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PK18-421 - Original - Sea-Tac Sweeping Service - Snow Plowing at Various Facilities - 11/06/2018
.- 'NT Records Management Document CONTRACT COVER SHEET A'll iiis is to be completed by the Contract Manager prior to suubraniission to the City Clerk's Office.. Ail portioins are to be completed. 1f you have questions, please contact the City Clerk's Office at, .253-856-5725.. ❑ Blue/Motion Sheet Attached ❑ Pink Sheet Attached Vendor Name: Sea-Tac Sweeping Service .... ........ .... Vendor Number (JDE): 34267 Contract Number (City Clerk): nK1FS- ` �21 Category: Contract Agreement Sub-Category (if applicable) Project Name: Snow Plowing Agreement 10/2018 OS/2019 Various Facilities Contract Execution Date: 11/06/18 Termination Date: 05/31/2019 Contract Manager: Nancy Clary Department: Parks Contract Amount: $7,500 Approval Authority: ❑ Director ❑ Mayor ❑ City Council X Facilities Management Superintendent Other Details: p KENT GOODS & SERVICES AGREEMENT between the City of Kent and Sea-Tac Sweeping Service THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Sea-Tac Sweeping Service organized under the laws of the State of Washington, located and doing business at 26305 79th Ave S, Kent 98032, Simone Vinson, 253 854-9707, info@seatacsweeping,com (hereinafter the "Vendor"). AGREEMENT I. DESCRIPTION OF WORK. Vendor shall provide the following goods and materials and/or perform the following services for the City; SeaTac Sweeping shall] provide snow plowing services on an as needed basis at the rate of $325 per hour at the following City of Kent locations: City Hall, Commons, Corrections, Municipal Court and Senior Center, in accordance with the Show Plowing Agreement which is attached and incorporated as Exhibit A, Vendor acknowledges and understands that it is not the Clty's exclusive provider of these goods, materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and services through other sources. II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete the work and provide all goods, materials, and services by May 31, 2019, III. COMPENSATION. The City shall pay the Vendor an amount not to exceed $7,500.00, including applicable Washington State Sales Tax, for the goods, materials, and services contemplated in this Agreement, The City shall pay the Vendor the following amounts according to the following schedule; Vendor shall invoice as work is complete, Net Terms; 30 days I If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option to only pay that portion of the Invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. GOODS & SERVICES AGREEMENT - 1 ($20,000 or Less, incl. WSST) NA. f4k --Qr U I WQ.,k The City reserves its right to withhold payment from Vendor for any defective or unauthorized goods, materials or services. If Vendor Is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services from other sources, and Vendor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, Incurred by the City beyond the maximum Agreement price specified above, The City further reserves Its right to deduct these additional costs incurred to complete this Agreement with other sources, from any and all amounts due or to become due the Vendor, B, Fi VENDOR'S ACCEPTANCE OF FINAL PAYMENT SHALL CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR FINAL PAYMENT IS MADE, IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor- Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: A. The Vendor has the ability to control and direct the performance and details of Its work, the City being interested only in the results obtained under this Agreement. B, The Vendor maintains and pays for Its own place of business from which Vendor's services under this Agreement will be performed. C. The Vendor has an established and independent business that is eligible for a business deduction for federal Income tax purposes that existed before the City retained Vendor's services, or the Vendor is engaged in an independently established trade, occupation, profession, or business of the same nature as that Involved under this Agreement. D„ The Vendor Is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, Including the Internal Revenue Service and the state Department of Revenue, E, The Vendor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Vendor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Vendor maintains a set of books dedicated to the expenses and earnings of its business, V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement, VI. CHANGES. The City may issue a written amendment for any change in the goods, materials or services to be provided during the performance of this Agreement, If the Vendor determines, for any reason, that an amendment Is necessary, Vendor must submit a written amendment request to the person listed in the notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days of the date Vendor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Vendor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all equitable adjustments, However, If the parties are unable to agree, the City will determine the equitable adjustment as It deems appropriate, The Vendor shall proceed with the amended work upon receiving either a written amendment from the City or an oral order from the City before actually receiving the written amendment. If the Vendor fails to require an GOODS & SERVICES AGREEMENT - 2 ($20,000 or Less, Including WSST) amendment within the time allowed, the Vendor waives its right to make any claim or submit subsequent amendment requests for that portion of the contract work, If the Vendor disagrees with the equitable adjustment, the Vendor must complete the amended work; however, the Vendor may elect to protest the adjustment as provided In subsections A through E of Section VII, Claims, below. The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. An amendment that Is accepted by Vendor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. VII. CLAIMS. If the Vendor disagrees with anything required by an amendment, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Vendor may file a claim as provided in this section, The Vendor shall give written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14) calendar days of the date the Vendor knew or should have known of the facts or events giving rise to the claim, whichever occurs first , Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been waived by the Vendor unless a timely written claim Is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Vendor's written claim shall include the information set forth in subsections A, items 1 through 5 below. FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY. A. [y®tJgQ__gf Clain}. Provide a signed written notice of claim that provides the following information: 1, The date of the Vendor's claim; 2, The nature and circumstances that caused the claim; 3. The provisions in this Agreement that support the claim; 4. The estimated dollar cost, if any, of the claimed work and how that estimate was determined; and 5. An analysis of the progress schedule showing the schedule change or disruption if the Vendor is asserting a schedule change or disruption. B,, Life o: . The Vendor shall keep complete records of extra costs and time incurred as a result of the asserted events giving rise to the claim. The City shall have access to any of the Vendor's records needed for evaluating the protest. The City will evaluate all claims, provided the procedures in this section are followed. If the City determines that a claim is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. C, Y4l c6s C7 tly toarBpic>lr Piotc*s..t_rd 4adr _k. In spite of any claim, the Vendor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. D, j ailu f>__tn P.rL;rt54{mI} gj}ites Wc�Ive}. By not protesting as this section provides, the Vendor also waives any additional entitlement and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). E. railure to Flaw Prog�r_}axes Canstlts yjyE. By falling to follow the procedures of this section, the Vendor completely waives any claims for protested work and accepts from the GOODS & SERVICES AGREEMENT - 3 ($20,000 or Less, including WSST) City any written or oral order (including directions, instructions, Interpretations, and determination). VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT SHALL BE FOREVER BARRED, THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. IX. WARRANTY. Vendor warrants that it will faithfully and satisfactorily perform all work provided under this Agreement In accordance with the provisions of this Agreement. In addition to any other warranty provided for at law or herein, this Agreement is additionally subject to all warranty provisions established under the Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants goods are merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance with their specifications and Vendor's representations to City. The Vendor shall promptly correct all defects In workmanship and materials: (1) when Vendor knows or should have known of the defect, or (2) upon Vendor's receipt of notification from the City of the existence or discovery of the defect, In the event any part of the goods are repaired, only original replacement parts shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for an additional year beyond the original warranty period applicable to the overall work. The Vendor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Vendor shall pay all costs Incurred by the City in order to accomplish the correction. X. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. XI. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, Including all legal costs and attorney fees, arising out of or In connection with the Vendor's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to avoid any of these covenants of indemnification. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER !BD I TRIAL. TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Vendor refuses tender of defense in any suit or any clairn, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Vendor's part, then Vendor shall pay all the City's costs for defense, Including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Vendor's part. The provisions of this section shall survive the expiration or termination of this Agreement. GOODS & SERVICES AGREEMENT - 4 ($20,000 or Less, Including WSST) XII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and Incorporated by this reference. XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary precautions and shall be responsible for the safety of Its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Vendor's own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIV. MISCELLANEOUS PROVISIONS. A. P�yl. Iarial 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-Waiwe _f�rl . The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain In full force and effect, C. Resolution of Disipg1gs rLr j_Qv,i�Irlg_I aw, This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all Its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; g yi&LQ Ir, however, nothing in this paragraph shall be construed to limit the City's right to Indemnification under Section XI of this Agreement. D. Writrl d g. 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. Assign ii A. 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. J'?loditieatlmn,. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless In writing and signed by a duly authorized representative of the City and Vendor, G. L,=j timr= rve rgr hIY. 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, CaLn.gai.Mance wi.Y �ryw The Vendor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or In the future become applicable to Vendor's business, equipment, and personnel engaged In operations covered by this Agreement or accruing out of the performance of those operations. GOODS & SERVICES AGREEMENT - 5 ($20,000 or Less, including INSST) I. 4ij2�grJ2ol,:cly , . The Vendor acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes, emails, and other records prepared or gathered by the Consultant in its performance of this Agreement may be subject to public review and disclosure, even if those records are not produced to or possessed by the City of Kent. As such, the Vendor agrees to cooperate fully with the City In satisfying the Clty`s duties and obligations under the Public Records Act. J. Cily License lieeluirecl. 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. Q_WnLe r rts a SianaturgAe I _mall, This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that signature shall have the same force and effect as if the Agreement bearing the original signature was received in person. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. All acts consistent with the authority of this Agreement and prior to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. VENDOR: CITY OF KENT r, A, y"_ ' ` s(signature) (signature) Print Name: A\ V insnn Print Name: Alex Ackley, Facilities Superintendent Its:_ iiY1\ Its: Parks, Recreation and Community DATE (title) Services IO�a`1�18 DATE: _ TO NOTICES TO BE SENT : NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Al Vinson Nancy Clary Al Vinson, Inc. dba Sea-Tac Sweeping Service City of Kent 26305 79" Ave S 220 Fourth Avenue South Kent, wA 98032 Kent, WA 98032 253 854-9717 (telephone) (253) 856-5084 (telephone) 253 854-7244 (facsimile) (253) 856-6080 (facsimile) ATTEST: Kent Citv Clerk P GOODS & SERVICES AGREENENT - 6 ($20,000 or Less, including WSST) F DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1,2, 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer, 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above, By signing below, I agree to fulfill the five requirements referenced above. By: ............... - ..... --- .._....... _._.. .. For: .. ti .N in5o0..Int... � c .. rah...................................... .... Title: --1f2Sk&y1t, Date: EEO COMPLIANCE DOCUMENTS 1 of 3 9 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1 1998 NUM Y SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY;. Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 of 3 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as � ._. ......_ __ ---- that was entered into on the. _...... (date), between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. By _.... ...., . _____._.... _. �__ ......_ For: Title: Date: EEO COMPLIANCE DOCUMENTS - 3 of 3 EXHIBIT A SEA-TAC SWEEPING SERVICE 26305 79" Ave. S., KENT, WA 98032 TEL: (253) 854-9717 or (206) 246-4400 FAX: (253) 854-7244 Snow Plowing Agreement SNOW PLOWING RATE: $325.00 PER HOUR (1 HOUR MINIMUM) SANDING RATE: $325.00 PER HOUR(l HOUR MINIMUM) Will you require snow plowing? .....,.yes __............ l. Would you like automatic snow plowing without the necessity of calling, if snow , yea _no fall exceeds three (3) inches in depth? An inspection fee of$150.00 will be charged if we arrive and there is not enough or no snow to plow. 2. Are there Doctors' offices on these properties? ___yes ...._... .....no 3. Would you like your lot & driveways sanded? yes no Must call and request 4. Would you like automatic sanding of lot & driveways if ice conditions occur after a three (3) inches or more of snow fall? yes }v.MMMMMMMM..MMMMMMMMMY MM MSIP M M MMMMMMMMMMMiM Mtl M M M M M M M A M M M M M N W,0.C Y Y..M M M MMI Please list the locations(s) that require snow plowing service: k3uildir_og/Prop(L ty Na„me Address City 2. Use additional pages for more locations. DISCLAIMER OF L111 BILUTY The customer of Sea-Tac Sweeping will hold Sea-Tac Sweeping harmless from any and all claims, actions, suits, liability, costs and expenses, including casts of defense, as a result of any claim of hoddi, injury or property damage to services provider! or not provided under this snow plowing agreement. Provided, this disclaimer shall not release Sea-Tac Sweeping firom liability for any property damage or p000uai injury due to negligence of Sea-Tac Sweeping if the injury occurs while Sea-Tic Sweeping is physically on the Premises conducung,vaow plowing and If the injury is due to impact with Sea-Tac Sweeping equipment. At.CEPTAN("D.' Olt AGREEMENT (Agreement valid from: October 201 a thru May 2019) Acceptance of agreement and authorization for service initiation requires your signature, Authorized Signature Date Print Name Title Phone Number Company Name Billing Address EXHIBIT A Locations requiring snow plowing service; Bullding/Property Name -City of Kent Facilities Address City Kent City Hall 220 4th Ave S Kent Kent Commons 525 4th Ave N Kent Kent Corrections 1230 Central Ave S Kent Kent Municipal Court 1220 Central Ave S Kent Kent Senlor Center 600 E Smith St Kent EXHIBIT B INSURANCE REQUIREMENTS FOR SERVICE CONTRACTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may 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. croCnes :fgl Get .)_ L,] I�aipLTY, insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract, The City shall be named as an insured under the 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. Anomobil .wLiability 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. 3, /clrker ",_Cc7rt r_pc ega.linn_cover°age 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. C€ �7mcrciq,Gcr1 w0l i iabil-KY insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products-completed operations aggregate limit, 2, A�iCorrrrabile,.L�tal1ty Insurance with a minimum combined single^limit for bodily injury and property damage of $2,000,000 per accident. 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 rent 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 Kadditianai insured shah be attached to the Certitac .te of Insuran e-, 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 Ccrdftaates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured cndorsernent, 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. Client#: 133867 5EATSWEE ACORD., CERTIFICATE OF LIABILITY INSURANCE DATE "n,DaIYYYY, _ 613 112 01 0 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT If the certificate holder Is an ADDITIONAL INSURED,the poiloy(les)must have ADDITIONAL INSURED provielons Or be endorsed It SUBROGATION IS WAIVED',Subject to the terms and conditions of the policy,Contain Policies play require an.endorsement.A statement on this certificate does not confer any rights to the certiflcate holder In lieu of such ondoraomont(Bj. PRooucER CT r3��L.. Carey Jackson Propel Insurance Gu rr. 1253310-4142 �.j,�x,am), 868677.1326 AID'6„ Ifl Tacoma Commercial Insurance rro cnnu a _ RoonCsa. y I cicsonp3.rprol>n19nsLlrance,com 1201 Pacific Ave, Suite 1000 R . tNaURERfal APC4reDIND rav9nacc ... Nn1c e... Tacoma WA 98402 ousuREw.n rl rl e�lairr�r„��c��w<� 26623 . r INSURED ... _,_.. _.. IINSURDRA rewivaFraunnyc 1nC,0Ai„-n<e _. 26674 Al Vinson Inc., dba Sea-Tac Sweeping -- INSURPR O:r ieb,eemneyc nr nvmAm,n�o 26666 26305 79th Avenue South INSURER D': Kent, WA 98032 INSURERE', COVERAGES CERTIFICATE NUMBER: _REVISION NUMSER' UTS IS TO ,FRTIFY THAT THE POI CIEB OF INSURANCE LISTEN) OE'LOW HAVE BEEN ISSUEO TO II IN,7N41LD NAMED ABOVE ECH THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY RERUIREMENT, TERM OR CONDITIONOF' ANY CONTRACTOR OTHER DOCUMENT W11i RESPECT 7'0 NMICH TYIIS CF.RTIFICASE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE. POLIGIES DESCRIBED HEREIN IS SULAFC'T TO ALL 111E TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ,. JC - A)fill"A44nn ®- hid IXCy P 01: n� LIMITS ri TYPE of INsuRANCE 1 W1VRr a m.uax NIPABEf¢ ifirnylFYMalkl7lf ) n�aolrYv�i y, 1( COMMERCIAL sENERALLIABILITY IP6309K7h040[aHXf8 06101120100610112019CACHOCCURRENCE $1,000,000 cL uals.AlnoF X�c�:ui OrkwI1,111KIIV I� r 1Lnr,Iwnuilru-..rl 1300„000 X. PD Ded: $600 .,._.. eolru v .... •,,I s5,000 ,nn r xngruNdrnax s1,000,000 _t eatk' Arl ,,slr '... Lnlslrn Ii ,IPC2 gVLNLISM AI<vu1,,n;rl 32,000,000 f I .o nitaaDyuT"v rrrrrvrrP nr,'n rr2,flDD,000 �nl nrr I a C sAUTOMOBILELIP6ILITY 8109K6882881843G 61011201806l011201Q'�IN�.....P'),'.;rjlN'llw'u"All° $1,000.000__ AN,/U1'0 ertI I NILRY lour p owin) ,N4dlr Ili Vult l� ooni,e rllrnr Ip.A,xOPoldp t �Z11 a :1NLv iX y X, IIII It UNLrV'.0lI it In idBBnved1 le gn�AN+.INO 3 nnlr ww,v X .wlrL;c�n+cr g X UMBRELLA LIAR X Ecrwll�rH n1 CLP9K8104221843 610112018 0El0112019�cnr.Hactp,lelstNar; $6,000,000 EXCESS LIAB nuuaaRaAH S6,000,000 Unit XI NJJOI-r0IUAIS$10,000 ._..?. - r A WORKERSCOMPENSANON P6309K780401PHX18 0010112018IDG/011201n "''" ann AND EMPLOYERS LIABILtlTY S6P ClYd'L ( �EO TnNycRrarrl� uwlr�e+rw hILxe�Cunvl y4N . 1 r 0,000,000 I¢pa rIi Frmlln as+a+EP.runrD4 N� Nra rI_I I"IN01rLurll;.11,000,000 �I iMan Imu rY In NIII uy„ a rruo,I,r EI ul1rnsr_ Pnur.YCIMII r1,000,000 DtlS1 RIP IIOLI Or OP li\TIONS➢nl0w y 9 $1 000 Comp Doductlble C ,Auto Physical Drn 8109K6882881843G 6/0'1/2018'061011204R $1,000 Collision Dad I .DE$_._...__.._�._ ...._,_...,_. _ -.. ........�.m..0,nI.............. U�. - _ DESCRIPTION Or OPERATIONS I LOCATIO N31 VEHICLES(AGGRO 101,AS01lIn M1ul nomnrko BcNaNule,may Do nHeM1NaA P mudn nAncp In regoitga) RE: Operations performed by the Named Insured.Additional Insured status applies per attached form(s) t.(.It'1`t]'74^ CANCEI Al i'ION .......,. ..........._.�..,� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Nancy Clary 220 4th Ave S ACCORDANCE WITH THE POLICY PROVISIONS. Kent, WA 98032-0000 ._..._...__..._...._____._.._..._. ,......_....._..___..m.__ ....,...-.._.._.............m...,..,._._._....-......._ AUTHORIZED REPRESENTATIVE _.__._.._._...._..,.....m.,........ ..__....... ......W.....,m_........_.__.._..,..�,.,.__.,._..............m, .90U,2_ .. CORD C._ ...�..........__. ©1988.201E ACORD CORPORATION.All rlghta reservrd. ACORD 25(201(yT3) 1 of 1 The AGORD name and logo ere rogls(ared marks of ACOR❑ #S32133561M3213305 CJ00 I COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR SERVICE INDUSTRIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage However, coverage for any injury, dar'nage or medical expenses described In any of the provisions of this endorsement inay do excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to tine extent that coverage is excluded or limited by Such an endorsement. The fopowing listing is a general cover- age description only. Limitations and exclusions may apply to these coverages, Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what Is and is not covered. A. Broadened Named Insured I. Amended Bodily Injury Definition B. Blanket Additional Insured—Broad Form Vendors J. Bodily Injury To Co-Employees And Co-Volunteer C. Damage To Premises Rented To You Workers Perils of fire, explosion, lightning, smoke, K. Aircraft Chartered With Crew water L. Non-Owned Watercraft— Increased From 25 Feet Limit increased to $300,000 To 50 Feet D. Blanket Walver Of Subrogation M. Increased Supplementary Payments E. Blanket Additional Insured — Owners, Managers Cost of bail bonds Increased to $2,500 Or Lessors Of Premises Loss of earnings increased to $500 per day F. Blanket Additional Insured — Lessors Of Leased N. Knowledge And Notice Of Occurrence Or Offense Equipment O, Unintentional Omission G. Incidental Medical Malpractice H. Personal Injury—Assumed By Contract P. Reasonable Force — Bodily Injury Or Property Damage PROVISIONS B. BLANKET ADDITIONAL INSURED — BROAD A. BROADENED NAMED INSURED FORM VENDORS 1. The followingis added to SECTION II —WHO The following Is added to SECTION 11 — WHO IS AN INSUREDI IS AN INSURED: Any parses or organization flier is a vendor and Any organization, other than a partnership or that you have agreed In a written contract or joint venture, over which you maintain owner- agreement to Incllude as an additional insured on ship or majority Interest on the effective date this Coverage Part is an insured, but only with ro. of the policy qualifies as a Named Insured, $pact to llabllity for "bodily injury" or "property However, coverage for any such organization damage'' that: will cease as of the date during the policy pe- a. IS caused by an"occurrence" that takes place riod that you no longer maintain ownership of, after you have signed and executed that con- or majority interest in, such organization, tract or agreement, and 2. The following replaces Paragraph 4.a. of b. Arises out of "your products" which are dis- SECTION II—WHO IS AN INSURED: tributed or sold in the regular course of such vendor's business. a. Coverage under this provision Is afforded The insurance provided to such vendor is subject only until the 180th day after you acquire to the following provisions: or form the organization or the end of the policy period, whichever is earlier, unless a. The limits of Insurance provided to such ven- reported In wrlling to us within 180 days dor will be the limits which you agreed to pro- CG D4 67 07 13 rp 2013 The 7revelers Indemnity con)pany.All right reserved, Page 1 of 7 Includes copyrlghied malnrlal of Insurance Servinen Office, Inc.with to permisslon. COMMERCIAL GENERAL LIABILITY vide in the written contract or agreement, or Exclusions c, through n. do not apply to dam- the limits shown In the Declarations of this age to premises while rented to you, or tem- Coverage Part, whichever are less porarily occupied by you with permission of It. The insurance provided to such vendor does the owner, caused by: not apply to: a. Fire, (1) "Bodily Injury" or "property damage" for It. Explosion; which the vendor Is obligated to pay c. Lightning; damages by reason of the assumption of liability in a contract or agreement, This d. Smoke resulting from such fire, explosion, exclusion does not apply to liability for or lightning; or damages that the vendor would have in e. Water. the absence of the contract or agreement; (2) Any express warranty unauthorized by A se premises Ie of Insurance applies to such damage to premises as described in Para- ycul graph 6. of Section III —Limits Of Insurance, (3) Any physical or chemical change in "your This Insurance does not apply to damage to products' made intentionally by such vendor, premises while rented to you, or temporarily occupied you with permission of the (4) Repackaging, unless unpacked solely for the purpose of Inspection, demonstration, owner, caused d by: testing, or the substitution of parts under a. Rupture, bursting, or operation of pres- Instructions from the manufacturer, and sure relief devices; then repackaged In the original contalner, b. Rupture or bursting due to expansion or (5) Any fallure to make such Inspections, ad- swelling of the contents of any building or justmenN, tests or servicing as vendors structure, caused by or resulting from wa- agree to perform or normally undertake to ter; perform in the regular course of business, c. Explosion of steam boilers, steam pipes, in connection with the distribution or sale steam engines, or steam turbines. of"your products"; (6) Demonstration, installation, servicing er 2, The following replaces Paragraph 6. of SEC- repair operations, except such operations TION III —LIMITS OF INSURANCE: performed at such vendor's premises in Subject to S. above, the Damage To Prem- connectlon with the sale of "your prod- Ises Rented To You Limit is the most we will ucts"; or pay under Coverage A for damages because (7) "Your products" which, after distribution of "property damage" to any one premises or sale by you, have been labeled or re- while rented to you, or temporarily occupied labeled or used as a container, part or in- by you with permission of the owner, caused gredient of any other thing or substance by fire; exploslonl lightning; smoke resulting by or for such vendor from such fire, explosion, or lightning; or wa- Coverage under this provision does not apply to: ter, The Damage To Premises Rented To You Limit will apply to all damage proximately a. Any person or organization from whom you caused by the same "occurrence whether have acquired "your products", or any ingre- such damage results from fire; explosion; dient, part or container entering into, accom- lightning; smoke resulting from such fire, ex- panying or containing such products; or plosion, or lightning; water, or any combina- b. Any vendor for which coverage as an add!- tion of any of these. tional Insured specifically is scheduled by en- The Damage To Premises Rented To You dorsement. Limit will be the higher of: C. DAMAGE TO PREMISES RENTED TO YOU a. $300,000; or 1. The following replaces the last paragraph of b, The amount shown on the Declarations of Paragraph 2., Exclusions, of SECTION I — this Coverage Part for Damage To Prem- COVERAGES — COVERAGE A BODILY IN• Ises Rented To You Limit. JURY AND PROPERTY DAMAGE LIABIL- ITY: Page 2 of 7 ©2013 The Travelers Indemnity Company.All right reserved, CG D4 67 07 13 Includes copyrighted material of Insurance Services Office, Inc,with Its permisslon. COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph a. of the a. Is "bodily injury" or"property damage" caused definition of "Insured contract" In the DEFINI- by an "occurrence" ghat takes place, or "per- TIONS Section: sonal Injury" or "advertising injury" caused by a. A contract for a lease of premises. How- an offense that is committed, after you have ever, that portion of the contract for a signed and executed that contract or agree- lease of premises that indemnlfies any ment; and person or organization for damage to b. Arises out of the ownership, maintenance or premises while rented to you, or tempo- use of that part of any premises leased to rarily occupied by you with permission of you. the owner, caused by: The insurance provided to such premises owner, (1) Fire; manager or lessor is subject to the following pro- visions: (2) Exploslon; a. The limits of insurance provided to such (3) Lightning; premises owner, manager or lessor will be (4) Smoke resulting from such fire, ex- the limits which you agreed to provide In the plosion, or lightning; or written contract or agreement, or the Ilrttits 5 shown on the Declarations of this Coverage O Water, Part, whichever are less. is not an "Insured contract" b, The insurance provided to such premises 4. The following replaces Paragraph 4.b.(1)(b) owner, manager or lessor does not apply to: of SECTION IV — COMMERCIAL GENERAL 1 "Bodily injury" or "property dams e'" LIABILITY CONDITIONS' { ) yar k caused by an "occurrence'" that takes (b) That Is insurance for premises rented to place, or "personal injury" or "advertisIng you, or temporarily occupied by you with injury" caused by an offense that is corn- the permission of the owner; mltted, after you cease to be a tenant In D. BLANKET WAIVER OF SUBROGATION that premises, or The following Is added to Paragraph 8., Transfer (2) Structural alterations, new construction or Of Rights Of Recovery Against Others To Us, demolition operations performed by or on Lk of such premises owner, manager of SECTION IV — COMMERCIAL GENERAL L ABILITY CONDITIONS: o f Iessan to such premises We waive any right of recovery we may have c. The insurance provided is owner, manager or lessor is excess over any against any person or organization because of valid and collectible other insurance available payments we make for Injury or damage arising to such premises owner, manager or lessor, out of premises owned or occupied by or rented unless you have agreed In a written contract or loaned to you; ongoing operations performed for this Insurance to apply on a primary or by you or on your behalf, done under a contract contributory basis. with that person or organization; "your work"I or F. BLANKET ADDITIONAL INSURED — LESSORS "your products We waive this right where you OF LEASED EQUIPMENT have agreed to do so as part of a written contract, executed by you prior to loss, The following is added to SECTION II — WHO IS E. BLANKET ADDITIONAL INSURED— OWNERS, AN INSURED: MANAGERS OR LESSORS OF PREMISES Any person or organization that is an equipment The following is added to SECTION II —WHO IS lessor and that you have agreed In a written con- AN INSURED, tract or agreement to include as an additional in- sured on this Coverage Park is an Insured, but Any person or organization that Is a premises only with respect to liability for "bodily injury", owner, manager or lessor and that you have "property damage", "personal Injury" or "adverts- agreed in a written contract or agreement to ing injury"that name as an additional insured on this Coverage a. Is rbodliy injury" or"property dtanragfs°" caused Part is an Insured, but only with respect to liability by an "occurrence"urrence" that takes place, or "por- for "bodily injury", property damage", 'personal sonal Injury or "iclvedismg Injury caused by injury" or'advertising injury" that an offense that is committed, after you have CG D4 67 07 13 ®2013 The Travelers Indemnity rani sny.All right reserved. Page 3 of 7 Includes copyrighted malorlal or Insurance SeNicmw Office,Inq,with Its permission. COMMERCIAL GENERAL LIABILITY signed and executed that contract or agree- "Good Samaritan services" means any emer- ment', and gency medical services for which no corl b. Is caused, In whole or in part, by your acts or satlon is demanded or received. omissions in the maintenance, operation or 3. The following is added to Paragraph 2.a.(1) of use by you of equipment leased to you by SECTION 11 -WHO IS AN INSURED: such equipment lessor. Unless you are in the business or occupation The insurance provided to such equipment lessor of providing professional health care services, is subject to the following provisions Paragraphs (1)(a), (b), (c) and (d) above do a. The limits of insurance provided to such not apply to any "bodily injury" arising out of equipment lessor will be the limits which you any providing or falling to provide "Incidental agreed to provide In the written contract or medical services" by any of your "employ- agreement, or the limits shown on the Decla- ees", other than an employed doctor. Any rations of this Coverage Part, whichever are such "employees" providing or failing to pro- less. vide "incidental medical services" during their b. The insurance provided to such equipment work hours for you will be deemed to be act- essoi does not a to an "bodily injury" or Ing within the scope of their employment by apply y y ry,, you or performing duties related to the con- "property damage" caused by an "occur- duct of your business rence"that takes place, or"personal injury" or "advertising injury" caused by an offense that 4. The following exclusion Is added to Para- is committed, after the equipment lease ex- graph 2., Exclusions, of SECTION I - COV- pires, ERAGES - COVERAGE A BODILY INJURY c. The Insurance provided to such equipment AND PROPERTY DAMAGE LIABILITY lessor is excess over any valid and collectible Sale Of Pharmaceuticals other insurance available to such equipment "Bodily injury" or "property damage" arising lessor, unless you have agreed in a written out of the willful violation of a penal statute or contract for this insurance to apply on a pri- ordinance relating to the sale of pharmaceutl- mary or contributory basis, cals committed by, or with the knowledge or G. INCIDENTAL MEDICAL MALPRACTICE consent of, the Insured. 1. The following Is added to the definition of''oc_ 6. The following is added to Paragraph 6. of currence" In the DEFINITIONS Section: SECTION III -LIMITS OF INSURANCE. Unless you are in the business or occupation For the purposes of determining the applica- of providing professional health care services, ble Each Occurrence Limit, all related acts or "occurrence" also moans an act or omission omissions committed In the providing or fall- committed in providing or failing to provide Ing to provide "incidental medical services" to "incidental medical services"to a person, any one person will be considered one "oc- 2. The following Is added to the DEFINITIONS currence". Section 6, The following is added to Paragraph 4.b., Ex- "Incidental medical services" means: cess Insurance, of SECTION IV - COM- MERCIAL GENERAL LIABILITY CONDI- a. Medical, surgical, dental, laboratory, x-ray TIONS: or nursing service or treatment, advice or This Insurance is excess over any valid and instruction, or the related furnishing of collectible other insurance, whether primary, food or beverages, excess, contingent or on any other basis, that b. The furnishing or dispensing of drugs or is available to any of your "employees" for medical, dental, or surgical supplies or "bodily injury" that arises out of providing or appliances; failing to provide "Incidental medical services" c. First aid. or to any person to the extent not subject to d. "Goad Samaritan services'', Paragraph 2.a,(1) of SECTION II - WHO IS ANINSURED Page 4 of 7 Q 2013 The Travelers Indemnity Company.All right reserved. CG D4 67 07 13 includes oopyrlghted material of Inaefanee Services Cf(Ics, Inc,with Its permission, COMMERCIAL GENERAL LIABILITY i H, PERSONAL INJURY — ASSUMED BY CON- 3, The following replaces Paragraph 2.d, of TRACT SUPPLEMENTARY PAYMENTS — COVER- T 1. The following replaces Exclusion a., Contrac- AGES A AND B. tual Liability, in Paragraph 2, of SECTION I d. The allegations In the "suit" and the in- - COVERAGES — COVERAGE B PER- formation we know about the "occur- SONAL AND ADVERTISING INJURY LI• rence" or offense are such that no conflict ABILITY; appears to exist between the interests of e. Contractual Liability the insured and the Interests of the in- "Personal Injury" or"advertising Injury" for demnitee; which the insured is obligated to pay 4. The following replaces the first subparagraph damages by reason of the assumption of of Paragraph f, of the definition of "Insured liability In a contract or agreement. This contract" In the DEFINITIONS Section: exclusion does not apply to: f. That part of any other contract or agree- (1) Liability for damages that the Insured ment pertaining to your business (Includ- would have in the absence of the ing an Indemnification of a municipality In contract or agreement; or connection with work performed for a (2) Liability for damages because of municipality) under which you assume the "personal injury" assumed In a con- tort liability of another party to pay for tract or agreement that is an "Insured "bodily Injury," "property damage" or"per- contract", provided that the "personal sonal injury"to a third person or organlza- Injury" is caused by an offense com- tlon. Tort liability means a liability that mitted subsequent to the execution of would be imposed by law in the absence the contract or agreement. Solely for of any contract or agreement, the purposes of liability assumed in I. AMENDED BODILY INJURY DEFINITION an "Insured contract", reasonable at- torneys fees and necessary litigation The following replaces the definition of "bodily in- expenses incurred by or for a party jury" in the DEFINITIONS Section, other than an insured will be deemed "Bodily Injury" means bodily injury, mental an- to be damages because of "personal injury", provided that guish, mental injury, shook, fright, disability, hu- mlliation, sickness or disease sustained by a per- (a) Liabillty to such party for, or for son, including death resulting from any of these at the cost of, that party's defense any time, has also been assumed In the same "insured contract"; and J, BODILY INJURY TO CO-EMPLOYEES AND (b) Such attorney fees and litigation CO-VOLUNTEER WORKERS expenses are for defense of that The following is added to Paragraph 2.a.(1) of party against a civil or alternative SECTION II —WHO IS AN INSURED: dispute resolution proceeding in which damages to which this IIn• Paragraph (1)(a) above does not apply to "bodily surance applies are alleged, Injury""to a co-"arnployea" In the course of the co- t. The following replaces the third sentence of employee's" employment try you or performing Paragraph 2. of SUPPLEMENTARY PAY- duties related to tits your conduct of your business, or MENTS—COVERAGES A AND B: to "bodily performing to ties other "volunteer workers" while perfcrming duties related to the conduct of Notwithstanding the provisions of Paragraph your business. 2.b.(2) of Section I — Coverage A — Bodily In- K. AIRCRAFT CHARTERED WITH CREW jury And Property Damage Liability or Para- graph 2.e. of Section I — Coverage B — Per- The following Is added to Exclu:slon g., Aircraft, sonal and Advertising Injury Liability, such Auto Or Watercraft, in Paragraph 2. of SECTION payments will not be deemed to be darnagcs I — COVERAGES — COVERAGE A BODILY IW because of"bodily injury", "property damage" JURY AND PROPERTY DAMAGE LIABILITY: or "personal injury", and will not reduce the This exclusion does not apply to an aircraft that limits of insurance, is: CG 04 67 07 13 ©'2()43 The Travelers Indomnity Company,All right reserved, Page 5 of 7 Includes copyrlgoted material of Insurance$0 VICee Ofllce, Ina with its permission. COMMERCIAL GENERAL LIABILITY (a) Chartered with crew to any Insured', e. The following provisions apply to Paragraph b) Not owned by any insured; and a, above, but only for the purposes of the in- surance provided under this Coverage Part to (c) Not being used to carry any person or prop- you or any insured listed In Paragraph I. or 2, erty for a charge, of Section II —Who Is An Insured: L, NON-OWNED WATERCRAFT (1) Notice to us of such 'occurrence" or of- t. The following replaces Paragraph (2) of Ex- fense must be given as soon as practiica- clusion g., Aircraft, Auto Or Watercraft, in ble only after the "occurrence" or offense Paragraph 2, of SECTION I — COVERAGES Is known to you (If you are an individual), — COVERAGE A BODILY INJURY AND any of your partners or members who is PROPERTY DAMAGE LIABILITY: an Individual (if you are a partnership or (2) A watercraft you do not own that is: joint venture), any of your managers who is an Individual (If you are a limited liability (a) Fifty feet long or less; and company), any of your trustees who is an (b) Not being used to carry any person or Individual (if you are a trust), any of your property for a charge. "executive officers" or directors (If you are 2. The following is added to Paragraph 2. of an organization other than a partnership, SECTION II—WHO IS AN INSURED; joint venture, limited liability company or bust) or any "employee" authorized by Any person or organization that, with your ex- you to give notice of an "occurrence" or press or Implied consent, either uses or is re- offense. sponsible for the use of a watercraft that you (2) If you are a partnership, joint venture, lim- do not own that is. ited liability company or trust, and none of (1) Fifty feet long or less; and your partners, joint venture members, (2) Not being used to carry any person or managers or trustees are individuals, no- property for a charge lice to us of such "occurrence" or offense M. INCREASED SUPPLEMENTARY PAYMENTS must be given as soon as practicable only after the"occurrence' or offense is known 1. The following replaces Paragraph 1.b. of by: SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- (a) Any individual who is. AGES, (i) A partner or member of any part- b, Up to $2,500 for cost of bail bonds re- nership or joint venture; qulred because of accidents or traffic law (II) A manager of any limited liability violations arising out of the use of any company', vehicle to which the Bodily Injury Liability (iii) A trustee of any trust; or Coverage applies. We do not have to fur- (Iv) An executive officer or director of nlsh these bonds. any other organization; 2. The following replaces Paragraph 1.d, of SUPPLEMENTARY PAYMENTS — COVER- that is your partner, joint venture or AGES A AND B of SECTION I — COVER- member, manager or trustee; or AGES: (b) Any "employee" authorized by such d. All reasonable expenses incurred by the partnership, joint venture, limited li- insured at our request to assist us in the ability company, trust or other crgani- lnvestigation or defense of the claim or zatlon to give notice of an 'occur- suit", including actual loss of earnings up rence'or offense. to $500 a day because of tlme off from (3) Notice to us of such "occurrence" or of- work. fense will be deemed to be given as soon N, KNOWLEDGE AND NOTICE OF OCCUR- as practicable If it Is given In good faith as RENCE OR OFFENSE soon as practicable to your worlters' compensation insurer. This applies only if The following is added to Paragraph 2„ Duties In you subsequently give notice to us of the The Event of Occurrence, Offense, Claim or "occurrence' or offense as soon as prac- Sult, of SECTION IV — COMMERCIAL GEN- ticable after any of the persons described ERAL LIABILITY CONDITIONS: Page 6 of 7 ©2013 The Travelers Indemnity Company.All right reserved, CG D4 67 07 13 Includes copyrighted material of Insurance services office, Inc.with Its permission. COMMERCIAL GENERAL LIABILITY in Paragraphs e.(1) or (2) above discov- relied upon in issuing the policy will not prejudice ers that the "occurrence" or offense may your rights under this insurance. However, this result In sums to which the insurance provision does not sxffect our right to collect add4- provlded under this Coverage Part may tional premium or to exercise our rights of cancei- apply, lotion ar nonrenowal in accordance with appliaa- However, if this policy Includes an endorse- ble insurance laws or regulations. merit that provides limited coverage for "bod- P. REASONABLE FORCE — BODILY INJURY OR ily Injury" or "property damage" or pollution PROPERTY DAMAGE costs arising out of a discharge, release or The following replaces Exclusion a., Expected Or escape of "pollutants" which contains a re- Intended Injury, in Paragraph 2. of SECTION I — qulrement that the discharge, release or es- COVERAGES — COVERAGE A BODILY IW cape of "pollutants" must be reported to us JURY AND PROPERTY DAMAGE LIABILITY, within a specific number of days after its abrupt commencement, this Paragraph e. a. Expected or Intended Injury or Damage does not affect that requirement. "Bodily injury" or "property damage" expected 0. UNINTENTIONAL OMISSION or intended from the standpoint of the in- sured. This exclusion does not apply to "bod- The following Is added to Paragraph 6., Repre. ily injury" or"property damage" resulting from sentations, of SECTION IV — COMMERCIAL the use of reasonable farce to protect any GENERAL LIABILITY CONDITIONS person or property. The unintentional omission of, or unintentional er- ror in, any information provided by you which we CG 04 67 07 13 ®2013 The Travelers Indemnity Company.All right reserved. Page 7 of 7 Includes copyrighted malarial of InsYiranca Services Office, Inc.with Its permission, COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) Is amended c) The Insurance provided to the additional In- to include any person or organization that you sured does not apply to "badlly injury" or agree in a "written contract requiring Insurance" '.property damage" caused by "Your work" to include as an additional Insured on this Cover- and Included In the "pro(iucts-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for"bodily Injury" requiring insurance" spoolOoally roquires you grope y damage" or"personal InJury"l and to provide such coverage for tha'I addl0onni insured, and then tare insurance provided to b) If, and only to the extent that, the injury or the addltlonal insured applies only to such damage Is Caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor In the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring Insur- requiring Insurance" applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever Is insured with respect to the Independent acts earlier. or omissions of such person or organization, 3, The Insurance provided to the additfonnil Insured 2, The Insurance provided to the additional Insured by this ondorserneni is excess over any valid and by this endorsement is limited as follows: colloctlbio "other Insurance", whether primary, a) In the event that the LPrnlls Of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the addltlonal Insured for a loss we exceed line limits of liability required by the cover under this endorsement, However, if the "written contract requiring Insurance", the in- "wrftien contract requiring Insurance" specifically surance provided to the additional Insured roquirr"is that this instiranae apply on a primary shall be limited to the limits of liability re- beetle or a primary and nOn-conlobutory basis, quirod by that "whtlen contract requiring In- this laasurance Is primary to "other insurance" swnnce This andorsemont shall not In- available to the additional insured which covers crease the limits of Insurance described In that person or unionization as a nomad insured Section III —Limits Of Insurance for suds loss, and we will not share with that other insurance". But the Insurance provided to b) The insurance provided to the additional in- the additional Insured by this endorsement 4111 is sured does not apply to "bodily injury", "prop- excoss Over any valid and cotiocttbia "other In- erty damage" or "personal Injury" arising out suranoo', whelhor priniany" excess, contingent or of the rendering of, or failure to render, any of any other basis th'al its oy alYiho to the aaddl- professlonal architectural, ongineedng or sur- iiortet insured when that parson or organization (s veying services, including; an addillonral Insured uatdor such "ollher Insar- I. The preparing, approving, or falling to once". prepare or approve, maps, shop draw- 4, As a condition of coverage provided to the Inge" opinions, reports, surveys, field or- addltlonal Insured by this endorsement ders or change orders, or the preparing, a) The additional Insured must glue us written approving, or failing to colora or nOLlce as soon as prarticabla of an ''occur- rence"drawings and spec)ncmtiorrs;andd or an offense which may result In a ii, Supervisory, Inspection, architectural or claim. To the extent possible, such notice engineering activities. should Include; CG D2 46 08 05 0 2005 The St Paul Travelers Companies, Inc, Page 1 of 2 I COMMERCIAL GENERAL LIABILITY I. How, when and where the "occurrence" any provider of"other Insurance"which would or offense look place; cover the additional insured for a loss we it, The names and addresses of any Injured cover under this endorsement. However, this persons and witnesses; and condition does not affect whether the Insur• ance provided to the additional Insured by III. The nature and location of any Injury or this endorsement Is primary to 'other Insur- damage arising out of the "occurrence" or ance" available to the additional Insured offense. which covers that person or organization as a b) If a claim is made or"suit" Is brought against named Insured as described in paragraph 3, the additional Insured, the additional insured above. must: 5, The following definition Is added to SECTION V. L Immediately record the specifics of the —DEFINITIONS: claim or"suit" and the date received; and "Written contract requiring insurance" means il. Notify us as soon as practicable, that part of any written contract or agreement The additional insured must see to it that we under which you are required to include a In- receive written notice of the claim or"suit" as person organization as an additional soon as practicable the " on this Coverage Part, provided that the "bodily Injury" and "properly damage" oo- c) The additional Insured must Immediately curs and the "personal Injury"Is caused by an send us copies of all legal papers received In offense committed: connection with the claim or "suit", cooperate a. After the signing and execution of the with us In the Investigation or settlement of contract or agreement by you', the claim or defense against the "suit', and otherwise comply with all policy conditions. b, While that part of the contract or d) The additional Insured must tender the de- agreement Is in affect; and fense and indemnity of any claim or "suit" to c. Before the end of the policy period Page 2 of 2 ® 2005 The St, Paul Travelers Companies, Inc. CG D2 45 08 05 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided underthe following BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However coverage for any Injury, darn cige or medical expenses described In any of the provisions of this ondorsomant may be oxcludod or limited by another endorsernont to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage Is excluded or limited, by such an endorsement. The following fisting Is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and Is not covered, A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF B. BLANKET ADDITIONAL INSURED USE— INCREASED LIMIT C, EMPLOYEE HIRED AUTO I, PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS — INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO — LIMITED WORLDWIDE COV- LOSS ERAGE— INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE —GLASS N. UNINTENTIONAL ERRORS OR OMI5SIONS PROVISIONS A. BROAD FORM NAMED INSURED this Insurance applies and only to the extent that The following Is added to Paragraph A.1., Who Is person or orgainization qualifies as an lasurod" An Insured, of SECTION II —COVERED AUTOS under the Who Is Ali Insured provision cw0ined LIABILITY COVERAGE: In Sectlon II. Any organization you newly acquire or form dur- C. EMPLOYEE HIRED AUTO ing the policy period over which you maintain 1. The following Is added to Paragraph AA., 50% or more ownership Interest and that is not Who Is An Insured, of SECTION II — COV- separately Insured for Business Auto Coverage, ERED AUTOS LIABILITY COVERAGE. Coverage under this provision Is afforded only un- Art ""employee"" of yours Is an "Insured" while tll the 180th day after you acquire or form the or- operating an auto" hired or ronlet under a ganlzation or the end of the policy period, which- contract or ragreenlant In Ali "ennployll ever is earlier, panne, with your permission, while performing duties related to the oondcicl of your hush- B. BLANKET ADDITIONAL INSURED ness. The following Is added to Paragraph c. In A,1., 2. The following replaces Paragraph b, In Who Is An Insured, of SECTION II — COVERED Other Insurance, of SECTION IV — BUSI- AUTOS LIABILITY COVERAGE: NESS AUTO CONDITIONS: Any person or organization who Is required under It. For Hired Auto Physical Damage Cover- a written contract or agreement between you and age, the following are deemed to be cov- that person or organization, that Is signed and ered 'autos" you own: executed by you before the "bodily Injury" or (1) Any covered "auto" you lease, hire, "property damage" occurs and that is In effect rent or borrow and during the policy period, to be named as an addl. (2) Any covered "auto" hired or rented by Clonal Insured Is an 'Insured" for Covered Autos your "employee" under a conlracl in Liability Coverage, but only for damages to which an "employee's" name, with your CA T3 53 02 15 0 2015 The Travelers Indemnity company.All rights reserved. Page 1 of 4 Includes copyrighted mataflal of Insurance Servloas Office,Inc,wllh Its permission. COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busl- brought outside the United states of ness. America, the territories and possessions However, any "auto" that Is leased, hired, of the United States of Arnerica, Puerto rented or borrowed with a driver Is not a Rico and Canada: covered "auto (i) You must arrange to defend the "In- D, EMPLOYEES AS INSURED sured" against, and investigate or set- The followingis added to Paragraph A,1., Who Is lie any such claim or "suit" and keep us advised of all proceedings and ac- An Insured, of SECTION II —COVERED AUTOS tions. LIABILITY COVERAGE: (if) Neither you nor any other Involved An a covered e" of you is an "insured" while us- Y "employee" Y "insured" will make any settlement don'tling own, hire or borrow without our consent. In your business or your personal affairs. E, SUPPLEMENTARY PAYMENTS — INCREASED (III) We may, at our discretion, participate In defending the "Insured" against, or LIMITS In the settlement of, any claim or 1. The following replaces Paragraph A,2,a.(2), "salt". of SECTION II — COVERED AUTOS LIABIL- (iv) We will reimburse the "Insured" for ITY COVERAGE: sums that the "Insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "properly damage" to which bons) recurred because of an "accident" this insurance applies, that the "in- we coven We do riot have to furnish sured'' pays with our consent, but these bands. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE, (4) All reasonable expenses Incurred by the (v) We will reimburse the "Insured" for "Insured" at our request, Including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense F, HIRED AUTO — LIMITED WORLDWIDE COV- "s the "insured" against any such ERAGE—INDEMNITY BASIS uitn but only up t and included within the limit described in Para- The following replaces Subparagraph (5) in Para- graph C,, Limits Of Insurance, of graph B,7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, excepl any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation Imposed by the Insurance in payments for damages, United States of America applies to and pro- settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance avallable ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis, without a driver for a period of 30 days or less (c) This Insurance is not a bull for re- and that is not an "auto" you lease, hire, rent quired or compulsory Insurance In any or borrow from any of your "employees", country outside the United States, its ter- partners (if you are a partnership), members ritories and possessions, Puerto Rice and (if you are a limited liability campany) or Canada, members of their households. Page 2 of 4 U 2015 The Travelers Indemnity Company,All rights reserved. CA T3 53 02 15 Includes copyrighted malarial of Insurance eervlces Offloe,Inc.with Its permiselon, COMMERCIAL AUTO You agree to maintain all required or (2) In or on your covered "auto". compulsory Insurance In any such coun- This coverage applies only In the event of a total try up to the minimum limits required by theft of your covered "auto", local law Your failure to comply with No deductibles apply to this Personal Property compulsory Insurance requirements will coverage. not invalidate the coverage afforded by this policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following Is added to Paragraph B.3., Excl'u- had you complied with the compulsory In- sions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE. (d) It is understood that we are not an admlt- Exclusion 3.a, does not apply to "loss" to one or too or authorized Insurer outside the more airbags In a covered "auto" you awn that In- United States of America, its territories flate due to a cause other than a cause of "loss" and possessions, Puerto Rico and Can- set forth In Paragraphs A.1.b. and A.1.c., but ada. We assume no responsibility for the only furnishing of certificates of insurance, or a. If that "auto" Is a covered "auto" for Compre- for compliance in any way with the laws hensive Coverage under this policy; of other countries relating to Insurance b. The alrbags are not covered under any war- G. WAIVER OF DEDUCTIBLE — GLASS ranty; and The following is added to Paragraph D„ Deducti. c. The alrbags were not Intentionally inflated ble, of SECTION III — PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any COVERAGE: one "loss", No deductible for a covered "auto" will apply to L. NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage If the glass Is repaired rather than LOSS replaced. The following Is added to Paragraph A,2,a., of H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF SECTION IV—BUSINESS AUTO CONDITIONS: USE— INCREASED LIMIT Your duty to give us or our authorized fopresentEa- The following replaces the last sentence of Para- (ive prompt notice of Ilea accidli l Or 10815" ap- graph AA.b., Loss Of Use Expenses„ of SEC- plWs only wizen the "accidonl" or "lass is known TtON Ill—PHYSICAL DAMAGE COVERAGE: to: However, the most we will pay for any expenses (a) You (If you are an individual); for Tess of use Is $05 per day, to a maximum of (b) A partner(If you are a partnership); $750 for any one "accident (c) A member (If you are a limited liability com- I. PHYSICAL DAMAGE — TRANSPORTATION pany)I EXPENSES—INCREASED LIMIT (d) An executive officer, director or insurance The following replaces the first sentence In Para- manager (if you are a corporation or other or- graph A„4.a., Transportation Expenses, of ganlzatlon); or SECTION III — PHYSICAL DAMAGE COVER- (a) Any "employee" authorized by you to give ri AGE tice of the "accident" or"loss". We will pay up to $50 per day to a maxima of M. BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense In- The following rellaces Prail A.5„ Transfer curred by you because of the total (heft of a cov- Of Rights Of Recovery Against Others To Us, ered "auto" of the private passenger type. of SECTION IV -- BUSINESS AUTO CONDI- J. PERSONAL PROPERTY TIONS; The following is added to Paragraph A,4„ Cover- 6, Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: VVo waive any right of r000very we may Wive Personal Property against any poll of organization is thee ex- elll rormired (if you by A written contract We will pay up to $400 for "loss" to wearing ap- stgfafrtl and executed prior to any "oecld"It" pal and other personal property which Is: or"loss", prc lod that the "accident"of "loss" (1) Owned by an "insured and arises out of 00erla4Bons conlramli by CA T3 53 02 15 Q 2015 The Travelers Indemnity company.All rlghls reserved, Page 3 of 4 Includes copyrighted material of Insurance services office,Inc.with Its permission. � e COMMERCIAL AUTO such contract, The waiver applies only to the The unintentional omisslon of, or unintentional person or organization designated In such error In, any Information given by you shall not contract, prejudlce your rights under this Insuranco. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our r'Ight to color The following Is added to Paragraph 5,2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or p'rauod, of cancellation or non-renewal, SECTION IV—BUSINESS AUTO CONOITIONSI Page 4 of 4 ®2016 The Travelers Intl Company.All rights reserved, CA T3 63 02 16 Includes oopyrlghted material of Insurance Servlose Offloe,Inc,with Its psrmisslor, COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 2. The following is added to Paragraph B.5., Other 1. The following is added to Paragraph AA.c., Who Insurance of SECTION IV — BUSINESS AUTO Is An Insured, of SECTION II — COVERED CONDITIONS: AUTOS LIABILITY COVERAGE: Rogardless of the provisions of paragraph a, and Any person or organization who is required under paragl'apht d. of this part 5. Other insurance, this a wrt ten contract or agreement between you and insurance is primary to and non-contributory with that person or organization, that is signed and applicable other Insurance under which an addl- executed by you before the ""bodily injury" or tional insured person or organization is the first "property damage" occurs and that Is in efi named Insured when the written contract or during the policy period, to be named as an addl- agreement between you and that person or or- tlonaR insured is an "insured" for Covered Autos ganization, that is signed and exeCLlled by you Liability Coverage" but only for damages to which before the "bodily injury" or "property damage" this insurances applies mid only to the extent that occurs and that Is in effect during the policy pe- person or organization qualifies as an "insured" riod, requires this Insurance to be primary and under the Who Is An Insured provision contained in SECTION 11 non-contributory. CA T4 74 02 15 ©2015 The Travelere Indemnity Company.All rights reserved, Page 1 of 1 Includes copyrighted molmial of Insurance services Office,Ina with Its permission TRAVELERS POLICY NUMBER: P-530-9K780401-PHX-18 EFFECTIVE DATE: 06-01-18 ISSUE DATE: 06-26-18 LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS BY LINE OF BUSINESS. IL TO 02 11 89 COMMON POLICY DECLARATIONS IL T8 01 10 93 FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS IL T3 19 08 10 COMMON POLICY CONDITIONS WA-DELUXE IL TO 03 04 96 LOCATION SCHEDULE IL F1 18 10 13 AMENDMENT OF NAMED INSURED - WASHINGTON DELUXE PROPERTY DX TO 00 11 12 DELUXE PROP COV PART DECLARATIONS DX 00 03 07 94 DELUXE PROP COV PART SCHED-SPECIF LIMITS DX 00 01 07 94 MORTGAGEE HOLDER SCHEDULE DX 00 04 11 12 TABLE OF CONTENTS - DELUXE PROP COV PART DX T1 00 11 12 DELUXE PROPERTY COVERAGE FORM DX T1 01 11 12 DELUXE BI (AND EE) COVERAGE FORM DX T8 01 GENERAL PURPOSE ENDORSEMENT DX T4 61 11 12 BUSINESS INCOME-COINSURANCE DX T3 19 11 12 CAUSES OF LOSS-EQUIPMENT BREAKDOWN DX T3 79 11 12 LOSS PAYABLE PROVISIONS DX T4 02 01 15 FEDERAL TERRORISM RISK INSURANCE ACT DIS DX O1 26 12 13 WASHINGTON CHANGES DX 03 18 11 11 WASHINGTON CHANGES - DOMESTIC ABUSE DX T3 98 04 02 ELECTRONIC VANDALISM LIMITATION ENDT COMMERCIAL GENERAL LIABILITY CG TO O1 11 03 COML GENERAL LIABILITY COV PART DEC CG 03 00 01 96 DEDUCTIBLE LIABILITY INSURANCE CO TO 07 09 87 DECLARATIONS PREMIUM SCHEDULE CG TO 08 11 03 KEY TO DECLARATIONS PREMIUM SCHEDULE CG TO 34 11 03 TABLE OF CONTENTS CG 00 01 10 01 COMMERCIAL GENERAL LIABILITY COV FORM CG D2 55 11 03 AMENDMENT OF COVERAGE - POLLUTION CG D3 75 03 06 ADD'L INSUR-MORTGAGEE,ASSIGNEE,SUCCESOR CG D4 71 01 15 AMEND COVERAGE B - PERS & ADV INJURY GN 01 13 11 03 EMPLOYERS OVERHEAD LIABILITY CG DO 37 04 05 OTHER INSURANCE-ADDITIONAL INSUREDS CG D2 03 12 97 AMEND-NON CUMULATION OF EACH OCC CG D2 11 01 04 DESIGNATED PROJECT(S) GEN AGGR LIMIT CG D2 46 08 05 BLANKET ADDITIONAL INSURED (CONTRACTORS) CG D4 06 02 08 BUILDING SERVICE CONTRACTORS EXT ENDT CG D4 13 04 08 AMENDMENT OF COVERAGE-COOLING-POLLUTION CG D4 67 07 13 XTEND ENDORSEMENT FOR SERVICE INDUSTRIES CG D2 56 11 03 AMENDMENT OF COVERAGE CO D3 26 10 11 EXCLUSION - UNSOLICITED COMMUNICATION IL T8 01 10 93 PAGE: 1 OF 2 TRAVELERS) POLICY NUMBER: P-630-9K780401-PHX-18 EFFECTIVE DATE: 06-01-18 ISSUE DATE: 06-26-18 COMMERCIAL GENERAL LIABILITY (CONTINUED) CG D3 56 05 14 MOBILE EQUIP REDEFINED-EXCL OF VEHICLES CG D4 21 07 08 AMEND CONTRAC LIAR EXCL-EXC TO NAMED INS CG D6 18 SO 11 EXCL-VIOLATION OF CONSUMER FIN PROT LAWS CG D7 46 01 15 EXCL-ACCESS OR DISCL OF CONF/PERS INFO CG DO 76 06 93 EXCLUSION-LEAD CG D1 42 01 99 EXCLUSION-DISCRIMINATION CG D2 40 09 15 EXCLUSION -SILICA OR SILICA-RELATED DUST CG F2 45 07 02 EXCLUSION - WAR - WASHINGTON CG T4 78 02 90 EXCLUSION-ASBESTOS CG F2 66 11 03 WA CHANGES EMPLOY RELATED PRACTICES EXCL CG F4 66 01 08 WASHINGTON CHANGES-WHO IS AN INSURED CG F2 41 05 02 WASHINGTON - FUNGI OR BACTERIA EXCLUSION EMPLOYEE BENEFITS LIABILITY CG TO 09 09 93 EMPLOYEE BENEFITS LIAB COV PART DEC CG TO 43 01 16 EMPLOYEE BENEFITS LIAB TABLE OF CONTENTS CG T1 01 01 16 EMPLOYEE BENEFITS LIABILITY COV FORM INTERLINE ENDORSEMENTS IL T3 68 01 15 FEDERAL TERRORISM RISK INS ACT DISCLOSE IL T4 00 12 09 DESIGNATED ENTITY-C/NR PROVIDED BY US IL T4 12 03 15 AMEDT COMMON POLICY COND-PROHIBITED COVG IL T4 14 01 15 CAP ON LOSSES CERTIFIED ACT OF TERRORISM IL 01 23 11 13 WASHINGTON CHANGES - DEFENSE COSTS IL O1 98 09 08 NUCLEAR ENERGY LIABILITY EXCLUSION IL T9 80 10 94 WA CHANGES-ACTUAL CASH VALUE IL T9 82 11 12 WA CHANGES-EXCLUDED CAUSES OF LOSS IL T8 01 10 93 PAGE: 2 OF 2 I POLICY NUMBER: 810-9X6 8 82 6 8-18-14-G EFFECTIVE DATE: 06/01/2018 ISSUE DATE: o6/18/2018 LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS BY LINE OF BUSINESS IL TO 02 11 89 COMMON POLICY DECLARATIONS IL T6 01 01 01 FORMS ENDORSEMENTS AND SCHEDULE NUMBERS IL TO 05 06 10 COMMON POLICY CONDITIONS - WASHINGTON IL Fl 18 10 13 AMENDMENT OF NAMED INSURED - WASHINGTON IL T3 02 07 86 CALCULATION OF PREMIUM - COMPOSITE RATES IL T8 25 CALCULATION OF PREMIUM - COMPOSITE RATES COMMERCIAL AUTO CA TO 01 02 15 BA- COVERAGE PART DEC$ (ITEMS 1 & 2) CA TO 03 02 15 BUS AUTO COV PART DECLARATIONS-4&5 CA TO 30 02 16 BUSINESS AUTO/MC COV PART-UM SUPPL SCHD CA TO 31 02 15 TABLE OF CONTENTS-BUSINESS AUTO COV FORM CA 00 01 10 13 BUSINESS AUTO COVERAGE FORM CA 01 35 10 13 WASHINGTON CHNG CA 21 34 10 13 WASHINGTON UNDERINSURED MOTORISTS COVERAGE CA 99 03 10 13 AUTO MEDICAL PAYMENTS COVERAGE CA T4 52 02 16 SHORT TERM HIRED AUTO - ADDITIONAL INSURED AND LOSS PAYEE CA T4 59 02 15 AMENDMENT OF EMPLOYEE DEFINITION CA T4 74 02 16 BLANEET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE CA T3 53 02 15 BUSINESS AUTO EXTENSION ENDORSEMENT INTERLINE ENDORSEMENTS IL T4 12 03 15 AMNDT COMMON POLICY COND-PROHIBITED COVG IL 01 23 11 13 WASHINGTON CHANGES - DEFENSE COSTS IL 01 98 09 08 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (BROAD FORM) IL T8 01 01 01 PAGE: 1 of 1 City of Kent Business License KENT SEA-TAC SWrePINU SERVICE AL.,VINSON 26305 79TFI AVE S KEN"f, WA 98032 Please tear a.t perforation LICENSE BUSINESS LICENSE jod us w ez i a localb QJl d and usC Inr,must b�coded BE PAID ANNUALLY BY No 7715 Cm nil yucllfwd t TO AVOID PENALTY s il� within Ih uiiy or KEN T Issunnoe of License Does Nut Imply Llecnsee's Knn t. Cumphnnce with State and Local Laws ,,. THIS LICENSE MUST BE POSTED IN A CONSPICUOUS PLACE. NOT TRANSFERABLE OR ASSIGNABLE 2 018 NAME AND ADDRESS OF BUSINESS BLC-9613751 SEA 'I'AC SWEI-PING 9ERVICF NIAYOIi 26305 79 AVE S Tax The City KFN1' Endorsement WA 9S032 tion of Kant