. Additional Insured - Contractual cease to be a tenant in that Obligations premises. (1) This policy is amended to include (b) Structural alterations, new as an Insured any person or or- construction or demolition ganization (hereinafter called Ad- operations performed by or ditional Insured) that you are re- on behalf of the "Additional quired by a written "insured con- Insured." tract" to include as an Insured, subject to all of the following b. Additional Insured - Funding provisions: Sources (a) Coverage is limited to liability (1) This policy is amended to include arising out of: as an Insured any Funding Source which requires you in a written (i) your ongoing oper- contract to name the Funding ations performed for Source (hereinafter called Addi- such Additional Insured, tional Insured) as an Insured but or only with respect to liability aris- ing out of your premises, "your (ii) that Insured's financial work" for such Additional Insured, control of you, or or acts or omissions of such Ad- ditional Insured in connection with (iii) the maintenance, opera- the general supervision of "your tion or use by you of work" and only to the extent set equipment leased to forth as follows: you by such Additional Insured, or (a) The Limits of Insurance ap- plicable to the Additional In- (iv) a state or political sub- sured are the lesser of those division permit issued specified in the written con- to you. tract or agreement or in the Declarations for this policy (b) Coverage does not apply to and subject to all the terms, any "occurrence" or offense: conditions, and exclusions for this policy. The Limits of (i) which took place be- Insurance applicable to the fore the execution of, Additional Insured are inclu- or subsequent to the sive of and not in addition to completion or expira- the Limits of Insurance tion of, the written "in- shown in the Declarations. sured contract", or (b) The coverage provided to (II) which takes place after the Additional Insured(s) is you cease to be a ten- not greater than that cus- ant in that premises. Includes copyrighted material of Insurance Service Office with its permission, Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12101) XS (Page 2 of 4) (c) With respect to architects, work" done under a contract for that engineers, or surveyors, person or organization and included in coverage does not apply to the "products-completed operations "Bodily Injury," "Property hazard." Damage," "Personal and Ad- vertising Injury" arising out 3. NON-OWNED OR CHARTERED WATER. of the rendering or the fail- CRAFT ure to render any profes- sional services by or for you Section I - Coverages, Coverage A, Item including: 2.g.(2) is replaced with: (i) the preparing, approv- (2) A watercraft you do not own that is: ing, or failing to pre- pare or approve maps, (a) less than 51 feet long; and drawings, opinions, re- ports, surveys, change (b) not being used to carry persons or orders, designs or property for a charge. specifications, and 4. BROADENED PERSONAL AND ADVERTISING (ii) supervisory, inspection, INJURY or engineering services. Unless "Personal and Advertising Injury" is ex- If an Additional Insured endorsement is at- cluded from this policy: tached to this policy and specifically names a person or organization as an Insured, then the SECTION V - DEFINITIONS Item 14. is re- coverage in Section 11 - WHO IS AN placed by: INSURED 5. Automatic Additional Insured(s) does not apply to that person or organization. 14. "Personal and Advertising Injury" means injury, including consequential "bodily in- jury," arising out of one or more of the following offenses: SECTION IV - COMMERCIAL GENERAL a. false arrest, detention or imprison- LIABILITY CONDITIONS, Item 8. is replaced ment; with: b. malicious prosecution; 8. Transfer of Rights of Recovery Against Others to us and Blanket Waiver of c. the wrongful eviction from, wrongful Subrogation entry into, or invasion of the right of private occupancy of a room, dwelling a. If an Insured has rights to recover all or premises that a person occupies by or part of any payment we have made or on behalf of its owner, landlord or under this Coverage Part, those rights lessor, are transferred to us. The Insured must do nothing after loss to impair them. d. oral, written, televised, videotaped, or At our request, the Insured will bring electronic publication of material, in "suit" or transfer those rights to us and any manner, that slanders or libels a help us enforce them. person or organization or disparages a person's or organization's goods, pro- b. If required by a written "insured con- ducts or services; tract", we waive any right of recovery we may have against any person or e. oral, written, televised, videotaped, or organization because of payments we electronic publication of material, in make for injury or damage arising out any manner, that violates a person's of your ongoing operations or "your right of privacy, or Includes copyrighted material of Insurance Service Office with its permission. Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12/01) XS (Page 3 of 4) f. mental injury, mental anguish, humili- Subject to 5. above, the Damage to Prem- ation, or shock, if directly resulting ises Rented to You Limit is the most we from Items 14.a. through 14.e. will pay under Coverage A for damages because of "property damage" to your g. the use of another's advertising idea in building, or to personal property of others your "advertisement"; or in your care, custody and control while at premises rented to you or temporarily h. infringing upon another's copyright, occupied by you with permission of the trade dress or slogan in your "adver- owner, arising out of any one fire. tisement." The Damage to Premises Rented To You 5. MENTAL INJURY, MENTAL ANGUISH, Limit is replaced by the following Damage HUMILIATION, OR SHOCK INCLUDED IN to Premises Rented To You Limit. BODILY INJURY DEFINITION The Damage to Premises Rented To You Section V - Definitions, Item 3. is replaced Limit is the greater of: with: (1) $300,000; or 3. "Bodily injury" means physical injury, sick- ness, or disease, including death of a per- (2) the amount shown in the Declarations son. "Bodily injury" also means mental in- for Damage to Premises Rented to jury, mental anguish, humiliation, or shock You Limit. if directly resulting from physical injury, sickness, or disease to that person. B. This provision is subject to all the terms of SECTION III - LIMITS OF INSURANCE. 6. MEDICAL PAYMENTS C. This provision 5. does not apply if Damage to Premises Rent to You Liability of COV- A. The Medical Expense Limit in Paragraph 7, of SECTION III - LIMITS OF INSURANCE y the A (SECTION h is excluded either b is replaced by the following Medical Ex- by the provisions of the Coverage Part or by endorsement. pense Limit. The Medical Expense Limit provided by 8. SUPPLEMENTARY PAYMENTS this policy shall be the greater of: A. In the SUPPLEMENTARY PAYMENTS - a. $10,000; or COVERAGES A and B provision, Item 1.b., and 1.d are replaced with: b. The amount shown in the Declarations 1.b. Up to $500 for cost of bail bonds for Medical Expense Limit. required because of accidents or traf- B. This provision 7. is subject to all the terms fic law violations arising out of the use In- of SECTION III - LIMITS OF INSURANCE. any vehicle which the Bodily In- juu ry Liability Coverage applies. We do not have to furnish these bonds. C. This provision 7. does not apply if COVERAGE C. MEDICAL PAYMENTS is 1.d. All reasonable expenses incurred by excluded either by the provisions of the the Insured at our request to assist us Coverage Part or by endorsement. in the investigation or defense of the claim or "suit," including actual loss of 7. DAMAGE TO PREMISES RENTED TO YOU earnings up to $500 a day because of LIMIT time off work. A. SECTION III - LIMITS OF INSURANCE, This endorsement does not change any other Item 6. is replaced with: provision of the policy. Includes copyrighted material of Insurance Service Office with its permission, Copyright, Insurance Services Office, Inc., 2001 CIS 82 24 (Ed. 12/01) XS (Page 4 of 4) AQUAMGM-01 TMOC ATIECERTIFICATE OF LIABILITY INSURANCE D0 4/1 712I.0 1 8 Y) k,..r. 0 411 7/2 01 8 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). .......................--........,...........m.................. .......... ... PRODUCER CONTACT .Ho Hub International Northwest LLC PIioNE PAx 12100 NE 195th Street,Suite 200 IAIc,Nu Ext1 (425)489 4500. __ (AID,Npipl425p 485-8489 Bothell,WA 98011 ,Ae' y6nDw.If]fUMUbdg4tEl'YfB41C1pol.CGm _ _ .....-,. __..._INSURER(Sj AFFOR{DJNG,COWE,IA4 . --- NAICW INSURER A:Great American Insurance Company 16691 ........ ... ....... __.___ ____. .,..._ ._..,..m ............ ... .... .... . INSURED INSURER B Aquatic Management Group Inc. INSURER — PO Box 129 INSURER D Kent,WA 98035-0129 .... - .____ ___ .... .. ....... INSURER E' INSURER F GOVERAGES__........_—._....................... CERTIFICATE N.UMBEftwww_......_____. 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 SUBR POLICY EFF POLICY EXP V .. 1. TYPE OFINSURANCE NhIq5 W%nn POLICYNUMBER wuue.wr-u uw nnmww LIMITS A X COMMERCIAL GENERAL LIABILITY m PACHQ rLIRRFNCF, 8 1,DDD,DDD . CLAIMSDAMAGETO RENTED 1,000,000 MADE [X OCCUR MAC0666137 04 04115/2016 0411512D19 Iccc F I r X Abuse&Molestation MFO PXP(A— 20,000 PERSQNAI &AnviTl s 1,000,000 CENT,AOGRF{ATF LIMTAPPLIES PER rFNFRAI Pr,.fRFr.ATF S 2,000,000 POLICY dh [X l LOG PRnnnrTc.rOMPrnP Ar,[; x 2,000,000 OTt•44 R: ......... _ __ ........-. __..m....�...._ A LOMk1YNEOSINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITY (LaaTrtQcnU c .. ANY AUTO _ MAC068613704 04/15/2018 04/1512019 BODILY INJJRY(Per oarson7 " OWNED SCHEDULED _......m AUTOS ONLY AUTOS ,.BODILY INJJRY(Per idenll D b _—_ pry�N ppy� (1 p -_,.. ..X.. AU1S ONLY X_ A413'OS QNI.Y VPODf ncL^.�NTAMAC F .. .. ........ __............... ....... _... ... 5 m.. UMBRELLA Line OCCUR EACH OCCURRENCE __ § EXCESS LIAR CLAIMS-MADE AGGREGATE e DE❑ RETENTIONS __ a ..................... A WORKERS COMPENSATION rCTATIITFX DaH- AND EMPLOYERS'LARILITY MAC068613704 0411512018 04/15/2019 1,000,000 AN PROPRIETORIPARTNER/EXECUTIVE YIW EL EACH ACCIDENT F OFF ICERA EMBER EXCLUDED4 NIA - 1,DOO,000 (Mandatory In NH) EL DISEASE EA EMPLOYEE: .B r descnbe under _......: __....... .. yea. 1,000,000 nFSCRIPTInN nF OPERATIONS nalnw Fl DISEASE POLICY LIMIT e ..__. ....._ ....... ..... .... ...._ ...... DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be shouted it more space Is required) Certificate holder is an additional insured per form attached, ____ ............................... ®..... CERTIFICATE HOLDER ... .......... CANCELLATRC'YN..............._...._ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE HI Kline School District Facilities Service Dept. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 P ACCORDANCE WITH THE POLICY PROVISIONS. 17810 8th Ave.S. Burien,WA 98148-1788 --------------'------ -- AUTHORIZED REPRESENTATIVE ..__.................................................... - - _.......... ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Administrative Offices GREAT 301 E 4th street AMERICAN, ClncinnadOH 452OZ-4201 CG 82 24 INSURANCE GROUP 513 ph (Ed. 12 01) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. SOCIAL SERVICE AGENCY GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following provision is added to SECTION (2) With respect to the insurance af- II - WHO IS AN INSURED forded the Additional Insured identified in Paragraph A.(1) of 5. AUTOMATIC ADDITIONAL INSURED(S) this endorsement, the following additional provisions apply: a. Additional Insured - Manager or Lessor of Premises (a) This insurance applies only to liability arising out of the (1) This policy is amended to include ownership, maintenance or as an insured any person or or- use of that portion of the ganization (hereinafter called Ad- premises leased to you. ditional Insured) from whom you lease or rent property and which (b) The Limits of Insurance ap- requires you to add such person plicable to the Additional In- or organization as an Additional sured are the lesser of those Insured on this policy under: specified in the written con- tract or agreement or in the (a) awritten contract; or Declarations for this policy and subject to all the terms, (b) an oral agreement or con- conditions, and exclusions tract where a Certificate of for this policy. The Limits of Insurance showing that per- Insurance applicable to the son or organization as an Additional Insured are inclu- Additional Insured has been sive of and not in addition to issued; the Limits of Insurance shown in the Declarations. but the written or oral contract or agreement must be an "insured (c) In no event shall the cov- contract," and, erages or Limits of Insurance in this Coverage Form be in- (i) currently in effect or be- creased by such contract. come effective during the term of this policy, and (d) Coverage provided herein is excess over any other valid (ii) executed prior to the "bodily and collectible insurance injury," "property damage," available to the Additional In- .'personal and advertising in- sured whether the other in- jury." surance is primary, excess, Includes copyrighted material of Insurance Service Office with its permission. Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12/01) XS (Page 1 of 4) contingent or on any other tomarily provided by the basis unless a written con- policy forms specified in and tractual arrangement specifi- required by the contract. cally requires this insurance to be primary. (c) In no event shall the cov- erages of Limits of Insurance (3) This insurance does not apply to: in this Coverage Form be in- creased by such contract. (a) Any "occurrence" or offense which takes place after you c. Additional Insured - Contractual cease to be a tenant in that Obligations premises. (1) This policy is amended to include (b) Structural alterations, new as an Insured any person or or- construction or demolition ganization (hereinafter called Ad- operations performed by or ditional Insured) that you are re- on behalf of the "Additional quired by a written "insured con- Insured." tract" to include as an Insured, b. Additional Insured Funding subject to all of the following provisions: Sources 1 This policy is amended to include (a) Coverage is limited to liability ( ) p y arising out of: as an Insured any Funding Source which requires you in a written (1) your ongoing oper- contract to name the Funding ations performed for Source (hereinafter called Addi- such Additional Insured, tional Insured) as an Insured but or only with respect to liability aris- ing out of your premises, "your (ii) that Insured's financial work" for such Additional Insured, control of you; or or acts or omissions of such Ad- ditional Insured in connection with (iii) the maintenance, opera- the general supervision of "your tion or use by you of work" and only to the extent set equipment leased to forth as follows: you by such Additional Insured; or (a) The Limits of Insurance ap- plicable to the Additional In- (iv) a state or political sub- sured are the lesser of those division permit issued specified in the written con- to you. tract or agreement or In the Declarations for this policy (b) Coverage does not apply to and subject to all the terms, any "occurrence" or offense: conditions, and exclusions for this policy. The Limits of (i) which took place be- Insurance applicable to the fore the execution of, Additional Insured are inclu- or subsequent to the sive of and not in addition to completion or expira- the Limits of Insurance tion of, the written "in- shown in the Declarations. sured contract", or (b) The coverage provided to (ii) which takes place after the Additional Insured(s) is you cease to be a ten- not greater than that cus- ant in that premises. Includes copyrighted material of Insurance Service Office with its permission. Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12101) XS (Page 2 of 4) (c) With respect to architects, work" done under a contract for that engineers, or surveyors, person or organization and included in coverage does not apply to the "products-completed operations "Bodily Injury," "Property hazard." Damage," "Personal and Ad- vertising Injury" arising out 3. NON-OWNED OR CHARTERED WATER- of the rendering or the fail- CRAFT ure to render any profes- sional services by or for you Section I - Coverages, Coverage A, Item including: 2.g.(2) is replaced with: (i) the preparing, approv- (2) A watercraft you do not own that is: ing, or failing to pre- pare or approve maps, (a) less than 51 feet long, and drawings, opinions, re- ports, surveys, change (b) not being used to carry persons or orders, designs or property for a charge. specifications; and 4. BROADENED PERSONAL AND ADVERTISING (ii) supervisory, inspection, INJURY or engineering services. Unless "Personal and Advertising Injury" is ex- If an Additional Insured endorsement is at- cluded from this policy: tached to this policy and specifically names a person or organization as an Insured, then the SECTION V - DEFINITIONS Item 14. is re- coverage in Section II - WHO IS AN placed by: INSURED 5. Automatic Additional Insured(s) does not apply to that person or organization. 14. "Personal and Advertising Injury" means injury, including consequential "bodily in- jury," arising out of one or more of the following offenses: SECTION IV - COMMERCIAL GENERAL a. false arrest, detention or imprison- LIABILITY CONDITIONS, Item 8. is replaced ment; with: b. malicious prosecution; 8. Transfer of Rights of Recovery Against Others to us and Blanket Waiver of c. the wrongful eviction from, wrongful Subrogation entry into, or invasion of the right of private occupancy of a room, dwelling a. If an Insured has rights to recover all or premises that a person occupies by or part of any payment we have made or on behalf of its owner, landlord or under this Coverage Part, those rights lessor; are transferred to us. The Insured must do nothing after loss to impair them. d. oral, written, televised, videotaped, or At our request, the Insured will bring electronic publication of material, in "suit" or transfer those rights to us and any manner, that slanders or libels a help us enforce them. person or organization or disparages a person's or organization's goods, pro- b. If required by a written "insured con- ducts or services, tract", we waive any right of recovery we may have against any person or e. oral, written, televised, videotaped, or organization because of payments we electronic publication of material, in make for injury or damage arising out any manner, that violates a person's of your ongoing operations or "your right of privacy; or Includes copyrighted material of Insurance Service Office with its permission,. Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12/01) XS (Page 3 of 4) f. mental injury, mental anguish, humili- Subject to 5. above, the Damage to Prem- ation, or shock, if directly resulting ises Rented to You Limit is the most we from Items 14.a. through 14.e. will pay under Coverage A for damages because of "property damage" to your g. the use of another's advertising idea in building, or to personal property of others your "advertisement"; or in your care, custody and control while at premises rented to you or temporarily h. infringing upon another's copyright, occupied by you with permission of the trade dress or slogan in your "adver- owner, arising out of any one fire. tisement." The Damage to Premises Rented To You 5. MENTAL INJURY, MENTAL ANGUISH, Limit is replaced by the following Damage HUMILIATION, OR SHOCK INCLUDED IN to Premises Rented To You Limit. BODILY INJURY DEFINITION The Damage to Premises Rented To You Section V - Definitions, Item 3. is replaced Limit is the greater of: with: (1) $300,000; or 3. "Bodily injury" means physical injury, sick- ness, or disease, including death of a per- (2) the amount shown in the Declarations son. "Bodily injury" also means mental in- for Damage to Premises Rented to jury, mental anguish, humiliation, or shock You Limit. if directly resulting from physical injury, sickness, or disease to that person. B. This provision is subject to all the terms of SECTION III - LIMITS OF INSURANCE. 6. MEDICAL PAYMENTS C. This provision 5. does not apply If Damage to Premises Rent to You Liability of COV- A. The Medical Expense Limit in Paragraph 7. ERAGE A (SECTION 1) is excluded either of SECTION III - LIMITS OF INSURANCE i by the provisions of the Coverage Part or s replaced by the following Medical Ex- by endorsement. pense Limit. The Medical Expense Limit provided by 8. SUPPLEMENTARY PAYMENTS this policy shall be the greater of: A. In the SUPPLEMENTARY PAYMENTS - a. $1D,000; or COVERAGES A and B provision, Item 1.b., and 1.d are replaced with: b. The amount shown in the Declarations 1.b. Up to $500 for cost of bail bonds for Medical Expense Limit. required because of accidents or traf- fic law violations arising out of the use B. This provision 7. is subject to all the terms In- of SECTION III - LIMITS OF INSURANCE. jury any vehicle which the Bodily In- ury Liability Coverage applies. We do not have to furnish these bonds. C. This provision 7. does not apply if COVERAGE C. MEDICAL PAYMENTS is 1.d. All reasonable expenses incurred by excluded either by the provisions of the the Insured at our request to assist us Coverage Part or by endorsement. in the investigation or defense of the claim or "suit," including actual loss of 7. DAMAGE TO PREMISES RENTED TO YOU earnings up to $500 a day because of LIMIT time off work. A. SECTION III - LIMITS OF INSURANCE, This endorsement does not change any other Item 6. is replaced with: provision of the policy. Includes copyrighted material of Insurance Service Office with its permission. Copyright, Insurance Services Office, Inc., 2001 CG 82 24 (Ed. 12/01) XS (Page 4 of 4) Aquatic Management Group, Inc. FA 75 - ,I � Aquatics Management Group PO Box 129 INVOICE NO: 365 Kent WA 98035-0129 DATE: May 25, 2018 i i To: Ship To: Julie Parascondola Aquatics Management Group City of Kent PO Box 129 Kent WA 98035-0129 SALESPERSON P.O. NUMBER DATE SHIPPED I SHIPPED VIA F.O.B. POINT TERMS QUANTITY DESCRIPTION UNIT PRICE AMOUNT j 1 Operations subsidy 2018 $125.000.00 Joe SUBTOTAL SALES TAX SHIPPING & HANDLING TOTAL DUE $125,000.00 Make all checks payable to:Aquatic Management Group If you have any questions concerning this invoice, call: Ken Spencer, 206-824-4722 Ken nethrspencer@comcast.net THANK YOU FOR YOUR BUSINESS!