HomeMy WebLinkAboutPK18-397 - Original - Kent Youth and Family Services - Contract - 10/08/2018 NT Records Management Document
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to the City Clerk's Office. All portions are to be completed.
If you have questions, please contact the City Clerk's Office at 253-856-5725.
Blue/Motion Sheet Attached
Pink Sheet Attached
Vendor Name: Kent Youth and Family Services
Vendor Number (JDE): 33841
Contract Number (City Clerk): � �1�
Category: Contract Agreement
Sub-Category (if applicable): Qho0 se_an__1g'.,n .............
....._...
Project Name: Olweus Bullvino Prevention
Contract Execution Date: 10-8-18 Termination Date: 12-31-18
Contract Manager: Lori Guilfoyle Department: Parks
Contract Amount: $10,000
Approval Authority: ® Director ❑ Mayor ❑ City Council
Other Details:
KENT
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
Kent Youth and Family Services
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter
the "City"), and Kent Youth and Family Services organized under the laws of the State of Washington,
located and doing business at 232 S. 2n0 Ave #201 (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:
Consultant shall provide the Olweus Bullying Prevention Program to Kent Youth. Goals of the
program include: reduce existing bullying issues among students, prevent the development
of new bullying issues, provide drug resistance education and achieve better peer
relationships.
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
$10,000, 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 quarterly payment invoices to the City for work performed, and
a final bill upon completion 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 KCW, the parties make the following representations:
CONSULTANT SERVICES AGREEMENT - 1
($20,000 or Less)
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 possession 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.
VI I. INDEMNIFICATION. 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
suits, 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
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER )NDUSTRIAL
CONSULTANT SERVICES AGREEMENT - 2
($20,000 or Less)
INSIIRAACF, 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 anc 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, CITY'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. ReS,yc_NaFnle_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. f4,o11„rf,A[w�;r s f„ r yi,,. 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. ResoButioir of Doslauteind Gygrning Law'. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any
dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means
of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules
and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred
CONSULTANT SERVICES AGREEMENT - 3
($20,000 or Less)
in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or
award provided by law; rOp vided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section VII of this Agreement.
D. Witten Mice. 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. Ass1l e t. 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. iQSIIfIcaCY4n. 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. 4 4gCtSfllgnk• 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. ;7,gmgliance y i,th 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.
Lgsiness i icen g f gg ,p g 1, Prior to commencing the tasks described in Section 1,
Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5,01 of the
Kent City Code.
K. Ciawwwwi Is and Sign atures ty rax_Qr_ErUaj. 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
($20,000 or Less)
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:
/J r
+r � i /-f--- ------- Print N (sr�7r dE re
r rrd#rr'�)
Print N me:, Name: Merino Hanson
Its: �,x1e. Human Sevices Manager
l a!v.
DATE: i4 i DATE: ._.�. j
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Mike Heinisch, Executive Director Lori Guilfoyle
Kent Youth and Family Services City of Kent
232 South 2n0 Ave, #201 220 Fourth Avenue South
Kent, WA 98032 Kent, WA 98032
253.859.0300 (telephone) (253) 253.856.707C (telephone)
253.859.0745 facsimile 253 253.865.6070 facsimile
ATTEST:
,lfenk City--lerk
CONSULTANT SERVICES AGREEMENT - 5
($20,000 or Less)
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.
1 During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer,
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing(below, I agree to fulfill the five requirements referenced above.
For ��� _For! �� a v���
Title: ✓� ' P r'acfid ,�
Date: yG0'f ✓'d�
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 ..w__....w- _ ._..._ (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
/ Exhibit A Criminal Justice
�✓ KEIT 2018 Billing Voucher
and Service Report
RA6'KS' RECGEAMIN 5
�U WI M WV I rY >E RV ICES;
To: Agency: Kent Youth & Family Services
Lori Guilfoyle
Housing & Human Services
Parks,hRecreation & Community Services Program Contact: Cyoon McBride
2204 Ave. South, Kent, WA 98032 Telephone: 206 354-6797
Iguilfoyle@kentWA.gov E-mail: cyoonm@kyfs.org
Phone: (253) 856-5070
Reporting Program Amount
Period Requested
Fourth Quarter Bullying Prevention Program $
BUDGET SUMMARY
FOR DEPARTMENT USE ONLY Total Contract Amount $ 10,000
VENDOR NUMBER #33841 Current Request $
Amount Remaining $
2018 KENT FUNDED SERVICE UNITS
Note: Unduplicated client counts must be reported both quarterly and year-to-date
New City of Total
Kent Total Kent Service
Funded
Service Unit Description Service Units Planned Funded Service Service Units to
Date (ALL
Units This Units To Funding
Ouarter Date Sources)
..._._.., ......._......................... ......... ---
Service Unit/Performance Measure
Olweus Bullying Prevention Program Offered to Kent Youth
._ ... .. .._... �.. ......... -....._..... .... ..... ._._._.... -----...
Drug resistance Education Offered to Kent Youth
*Please attach a narrative explanation to this report in the event that the program is not meeting
performance measures.
Authorized Signature - must be signed by Executive Director Date
FOR DEPARTMENT USE ONLY
AUTHORIZED FOR PAYMENT
DATE;tE ................. ... _.---------- -, ,...__ _.
EXHIBIT B
INSURANCE REQUIREMENTS FOR
HUMAN SERVICES GENERAL FUND AGREEMENTS
Insurance
The Contractor shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which may
arise from or in connection with the performance of the work hereunder by the
Contractor, their agents, representatives, employees or subcontractors.
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
I. G<arrorn. rciaL... cneraU Lia.kiPi'ky insurance shall be written on ISO occurrence
form CG 00 01 and shall cover liability arising from premises, operations,
independent contractors, products-completed operations, personal injury and
advertising injury, and liability assumed under an insured contract, The
Commercial General Liability insurance shall be endorsed to provide the
Aggregate Per Project Endorsement ISO form CG 25 03 11 85. There shall
be no endorsement or modification of the Commercial General Liability
insurance for liability arising from explosion, collapse or underground
property damage. The City shall be named as an insured under the
Contractor's Commercial General Liability insurance policy with respect to the
work performed for the City using ISO additional insured endorsement CG 20
10 11 85 or a substitute endorsement providing equivalent coverage.
2. Automobile Labi& 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,
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. omercial General Liabili insurance shall be written with limits no less
than $1,000,000 each occurrence, $1,000,000 general aggregate and a
$1,000,000 products-completed operations aggregate limit.
2. Automobile Liability, insurance with a minimum combined single limit for
bodily injury and property damage of $1,000,000 per accident.
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:
EXHIBIT B (Continued)
1. The Contractor's insurance coverage shall be primary insurance as respect the
City. Any Insurance, self-insurance, or insurance pool coverage maintained by
the City shall be excess of the Contractor's insurance and shall not contribute
with it.
2. The Contractor's insurance shall be endorsed to state that coverage shall not be
cancelled by either party, except after thirty (30) days prior written notice by
certified mail, return receipt requested, has been given to the City.
3. The City of Kent shall be named as an additional insured on all policies (except
Professional Liability) as respects work performed by or on behalf of the
contractor and a copy of the endorsement naming the City as additional insured
shall be attached to the Certificate of Insurance. The City reserves the right to
receive a certified copy of all required insurance policies. The Contractor's
Commercial General Liability insurance shall also contain a clause stating that
coverage shall apply separately to each insured against whom claim is made or
suit is brought, except with respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not less
than ANII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the
amendatory endorsements, Including but not necessarily limited to the additional
insured endorsement, evidencing the insurance requirements of the Contractor
before commencement of the work.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or shall
furnish separate certificates and endorsements for each subcontractor. All
coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Contractor.
KenIYFS55Revi5ed
Non Profit Insurance Program
CERTIFICATE OF COVERAGE Issue Date: 05/19/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CFRTIFI CATE DOES
NOT AMEND,EXTEN D OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONSOTUE A CONTRACT
BETWEEN THE ISSUING INSURER(SI,AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(es)must be endorsed If SUBROGRATION IS WAIVED,sublect to the terms and conditions of
the policy,certain coverage may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER COMPANIES AFFORDING COVERAGE
',. GENERAL LIABILITY
Clear Risk Solutions American Alternative Insurance Corporation, et al.
451 Diamond Drive
Ephrata, WA 98823 AUTOMOBILE LIABILITY
American Alternative Insurance Corporation,et al.
INSURED
PROPERTY
Kent Youth and Family Services American Alternative Insurance Corporation,et al.
232 2nd Avenue South MISCELLANEOUS PROFESSIONAL LIABILITY
Kent, WA 98032 Princeton Excess and Surplus Lines Insurance Company
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
INDICATED, NOT WITHSTANDING ANY REVUIREMENI. TERM OR CONDTHON Or CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLCIES 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 POLICY NUMBER, POLD D ICATE FF POLICCYE XP DESCRIPTION LIMITS
Ai
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY NH-URLA00001309 0610112018 OW0112020 PEROCCURRENCE $51000WO
OCCURRENCE FORM PER MEMBER AGGREGATE $10,000,000
INCLUDES STOP GAP PRODUCLCOMP/OP $5,000,000
PERSONAL III INJURY $5,000,000
(LIABILITY IS SUBJECT TO A$50.000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $50,000,000
AUTOMOBILE LIABILITY `
ANY AUTO Ni A2.RL-000001 3 09 O61t}1f2018 06/01/2020 COMBINED SINGLE LIMIT $5.000,000
LIABILITY IS StIBIECT TOA$50ADO SIR PAYABLE FROM PROGRAM FUNDS) ANNUALPOOLAGGRFGAIE NOONE:
PROPERTY
NI AZ 10000013.09 0610112010 06/0112020 ALL RISK PER OCC EXCL EC a FL $75,060,000
EARTHQUAKE PER OCC $1,000,000
FLOOD PER OCC $1,000,000
(PROPERTY IS SUBJECT TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
MISCELLANEOUS PROFESSIONAL LIABILITY
N1-A3 RL�000006009 06/0112018 0610112020 PER CLAIM $1,000,000
LIABILITY 15 SUBJECT TO $SO 000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I SPECIAL ITEMS
Regarding funding received. The City of Kent, its elected,and appointed officials are named as Additional
Insured regarding this funding only and are subject to policy terms,conditions, and exclusions. Additional
Insured endorsement is attached.
CANCELLATION
SHOULD ANY OF THE ADOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE
MYTH I THE POLI CY PROVISIONS.
CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE
644
Ci0 tyy of Kent
22 4th Ave 5
Kent,WA 98032 _
3393639
AMERICAN ALTERNATIVE
INSURANCE COMPANY
ADDITIONAL INSURED- DESIGNATED PERSON OR ORGANIZATION
(GENERAL LIABILITY)
Named Insured
Non Profit Insurance Program (NPIP)
Policy Number Entlorsemen[Effective
N1 A2 RL-000001309 W11201B
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
This endorsement modifies insurance provided under the following:
GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above.
Schedule
Person or Organization(Additional Insured): As Per Schedule on file with Clear Risk Solutions, Underwriting Administrator
City of Kent
220 4th Ave S
Kent,WA 96032
Regarding funding received.The City of Kent,its elected,and appointed officials are named as Additional
Insured regarding this funding only and are subject to policy terms,conditions,and exclusions.Additional
Insured endorsement is attached.
A. With respects to the General Liability Coverage Part only,the definition of Insured in the Liability Conditions, Definitions
and Exclusions section of this policy is amended to include as an Insured the Person or Organization shown in the above
Schedule.Such Person or Organization is an Insured only with respect to liability for Bodily Injury, Property Damage,or
Personal and Advertising Injury caused in whole or in part by your acts or omissions or the acts or omissions of those
acting on your behalf,
1, In performance of your ongoing operations;or
2, In connection with your premises owned or rented to you.
B. The Limits of Insurance applicable to the additional Insured are those specified in either the:
1, Written contract or written agreement;or
2. Declarations for this policy,
whichever is less.These Limits of Insurance are inclusive and not in addition to the Limits Of Insurance shown in the Declarations.
All other terms and conditions remain unchanged.
Includes copyrighted material of the Insurance Services Office, Inc.,with its permission„
RL 2163 12112 Page 1 or 1
3393640