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HomeMy WebLinkAboutPW18-455 - Original - Busby Junk Removal, LLC - Dvorak Barn - Contract - 12/05/2018 KENT Records Management Document CONTRACT COVER SHEET Ibis is to ix.'3 co!n" 1pilebvll Iuy ".J" P-c,,nzKjcn pr'�uvji ac skjt)iwp ,ss oo Atli If virn'� haveqpv9 .!Sfloins' Vendor Name: Busby Junk Removal, LLC Vendor Number (]DE): Contract Number (City Clerk): ............... PW 1S5-45 t) Category: Agreement Sub-Category (if applicable): Project Name: Dvorak Barn Contract Execution Date: 1 2/5/1 8 Termination Date: 1 2/1 4/1 8 Contract Manager: Toby Hallock Department: PW Engineering Contract Amount: $612.28 Budgeted: � Grant? Part of NEW Budget: 0 Local: State: 0 Federal: 0 Related to a New Position: 0 Basis for Selection of Contractor? Bid: Small Works Roster: F Direct Negotiation: EI RFP: H Quotes: Approval Authority: (i) Director 0 Mayor 0 City Council Other Details: Clear the debris from the Dvorak barn which is located at 22306 Russell Road, ...............___........ "'ZoO KENT GOODS & SERVICES AGREEMENT between the City of Kent and Busby Junk Removal, LLC THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Busby Junk Removal, LLC organized under the laws of the State of Washington, located and doing business at 11821 1241h Ave. NE, Kirkland, WA 98034, Phone: (425) 502- 8396, Contact: Heath Williams (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: The Vendor shall clear the debris from the Dvorak Barn which is located at 22306 Russell Road, Kent, WA. For a copy of the Vendor's estimate, see Exhibit A which is attached and incorporated by this reference. Vendor acknowledges and understands that it is not the City's exclusive provider of these goods, materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and services through other sources. II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete the work and provide all goods, materials, and services by December 14, 2018. III, COMPENSATION, The City shall pay the Vendor an amount not to exceed Six Hundred Twelve Dollars and Twenty-Eight Cents ($612,28), including applicable Washington State Sales Tax, for the goods, materials, and services contemplated in this Agreement. The City shall pay the Vendor the following arnounts according to the following schedule: The Vendor shall be paid after execution of agreement and submittal of invoice. If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. GOODS & SERVICES AGREEMENT - 1 ($20,000 or Less, incl. WSST) A, Defective or Unauthorized Work. 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, Final Pa m nt: Waiver of Clalms. 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 slake 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 frorn 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. Notice of Claim. Provide a signed written notice of claim that provides the following information: 1. The date of the Vendor's claim; 2. The nature and circumstances that caused the claim; 3. The provisions in this Agreement that support the claim; 4. The estimated dollar cost, if any, of the claimed work and how that estimate was determined; and 5. An analysis of the progress schedule showing the schedule change or disruption if the Vendor is asserting a schedule change or disruption. B. Records. 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. Vendors Duty to Compiete Protested Work. In spite of any claim, the Vendor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. D. Failure to Rrotest Constututes aivr. 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. ilur to Follow Procedras Constgtutes Wg ver. By failing to follow the procedures of this section, the Vendor completely waives any claims for protested work and accepts from the GOODS & SERVICES AGREEMENT - 3 ($20,000 or Less, including WSST) City any written or oral order (including directions, instructions, interpretations, and determination). VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. IX. WARRANTY. Vendor warrants that it will faithfully and satisfactorily perform all work provided under this Agreement in accordance with the provisions of this Agreement. In addition to any other warranty provided for at law or herein, this Agreement is additionally subject to all warranty provisions established under the Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants goods are merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance with their specifications and Vendor's representations to City. The Vendor shall promptly correct all defects in workmanship and materials: (1) when Vendor knows or should have known of the defect, or (2) upon Vendor's receipt of notification from the City of the existence or discovery of the defect. In the event any part of the goods are repaired, only original replacement parts shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for an additional year beyond the original warranty period applicable to the overall work. The Vendor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the correction. X. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. XI. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Vendor's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to avoid any of these covenants of indemnification. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER INDUSTT AL INSURANCE, TITLE 51, RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Vendor refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Vendor's part, then Vendor shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Vendor's part. The provisions of this section shall survive the expiration or termination of this Agreement. GOODS & SERVICES AGREEMENT - 4 ($20,000 or Less, including WSST) XII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Vendor's own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIV. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waver of Brea h. 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 f Dis utes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; prqyideo, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section XI of this Agreement. D. Written Noliee. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent, F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any 4anguage contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Vendor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. GOODS & SERVICES AGREEMENT - 5 ($20,000 or Less, including WSST) I. Public Record& Act. The Vendor acknowledges that the City Is a public agency subject to the Public Records Act codified In Chapter 42.56 of the Revised Code of Washington and documents, notes, emails, and other records prepared or gathered by the Consultant in Its performance of this Agreement may be subject to public review and disclosure, even if those records are not produced to or possessed by the City of Kent. As such, the Vendor agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. J. Clkw Business UpglJge Required. 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. Cfankeroarts and Signatures by Fax or Email. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that signature shall have the same force and effect as if the Agreement bearing the original signature was received in person. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. All acts consistent with the authority of this Agreement and prior to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. ND OR- CITY OF KENT: By PBy: , � f�lacfa�i5 fgna (signature) Print Na e: ra nr ee N Print Name: Michael Mactutis, P.E. Its: Its: Environmental Engineering Manager (title) r^l ,,�; DATE: nve 6�� 2-6 t yy DATE: I z-LS !L t7 NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Heath Williams Timothy J. LaPorte, P.E. Busby Junk Removal, LLC City of Kent 11821 124"'Ave. NE 220 Fourth Avenue South Kirkland, WA 98034 Kent, WA 98032 (425) 502-8396 (telephone) (253) 856-5500 (telephone) N/F(facsimile) (253) 856-6500 (facsimile AM W T: ��7N k Kent City Clerk am,.o.a.awreuoa GOODS&SERVICES AGREEMENT- 6 ($20,000 or Less, Including WSST) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. By: -2 For: j LIP t±a 0U � ` Z C Title: e Date: l EEO COMPLIANCE DOCUMENTS - 1 of 3 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 of 3 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on 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 S'; e BUSBY JUNK REMOVAL 11821 1241" Ave NE ]0B ESTIMATE W15450 Kirkland, WA 98034 DATE: OCTOBER 25, 2018 Phone (877) 404-5865 PROPOSED DATE OF JOB : TB❑ To: Project: Tash Achade (206)432-6211 Barn Clean Out: 22306 Russel Road Kent, Wa 98032 f re lr vlt�ii'k:rviiMs�,r tp{:v DESCRIPTION Each truck is 12 feet long 8 feet wide and 5 feet high and holds 480 cubic feet of space priced at $545 11 a load. Price includes labor*, item removal, disposal and recycling fees Barn clean out: 1 -a) Dimensions of loose unwanted items in barn estimated at 300 cubic feet of volume or 5/8 $390 truckload. 2 -a) Estimated amount of straw in upper part of barn at 2 cubic yards for $120 per yard. $240 3 -a) Estimated amount of straw in lower extension of barn at 4+ cubic yards for $120 per yard.(Price not included in this estimate) Summary Estimated total volume is 480 cubic feet ---- ---------------------------------------------- $390 Local city discount @ $10% off------------------------------------------------------------------------- -$:39,G.DO Estimated total bedload items @ $120 per yard (discount doesn't apply) -------------- $290 Estlmated Total Volume Charge ------------------------------------------------ $591.00 RubbishTax(3.6%)--------------------------------------------------------------------------- $21.28 V Total $612.28 Thank you for your business! Partner:_ Heath Williams Signature- Date: lni2s�rp1.8.... 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. Automobile Lia9aiVity insurance covering all owned, non-owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The Commercial General Liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Automobile Uabilit insurance with a minimum combined single limit for bodily A uiry and property damage of $1,000,000 per accident. 2. Commercial General Liability: 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. EXHIBIT B (Continued ) i C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Contractor's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the 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. Ace� CERTIFICATE OF LIABILITY INSURANCE DATEnAM(DD)YYYY) (,`�" 11/29/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER cOrvTgcT Karen L Padilla CUNT Bell Anderson Agency, Inc, PHONE E.0 (425)291-5200 Ilafc Nol;(°zs zs151oo 600 SW 39th St, Suite 200 EMAIL karenp@bell-anderson.com INSURER(S)AFFOROING COVERAGE 4 NAIC# Renton WA 9BO57 INSURERA Western National Mutual Insurance 415377 INSURED INSURER e Busby Junk Removal LLC INSURER c: 11821 124th Ave. NE INSURER D: INSURER Kirkland WA 98034 INSURER F: COVERAGES CERTIFICATE NUMBER:CL18112932292 REVISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BYf PAID CLAIMS. INT4'il TYPEOF INSURANCE IhIDbL SUE3R ILLS2 WNW µDLIOY NUMIaER PA NOIIpp Y145 1-1 WYY ! MM�IIBOSYYYIY LIMITS II X 1 COMMERCIAL GENERAL LIABILITY ,,,, (f GI OCCURRENCE g 1,000,000 A ITS' NIX x.� oc,�ulz QAMAGL XO 6tHNYLII fRLMISES La nexrrr e•nsl} $ 100,000 CPP115257502 12/1/201E 12/1/2019 .. MI DInPAn�( yupenMefvl C 5,000 PI.R50hlhd&ADV INJURY 8 1,000,000 I;INl hGN12LGHl L I IMIf APIT IS PER CENERAI AGGhEGAFE .Is 2,000,000 POLICE�..xi UFrA LDC PRODUCTS COMPIOPACG S 2,000,000 C7IIFPo AUTOMOBILE LIABILITY L)MUNIU)SINULC LIMIT $ 1,000, 000 ,B dT,FI.luIC9JU _ _ A ANY Auro eoDlLv wdurty(F I r uu) 9 ALL UWNED _ -CHEDULEO rticclden Ll g 4U TOS x ,Autos CPP115227702 12/l/2018 12/1/2019 DODILYINIUFY(F X, HIRED AUTOS X AS TL D$OWNED AS INOPFRTE DARA(C J "� IGn aexmlufvy)_ I b X UMBRELLALIAB I X T 1 , EXCESS LIgB OCCUR EACH OCCURRENCE T 000 eD(} A 1 CLAIMS MADE Uem102E45402 12/1/2015 12/1/2019 AUt,Itl(rUE _11 1f000,000 I)E;fa x I Hf ILNIUSGS 10 000 li 3 WORKERS COMPENSATION AND EMPLOYERS LIABILITY YIN RrA"fIJrF R i'IDt bill ANY PROPRIETORPARTNEMErECUTIJE I " L $ A ( 6G aIM9C:MN el;llnn D E LACH ACCIDE NF 1 q NIA 1,000,000 (MM.nvlTlorym NH) CPP315257502 12/1/2018 12/1/2019 LI II,I,ISL IALMILQyEkIs Ay lest Or _ 1,000,000 6E CVCIP�LOIN Of GPI I'IFl tMCIN(a`belom 1#'A Stop Gap ELDISEASE 101L4.Y UMT i,6 1,000,000 -T DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be atta0ed it more space Is requhetl) RE; Dvorak Barn 22306 Russell Road, Kent WA- The Certificate Holder is additional insured per the attached endorsement #WNGL49 0715; Waiver of subrogation per the attached endorsement #WNGL39 0818; Primary 6 non-contributory coverage per the attached endorsement #WNGL49 0715; Per Project Aggregate per attached endorsement CG2503 0509. CERTIFICATE HOLDER CANCELLATION nyoshitake@kentwa.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 220 Fourth Ave S ACCORDANCE WITH THE POLICY PROVISIONS. Kent, WA 98032 AUTHORIZED REPRESENTATIVE JGson Webb °7A' I ..- .-.-_.— ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INSn25,,Plan,, Western National Mutual Insurance Company " 4700 West 77th Street Edina, MN 55435 WESTERN NATIONAL www.wnlns.com COMMERCIAL GENERAL LIABILITY " "°"°'h'..'°°"r A Mutual Company COVERAGE PART Group # 0001102445 Policy Period: From DECEMBER 1, 2018 To DECEMPER 1, 2019 Policy # CPP 1152575 02 12:01 A.M. standard time at the Named Insured's mailing address. Transaction RENEWAL DECLARATION��� _...__ Insured Name and Address Agent BUSBY JUNK REMOVAL LLC BELL A.NDERSON AGENCY INC 04081 11821 124TH AVE NE 600 SW 39TH ST STE 200 KIRKLAND WA 98034 RENTON, WA 98057-4919 Telephone: 425-291-5200 Business Description Type of Business Audit Period Billing Type JUNK REMOVAL LIMITED LIABILITY CO ANNUAL DIRECT IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. LIMITS OF INSURANCE General Aggregate Limit (Other than Products-Completed Operations) $ 2, 000, 000 Products - Completed Operations Aggregate Limit $ 2, 000, 000 Each Occurrence Limit $ 1, 000, 000 Personal and Advertising Injury Limit, any one person or organization $ 1, 000, 000 Medical Expense Limit, any one person $ 5, 000 Damage to Premises Rented to you, any one premises $ 100, 000 LOCATIONS OF ALL PREMISES YOU OWN, RENT OR OCCUPY Refer to attached schedule. CLASSIFICATIONS Refer to attached schedule, PREMIUM FOR THIS COVERAGE PART $ 3, 384 .00 DISCLOSURE OF PREMIUM: The portion of your annual premium attributable to coverage for certified acts of terrorism is $ ?6.FLj1 c' D Forms and Endorsements Applicable to this Policy See Forms and Endorsements Schedule Issued Date: 11/30/2018 WN GL 06 07 07 INSURED COPY Page 1 of 6 Western National Mutual Insurance Company Policy Number: CPP 1152575 02 4700 West 77th Street RENEWAL DECLARATION Edina, MN 55435 Named Insured: www.wnins.com BUSBY JUNK REMOVAL LLC FORMS AND ENDORSEMENTS SCHEDULE Coverage Line Form Number Ed. Date Description . ... ...... -----. ' t IL0123 ) o is _.. General Lrabili y _ (tl/13) WA Chances Defrn e C General Liability IL0146 (08/10 WA Common PolicyConditions General Liability IL0198 (09/08) Nuclear Energy Liab Excl Endt General :Liability CGo001 (o4/13) Comm1 Gen Liab Coverage Form General Liability CGo197 (I2107) WA Chgs-Empl-Related Practices General Liability CG0435 (12/0'/) Employee Benefits Liab Co General 1,labiIIty CG0442 (11/03) ,Stop Gap-Employers Liab-WA General Lability CG'0450 (05/08) WA Changes - Who Id An Insured General L ability CG2106 (05/14) Real Access or Disclosure General Lia}ility CG2109 (06/15) Exclusion-Unmanned Aircraft General Liability CG2116 (04/13) ExcL Designated Prof Service General L ability CG2149 (09/99) Total Pollution Feel Endorse General Liability CG2160 (09/98) Pell-Yr 2000 Computer Rel L Ot General Liability CG2175 (01/15) Excl CAT and other Outside US General Liability CG2186 (12/04) Excl-Exterior, Insul & Fin .Sys General Liability CG2426 (04/13) Amendment of Ins. Contract Def General Liability CG2503 (OS/o9) Designated Construction Proj General Liability CG2677 (12/04) WA -Fungi or Bacteria Exclusion General L ability WNGL02 (07/1.U) Punitive D vnxges Exclusion General Liability WNG'L10 (01/04) Exc1 Lead Liability Endt General. Liability WNGL104 (03/16) Cyber Liability General Liability WNGL145 (12/10) Cyber Crime Coveraqe Emit WA General Liability WNGLIS (12/16) Exclusion.-A-bestos General Liability WNGL21 (o7/1.4) Abuse or Molestation Excl General Liability WNGL39 (o8/1E?) Comm Gen Liab Enhancement Endt General Liability WNGL49 (07/15) Addl Insd-Own, Less, Cont-Auto Issued Date: 11/30/2018 WN IL 26 07 07 INSURED COPY Page 6 of 6 POLICY NUMBER: CPP 1152575 01 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): .......... Designated PER WRITTEN CONTRACT OR AGREE- MENT WHERE YOU AGREED TO PRO- VIDE A SEPARATE GENERAL AGGRE- GATE LIMIT FOR EACH PROJECT Information required to complete this Schedule, if not shown above, will be shown in the Declarations, A. For all sums which the insured becomes le- gate Limit for that designated construction gally obligated to pay as damages caused by project. Such payments shall not reduce "occurrences" under Section I - Coverage A, the General Aggregate Limit shown in the and for all medical expenses caused by acci- Declarations nor shall they reduce any dents under Section I - Coverage C, which other Designated Construction Project can be attributed only to ongoing operations General Aggregate Limit for any other at a single designated construction project designated construction project shown in shown in the Schedule above: the Schedule above. 1. A separate Designated Construction Proj- 4. The limits shown in the Declarations for ect General Aggregate Limit applies to Each Occurrence, Damage To Premises each designated construction project, and Rented To You and Medical Expense that limit is equal to the amount of the continue to apply. However, instead of General Aggregate Limit shown in the being subject to the General Aggregate Declarations. Limit shown in the Declarations, such 2. The Designated Construction Project Gen- limits will be subject to the applicable eral Aggregate Limit is the most we will Designated Construction Project General pay for the sum of all damages under Aggregate Limit. Coverage A, except damages because of B. For all sums which the insured becomes "bodily injury" or "property damage" legally obligated to pay as damages Caused by included in the "products-completed oper- "occurrences" under Section I - Coverage A, ations hazard", and for medical expenses and for all medical expenses caused by under Coverage C regardless of the accidents under Section I - Coverage C, number of: which cannot be attributed only to ongoing a. Insureds; operations at a single designated construction b. Claims made or "suits" brought; or project shown in the Schedule above: 1. Any payments made under Coverage A c. Persons or organizations making for damages or under Coverage C for claims or bringing "suits", medical expenses shall reduce the amount 3. Any payments made under Coverage A available under the General Aggregate for damages or under Coverage C for Limit or the Products-completed Opera- medical expenses shall reduce the Desig- tions Aggregate Limit, whichever is ap- nated Construction Project General Aggre- plicable; and CG 25 03 05 09 c' Insurance Services Office, Inc., 2008 Page 1 of 2 2. Such payments shall not reduce any Des- D. If the applicable designated construction proj- ignated Construction Project General act has been abandoned, delayed, or aban- Aggregate Limit. doned and then restarted, or if the authorized C. When coverage for liability arising out of the contracting parties deviate from plans, blue- "products-completed operations hazard" is prints, designs, specifications or timetables, provided, any payments for damages because the project will still be deemed to be the same of "bodily injury" or "property damage" in- construction project. chided in the "products-completed operations E. The provisions of Section III - Limits Of in hazard" will reduce the Products-completed surance not otherwise modified by this Operations Aggregate Limit, and not reduce endorsement shall continue to apply as the General Aggregate Limit nor the Desig- stipulated. nated Construction Project General Aggregate Unlit, Page 2 of 2 ° Insurance Services Office, Inc., 2008 CG 25 03 05 09 COMMERICAL GENERAL LIABILITY WIN GL 39 08 18 i COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT The Commercial General Liability Enhancement Endorsement is an optional endorsement that provides coverage en- hancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is pro- vded by this summary, refer to following endorsement for changes in your policy. SUMMARY OF COVERAGES PAGE Bodily Injury And Property Damage Liability Non Owned Watercraft Up To 50 Feet ...............................................................................2 Property Damage Liability • Elevators........ . ..__..........._...,,. ........ .......... ............3 • Fire, Lightning, Explosion Or Sprinkler Leakage Exception ...__..........................................3 • Borrowed Equipment ($25,000 Per Occurrence, $50,000 Aggregate, $2,500 Deductible Per Occurrence ..............._............._..........,,,,,,,.............,.................,,3 Supplementary Payments — Amended • Bail Bonds Up To $5,000. . ......... .. ............,,,.,,,.,,.... .........., _.... .. ,,..........4 • Loss of Earnings Up To $500/Day ............................................._.............,........................4 Who Is An Insured Amendments • Employee Bodily Injury To A Co-Employee........................................._...........................,..4 • Newly Formed Or Acquired Organizations For Up To 180 Days ..... ................................4 • Blanket Additional Insured —Vendors —As Required By Contract .. 4 • Blanket Additional Insured — Lessor Of Leased Equipment......_.__......................................6 • Blanket Additional Insured — Managers Or Lessors Of Premises__ .. ...... • Blanket Additional Insured — State Or Governmental Agency Or Subdivision Or Political Subdivision — Permits Or Authorizations ......................................................7 • Blanket Additional Insured — State Or Governmental Agency Or Subdivision Or Political Subdivision — Permits Or Authorizations Relating To Premises ......................8 Damage To Premises Rented To You — $300,000.........................................................................9 Medical Payments Increased Limit — $1 0,000 Or Amount Shown on Declarations .............................9 Conditions • Knowledge of Occurrence, Offense, Claim Or Suit Amended................... ...... ... ._.........._..9 • Unintentional Failure To Disclose Hazards .......................................................................9 Waiver of Subrogation..... ......... _ ......... ...... .... ..... 10 Insured Contract Amended........ ..... _ . , .....,..... 10 Personal And Advertising Injury Redefined • Televised, Videotaped Or Electronic Publication 10 WIN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission, Page 1 of 10 COMMERCIAL GENERAL LIABILITY W N GL 39 08 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. SECTION I— COVERAGES AMENDMENTS (3) Parking an "auto" on, or on the ways next to, COVERAGE A — BODILY INJURY AND PROPERTY premises you own or rent, provided the"auto" DAMAGE LIABILITY is not owned by or rented or loaned to you or the insured, A. Non Owned Aircraft Or Watercraft (4) Liability assumed under any "insured con- Item 2. Exclusions, Paragraph g. is replaced by the tract" for the ownership, maintenance or use following of aircraft or watercraft; or g. Aircraft, Auto Or Watercraft (5) "Bodily injury" or "property damage" arising "Bodily injury" or"property damage' arising out of out of. the ownership, maintenance, use or entrustment (a) The operation of machinery or equipment to others of any aircraft, "auto" or watercraft that is attached to, or part of, a land owned or operated by or rented or loaned to any vehicle that would qualify under the insured. Use includes operation and "loading or definition of "mobile equipment" if it were unloading". not subject to a compulsory or financial This exclusion applies even if the claims against responsibility law or other motor vehicle any insured allege negligence or other wrong- insurance law where it is licensed or doing in the supervision, hiring, employment, principally garaged; or training or monitoring of others by that insured, if (b) The operation of any of the machinery or the "occurrence" which caused the "bodily injury" equipment listed in Paragraph f. (2) or f. or "property damage" involved in the ownership, (3) of the definition of "mobile equip- maintenance, use or entrustment to others of any ment". aircraft. "auto" or watercraft that is owned or B. Damage To Property Coverage Extensions operated by or rented or loaned to any insured. Item 2. Exclusions, Paragraph j. is replaced by the This exclusion does not apply to: following: (1) A watercraft while ashore on premises you j. Damage To Property own or rent; (2) A watercraft you do not own that is: "Property damage' to: (a) Less than 50 feet long; and (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or (b) Not being used to carry persons or prop- any other person, organization or entity, for erty for a charge, repair, replacement, enhancement, restora- This Subparagraph (2) applies to any person, tion or maintenance of such property for any who with your expressed or implied consent, reason, including prevention of injury to a either uses or is responsible for the use of the person or damage to another's property, watercraft; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises, WN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission„ Page 2 of 10 (3) Property loaned to you, The insurance provided for "property damage" from (4) Personal property in the care, custody or con- the use of elevators and for "property damage" to trol of the insured, borrowed equipment is excess over any other valid and collectible property insurance (Including any de- (5) That particular part of real property which ductible portion thereof) available to the insured you or any contractors or subcontractors working directly or indirectly on your behalf whether primary, excess, contingent or on any other I are performing operations, if the "property basis. damage" arises out of those operations, or C. Damage To Premises Rented To You (6) That particular part of any property that must Item 2. Exclusions, the last paragraph is replaced by be restored, repaired or replaced because the following: "your work" was incorrectly performed on it. Exclusions c. through n. do not apply to damage by Paragraphs (1), (3) and (4) of this exclusion do not fire, lightning, explosion or sprinkler leakage to apply to "property damage" (other than damage by premises while rented to you or temporarily occupied fire, lightning, explosion or sprinkler leakage) to by you with permission of the owner, A separate limit premises, including the contents of such premises, of insurance applies to this coverage as described in rented to you for a period of seven or fewer Paragraph 6. of SECTION III — LIMITS OF consecutive days. A separate limit of insurance INSURANCE. applies to Damage To Premises Rented To You as described in SECTION III —LIMITS OF INSURANCE. COVERAGE B — PERSONAL AND ADVERTISING However, the provisions of this paragraph do not INJURY LIABILITY apply if coverage for Damage To Premises Rented To You is excluded by endorsement. D. Personal And Advertising Injury Item 2. Exclusions is amended by replacing Sub- Paragraph (2) of this exclusion does not apply if the paragraphs b. and c. with the following: premises are "your work" and were never occupied, rented or held for rental by you. b. Material Published With Knowledge Of Falsity Paragraphs (3) and (4) of this exclusion do not apply "Personal and advertising injury" arising out of to the use of elevators, oral, written, televised, videotaped or electronic publication, in any manner, of material, if done by Paragraphs (3), (4), (5) and (6) of this exclusion do or at the direction of the insured with knowledge not apply to liability assumed under a sidetrack of its falsity. agreement. c. Material Published Prior To Policy Period Paragraph (4) of this exclusion does not apply to "Personal and advertising injury" arising out of property damage" to borrowed equipment while not oral, written, televised, videotaped or electronic being used to perform operations at the jobsite. publication, in any manner, of material whose first Subject to Paragraph 2. of SECTION III—LIMITS OF INSURANCE, the rules below fix the most we will pay publication took place before the beginning of the policy period. for "property damage" under this provision: (1) $25,000 any one "occurrence", regardless of the SUPPLEMENTARY PAYMENTS —COVERAGES A number of persons or organizations who sustain AND B damages because of that "occurrence'; E. Supplementary Payments —Coverages A and B (2) $50,000 annual aggregate, and Item 1. is amended by replacing Subparagraphs b. (3) We will pay only for damages in excess of$2,500 and d. with the following: as a result of any one "occurrence", regardless of b. Up to $5,000 for cost of bail bonds required be- the number of persons or organizations who cause of accidents or traffic law v,olations arising sustain damages because of that ''occurrence", out of the use of any vehicle to which the Bodily We may, or if required by law, pay all or any part Injury Liability Coverage applies. We do not have of any deductible amount, if applicable, to effect to furnish these bonds. settlement of any claim or "suit''. Upon notice of our payment of a deductible amount, you shall d. All reasonable expenses incurred by the insured promptly reimburse us for the part of the at our request to assist us in the investigation or deductible amount we paid. defense of the claim or"suit", including actual loss Paragraph (6) of this exclusion does not apply to of earnings up to $500 a day because of time offfrom work. "property damage" included in the "products-com- pleted operations hazard". WIN GL 39 08 18 Includes copyrighted material of the Insurance Service office, Inc.,with its permission,. Page 3 of 10 SECTION II—WHO IS AN INSURED AMENDMENTS The following are added: A. Employee Bodily Injury To A Co-Employee C. Blanket Additional Insured — Vendors — As Re- Paragraph 2. a. (1) is replaced by the following: quired By Contract However, none of these employees" or "volunteer 1. Section II — Who Is An Insured is amended to workers" are insureds for 'bodily injury" or "personal include as an additional insured any person(s) or and advertising injury": organizaticn(s) (referred to throughout this (a) To you, to your partners or members (if you are a endorsement as vendor) with whom you have partnership or joint venture), to your members (if agreed in a written contract, executed prior to you are a limited liability company), to a cc- loss, to name as an additional insured, but only "employee" while in the course of his or her with respect to "bodily injury" or "property employment or performing duties related to the damage" arising out of"your products" which are conduct of your business, or to your other distributed or sold in the regular course of the "volunteer workers" while performing duties vendor's business. related to the conduct of your business, However, (b) To the spouse, child, parent, brother or sister of a. The insurance afforded to such vendor only the co-"employee" or "volunteer worker' as a applies to the extent permitted by law; and consequence of Paragraph (1)(a) above; b. If coverage promded to the vendor is required (c) For which there is any obligation to share by a contract or agreement, the insurance damages with or repay someone else who must afforded to such vendor will not be broader pay damages because of the injury described in than that which you are required by the Paragraph (1)(a) or (b) above, or contract or agreement to provide for such (d) Arising out of his or her providing or failing to vendor. provide professional health care services. 2. With respect to the insurance afforded to these However, if a suit seeking damages for "bodily injury" vendors, the following additional exclusions 1 ry„ or "personal and advertising injury" to any cc- apply: "employee" or other "volunteer worker' arising out of a. The insurance afforded the vendor does not and in the course of the co-"employee's" or"volunteer apply to worker's" employment or while performing duties (1) "Bodily injury" or "property damage" for related to the conduct of your business, or a suit which the vendor is obligated to pay dam- seeking damages brought by the spouse, child, ages by reason of the assumption of parent, brother or sister of the cc-"employee" or other liability in a contract or agreement. This ..volunteer worker', is brought against you or a cc- exclusion does not apply to liability for "employee" or a "volunteer worker', we will reimburse damages that the vendor would have in the reasonable costs that you incur in providing a the absence of the contract or defense to the co-"employee" or 'volunteer worker" agreement, against such matters. Any reimbursement made (2) Any express warranty unauthorized by pursuant to this sub section will be in addition to the you; limits of liability set forth in the Declarations. (3) Any physical or chemical change in the B. Newly Acquired Organizations product made intentionally by the vendor; Paragraph 3. a. is replaced by the following: (4) Repackaging, except when unpacked a. Coverage under this provision is afforded only solely for the purpose of inspection, until the 180th day after you acquire or form the demonstration, testing, or the organization or the end of the policy period, substitution of parts under instructions whichever is earlier; from the manufacturer, and then repackaged in the original container, W N GL 39 OH 18 Includes copyrighted material of the Insurance Service Office, Inc with its permission, Page 4 of 10 (5) Any failure to make such inspections, 4. With respect to the insurance afforded to these adjustments, tests or servicing as the vendors, the following is added to Section III — vendor has agreed to make or normally Limits Of Insurance, undertakes to make in the usual course If coverage provided to the vendor is required by of business, in connection with the a contract or agreement, the most we will pay on distribution or sale of the products, behalf of the vendor is: (6) Demonstration, installation, servicing or repair operations, except such a. The minimum amount required by the operations performed at the vendor's contract or agreement, or premises in connection with the sale of b. The Limits of Insurance shown in the the product, Declarations, (7) Products which, after distribution or sale whichever is less. by you, have been labeled or relabeled or used as a container, part or ingredient of This endorsement shall not increase the any other thing or substance by or for the applicable Limits of Insurance shown in the vendor, or Declarations. (8) "Bodily injury or "property damage" 5. With respect to the insurance afforded to these arising out of the sole negligence of the additional insureds, the following additional vendor for its own acts or omissions or exclusion applies: those of its employees or anyone else This insurance does not apply to: acting on its behalf. However, this exclusion does not apply to. a. "Bodily injury", "property damage" or "personal and advertising injury" arising out (i) The exceptions contained in of the rendering of, or the failure to render, Subparagraphs (4) or (6), or any professional architectural, engineering or (ii) Such inspections, adjustments, tests surveying services, including: or servicing as the vendor has (1) The preparing, approving, or failing to agreed to make or normally prepare or approve, maps, shop undertakes to make in the usual drawings, opinions, reports, surveys, course of business, in connection field orders, change orders or drawings with the distribution or sale of the and specifications; or products. (2) Supervisory, inspection, architectural or 3. This Provision C. does not apply: engineering activities. a. To any insured person or organization from This exclusion applies even if the claims whom you have acquired such products, or any ingredient, part or container, enteringagainst an additional insured allege negligence or other wrongdoing in the into, accompanying or containing such supervision, hiring, employment, training products, or monitoring of others by that insured, if b. To any vendor for which coverage as an addi- the "occurrence" which caused the tional insured specifically is scheduled by "bodily injury" or "property damage", or endorsement; or the offense which caused the "personal c. When liability included within the "products- and advertising injury", involved the completed operations hazard" has been ex- rendering of or failure to render any cluded for such product either by the provi- professional services by youwith respect sions of the coverage part or by endorse- to your providing engineering, ment, architectural or surveying services in your capacity as an engineer, architect or surveyor„ WN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc„w ith its permission, Page 5 of 10 D. Blanket Additional Insured — Lessor Of Leased 4. With respect to the insurance afforded to these additional insureds, the following additional Equipment exclusion applies, 1. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or This insurance does not apply to: organization(s) from whom you lease equipment a. "Bodily injury", "property damage" or when you and such person(s) or organization(s) "personal and advertising injury" arising out have agreed in writing in a contract or agreement, of the rendering of, or the failure to render, executed prior to loss, that such person(s) or any professional architectural, engineering or organization(s) be added as an additional insured surveying sevices, including: on your policy. Such person(s) or organization(s) (1) The preparing, approving, or failing to is an insured only with respect to liability for prepare or approve, maps, shop "bodily injury", "property damage" or "personal drawings, opinions, reports, surveys, and advertising injury"caused, in whole or in part, field orders, change orders or drawings by your maintenance, operation or use of and specifications, or equipment leased to you by such persons) or eroiso(y) Su organization(s). p ry, inspection, architectural or engineering activities, However, the insurance afforded to such additional insured: This exclusion applies even if the claims against an additional insured allege a. Only applies to the extent permitted by law, negligence or other wrongdoing in the and Supervision, hiring, employment, training or b. Will not be broader than that which you are monitoring of others by that insured, if the required by the contract or agreement to 'occurrence" which caused the "bodily injury" provide for such additional insured, or "property damage", or the offense which A person's or organization's status as an addi- caused the "personal and advertising injury", tional insured under this endorsement ends when involved the rendering of or failure to render their contract or agreement with you for such any professional services by you with respect leased equipment ends. to your providing engineering, architectural or 2. With respect to the insurance afforded to these surveying services in your capacity as anengineer, architect or surveyor. additional insureds, this insurance does not apply to any "occurrence" which takes place after the E. Blanket Additional Insured — Managers Or Les- equipment lease expires. sors Of Premises 3. With respect to the insurance afforded to these 1. Section II — Who Is An Insured is amended to additional insureds, the following is added to include as an additional insured any person(s) or Section III — Liniils Of Insurance organization(s) with whom you have agreed in a If coverage provided to the additional insured is written contract, executed prior to loss, to name required by a contract or agreement, the most we as an additional insured, but only with respect to will pay on behalf of the additional insured is liability arising out of the ownership. maintenance a. The minimum amount required by the or use of that part of the premises leased to you, contract or agreement; or subject to the following additional exclusions: b. The Limits of Insurance shown in the This insurance does not apply to: Declarations, a. Any"occurrence" which takes place after you whichever is less. cease to be a tenant in that premises. This endorsement shall not increase the b. Structural alterations, new construction or applicable Limits of Insurance shown in the demolition operations performed by or on Declarations, behalf of such additional insured. WIN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc„with its permission. Page 6 of 10 However: F. Blanket Additional Insured — State Or a. The insurance afforded to such additional Governmental Agency Or Subdivision Or Political insured only applies to the extent permitted Subdivision — Permits Or Authorizations by law, and Section II — Who Is An Insured is amended to in- b. If coverage provided to the additional insured clude as an additional insured any state or is required by a contract or agreement, the governmental agency or subdivision or political insurance afforded to such additional insured subdivision with whom you have agreed in a written will not be broader than that which you are contract, executed prior to loss, to name as an required by the contract or agreement to additional insured, subject to the following provsiens provide for such additional insured 1. This insurance applies only with respect to op- t. With respect to the insurance afforded to these erations performed by you or on your behalf for additional insureds, the following is added to which the state or governmental agency or sub- Section III— Limits Of Insurance: division or political subdivision has issued a If coverage provided to the additional insured is permit or authorization, required by a contract or agreement, the most we However: will pay on behalf of the additional insured is a. The insurance afforded to such additional a. The minimum amount required by the insured only applies to the extent permitted contract or agreement, or by law, and b. The Limits of Insurance shown in the b. If coverage provided to the additional insured Declarations, is required by a contract or agreement, the insurance afforded to such additional insured whichever is less. will not be broader than that which you are This endorsement shall not increase the required by the contract or agreement to applicable Limits of Insurance shown in the provide for such additional insured. Declarations. 2. This insurance does not apply to 3. With respect the insurance afforded these a "Bodily injury", "property damage" or "per- exclusion applies, additional insureds, reds, the following add .additional sonal and advertising injury" arising out of op- erations performed for the federal govern- This insurance does not apply to: ment, state or municipality; or a. "Bodily injury", y damage" or b. "Bodily injury" or "property damage" included "property .,personal and advertising injury" arising out within the "products-completed operations of the rendering of, or the failure to render, hazard". any professional architectural, engineering or 3. With respect to the insurance afforded to these surveying services, including: additional insureds, the following is added to (1) The preparing, approving, or failing to Section III— Limits Of Insurance: prepare or approve, maps, shop f coverage provded to the additional insured is drawings, opinions, reports, surveys, required by a contract or agreement, the most we field orders, change orders or drawings and specifications; or will pay on behalf of the additional insured is. b required amount The minimum amou re (2) Supennsory, inspection, architectural or a. q Y the engineering activities, contract or agreement; or This exclusion applies even if the claims b. The Limits of Insurance shown in the against an additional insured allege Declarations, negligence or other wrongdoing in the whichever is less. supervision, hiring, employment, training or This endorsement shall not increase the monitoring of others by that insured, if the applicable Limits of Insurance shown in the "occurrence" which caused the "bodily injury" Declarations. or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. WN GL 39 08 18 Includes Copyrighted material of the Insurance Service Qffice, Inc.,with its permission. Page 7 of 10 4. With respect to the insurance afforded to these b. The construction, erection or removal of additional insureds, the following additional elevators; or exclusion applies c. The ownership, maintenance or use of any This insurance does not apply to elevators covered by this insurance. a. "Bodily injury", "property damage" or However, ,.personal and advertising injury" arising out a. The insurance afforded to such additional of the rendering of, or the failure to render, insured only applies to the extent permitted any professional architectural, engineering or by law, and surveying services, including: b. If coverage provided to the additional insured (1) The preparing, approving, or failing to is required by a contract or agreement, the prepare or approve, maps, shop insurance afforded to such additional insured drawings, opinions, reports, surveys, will not be broader than that which you are field orders, change orders or drawings required by the contract or agreement to and specifications, or provide for such additional insured. (2) Supervisory, inspection, architectural or 2. With respect to the insurance afforded to these engineering activities. additional insureds, the following is added to This exclusion applies even if the claims Section III — Limits Of Insurance: against an additional insured allege If coverage provided to the additional insured is negligence or other wrongdoing in the required by a contract or agreement, the most we supervision, hiring, employment, training or will pay on behalf of the additional insured is. monitoring of others by that insured, if the "occurrence" which caused the ''bodily injury" a. The minimum amount required by the or "property damage", or the offense which contract or agreement, or caused the "personal and advertising injury", b. The Limits of Insurance shown in the involved the rendering of or failure to render Declarations, any professional services by you with respect to your providing engineering, architectural or whichever is less. surveying services in your capacity as an This endorsement shall not increase the engineer, architect or surveyor. applicable Limits of Insurance shown in the G. Blanket Additional Insured — State Or Declarations. Governmental Agency Or Subdivision Or Political 3. With respect to the insurance afforded to these Subdivision —Permits Or Authorizations Relating additional insureds, the following additional To Premises exclusion applies: Section II — Who Is An Insured is amended to in- This insurance does not apply to'. clude as an additional insured any state or a. "Bodily Injury", "property damage" or governmental agency or subdivision or political '.personal and advertising injury" arising out subdivision with whom you have agreed in a written of the rendering of, or the failure to render, contract, executed prior to loss, to name as an any professional architectural, engineering or additional insured, subject to the following provision: surveying services, including: 1. This insurance applies only with respect to the fol- (1) The preparing, approving, or failing to lowing hazards for which the state or prepare or approve, maps, shop governmental agency or subdivision or political drawings, opinions, reports, surveys, subdivision has issued a permit or authorization field orders, change orders or drawings in connection with premises you own, rent or and specifications; or control and to which this insurance applies: (2) Supervisory, inspection, architectural or a. The existence, maintenance, repair, engineering activities. construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or WIN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc with its permission.. Page 8 of 10 This exclusion applies even if the claims SECTION IV — COMMERCIAL GENERAL LIABILITY against an additional insured allege CONDITIONS AMENDMENTS negligence or other wrongdoing in the supervision, hiring, employment, training or A. Knowledge Of Occurrence monitoring of others by that insured, if the Item 2. Duties In The Event Of Occurrence, Of- "occurrence" which caused the "bodily injury" fense, Claim or Suit is amended by adding the fol- or "property damage', or the offense which lowing: caused the "personal and advertising injury", e. You must give us or our authorized representa- involved the rendering of or failure to render tive prompt notice of an "occurrence", claim or any professional services by you with respect loss only when the "occurrence", claim or loss is to your providing engineering, architectural or surveying services in your capacity as an known to: engineer, architect or surveyor. (1) You, if you are an individual, (2) A partner, if you are a partnership, SECTION III —LIMITS OF INSURANCE AMENDMENTS (3) An executive officer or insurance manager, if you are a corporation', or A. Damage To Premises Rented To You (4) A member or manager, if you are a limited Paragraph 6. is replaced by the following: liability company. 6. Subject to Paragraph 5. above, the most we will B. Other Insurance pay under Coverage A for damages because of Item 4. Other Insurance, b. Excess Insurance (1) "property damage" to any one premises, while a u is replaced b the following:E rented to you, or in the case of damage by fire, (a) ( ) p y lightning, explosion or sprinkler leakage, while (ii) That is fire, lightning, explosion or sprinkler leak- rented to you or temporarily occupied by you with age insurance for premises rented to you or permission of the owner is the greater of. temporarily occupied by you with permission of a. $300,000; or the owner; C. Unintentional Failure To Disclose Hazards b. The amount shown next to the Damage To Premises Rented To You Limit in the Decla- Item 6. Representations is replaced by the following: rations, 6. Representations And Unintentional Failure To However, the provisions of this paragraph do not Disclose Hazards apply if Damage To Premises Rented To You a. By accepting this policy, you agree: Coverage is excluded by endorsement. (1) The statements in the Declarations are B. Medical Expense Limit accurate and complete, Paragraph 7. is replaced with the following: (2) Those statements are based upon repre- sentations you made to us; and 7. Subject to Paragraph 5. above, the most we will (3) We have issued this policy in reliance pay under Coverage C for all medical expenses upon your representations. because of "bodily injury" sustained by any one person is the greater of: b. If you unintentionally fail to disclose any haz- ards existing at the inception date of your a. $10,000; or policy, we will not deny coverage under this b. The amount shown next to the Medical Ex- Coverage Part because of such failure. pense Limit in the Declarations. However, this provision does not affect our This insurance does not apply if coverage for right to collect additional premium or exercise Medical Expenses is excluded either by the pro- our right of cancellation or non-renewal. visions of the coverage part or by endorsement. W N GL 39 08 18 Includes copyrighted material of the Insurance Service Cfice, Inc„with its permission. Page 9 of 10 D. Waiver of Subrogation SECTION V — DEFINITIONS AMENDMENTS Item 8. Transfer of Rights of Recovery Against A. Insured Contract Amended Others to Us Is hereby amended by the addition of the following: Paragraph 9. a. is replaced by the following: We waive any right of recovery we may have because a. A contract for a lease of premises. However, that of payments we make for injury or damage arising out portion of the contract for a lease of premises that of your ongoing operations or"your work"' done under indemnifies any person or organization for a written contract., executed prior to loss, requiring damage by fire, lightning, explosion or sprinkler such waiver with that person or organization and leakage to premises while rented to you or included in the "products completed operations temporarily occupied by you with permission of hazard". However, our rights may only be waived the owner is not an "insured contract"; prior to the "occurrence"' giving rise to the injury or B. Personal And Advertising Injury Redefined damage for which we make payment under this Paragraph 14. d. and e.are replaced by the following: Coverage Part. The insured must do nothing after a loss to impair our rights. At our request, the insured d. Oral, written, televised, videotaped or electronic will bring "suit" or transfer those rights to us and help publication of material that slanders or libels a us enforce those rights person or organization or disparages a person's or organization's goods, products or service; e. Oral, written, televised, videotaped or electronic publication of material that violates a person's right of privacy, W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission, Page 10 of 10 COMMERCIAL GENERAL LIABILITY WIN GL490715 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU PRIMARY AND NONCONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or or- additional insureds, the following additional exclu- ganizatior for whom you are performing opera- sion applies: tions when you and such person or organization This insurance does not apply to: have agreed in writing in a contract or agreement 1. "Bodily injury", "property damage"or "personal that such person or organization be added as an and advertising injury" arising out of the ren- additional insured on your policy. Such person or dering of, or the failure to render, any profes- organization is an additional insured only with re- sional architectural, engineering or surveying spect to liability for "bodily injury', "property dam- services, including: age" or "personal and advertising injury" caused, a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, 1. Your acts or omissions, or opinions, reports, surveys, field orders, 2. The acts or omissions of those acting on your change orders or drawings and specifica- behalf; dons; or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities, A person's or organization's status as an additional This exclusion applies even if the claims insured under this endorsement ends when your against an additional insured allege negli- operations for that additional insured are complet- gence or other wrongdoing in the supervision, ed. hiring, employment, training or monitoring of However: others by that insured, if the "occurrence" 1. The insurance afforded to such additional in- which caused the "bodily injury" or "property shred only applies to the extent permitted by damage'', or the offense which caused the law; and "personal and advertising injury', involved the rendering of or failure to render any profes- 2. If coverage provided to the additional insured sional services by you with respect to your is required by a contract or agreement, the in- providing engineering, architectural or survey. surance afforded to such additional insured ing services in your capacity as an engineer, will not be broader than that which you are re- architect or surveyor. quired by the contract or agreement to provide for such additional insured. WN GL 49 07 15 Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc.,with its permission., 2. "Bodily injury" or "property damage" occurring D. The following is added to the Other Insurance after: Condition and supersedes any provision to the a. All work, including materials, parts or contrary: equipment furnished in connection with Primary And Noncontributory Insurance such work, on the project (other than ser- vice, maintenance or repairs) to be per- This insurance is primary to and will not seek formed by or on behalf of the additional in- any contribution from any other insurance sured(s) at the location of the covered available to an additional insured under your operations has been completed; or policy provided that: b. That portion of "your work" out of which (1) The additional insured is a Named Insured the injury or damage arises has been put under such other insurance, and to its intended use by any person or or- (2) You have agreed in writing in a contract or ganization other than another contractor or agreement that this insurance would be subcontractor engaged in performing op- primary and would not seek contribution erations for a principal as a part of the from any other insurance available to the same project. additional insured. C. With respect to the insurance afforded to these additional insureds, the following is added to Sec- tion III—Limits Of Insurance. If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: 1. The minimum amount required by the contract or agreement, or 2. The Limits of Insurance shown in the Declara- tions; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. WIN GL 49 07 15 Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc.,with its permission.