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CAG2019-038 - Original - Gray & Osborne, Inc. - 640 Zone Booster Station Constrution Management Support Services - 01/29/2019
�41T Records Management Document CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to the City Clerk's Office. All portions are to be completed. If you have questions, please contact the City Clerk's Office at 253-856-5725. Vendor Name: Gray & Osborne, Inc. Vendor Number (IDE): Contract Number (City Clerk): Category: _Contract Agreement Sub-Category (if applicable): None Project Name: 640 Zone Booster Station Mayor' Sig attire 12/31/20 Contract Execution Date: Termination Date: Phil McConnell PW: Engineering Contract Manager: Department: g g Contract Amount: $49,954.00 Budgeted: ❑✓ Grant? Part of NEW Budget: Local: ❑ State: ❑ Federal: Related to a New Position; Basis for Selection of Contractor? Other Approval Authority: ❑ Director ✓❑ Mayor O City Council Other Details: Provide construction management support services for the oroiect. 0T CONSULTANT SERVICES AGREEMENT between the City of Kent and Gray & Osborne, Inc. THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Gray & Osborne, Inc. organized under the laws of the State of Washington, located and doing business at 1130 Rainier Ave. S., Suite 300, Seattle, WA 98144, Phone: (206) 284- 0860, Contact: Russ Porter (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: The Consultant shall provide construction management support services for the 640 Zone Booster Station Project. For a description, see the Consultant's Scope of Work which is attached as Exhibit A and incorporated by this reference. Consultant further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices within the Puget Sound region in effect at the time those services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon the effective date of this Agreement. Consultant shall complete the work described in Section I by December 31, 2020. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Forty Nine Thousand, Nine Hundred Fifty Four Dollars ($49,954.00), for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above,, and shall riot be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's biking rates shall be as delineated in Exhibit B. B. The Consultant shall submit monthly payment invoices to the City for work performed, and a final bill upon completion of all services described in this Agreement. The City shall provide payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any portion of an invoice, it shall notify the Consultant and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor- Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: CONSULTANT SERVICES AGREEMENT - 1 (Over$20,000) A. The Consultant has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Consultant maintains and pays for its own place of business from which Consultant's services under this Agreement will be performed. C. The Consultant has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Consultant's services, or the Consultant is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D, The Consultant is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. E. The Consultant has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Consultant's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Consultant maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project, which may be used by the City without restriction. If the City's use of Consultant's records or data is not related to this project, it shall be without liability or legal exposure to the Consultant. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates, Consultant shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, Injuries, damages, losses or suits, including ail legal costs and attorney fees, arising out of or in connection with the Consultant's Performance of this Agreement, except for that portion of the injuries and damages caused by the City's negiligence, The City's inspection or acceptance of any of Consultant's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out or bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, Its officers, Officials, employees, agents and volunteers, the Consultant's duty to defend, indemnify, and hold the City harmless, and Consultant's liability accruing from that obligation shall be only to the extent of the Consultant's negligence. CONSULTANT SERVICES AGREEMENT - 2 (Over$20,000) IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Consultant refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant's part, then Consultant shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Consultant's part. The provisions of this section shall survive the expiration or termination of this Agreement. VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit C attached and incorporated by this reference. IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work under this Agreement. X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents, and files available to the City upon the City's request. The Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. The City's use or reuse of any of the documents, data, and files created by Consultant for this project by anyone other than Consultant on any other project shall be without liability or legal exposure to Consultant. XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor with the authority to control and direct the performance and details of the work authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the Contract work and shall utilize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIII. MISCELLANEOUS PROVISIONS. A. ec elab8e Materdals. 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-Waiver rf Breach. 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. Reso9ution of Disputes aotd „G vernir7o-- 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 CONSULTANT SERVICES AGREEMENT - 3 (Over$20,000) of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section VII of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. A nment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modifi a 'ion. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Consultant. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. 1. Public. Retards Asti. The Consuiltant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes, emails, and other records prepared or gathered by the Consultant in its performance of this Agreement may be subject to public review and disclosure, even if those records are not produced to or possessed by the City of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act, J. City i3usiness License 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, CONSULTANT SERVICES AGREEMENT - 4 (Over$20,000) K. t=iuJ�te�la4br_ft;,. Ind ,irk. r)atlirees 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. CONSULTANT _.L.CITY OF KENT: __ .__... ... � By B y: a#iir of err�+) (signature) Print Name: Print Name: Dana Ral h its Prosldcni -. � ---" --- .. .,. .�___..� Its Mavqr (title) DATE:_..1 25,.{..1. ... DATE � .. ... NOTICES TO BE SENT TO: NOTICES TO BE SENT TO CONSULTANT: CITY OF KENT: Russ Porter Timothy J. LaPorte, P.E. Gray & Osborne, Inc, City of Kent 1130 Rainier Ave. S., Suite 300 220 Fourth Avenue South Seattle, WA 98144 Kent, WA 98032 (206) 284-0860 (telephone) (253) 856-5500 (telephone) 206) 283 3206 (facsimile) (253) 856 6500 (facsimile) APPROVED AS TO FORM Kent Law Department A7T= Kent City Clerk CONSULTANT SERVICES AGREEMENT - 5 (Over$20,000) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with Lhe regulations of the City's equal employment opportunity policies. The following questions specifically Identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 1 During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer, 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. By:�✓ ; ill For; GraV & Osborne, Inc, Title: PreSideuL Date: 1/25/I9 EEO COMPLIANCE DOCUMENTS - 1 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1„ Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (date), between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. By: For: Title: Date: EEO COMPLIANCE DOCUMENTS - 3 EXHIBIT "A" SCOPE OF WORK CITY OF KENT 640 ZONE BOOSTER STATION (PROJECT W20031)j CONSTRUCTION MANAGEMENT This contract amendment is for limited construction management services to support City of Kent staff for the construction of the 640 Zone Booster Station. This scope amends the previous Scopes of Work for design. This Scope of Work assumes the following items. The City of Kent will provide the day to day resident inspection. The City of Kent will coordinate special inspection under a separate contract. The City of Kent will take care of all monthly progress reports, certified payrolls, closeout paperwork, and general construction administration. SCOPE OF WORK Task 1 — Project Management and Oversight Objective: To provide overall project management and oversight of the project work. A. Ensure sufficient staff resources are dedicated to the project. B. Manage project budget and schedule. C. Prepare and provide monthly progress reports and invoices. Task 2 —Attend Preconstruction and Site Meetings Objective: To provide onsite attendance and support for the preconstruction meeting and additional site meetings, as necessary, to address construction issues as they arise. A. Attend preconstruction meeting with three Gray & Osborne personnel held and coordinated by City of Kent. B, Attend up to four meetings with two Gray & Osborne engineering personnel during construction to address construction issues as they arise. Additional meeting attendance can be provided on a cost basis if desired. Gr'ON1secr Page I oft Task 3— Office Support Objective: To provide office support including answering RFIs and submittal review. A. Answer contractor RFIs at the request of City of Kent staff. B. Provide submittal review at the request of City of Kent staff. Task 4 —Attend Witness Test at Control Panel Shop Objective: To provide the witness test at the control panel fabricator's shop per Specification Section 16940. A. A Gray & Osborne electrical engineer will attend the control panel shop test with City staff at System Interface, the control panel fabricator. B. Provide documentation of any control panel issues that require correction. Task 5— Startup and Commissioning Objective: To provide onsite attendance and support for startup and commissioning. A. Provide City staff with a startup protocol including system startup checklists. B. Attend startup and commissioning and provide onsite pressure, flow, and amperage testing to verify that each pump is operating correctly within the specifications and manufacturer's submittal information. C. Provide documentation of the startup and pump test for the City's records. Task 6—Provide Record Drawings Objective: To provide record drawings based upon Contractor and City staff markups. A. Modify project plan sheets per Contractor and City construction markups. B. Provide final record drawings in CAD and pdf forms for City records. Gv.(7 of i 6622 Page 2 of 2 N W � ; L O N rt 06 U y�q 'L7 U J J (t$ W C" N L n N Vl U G m '0 6S N U" w W ® yti W nr V co �'C W ;� o ar ❑ x1 `fl � rA � ❑ id C O �, �J L d° o o m U ,. m m d X G o W ° c EXHIBIT C INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS Insurance The Consultant 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 Consultant, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Automobile Lability 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 equivaient 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 Consultant'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. 4. Professional Liabiiity insurance appropriate to the Consultant's profession. B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $3,000,000 each occurrence, $3,000,000 general aggregate. EXHIBIT C (Continued) 3. Professional Liability insurance shall be written with limits no less than $3,000,000 per claim and $3,000,000 policy aggregate limit. 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 Consultant'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 Consultant's insurance and shall not contribute with it. 2. The Consultant'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 Consultant 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 Consultant'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 A:VII. E. Verification of Coverage Consultant 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 Consultant before commencement of the work. F. Subcontractors Consultant 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 Consultant. Isis- CERTIFICATE OF LIABILITY INSURANCE OATE25120/VYYYI �-"' 1 rzs/zo1 s 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 INSURERIS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT:. It the certificate holder is an ADDITIONAL INSURED,the pa8cy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the pottcy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Has of such andorsement(s). Hall PRODUCER 101h Ave NE Meg Alilson Barge Hall&Com an GQ.mPHON,.jwLL_3-628.2007 iC�N,,g7:360.026 2g07_._._..._., Poulsbo WA 98370s: aba q hg0ondccrm an com......__ ._._INSUREHI9t pFhYDRa1MG CeYYERgGE MAC —.ww... .a ....-_ gNguRER A:Harty®rd Casualty lnsuranca Camaeny 29424 _., _ INSURED 4 INSURER s:Travelers Casual and Sure Com an 19038 Gray&Osborne Inc !y Ty..__.....�.Y......._ _. 1130 Rainier Avenue South,Suite 300 INBURERC: ... ......_..._� __.e._ ................ Seattle WA 98144 INsuaea o: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1629144299 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1 R .._._....... .e_ ._. B _._ PO'LCCYEFp P --.... T�_,.YY1LIMRB ., ,...LLT TYPE OF INSURANCE OL ...._._.POLkCYNUMSER P . C A X COMMERCIAL GENERAL LIABILITY 52SBAOU7303 9YI012018 9110/2019 EACHOCCURRENCE $1.000.000 _....I GIAIMS.MADEX, OCCUR ETCSRENTEG—__ f300000 OCPIXCUIBFPD MED E%P✓w mo E70.BCY0 X.. .Sopamlbn lr�sda .___-----_ PERSONAL&AOY INJURY f1.000,tlOD . i GEN'LAGGREGATE LIMIT P r—] PER: GENERAL AGGREGATE $2.000,000 POLICY x1 JEGT LOC PRODUCTS-COMPlOP Ann 52,000,000 0 HER: S .—... A AUTOMOBILELIABIL" 52UECJS3276 9/10/201a 9/1012019 Cc etNE�DS- S11 GT"EU' T E1,DOO,OGD X ANY AUTO AIRKPnit BODILY INJURY(Per Pemen) E .,... OWNED .__.. SCHEDULED ................._......_.._..._,._.. .__ AUTOS ONLY AUTOS BODILY INJURY IParac4danut E HIRED — NONOWIVEO PRO IV 7AGE — ----- - .- AUTOSONLY AUTOS ONLY bra_...9B11. E S A X UMBRELLALWB, X OCCUR 52SBADU7303 911012018 9110/2019 EACH OCCURRENCE 52.000,Dtl0 _.__.... EXCESS LIAB cumms+dA.OE AGGREGATE S2.000,000 .--....., DEa X RETENT10Nf in nngS .. A WORNERSCOMPENSATION 52SBADU7303 9/10/2018 9/10/2019 Or AND EMPLOYERS'LIABILITY YIN P TUSE X _ WA SRR GA ANYPROMMEMBERRARTNEn/k%E'.CUTrYE ❑ NIA E.L.EACNACCIDENE b100W.0A0 OFFIGEIUMEMaEREMCLUDEDP ----�_._.._....., ...._ IMamIOIQl In Nu EL.DISEASE•EA EMPLOYE 51000000 e yyM®.doeadtro under ..__ ._ .._ DUSCRIPTION aF OPERATIONS bolmv E.A.DISEASE-POLICY LIMIT 51,000,000 B Pmtosslanel Uob,Mims Made 105339818 9110/2018 9110/2019 f3, 0G0 Pe r claim PotluUon uah,Davrrenw Form GE0, E3,W ,000 MI. DESCRIPTION OF OPERATIONS r LOCATION$I'VCHWLES,µCORD 14I.A0011 ..Y RamArta sahad.R,may bo.a'aaeNpa IrmPm AFaea h.raqueedi Cenifroala HGlder(s){slave an Additional Insured on the Commercial GDnol Liability and Auto Liability when required by written contract or agreement regarding activities by or on behalf of the Named Insured,The Commercial General Liability Insurance Is primary insurance and any other Insurance mainlainod by the Additional Insured shall be excess only and non-contributingg with this Insursoca.A waiwar o(suCaTogBilion applles to the Commercial General Llability, Auto Llabllily.Umbrella 1 Excess Liability and Workers Compensation I Emmployers.Liability In favor of the Additional Insured. Project:640 Zone Booster Station(Project W20031) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Kent ACCORDANCE WITH THE POLICY PROVISIONS. 220 Fourth Ave South Kent WA 98032 AUTHOR ACERESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2018I03) The ACORD name and logo are registered marks of ACORD Policy#52SBADU7303 BUSINESS LIABILITY COVERAGE FORM (b) Rented to, In the care, custody or b. Coverage under this provision does not control of, or over which physical apply to: control is being exercised for any purpose by you, any of your (1) "Bodily injury" or "property damage" "employees", "volunteer workers", that occurred;or any partner or member(if you are (2) "Personal and advertising injury" a partnership or joint venture), or arising cut of an offense committed any member (if you are a limited before you acquired or formed the lability company). organization, b. Real Estate Manager 4. Operator Of Mobile Equipment Any person(other than your"employee"or With respect to"mobile equipment'registered in ".volunteer worker"), or any organization your name under any motor vehicle registration while acting as your real estate manager. law, any parson is an Insured while drying such c. Temporary Custodians Of Your equipment along a public highway with your Property permission. Any other person or organization Any person or organization having proper responsible for the conduct of such person is temporary custody of your property if you also an insured, but only with respect to liability die, but only: arising out of the operation of the equipment,and only if no other Insurance of any kind Is available (1) With respect to liability arising out of the to that person or organization for this liability. maintenance or use of that property;and However,no person or organization is an Insured (2) Until your legal representative has with respect to: been appointed. a. "Bodily injury" to a co-"employee" of the d. Legal Representative If You Die person driving the equipment;or Your legal representative if you die, but b. 'Property damage" to property owned by, . only with respect to duties as such. That rented to, in the charge of or occupied by representative will have all your rights and you or the employer of any person who is duties under this Insurance. an insured under this provision. e. Unnamed Subsidiary S. Operator of Nonowned Watercraft Any subsidiary and subsidiary thereof, of With respect to watercraft you do not awn that Yours which Is a legally Incorporated entity Is less than 51 feet long and Is not being used of which you own a financial interest of _ to carry persons for a charge,any person Is an more than 50% of the voting stock on the Insured while operating such watercraft with effective date of this Coverage Part, your permission. Any other person or The insurance afforded herein for any organization responsible for the conduct of subsidiary not shown in the Declarations such person is also an insured, but only with as a named Insured does not apply to respect to liability arising out of the operation injury or damage with respect to which an of the watercraft, and only If no other insured under this Insurance is also an Insurance of any kind is available to that insured under another policy or would be person or organization for this liability. an insured under such policy but for its However, no person or organization Is an termination or upon the exhaustion of Its insured with respect to: limits of Insurance, a. "Bodily injury" to a co=employee' of the " 3. Newly Acquired Or Formed Organization person operating the watercraft;or Any organization you newly acquire or form, b. "Property damage" to property owned by, other than a partnership, joint venture or rented to, in the charge of or occupied by limited liability company, and over which you you or the employer of any person who is maintain financial interest of more than 50% of an Insured under this provision. the voting stock, will qualify as a Named - 0. Additional Insureds When Required By Insured if there Is no other similar Insurance Written Contract, Written Agreement Or available to that organization. However. Permit a. Coverage under this provision Is afforded The person(s) or organization(s) identified In only until the 180th day after you acquire Paragraphs a. through f. below are additional or.form the organization or the end of the insureds when you have agreed, in a written policy period,whichever is earner,and Form SS 00 08 04 05 Page 11 of 24 The Hartford Pdicy#528BADU7303 - BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a (a) Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional Insured on your agreed to make or normally policy, provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement,or the issuance of the permit with the distribution or sale of the A person or organization Is an additional products; Insured under. this provision only for that (f} Demonstration, installation, period of time required by the contract, servicing or repair operations, agreement or permit, except such operations performed However, in connection with the sale of the such person or organization is an at the vendor's premises in additional insured under this provision if such product; person or organization is included as an additional insured by an endorsement issued (g) Products which, after distribution by us and made a part of this Coverage Part, or sale by you, have been labeled including all persons or organizations added or relabeled or used as a as additional insureds under the specific container, part or ingredient of any additional insured coverage grants in Section other thing or substance by or for F.-Optional Additional Insured Coverages, the vendor,or a. Vendors (h) "Bodily injury" or "property Any person(s)or organization(s)(referred to damage" arising out of the sole below as vendor), but only with respect to negligence of the vendor for its "bodily injury" or "property damage' arising own acts or omissions or those of out of "your products-which are distributed Its employees or anyone else or sold in the regular course of the vendor's acting on its behalf. However,this business and only if this Coverage Pad exclusion does notapptyto; provides coverage for "bodily injury" or (1) The exceptions contained in "property damage" included within the Subparagraphs (d)or(f); or 'Products-completed operations hazard". (it) Such inspections, adjustments, (1) The Insurance afforded to the vendor tests or servicing as the vendor Is subject to the following additional has agreed to make or normally exclusions: undertakes to make In the usual This insurance does not apply to: course of business, inconnection with the distribution (a) "Bodily injury" or "property or sale of the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by reason of the assumption of insured person or organization from liability In a contract or agreement, wham you have acquired such products, This exclusion does not apply to or any Ingredient, part or container, liability for damages that the entering into, accompanying or vendor would have in the absence containing such products. of the contract or agreement; b. Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized by you; whom you lease equipment; but only (c) Any physical or chemical change with respect to their liability for"bodily In the product made intentionally injury", "property damage" or by the vendor, "personal and advertising Injury" caused, In whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely far the purpose of equipment leased to you by such Inspection, demonstration, testing, person or organization, or the substitution of parts under Instructions from the manufacturer, and then repackaged in the original container; Page 12 of 24 Form SS 00 08 04 05 Pdicy#52SDADU730313dicy# 52SBADU7303 BUSINESS LIABILITY COVERAGE FORM (2) With respect to the insurance afforded e. Permits Issued By State Or Political 10 these addltional insureds, this Subdivisions Insurance does not apply to any "occurrence" which takes place after` (1) Any state or political subdivision, but you cease to lease that equipment, only With respect to operations performed by you or on your behalf for c. Lessors Of Land Or Premises which the state or political subdivision (1) Any person or organizatlon from has Issued a permit, whom you lease land or premises, but (2) With respect to the Insurance afforded only with respect to liability arising out to these additional Insureds, this of the ownership, maintenance or use insurance does not apply to: of that part of the land or premises (a) "Bodily injury . "property damage" leased to you, or "personal and advertising (2) With respect to the insurance afforded injury" arising out of operations to these additional Insureds, this performed for the state or insurance does not apply to: municipality; or (a) Any `occurrence' which takes (b) 'Bodily injury"or"property damage" place after you cease to lease that Included within the "products- land or be a tenant In that completed operations hazard'. premises;or f. Any Other Party (b) Structural alterations, new (1) Any other person or organizaton who construction or ' demolition is not an Insured under Paragraphs a. operations performed by or on behalf of such person or through e. above, but only with organization. respect to liability for "bodily Injury", property damage" or "personal and d. Architects, Engineers Or Surveyors advertising injury" caused, In whole or (1) Any archllect engineer, or surveyor, but in part, by your acts or omissions or only with respect to liability for 'bodily the ads or omissions of those acting injury", "property damage" or "personal on your behalf: and advertising injury" caused, In whole (a) In the performance of your or in part, by your acts or omissions or ongoing operations; the ads or omissions of those acting on (b) In connection with your premises your behalf: owned by or rented to you; or (a) In connection with your premises; (c) In connection with"your work"and or included within the "products- (b) In the perforrrance of your completed operations hazard", but ongoing operations performed by only if you or on your behalf. (i) The written contract or written (2) With respect to the insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This insurance does not apply to (If) This Coverage Part provides "bodily Injury", "property damage" or coverage for "bodily injury" or "personal and advertising Injury' "property damage" included arising out of the rendering of or the within the "products- failure to render any professional completed operations hazard". services by or for you,including: (2) With respect to the insurance afforded (a) The preparing, approving, or to these` additional Insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, "Bodily reports, surveys, field orders, Injury", Property damage" or change orders, designs or personal and advertising injury" arising out of the rendering of, or the drawings and specifications;or failure to render, any professional (b) Supervisory, inspection, architectural, engineering or surveying architectural or engineering services,including: activities. Form SS 00 08 04 DS Page 13 of 24 Paicy#523BADU7303 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or This General Aggregate limit does not failure to prepare or approve, apply to "properly damage" to premises maps, shop drawings, opinions, while rented to you or temporarily reports, surveys, field orders, occupied by you with permission of the change orders, designs or owner, arising out of fire, lightning or drawings and specifications;or explosion. (b) Supervisory, inspection, 3. Each Occurrence Limit architectural or "engineering Subject to 2.2. or 2.b above, whichever activitles. applies, the most we will pay for the sum of all The limits of insurance that apply to additional damages because of all "bodily Injury', insureds are described in Section D. — Limits "property damage" and medical expenses Of Insurance, arising out of any one 'occurrence is the How this insurance applies when other Liability and Medical Expenses Limit shown in insurance is available to an additional insured the Declarations, is described in the Other Insurance Condition The most we will pay for all medical expenses in Section E.—Liability And Medical Expenses because of "bodily Injury" sustained by any General Conditions. one person Is the Medical Expenses Limit No person or organization is an insured with shown in the Declarations. respect to the conduct of any current or past 4. Personal And Advertising Injury Limit partnership, joint venture or limited liability Subject to 2.b. above,the most we will pay for company that is not shown as a Named Insured In the sum of all damages because of all the Declarations_ personal and advertising Injury" sustained by D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal LIMITS OF INSURANCE and Advertising injury Limit shown in the 1. The Most We Will Pay Declarations. The Limits of Insurance shown in the 5. Damage To Premises Rented To You Limit Declarations and the rules below fix the most The Damage To Premises Rented To You we will pay regardless of the number of. Limit is the most we will pay under Business Liability Coverage for damages because of a. Insureds; "property damage"to any one premises, while b. Claims made or"suits"brought;or rented to you, or in the case of damage by fire, c. Persons or organizations making claims or lightning or explosion, while rented to you or bringing "suits". temporarily occupied by you with permission of 2. Aggregate Limits the owner. The most we will pay for: In the case of damage by fire, lightning or explosion,the Damage 10 Promises Rented To a. Damages because of "bodily injury" and You Limit applies to all damage proximately Vol damage" Included in the caused by the same event, whether such "products-completed operations hazard" Is damage results from fire,lightning or explosion the Products-Completed Operations or any combination of these. Aggregate Limit shown in the S. How Limffs Declarations. Apply To Additional Insureds b. Damages because of all other "bodily The most we will pay on behalf of a person or injury", "property damage" or "personal organization who Is an additional Insured and advertising injury", including medical under this Coverage Part is the lesser of. expenses, Is the General Aggregate Limit a. The limits of insurance specified in a shown in the Declarations. written contract, written agreement or This General Aggregate Limit applies permit issued by a stale or political separately to each of your "locations" subdivision;or owned by or rented to you. b. The Limits of Insurance shown in the "Location" means premises involving the Declarations. same or connecting lots, or premises Such amount shall be a part of and not in whose connection is interrupted only by a addition to the Limits of Insurance shown in street, roadway or right-of-way of a the Declarations and described in this Section. railroad. Page 14 of 24 Form SS 00 08 04 05 Pdicy#52SBADU7303 BUSINESS LIABILITY COVERAGE FORM If more than one limit of Insurance under this (1) Immediately send us copies of any policy and any endorsements attached thereto demands, notices, summonses or applies to any Beim or"suit", the most we will pay legal papers received. In connection under this. policy and the endorsements is the with the claim or"suit"; single highest limit of liability of all coverages applicable to such claim or "suit". However, this (2) Authorize us to obtain records and paragraph does not apply to the Medical Expenses other information; limit setforth in Paragraph 3.above. (3) Cooperate with us In the Investigation, settlement of the claim or defense The Limits of Insurance of this Coverage Part apply against the"suit"; and separately to each consecutive annual period and to (4) Assist us, upon our request, In the any remaining period of less than 12 months,starting enforcement any right against any with the beginning of the policy period shown in the person or organization that may be Declarations, unless the policy period is extended after Issuance for an additional period of less than 12 liable to the insured because of Injury months. In that case, She additional period will be or damage to which this Insurance deemed part of the last preceding period for purposes may also apply. of determining the Limits of Insurance. d. Obligations At The Insured's Own Cost E. LIABILITY AND MEDICAL EXPENSES No Insured will, except at that insured's own GENERAL CONDITIONS cost voluntarily make a payment, assume any obligation, or Incur any expense, other 1. Bankruptcy than for first aid,without our consent. Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance the Insured's estate will not relieve us of our If we cover a claim or "suit" under this obligations under this Coverage Pert. Coverage Part that may also be covered 2. Duties In The Event Of Occurrence, by other Insurance available to an Offense,Claim Or Suit additional insured, such additional insured a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the other insurer for defense and indemnity. You at any additional onal insured must see to However, this provision does not apply to it-that we are notified as soon as P PPY practicable of an "occurrence" or an the extent that you have agreed in a offense which may result in a claim. To written contract, written agreement or the extent possible, notice should include: permit that this insurance is primary and non-contributory with the additional (1) How,when and where the "occurrence" Insured's own insurance, or offense took place; .. f. Knowledge Of An Occurrence, Offense, (2) The names and addresses of any Claim Or Suit Injured persons and witnesses;and Paragraphs a. and b. apply to you or to (3) The nature and location of any injury any additional insured only when such or damage arising out of the "occurrence', offense, claim or "suit" is "occurrence"or offense. known to: b. Notice Of Claim (1) You or any additional Insured that is If a claim Is made or "suit" Is brought an individual; against any insured, you or any additional insured must (2) Any pa if you or an additional Is a insured is a partnership; (1) Immediately record the specifics of the (3) Any manager, If you or an additional claim or "suit" and the dale received; insured Is a limited liability company; and (2) Notify us as soon as practicable. (4) manager,Any if"executive r"you�or an or Insurance You or any additional insured must see to insured is a corporation; it that we receive a written notice of the claim or"suit"as soon as practicable. (5) Any trustee,insured s Isaif you or an additional a trust; or c. Assistance And Cooperation Of The (6) Any elected or appointed official, if you Insured or an additional Insured is a political You and any other involved insured must: subdivision or public entity. Form SS 00 08 04 05 Page 15 of 24 Policy#52SBADU7303 BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to (3) We have issued this policy in reliance you and any additional Insured. upon your representations. 3. Financial Responsibility Laws b. Unintentional Failure To Disclose a. When this policy is certified as proof of Hazards financial responsibility for the future under If unintentionally you should fall to disclose the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the insurance business at the 'Inception date of this provided by the policy for "bodily injury" Coverage Part, we shall not deny any liability and "property damage" liability will coverage under this Coverage Part comply with the provisions of the law to because of such failure. the extent of the coverage and limits of 7, Other Insurance insurance required by that law. b. With respect to "mobile equipment" to If other valid and collectible insurance is which this Insurance applies, we will available for a loss we cover under this provide any liability, uninsured motorists, Coverage Part, our obligations are limited as underinsured motorists, no-fault or other follows: coverage required by any motor vehicle a. Primary Insurance law. We will provide the required limits for This insurance is primary except when b. those coverages. below applies. If other insurance is also 4. Legal Action Against Us primary, we will share with all that other No person or organization has a right under insurance by the method described in c. this Coverage Form: below. a. To join us as a party or otherwise bring us b. Excess Insurance into a "suit" asking for damages from an This insurance is excess over any of the insured; or other insurance, whether primary, excess, b. To sue us on this Coverage Form unless contingent or on any other basis: all of its terns have been fully complied (1) Your Work with. That is Fire, Extended Coverage, A person or organization may sue us to recover Builders Risk, Installation Risk or on an agreed settlement or on a final judgment similar coverage for'your work"; against an insured; but we will not be liable for (2) Premises Rented To You damages that are not payable under the terms of this insurance or that are in excess of the That Is fire, lightning or explosion applicable limit of insurance. An agreed Insurance for premises rented to you settlement means a settlement and release of or temporarily occupied by you with liability signed by us, the insured and the permission of the owner, claimant or the claimant's legal representative. (3) Tenant Liability - 5. Separation Of Insureds That is insurance purchased by you to Except with respect to the Limits of Insurance, cover your liability as a tenant for and any rights or duties specifically assigned "property damage"to premises rented in this policy to the first Named Insured, this to you or temporarily occupied by you insurance applies: with permission of the owner; a. As if each Named Insured were the only (4) Aircraft,Auto Or Watercraft Named Insured;and If the loss arises out of the maintenance b. Separately to each insured against whom or use of aircraft"autos"or watercraft to a claim is made or"suit"is brought. the extent not subject to Exclusion g. of 6. Representations SectionA.—Coverages. (5) Property Damage To Borrowed a. When You Accept This Policy Equipment Or Use Of Elevators By accepting this policy, you agree: If the loss arises out of "property (1) The statements in the Declarations damage" to borrowed equipment or are accurate and complete; the use Of elevators to the extent not (2) Those statements are based upon subject to Exclusion k, of Sectlon A.— representations you made to us;and Coverages. Page 16 of 24 Form SS 00 08 04 05 Pdicy#52SRADU7303 BUSINESS LIABILITY COVERAGE FORM (6) When You Are Added As An When this insurance is excess over other Additional Insured To Other insurance, we will pay only our share of Insurance the amount of the loss, If any, that That is other insurance available to exceeds the sum of you covering liability for damages (1) The total amount that all such other arising out of the premises or insurance would pay for the loss In the operations.or products and completed absence of this Insurance;and operations, for which you have been (2) The total of all deductible and self- added as an additional Insured by that insured amounts under all that other insurance; or insurance. (7) When You Add Others As An We will share the remaining loss,if any,with Additional Insured To This any other insurance that is not described in Insurance this Excess Insurance provision and was not That is other insurance available to an bought specifically to apply In excess of the additional insured. Limits of Insurance shown In the However, the following provisions Declarations of this Coverage Part apply to other insurance available to c. Method Of Sharing any person or organization who is an If all the other insurance permits additional insured under this Coverage contribution by equal shares,we will follow Part' this method also. Under this approach, (a) Primary Insurance When each insurer contributes equal amounts Required By Contract until It has paid Its applicable limit of This insurance is primary if you insurance or none of the loss remains, have agreed in a written contract, whichever comes first. written agreement or peril that If any of the other insurance does not permit this insurance be primary. If other contribution by equal shares, we will insurance is also primary, we will contribute by limits. Under this method,each share with all that other insurance Insurers share is based on the rallo of its by the method described in c. applicable limit of Insurance to the total below, applicable limits of insurance of all insurers. (b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against To Other Insurance When Others To Us Required By Contract a. Transfer Of Rights Of Recovery If you have agreed In a written If the insured has rights to recover all or contract, written agreement or part of any payment, including permit that, this insurance Is Supplementary Payments, we have made primary and non-contributory with under this Coverage Parl, those rights are the additional insured's own transferred to us. The insured must do insurance, this insurance is nothing after loss to Impair them. At oqr, primary and we will not seek request, the insured will bring "suit' or contribution from that other transfer those rights to us and help us insurance. enforce them. This condition does not Paragraphs(a)and (b)do not apply to apply to Medical Expenses Coverage. other insurance to which the additional b. Waiver Of Rights Of Recovery (Waiver insured has been added as an OfSubrogatlon) additional insured. When this insurance Is excess, we will If the insured has waived any rights of have no duty under this Coverage Part to recovery against any person or organization for all or part of any payment, defend the insured against any"suit"if any Including Supplementary Payments, we other insurer has a duty to defend the have made under this Coverage Part, we insured against that "suit". If no other also waive that right, provided the insured insurer defends, we will undertake to do waived their rights of recovery against so, but we will be ent(8ed to the Insured's such person or organization in a contract, rights against all those other insurers. agreement or permit that was executed prior to the injury or damage. Form SS 00 08 04 05 Page 17 of 24 Pdicy 52UECJS3276 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AND RIGHTS OF RECOVERY AGAINST OTHERS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Any person or organization whom you are required by contract to name as additional insured is an "insured" for LIABILITY COVERAGE but only to the extent that person or organization qualifies as an "insured" under the WHO IS AN INSURED provision of Section II -LIABILITY COVERAGE. B. For any person or organization for whom you are required by contract to provide a waiver of subrogation, the Loss Condition-TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable. Form HA 99 13 01 87 Printed in U.S.A, X THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional Conditions: m 0 N 0 N A. If this policy is cancelled by the Company, other If notice is mailed, proof of mailing to the last known than for non-payment of premium, notice of such mailing address of the certificate holder(s) on file with a cancellation will be provided at least thirty (30)days the agent of record or the Company will be sufficient M in advance of the cancellation effective date to the proof of notice. 0 certificate holder(s) with mailing addresses on file Any notification rights provided by this endorsement with the agent of record or the Company. o apply only to active certificate holder(s)who were issued N B. If this policy is cancelled by the company for non- a certificate of insurance applicable to this policy's term. opayment of premium, or by the insured, notice of Failure to provide such notice to the certificate holder(s) such cancellation will be provided within ten (10) will not amend or extend the date the cancellation days of the cancellation effective date to the becomes effective, nor will it negate cancellation of the certificate holder(s) with mailing addresses on file policy. Failure to send notice shall impose no liability of with the agent of record or the Company. any kind upon the Company or its agents or � representatives. c 0 0 t� e Q r� B 0 e e i� Form SS 12 23 06 11 Page 1 of 1 0 2011,The Hartford THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the fallowing additional If notice is mailed, proof of mailing to the last known Conditions: mailing address of the certificate holder(s) on file with A. If this policy is cancelled by the Company, other the agent of record or the Company will be sufficient than for nonpayment of premium, notice of such proof of notice. cancellation will be provided at least thirty (30) Any notification rights provided by this endorsement days in advance of the cancellation effective date apply only to active certificate holder(s) who were to the certificate holder(s) with mailing addresses issued a certificate of insurance applicable to this on file with the agent of record or the Company, policy's term. B. If this policy is cancelled by the Company for Failure to provide such notice to the certificate nonpayment of premium, or by the Insured, notice holder(s) will not amend or extend the date the of such cancellation wilt be provided within (10) cancellation becomes effective, nor will it negate days of the cancellation effective date to the cancellation of the policy. Failure to send notice shall certificate holder(s) with mailing addresses on file impose no liability of any kind upon the Company or its with the agent of record or the Company. agents or representatives. Form IH 03 13 06 11 Page 1 of 1 © 2011,The Hartford � I ��Imu � IIIV � d Iw WII I IIIV III I IIII IV m IIIIIIVI I .,w .� IWy W VUP ^ I WVU WIII �Ut I��,0 ml�IW UI ll w w w " " Wu � w mw' �,� „ � a a �: " �� '�� �o✓I� '.m .� mu oW � aw � Wu a. nnl � :. .� � ... ¢� m dluuu IIII II II I� m I IIIIII�IIII I a _ w U� I IU IIII II � � �I VI 9VI liuv I �^, II � nm; mm � V i uouulll ouuuu r r i WV,; .Rt 'Wup ion