HomeMy WebLinkAboutPW18-316 - Original - Gray & Osborne, Inc. - 125K Reservoir Recoating Engineer Consulting - 08/09/2018 i ANT Records Management Document
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CONTRACT COVER SWEET
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 253-856-572 .
❑ Blue/Motion Sheet Attached
® Pink Sheet Attached
Vendor Name: Gray & Osborne, Inc.
Vendor Number (JDE):
Contract Number (City Clerk): > ~ 3N LP
Category: Contract Agreement
Sub-Category (if applicable): Other__
Project Name: 125K Reservoir Recoating
Contract Execution Date: Termination Date: 12/31/18
Contract Manager: Mike Almaroof Department: PW: Operations
Contract Amount: $43,500
...... .......
Approval Authority: ❑ Director ® Mayor ❑ City Council
Other Details Grav & Osborne, Inc...
125K Reservoir
upgrade the site ac�essnand�sa#e� In addition to the recoating the City is going to
ty features. m..,v.
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CONSULTANT SERVICES AGREEMENT
between the City of Kent and
Gray & Osborne, Inc,
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Gray & Osborne, Inc. organized under the laws of the State of Washington,
located and doing business at 701 Dexter Ave N, Suite 200, Seattle, WA 98109, Phone: (206) 284-0860,
Contact: Russell Porter (hereinafter the "Consultant").
I. DESCRIPTION OF WORK.
Consultant shall perform the following services for the City in accordance with the following
described plans and/or specifications:
The Consultant shall provide Engineering Consulting services for the 125K Reservoir
Recoating Project. For a description, see the Consultant's Scope of Work which is attached
as Exhibit A and incorporated by this reference.
Consultant further represents that the services furnished under this Agreement will be performed in
accordance with generally accepted professional practices within the Puget Sound region in effect at the
time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in
Section I above immediately upon the effective date of this Agreement. Consultant shall complete the
work described in Section I by December 31, 2018.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed
Forty Three Thousand and Five Hundred Dollars ($43,500.00), for the services described in
this Agreement. This is the maximum amount to be paid under this Agreement for the work
described in Section I above, and shall not be exceeded without the prior written
authorization of the City in the form of a negotiated and executed amendment to this
agreement. The Consultant agrees that the hourly or flat rate charged by it for its services
contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1)
year from the effective date of this Agreement. The Consultant's billing rates shall be as
delineated in Exhibit A.
B. The Consultant shall submit monthly payment invoices to the City for work performed, and
a final bill upon core ion of all services described in this Agreement. The City shall
provide payment within forty-five (45) days of receipt of an invoice. If the City objects to
all or any portion of an invoice, it shall notify the Consultant 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,
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in
accordance with Ch. 51.08 RCW, the parties make the following representations:
CONSULTANT SERVICES AGREEMENT - 1
(Over$20,000)
A. The Consultant has the ability to control and direct the performance and details of its
work, the City being interested only in the results obtained under this Agreement.
B. The Consultant maintains and pays for its own place of business from which
Consultant's services under this Agreement will be performed.
C. The Consultant has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed before the City
retained Consultant's services, or the Consultant is engaged in an independently
established trade, occupation, profession, or business of the same nature as that
involved under this Agreement.
D. The Consultant 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 Consultant has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by Consultant's
business, and has obtained a Unified Business Identifier (UBI) number from the
State of Washington.
F. The Consultant maintains a set of books dedicated to the expenses and earnings of
its business.
V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party thirty (30) days written notice at its address set forth on the signature block of
this Agreement. After termination, the City may take possession of all records and data within the
Consultant's possesslon pertaining to this project, which may be used by the City without restriction. If
the City's use of Consultant's records or data Is not related to this project, it shall be without liability or
legal exposure to the Consultant.
VI. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the
Consultant or subcontractor 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. Consultant
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.
VII. INDEMNIFICA'TiION. Consultant shall defend, indemnify and hold the City, Its officers,
officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or
sullts, including all legal costs and attorney fees, arising out of or In connection with the Consultant'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 Consultant's work when completed shall not be
grounds to avoid any of these covenants of indemnification.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW
4.24.115, then, in the event of liability for damages arising out of bodily Injury to persons or damages to
property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers,
officials, employees, agents and volunteers, the Consultant's duty to defend, indemnify, and hold the City
harmless, and Consultant's liability accruing from that obligation shall', be only to the extent of the
Consultant's negligence,
CONSULTANT SERVICES AGREEMENT - 2
(Over$20,000)
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIA9
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 Consultant 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 Consultant's part, then
Consultant 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 Consultant's part.
The provisions of this section shall survive the expiration or termination of this Agreement.
VIII. INSURANCE. The Consultant 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.
IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide
reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the
work under this Agreement.
X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings,
designs, reports, or any other records developed or created under this Agreement shall belong to and
become the property of the City. All records submitted by the City to the Consultant will be safeguarded
by the Consultant. Consultant shall make such data, documents, and files available to the City upon the
City's request. The Consultant 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. As such, the Consultant agrees to
cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act.
The City's use or reuse of any of the documents, data, and files created by Consultant for this project by
anyone other than Consultant on any other project shall be without liability or legal exposure to
Consultant.
XI. CM'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor
with the authority to control and direct the performance and details of the work authorized under this
Agreement, the work must meet the approval of the City and shall be subject to the City's general right of
inspection to secure satisfactory completion.
XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant 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 Consultant's own risk, and Consultant 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.
XIII. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price
preference may be available for any designated recycled product.
B. Non-Walver of 13reach. 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. Resolutiop of Disputes and Governingw. 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
CONSULTANT SERVICES AGREEMENT - 3
(over$20,000)
of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules
and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred
in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or
award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section VII 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. ssi nment. Any assignment of this Agreement by either party without the written consent
of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment,
the terms of this Agreement shall continue in full force and effect and no further assignment shall be
made without additional written consent.
F. Modiftation. 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 Consultant.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative
of the City, and such statements shall not be effective or be construed as entering into or forming a part
of or altering in any manner this Agreement. All of the above documents are hereby made a part of this
Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any
language contained in this Agreement, the terms of this Agreement shall prevail.
H. Compliance with laws. The Consultant agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable to
Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or
accruing out of the performance of those operations.
I. Public Records Act. The Consultant 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 Consultant agrees to cooperate fully with the City in satisfying
the City's duties and obligations under the Public Records Act.
J• Oy—Iusiness license Requiire�. 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. Quoterparts 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.
CONSULTANT SERVICES AGREEMENT - 4
(over$20,000)
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.
CONSULTANT: CITY OF KENT:
By: By: �
(signature) (signature)
Print Name: Brian L. Sourwine, P.E. Print Name: Dana Ralph
Its Principal Items ^^mayor
DATE:
6/25A8e) DATE: � t�
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Russell Porter, P.E. Timothy 3. LaPorte, P.E.
Gray &Osborne, Inc. City of Kent
701 Dexter Ave N., Suite 200 220 Fourth Avenue South
Seattle, WA 98109 Kent, WA 98032
(206) 284-0860 (telephone) (253) 856-5500 (telephone)
(206) 283-3206 (facsimile) (253) 856-6500 (facsimile)
APPROVED AS TO FORM:
Gf,
Kent Law Department
ATTEST:/
Kent C6t Clerk
CONSULTANT SERVICES AGREEMENT - 5
(Over$20,000)
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 equirements referenced above.
By: "ry
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 1
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
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered
into on the (date), between the firm I represent and the City of
Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 3
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Mr, hlcgdam Almamof
Cit, of Kent
406 West Gosue
Kent.Washingron 98032
SUBJGCI SCOPE OF WOKK FOR 125K RESERVOIR RECOATFNG
CITY OF [CENT, KING COUNTY, WA, HING6I ON
Cr&O d201 Sri_'B
Dery Iblr.Almaroof',
As requested,we are providing this scope of work for coating improvements for the
125A00-gallon elevated 123h` Reservoir_ It is our understanding that rice City intends to
recout the interior and esWrior oFthc 125K Reservoir. Gray&;Oshome provided the City
with a coating assessment memorandum in July 2015 that reconunended exterior and
interior casting replucmnanC A Tooke gauge analysis'of the exterior taken at that time
shorted that the exterior coating likely had lead primer and this was confirmed with
laboratory analysis. The interior was recoated in t991 with Tnemee Series 20 paint and it
is assumed that it does not contain lead, based on the year and point hype,
to addition to reooating,die Ciiv would also like to upgrade the site access and sAtLt
Features of the rcser'crir including the fallowing,items,
• Replacement of the existing vew with a new vent structure similar to the
640 Reservoir.
• Upgrade of the ladder to improve access milli possible improvements
including a continuous slope eliminating the grade change near the lop,
in%estigafina a possible inaerrnediate landing,installation of a ladder cage,
and modilications to the ladder access at the base to improve seauri".
• Installation of a platform landing at the top of the access ladder to altow
easier access to the catwalk from the lower laddec.
• Replacement of canralk guardrail with a higher puardrail system with the
City standard.;ufety cabin system.
PsIr. b(egdarn Almaruof
June 13,2015
Pa,e
• htstallation of roof hatch uccuss improvements.
• froullatien of a guardrail ev rem from the new roof hatch asess pLitfnmi
to the vent structure including the Cr s standard safety-cable system.
• Installation eCehcctrical and comrnunicarions equiprnentincluding securit%
fesiures such as intrusion utarnts and motion detectors; installation of
control,signal,and spare conduits frOrri the reservoir to the control
building upproo mimufy 400 feet away;replacmnent of the pressure
sensinu line with a local>ample tap and pressure transducer,and
provisions in maintain and relocate the existing antenna and possible
fixture amennac. fhe specification will include coordination with Day
VV irelesv to ensure telecom function during and after corutruction.
The xrope of work described below provides engineering assismnce tluvmh design and
bidding_ Additional em+lnaering support dumnc,construction will ba under n separate
contract.
SCOPE OF R ORK
Ckns Oshnma will perfprm the following engineering;services,
• loitial Site A[sit-The initial ste visit will include anoverall inepeaficrn of
the reservoir including all exterior areas easily acecssible by ladders and
camalks. I he initial site visit may also include visiting other resenou
sites,if necessary and applicable,to revietc City olandards for safetq and
access equipment.
• Plan Set Preparation- Plrm-Sheets v:ih 6rclude site location,re&ar�oir
construction and existing accessories,access,available contractor la%down
area,and proposed reservoir modifications. Plans will be prepared based
upon record drawings if availahIe tram the City andbr aenaI phom snap Its.
No curve} will be pnrvidcd_
• S pre ci fi eutions -Recanting and modifieatian teclinieal spectficutiuns will
be prepared in CS[fortnot(DicLsions 1 through 16)and provided to the
City for ineluslon into the bidding documents prepared by City staff A
flvieaf with a swmped engineering seal will he provided for the technicnl
specification portion prepared by Grny&Osborne.
Cost Estimate-A design level cneireeri ng cost estimore vein ba pnry till ed.
iVfr.Mcydam Almarcof'
June 13,2018
Page 3
• Deliverables and City Review—60 and 90 percent plans,technical
specifications,and bid Ilne kern cost estimate will be provided For City
review. Gray&Osborne will attend one review meeting with City staff at
each review stage,
• A final 100 parcent Construction set of plans,technical specification,,and
cast estimate will be provided after City comment on the 90 percent
submittal.
• Gray&Osbome will assist the City during bidding by answering bidder
questions,attending a prebid walkthrough,and reviewing the bids prior to
award-
I'lie not-to-exceed cost for these services is S43,500 for plans,specifications,and cost
estimate. A list of hours and tasks is attached.
Sincerely,
GRAY R;GSBOME,INC.
Russell Porter,P.E_
RLPIhh
Encl.
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 wNch
may arise from or in connection with the performance of the work hereunder
by the Contractor, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
1. Automobile Liability insurance covering all owned, non-owned, hired
and leased vehicles. Coverage shall be written on Insurance Services
Office (ISO) form CA 00 01 or a substitute form providing equivalent
liability coverage. If necessary, the policy shall be endorsed to provide
contractual liability coverage.
2. Commercial general Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability arising from
premises, operations, independent contractors, products-completed
operations, personal injury and advertising injury, and liability
assumed under an insured contract. The Commercial General Liability
insurance shall be endorsed to provide the Aggregate Per Project
Endorsement ISO form CG 25 03 it 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. Workers` Compensation coverage as required by the Industrial
Insurance laws of the State of Washington.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Automobile Liability insurance with a minimum combined
single limit for bodily injury and property damage of
$1,000,000 per accident.
2. Commercial General Liability insurance shall be written with
limits no less than $2,000,000 each occurrence, $2,000,000
general aggregate and a $2,000,000 products-completed
operations aggregate limit.
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 CertiJote of Insurance. The
City reserves the right to receive a certified copy of all required insurance
policies. The Contractor's Commercial General Liability insurance shall
also contain a clause stating that coverage shall apply separately to each
insured against whom claim is made or suit is brought, except with
respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than ANII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Contractor before commencement of the work.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Contractor.
AER fi/2512018 CERTIFICATE OF LIABILITY INSURANCE °A'� 5f2078
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 INSUREi(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the
certificate holder in lieu of Such endorsement(s). "
PRODUCERHall&Company AIiSOn Andrus
19660
96 Pou010th WA Ave
NE PHONE as tlnls 6ha1la11dcomDanY,Dom m Nad�703:,,
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_INSUR@RAS3 AFFORDING COYERACE'. _ NAIC0
INSURER A:Hartford CasuaRV Insurance C.omganv 29424
INSURE° a INSURER a:Travelers Casualty and Surety Comoanv 19038
Grayy S GBborne Inc 9038 ..,
1130'Rainier Avenue South, Suite 300 INSURERC:
SeafRe WA.98144 INSURER D
INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER;6371B9014 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.
TYPE OF INSURANCE !Nsn ,NUM POUCYNUMBEII SAM LIKMERam LIMITS
A X COMMERCIAL GENERAL LIABILITY52SBADU7303 w102017 900201e EACH OCCURRENCE S1000_.Dm
CLAIMS-MADE OCCUR
S 300 000
X GCPIXCLI/aFP[l MEDEXPIArnaneoertenl $10,000
X S°°erau°"I^'n'. PERSONAL A AOV INJURY 111.000.000 _
GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $200(1,0W
PRODUCTS-CO
POLICY PnO' ❑
JFCT LOC LAWOP AGO S$0e)000
GTNER:', S
A AUTOMOBILE LIABILI 52UECJ53273 w102017 w10201B MBVNEO 61NGLEU IT 5
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X ANY AUTO GODLY INJURY(Perperson) 5
ALL OWNED SCHEDULED BOgLV INJURY(PoreccNorn) 5�..
AUTOS _ AUTOS
HIRED AUTOS NON S 04
AUTOS Uemy 5
5
A X UMBRELLA Me X OCCUR 52SBADV7303 WlMD17 8110201e EACH OG:URREN'CE $1.ORLOOD
EXCESS UAB CLAIMS-MADE AGGREGATE S1.000.0N)
DEO X RETENTION S .
Tn rm "s
A WORKERS COMPENSATION 525BADN303 &102017 w102013 slaTi rrE X...FwH_ wA Rim r;an
AND EMPLOYERS'LIABILITY _ __
ANY PROPRmTOREPARTNERIEXECUTPJE YIN E.L.EACHACCIDENT51000.000
OFFfCERIMEMSER EXCLUDED? NIA
IMand At"In,NNj E.L DISEASE-E4 EMPLOVEF E1.000.000
a 11 dow bn,ppPr FO ••••-•
RI'. i5N OPERAToN wbw ELDISEASE-POLICYL1Mn 31,000000
B Pm!®sai0rlel LFab Gehm Merle 105339819 91102017 9110f2wa $1,00g000 Per CWm
PMWaenneb:0avnerxe Foml 51,000,000AMMMe
De3CRIP74ON OF OPERATIONS I LOCATIONS/VP.KMWS JACORD 101,Rddwoml Raman,Schedule,may bu mtIimted U maim speos In mqutmdd
Re:125K Reserwolr ReDdahng
CRy of Kent..Is an additional Insured per wrihen contract or.agreement.between Insured and Insured's cuml on the General Liabibly and Aue mobile Llablgty
re arding Inability arisin�out of achy For
by or an behalf of the named Insured. This Insurance Is primary Insurance and any other Insurance maintained by the
AAdddidlonsi Insured shad be excess only and non-contributing mth this Insurance. A Waller of subrogation applies to tlhe General Liability,Auto Liablllty,&
Employers Liability and Umbrella t Excess Wblllty In favor of the Additional Insured.
CERTIFICATE HOLDER CANCELLA.TN?N
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Kent ACCORDANCE WITH THE POLICY PROVISIONS.
400 West Gowe
Kent WA 98032 Au RePRESENrarnE
z
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
Policy#52SBADU7303
BUSINESS LIABILITY COVERAGE FORM
(b) Rented to, In the care, custody or b. Coverage under this provision does not
control of, or over which physical apply to:
control is being exercised for any (1) "Bodily Injury" or "property damage'
purpose by you, any of your that occurred;or
"employees", "volunteer workers",
any partner or member(if you are (2) "Personal and advertising injury'
a partnership or joint venture), or arising out of an offense committed
any member (it you are a limited before you acquired or formed the
liability company). organzaton.
b. Real Estate Manager 4. Operator Of Mobile Equipment
Any person(other than your"employee"or With respect to"mobile equipment"registered in
volunteer worker"), or any organization your name under any motor vehicle registration
while acting as your real estate manager. law, any person is an insured while ddving such
c. Temporary Custodians Of Your equipment along a public highway with your
Property pemtission. Any other person or organization
Any person or organzation having proper responsible for the conduct of such person is
temporary custody ni your property if you also an insured, but only with respect to liability
die,but only: arising out of the operation of the equipment,and
only if no other insurance of any kind is available
(1) With respect to liability ar sing out of the to that person or organization for this liability.
maintenance or use of that property;and However,no person or organization is an Insured
(2) Until your legal representative has with respect to:
been appointed. a. "Bodily injury' to a co-"employee" of the
d. Legal Representative If You Die parson driving the equipment;or
Your legal representative if you die, but b. "Property damage" to property owned by, .
only with respect to duties as such. That rented to, in the charge of or occupied by
representative will have all your rights and you or the employer of any person who is
duties under this insurance. an insured under this provision.
e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft
Any subsidiary and subsidiary thereof, of With rasped to wsiercraft you do not own that
yours which is a legally incorporated entity is less than 51 feel long and is not being used
of which you own a financial interest of to carry persons for a charge,any person Is an
more than 50% of the voting stock on the Insured while operating such watercraft with
effective date of this Coverage Part. your permission, Any other person or
The insurance afforded herein for any organization responsible for the conduct of
subsid€ary not shown in the Declarations such person is also an insured, but only with
as a named Insured does not apply to respect to liability arising out of the operation
Injury or damage with respect to which an of the watercraft, and only if no other
insured under this Insurance Is also an Insurance of any kind is available to that
insured under another policy or would be person or organization for this liability.
an Insured under such policy but for Its However, no person or organization Is an
termination or upon the exhaustion of Its Insured with respect to:
limits of insurance. a. "Bodily injury" to a co-"employee" of the
3. Newsy Acquired Or Formed Organization person operating the watercraft or
Any organization you newly acquire or form, b. "Property damage" to property owned by,
other than a partnership, joint venture or rented to, in the charge of or occupied by,
limited liability company, and over which you you or the employer of any person who is
maintain financial Interest of more then 50%of an insured under this provision.
the voting stock, will qualify as a Named 5. Additional Insureds When Required By
Insured if there is no other similar insurance Written Contract, Written Agreement Or
available to that organization. However. Permit
a. Coverage under this provision is afforded The person(s) or organization(s) identified in
only until the 180th day after you acquire Paragraphs a. through I. below are additional
or form the organization or the and of the insureds when you have agreed, in a written
policy period,whichever Is earfler,and
Form SS 00 08 04 05 ex ily Page 11 of 24
The Hartford
Policy#52SBAOU7303
BUSINESS LIABILITY COVERAGE FORM
contract, written agreement or because of a (e) Any failure to make such
permit issued by a state or political inspections, adjustments, tests or
subdivision, that such person or organization servicing as the vendor has
be added as an additional Insured on your agreed to make or normally
policy, provided the Injury or damage occurs undertakes to make in the usual
subsequent to the execution of the contract or course of business, in connection
agreement; or the issuance of the permit. with the distribution or sale of the
A person or organization is an additional products;
Insured under this provision only for that (I) Demonstration, installation,
period of time required by the contract, servicing or repair operations,
agreement or permit. except such operations performed
However, no such person or organization is an at the vendor's premises in
connection with the sale of the
additional insured under this provision if such
person or organization Is included as an product;
additional insured by an endorsement issued (g) Products which, after distribution
by us and made a part of this Coverage Part, or sale by you, have been labeled
including all persons or organizations added or relabeled or used as a
as additional Insureds under the specific container, part or Ingredient of any
additional insured coverage grants in Section other thing or substance by or for
F.—Optional Additional Insured Coverages. the vendor,or
a. Vendors (h) "Bodily injury" or "property
Any person(s)or organization(s)(referred to damage" arising out of the sole
below as vendor), but only with respect to negligence of the vendor for its
"bodily injury" or "property, damage" arising own acts or omissions or those of
its employees or anyone else
out of "your products"which are distributed
or sold in the regular course of the vendor's acting on its behalf. However,this
business and only if this Coverage Part exclusion does not apply to:
provides coverage for "bodily injury" or (1) The exceptions contained in
"property damage" included within the Subparagraphs(d)or(f);or
"Products-completed operations hazard". (11) Such inspections, adjustments,
(1) The Insurance afforded to the vendor tests or servicing as the vendor
is subject to the following additional has agreed to make or normally
exclusions: ` undertakes to make In the usual
course of business, in
This insurance does not apply to: connection with the distribution
(a) "Bodily injury" or "property or sale of the products,
damage" for which the vendor is
obligated to pay damages by (2) This insurance does not apply to any
reason of the assumption of insured parson or organization from
whom you have acquired such products,
liability In a contract or agreement
This exclusion does not apply ro e any Ingredient, part container,
liability for damages that the entering into, accompanying
nying or
containing such products.vendor would have in the absence
of the contract or agreement; b. Lessors IN Equipment
(b) Any express warranty (1) Any person or organization from
unauthorized by you; whom you lease equipment; but only
(c) Any physical or chemical change with respect to their liability for"bodily
In the product made Intentionally injury", "properly damage" or
by the vendor, personal and advertising Injury"
caused, in whole or in part, by your
(d) Repackaging, except when maintenance, operation or use of
unpacked solely for the purpose of equipment leased to you by such
inspection, demonstation, testing, person or organization.
or the substitution of parts under
Instructions from the manufacturer,
and then repackaged In the
original container,
Page 12 of 24 Form SS 00 08 04 05
Policy#52SOADu7303 Policy#
52SBADU7303 BUSINESS LIABILITY COVERAGE FORM
(2) With respect to the insurance afforded e. Permits Issued By State Or Political
to these addlllonal Insureds, this Subdivisions
Insurance does not apply to any (1) Any state or political subdivision, but
"occurrence" which takes place after only with respect to operations
you cease to lease that equipment performed by you or on your behalf for
c. Lessors Of Land Or Premises which the state or political subdivision
(1) Any person or organization from has Issued a permit,
whom you lease land or premises, but (2) With respect to the insurance afforded
only with respect to liability arising out to these additional insureds, this
of the ownership, maintenance or use insurance does not apply to:
of that part of the land or premises a "Bodily injury",
leased to you. ( ) y � j nal "property damage"
or "personal and advertising
(2) With respect to the Insurance afforded injury" arising out of operations
to these additional Insureds, this performed for the state or
insurance does not apply to: municipality;or
(a) Any "occurrence" which takes (b) "Bodly injury"or"property damage'
place after you cease to lease that included within the "products-
land or be a tenant in that completed operations hazard".
premises;or f. Any Other Party
(b) Structural alterations, new
constriction or demolition (1) Any other person organization who
is not an insured under Paragraphs a.
operations performed by or on through e, above, but only with
behalf of such person or respect to liability for "bodily injury",
organization. "property damage" or "personal and
d. Architects,Engineers Or Surveyors advertising injury" caused, in whole or
(1) Any architect, engineer, or surveyor,but In part, by your acts or omissions or
only with respect to liability for "bodily the acts or omissions of those acting
Injury", "property damage" or 'personal on your behalf:
and advertising Injury" caused, In whole (a) In the performance or your
or in part, by your acts or omissions or ongoing operations;
the acts or omissions of those aping on (b) In connection with your premises
your behalf: owned by or rented to you;or
(a) In connection with your premises; (c) In connection with"your work"and
or
included within the "products-
(b) In the performance of your completed operations hazard", but
ongoing operations performed by only if
you or on your behalf. (1) The written contract or written
(2) With respect to the insurance afforded agreement requires you to
to these additional Insureds, the provide such coverage to
following additional exclusion applies: such additional insured;and
This insurance does not apply to (11) This Coverage Part provides
"bodily Injury", "property damage" or coverage for "bodily injury" or
"personal and advertising Injury" "property damage" included
arising out of the rendering of or the within the "products-
failure to render any professional completed operations hazard",
services by or for you,including: (2) With respect to the insurance afforded
(a) The preparing, approving, or to these additional insureds, this
failure to prepare or approve, insurance does not apply to:
maps, shop drawings, opinions, "Bodily injury', "property damage" or
reports, surveys, field orders, `personal and advertising injury"
change orders, designs or arising out of the rendering of, or the
drawings and specifications;or failure to render, any professional
(b) Supervisory, inspection, architectural, engineering or surveying
architectural or engineering services, Including:
activities.
Form SS 00 08 04 05 Page 13 of 24
Policy#52SBADU7303
BUSINESS LIABILITY COVERAGE FORM
(a) The preparing, approving, or This General Aggregate limit does not
failure to prepare or approve, apply to "properly damage" to premises
maps, shop drawings, opinions, while rented to you or temporarily
reports, surveys, field orders, occupied by you with permission of the
change orders, designs or owner, arising out of fire, lightning or
drawings and specifications;or explosion.
(b) Supervisory, Inspection, 3. Each Occurrence Limit
architectural or 'engineering Subject to 2.a. or 2.b above, whichever
activities. applies, the most we will pay for the sum of all
The limits of insurance that apply to additional damages because of all "bodily injury",
insureds are described in Section D. — Limits "property damage" and medical expenses
Of Insurance, arising out of any one "occurrence" is the
How this insurance applies when other Liability and Medical Expenses Limit shown in
insurance is available to an additional insured the Declarations.
Is described in the Other Insurance Condition The most we will pay for all medical expenses
In Section E-—Liabilty And Medical Expenses because of "bodily injury" sustained by any
General Conditions, one person Is the Medical Expenses Limit
No person or organization is an insured with shown in the Declarations,
respect to the conduct of any current or past 4. Personal And Advertising Injury Limit
partnership, joint venture or limited liability Subject to 2.b. above,the most we will pay for
company that is not shown as a Named Insured in the sum of all damages because of all
the Declarations.
"personal and advertising Injury" sustained by
D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal
LIMITS OF INSURANCE and Advertising Injury Limit shown in the
1, The Most We Will Pay
Declarations.
g5. Damage To Promises Rented To You Limit
Declarations and the r
The Limits e rules
shown In thes below fix the most The Damage To Promises Rented To You
we will pay regardless of the number of. Limit Is the most we will pay under Business
a. Insureds; Liability Coverage for damages because of
property damage" to any one premises, while
b. Claims made or"suits"brought; or rented to you,or in the case of damage by fire,
c. Persons or organizations making claims or lightning or explosion, while rented to you or
bringing "suits". temporarily occupied by you with permission of
2. Aggregate Limits the owner.
The most we will pay for; In the case of damage by fire, lightning or
explosion,the Damage to Premises Rented To
a. Damages because of 'bodily Injury" and
"prope dame You Limit applies to all damage proximately
rty damage" included In the caused by the same event, whether such
"products-completed operations hazard" is damage results from fire, lightning or explosion
the Products-Completed Operations or any combination of these.
Aggregate Limn shown In the Apply
Declarations. 6. How Limits I To Additional Insureds
It. Damages because of all other "bodily The most we will pay on behalf of a person or
injury", "property damage" or "personal organization who is an additional insured
and advertising injury", including medical under this Coverage Part is the lesser of.
expenses,,is the General Aggregate Limit a. The limits of insurance specified in a
shown in the Declarations. written contract, written agreement or
This General Aggregate Limit applies permit issued by a state or political
separately to, each of your "locations" subdivision;or
owned by or rented to you. b. The Limits of Insurance shown In the
"Location" means premises involving the Declarations.
same or connecting lots, or premises Such amount shall be a part of and not In
whose connection is interrupted only by a addition to the Limits of Insurance shown in
street, roadway or right-of-way of a the Declarations and described in this Section.
railroad.
Page 14 of 24 Form SS 00 08 04 05
Policy#52SBADU7303
BUSINESS LIABILITY COVERAGE FORM
If more than one limit of insurance under this (1) immediately send us copies of any
policy and any endorsements attached thereto demands, notices, summonses or
applies to any claim or"suit", the most we will pay legal papers received, in connection
under this policy and the endorsements is the with the claim or°suit";
single highest limit of liability of all coverages (2) Authorize us to obtain records and
applicable to such claim or "suit". However„ this other information;
paragraph does not apply to the Medical Expenses
limit set forth In Paragraph 3.above. (3) Cooperate with us In the investigation,
settlement of the Balm or defense
The Umits of Insurance of this Coverage Part apply against the"suit";and
separately to each consecutive annual period and to {4) Assist us, upon our request, In the
any remaining period of less than 12 months,startling enforcement any right against any
with the beginning of the policy period shown In the parson or organization that may be
Declarations, unless the policy period is extended
after issuance for an additional period of less than 12 liable to the insured because of injury
months. In that, case, the additonal period w5l be or damage to which this insurance
deemed art of the last preceding may also apply.
P p g period for Obligations At The Insured's Own Cost d, Obli
of determining the Umits of Insurance. 9
E. LIABILITY AND MEDICAL EXPENSES No Insured wtfl, except at that insured's own
GENERAL CONDITIONS cost, voluntarily make a payment, assume
any obligation, or Incur any expense, other
1. Bankruptcy than for first aid,wMout our consent.
Bankruptcy or insolvency of the insured or of 6. Additional Insured's Other Insurance
the insured's estate will not relieve us of our If we cover a claim or "suit" under this
obligations under this Coverage Part. Coverage Part that may also be covered
2. Duties In The Event Of Occurrence, by other insurance available to an
Offense,Claim Or Suit additional Insured, such additonal insured
a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the
other insurer for defense and indemnity.
You or any additional insured must see to
it-that we are notified as soon as However, this provision does not apply to
practicable of an "occurrence" or an the extent that you have agreed in a
offense which may result in a claim. To written contract, written agreement or
the extent possible, notice should include: permit that this insurance is primary and
non-contributory with the additional
(1) How,when and where the "occurrence" insured's own insurance.
or offense took place;
f. Knowledge Of An Occurrence, Offense,
(2) The names and addresses of any Claim Or Suit
injured persons and witnesses; and
Paragraphs a.al and rb.e apply to you or to
(3) The nature and location of any Injury
any additional Insured only when such
or damage arising out of the "occurrence", offense, claim or "suit" Is
occurrence"or offense. known to:
b. Notice Of Claim (1) You or any additional insured that is
If a claim is made or "suit" is brought an individual;
against any insured, you or any additional
Insured must (2) Any Partner, if you or an additional
Insured is a partnership;
(1) Immediately record the specifics of the (3) Any manager, If you or an additional
claim or "suit" and the date received; insured Is a limited liability company;
and
(2) Nobly,us as soon as practicable. (4) Any "executive officer'
manager, If you orr an
insurance
additional
You or any additional insured must see to insured is a corporation;
It that we receive a written notice of the
claim or"suit"as soon as practicable. {5) Any trustee, If you or an additional
insured is a trust; or
c. Assistance And Cooperation Of The (6) Any elected or appointed official, if you
Insured or an additional Insured is a political
You and any other involved insured must subdivision or public entity.
Form SS 00 08 04 05 Page 16 of 24
Pdicy#525BADU7303
BUSINESS LIABILITY COVERAGE FORM
This Paragraph f. applies separately to (3) We have issued this policy in reliance
you and any additional insured. upon your representations.
3. Financial Responsibility Laws b. Unintentional Failure To Disclose
a. When this policy is certified as proof of Hazards
financial responsibility for the future under If unintentionally you should fall to disclose
the provisions of any motor vehicle all hazards relating to the conduct of your
financial responsibility law, the insurance business at the inception dale of this
provided by the policy for 'bodily injury" Coverage Part, we shall not deny any
liability and "property damage"liability will coverage under this Coverage Part
comply wish the provisions of the law to because of such failure.
the extent of the coverage and limits of 7, Other Insurance
insurance required by that law.
b. With respect to "mobile equipment" to If other valid and collecUble Insurance Is
which this Insurance applies, we will available for a loss we cover under this
provide any liability, uninsured motorists, Coverage Part, our obligations are limited as
underinsured motorists, no-fault or other follows:
coverage required by any motor vehicle a. Primary Insurance
law, We will provide the required limits for This insurance is primary except when b.
those coverages, below applies. If other Insurance is also
4. Legal Action Against Us primary, we will share with all that other
No person or organization has a right under insurance by the method described In c.
this Coverage Form: below.
a. To join us as a party or otherwise bring us b. Excess Insurance
into a "suit' asking for damages from an This Insurance is excess over any of the
insured; or other insurance, whether primary, excess,
b. To sue us on this Coverage Form unless contingent or on any other basis:
all of its terms have been fully complied (1) Your Work
with. That is Fire, Extended Coverage,
A person or organization may sue us to recover Builder's Risk, Installation Risk or
on an agreed settlement or on a final judgment similar coverage for"your work";
against an insured;, but we will not be liable for (2) Premises Rented To You
damages that are not payable under the terms of
this insurance or that are in excess of the That Is fire, lightning or explosion
applicable limit of insurance. An agreed insurance for premises rented to you
settlement means a settlement and release of or temporarily occupied by you with
liability signed by us, the Insured and the permission of the owner;
claimant or the claimants legal representative. (3) Tenant Liability
y ^ S. Separation Of Insureds That Is insurance purchased by you to
Except with respect to the Limits of Insurance, cover your liability as a tenant for
and any rights or duties specifically assigned "property damage'to premises rented
in this policy to the first Named Insured, this to you or temporarily occupied by you
insurance applies: with permission of the owner;
a. As If each Named Insured were the only (4) Aircraft,Auto Or Watercraft
Named Insured;and 8 the loss arises out of the maintenance
b. Separately to each insured against whom or use of aircraft "autos"or watercraft to
a claim is made or"suit"Is brought the extent not subject to Exdudon g.of
6. Representations SectionA.—Coverages.
a, When You Accept This Policy (5) Properly Damage To Borrowed
Equipment Or Use Of Elevators
By accepting this policy,you agree: if the lass arises out of *property
(1) The statements in the Declarations damage" to borrowed equipment or
are accurate and complete; the use of elevators to the exient not
(2) Those statements are based upon subject to Exclusion k. of Section A.—
representations you made to us;and Coverages.
Page 16 of 24 Form SS 00 08 04 05
Policy#52SRADU7303
BUSINESS LIABILITY COVERAGE FORM
(6) When You Are Added As An When this insurance Is excess over other
Additional Insured To Other insurance, we will pay only our share of
Insurance the amount of the loss, if any, that
That is other insurance available to exceeds the sum of:
you covering liability for damages (1) The total amount that all such other
arising out of the premises or insurance would pay for the loss In the
operations,or products and completed absence of this Insurance;and
operations, for which you have been (2) The total of all deductible and self-
added as an additional insured by that insured amounts under all that other
insurance;or'
Insurance.
(7) When You Add Others As An We will share the remaining loss,if any,with
Additional Insured To This any other insurance that is not described in
Insurance this Excess Insurance provision and was not
That is other insurance available to an bought specifically to apply in excess of the
additional insured. Limits of Insurance shown In the
However, the following provisions Declarations of this Coverage Part
apply to other insurance available to c. Method Of Sharing
any person or organization who is an If all the other insurance permits
additional insured under this Coverage contribution by equal shares,we will follow
Part. this method also. Under this approach,
(a) Primary Insurance When each insurer contributes equal amounts
Required By Contract until it has paid Its applicable limit of
This insurance is primary if you Insurance or none of the loss remains,
have agreed In a written contract, whichever comes first.
written agreement or permit that If any of the otter Insurance does not permit
this insurance be primary. If other contribution by equal shares, we will
insurance is also primary, we will contribute by limits. Under this method,each
share with all that other insurance insurer's share is based on the ratio of its
by the method described in c. applicable limit of insurance to the total
below. applicable emits of insurance of all insurers.
(b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against
To Other Insurance When Others To Us
Required By Contract a. Transfer Of Rights Of Recovery
If you have agreed In a written If the insured has rights to recover all or
contract, written agreement or
permit that this insurance is pan of any payment including
Supplementary Payments, we have made
primary and non-contributory with under this Coverage Parl, those rights are
the additional Insured's own transferred to us. The Insured must do
Insurance, this Insurance is nothing after loss to Impair them. At oyr;
primary and we will not seek request, the Insured will bring "suit" or
contribution from that other transfer those rights to us and help us
insurance. enforce them. This condition does not
Paragraphs(a)and (b)do not apply to apply to Medical Expenses Coverage.
other insurance to which the additional 'b, Waiver Of Rights Of Recovery (Waiver
insured has been added as an Of Subrogation)
additional Insured.
If the insured has waived any rights of
When this insurance is excess, we will recovery against any person or
have no duty under this Coverage Part to organization for all or part of any payment,
defend the insured against any"suit"if any including Supplementary Payments, we
other Insurer has a duty to defend the have made under this Coverage Part, we
insured against that "suit". If no other also waive that right, provided the insured
insurer defends, we will undertake to do waived their rights of recovery against
so, but we will be enUUed to the insured's such person or organization In a contract,
rights against all those other insurers. agreement or permit that was executed
prior to the injury or damage.
Form SS 00 08 04 05 Page 17 of 24
Policy p 52UECJS3276
. t
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED AND
RIGHTS OF RECOVERY AGAINST OTHERS
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
A. Any person or organization whom you are required by contract to name as additional insured is an
"insured" for LIABILITY COVERAGE but only to the extent that person or organization qualifies as an
"insured" under the WHO IS AN INSURED provision of Section II-LIABILITY COVERAGE.
B. For any person or organization for whom you are required by contract to provide a waiver of subrogation,
the Loss Condition-TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable.
Form HA 9913 0187 Printed in U.S.A.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S)
This policy is subject to the following additional Conditions:
m
a
N
O
N
A. If this policy is cancelled by the Company, other If notice Is mailed, proof of mailing to the last known
N than for non-payment of premium, notice of such mailing address of the certificate holder(s) on file with
cancellation will be provided at least thirty (30)days the agent of record or the Company will be sufficient
in advance of the cancellation effective date to the proof of notice.
ncertificate holder(s) with mailing addresses on file Any notification rights provided by this endorsement
a with the agent of record or the Company.
o apply only to active certificate holder(s)who were issued
oB. If this policy is cancelled by the company for non- a certificate of insurance applicable to this policy's term.
c payment of premium, or by the insured, notice of Failure to provide such notice to the certificate holder(s)
such cancellation will be provided within [en (10) will not amend or extend the date the cancellation
days of the cancellation effective date to the becomes effective, nor will it negate cancellation of the
o certificate holder(s) with mailing addresses on file policy. Failure to send notice shall impose no liability of
with the agent of record orthe Company. any kind upon the Company or its agents or
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Form SS 12 23 06 11 Page 1 of 1
0 2011,The Hartford
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S)
This policy is subject to the following additional If notice is mailed, proof of mailing to the last known
Conditions: mailing address of the certificate holder(s) on file with
A. If this policy is cancelled by the Company, other the agent of record or the Company will be sufficient
than for nonpayment of premium, nofice of such proof of notice.
cancellation will be provided at least thirty (30) Any notification rights provided by this endorsement
days in advance of the cancellation effective date
to the certificate holder(s) with mailing addresses apply only to active certificate holder(s) who were
Issued a certificate of insurance applicable to this
on file with the agent of record or the Company. policy's term.
B. If this policy is cancelled by the Company for Failure to provide such notice to the certificate
nonpayment of premium, or by the Insured, notice holder(s) will not amend or extend the date the
of such cancellation will be provided within (10) cancellation becomes effective, nor will it negate
days of the cancellation effective date to the cancellation of the policy. Failure to send notice shall
certificate holder(s) with mailing addresses on file impose no liability of any kind upon the Company or its
with the agent of record or the Company. agents or representatives.
Form IH 03 13 06 11 Page 1 of 1
0 2011,The Hartford
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