HomeMy WebLinkAboutCAG2019-130 - Original - ANEW - Construction Trades Program - 01/01/2019 �.,NT Records Mana ement Document
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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: ANEW
Vendor Number (7DE):
Contract Number (City Clerk): 01 h16 l9 — 12)0
Category: ':hoose an item.
Sub-Category (if applicable): Choose an item.
Project Name: Construction Trades Program
Contract Execution Date: 1-1-2019 Termination Date: 12-31-2020
Contract Manager: Lori Guilfoyle Department: Parks
Contract Amount: $20,000 (10,000 per year)
Budgeted: ® Grant?
Part of NEW Budget: ❑ Local: ❑ State: ❑ Federal: ❑
Related to a New Position: ❑
Basis for Selection of Contractor?
Bid: ❑ RFP: ® Small Works Roster: ❑ Quotes: ❑
Approval Authority: ® Director ❑ Mayor ❑ City Council
Other Details:
W.9 wln Orpn
KENT
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
ANEW
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter
the "City"), and ANEW organized under the laws of the State of Washington, located and doing business at
550 SW 7th Street, Suite B305, Renton, WA 98057 and (406) 799-7259 (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:
ANEW will offer the Trades Rotation program and employment supports including assistance with
applications, resumes and interviewing for Kent residents seeking a family wage job or apprenticeship.
The following exhibits are attached and incorporated by this reference as if fully set forth herein; Exhibit
A, Scope and Schedule of Work, Exhibit B, Insurance Exhibit and Exhibit C, Debarment Certification.
t
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 12/31/2020.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed
$20000 ($10,000 per year), for the services described in this Agreement. This is the
maximum amount to be paid under this Agreement for the work described in Section I above,
and shall not be exceeded without the prior written authorization of the City in the form of a
negotiated and executed amendment to this agreement. The Consultant agrees that the
hourly or flat rate charged by it for its services contracted for herein shall remain locked at
the negotiated rate(s) for a period of one (1) year from the effective date of this.Agreement.
The Consultant's billing rates shall be as delineated in Exhibit A.
B. The Consultant shall submit quarterly payment invoices to the City for work performed, and
a final bill upon completion of all services described in this Agreement. The City shall provide
payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any
portion of an invoice, it shall notify the Consultant and reserves the option to only pay that
portion of the invoice not in dispute. In that event, the parties will immediately make every
effort to settle the disputed portion.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in
accordance with Ch. 51.08 RCW, the parties make the following representations:
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.
CONSULTANT SERVICES AGREEMENT- 1
($20,000 or Less)
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 all legal costs and attorney fees, arising out of or in connection with the Consultant's
performance of this Agreement, except for that portion of the injuries and damages caused by the City's
negligence.
The City's inspection or acceptance of any of Consultant's work when completed shall not be grounds
to avoid any of these covenants of indemnification.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115,
then, in the event of liability for damages arising out of bodily injury to persons or damages to property
caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials,
employees, agents and volunteers, the Consultant's duty to defend, indemnify, and hold the City harmless,
and Consultant's liability accruing from that obligation shall be only to the extent of the Consultant's
negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL
INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES
FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER.
CONSULTANT SERVICES AGREEMENT- 2
($20,000 or Less)
In the event Consultant refuses tender of defense in any suit or any claim, if that tender was made
pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having
jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant's part, then
Consultant shall pay all the City's costs for defense, including all reasonable expert witness fees and
reasonable attorneys'fees, plus the City's legal costs and fees incurred because there was a wrongful refusal
on the Consultant's part.
The provisions of this section shall survive the expiration or termination of this Agreement.
VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement,
insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference.
IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable
accuracy of any information supplied by It to Consultant for the purpose of completion of the work under
this Agreement.
X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings,
designs, reports, or any other records developed or created under this Agreement shall belong to and
become the property of the City. All records submitted by the City to the Consultant will be safeguarded by
the Consultant. Consultant shall make such data, documents, and flies 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. 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-Waiver of 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. Resolution of Disputes 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; provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section VII of this Agreement.
CONSULTANT SERVICES AGREEMENT - 3
($20,000 or Less)
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. 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 Consultant.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative
of the City, and such statements shall not be effective or be construed as entering into or forming a part of
or altering in any manner this Agreement. All of the above documents are hereby made a part of this
Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any
language contained in this Agreement, the terms of this Agreement shall prevail.
H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal
laws, rules, and regulations that are now effective or in the future become applicable to Consultant's
business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of
the performance of those operations.
I. Public Records Act. The Consultant acknowledges that the City is a public agency subject to
the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes,
emails, and other records prepared or gathered by the Consultant in its performance of this Agreement may
be subject to public review and disclosure, even if those records are not produced to or possessed by the
City of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties
and obligations under the Public Records Act.
J. City Business License Rgguired. 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. Counterparts 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
CONSULTANT SERVICES AGREEMENT - 4
($20,000 or Less)
to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed
to have applied.
CONSULTANT: CITY OF KENT:
By: y:
(signature) (signature)
Print Name: Karen Dove Pr' ame: 3ulie Parascondola
Its: Its: Parks Director
title) ;
DATE: DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Karen Dove Lori Guilfoyle
ANEW City of Kent
550 SW 7th Street, Suite B305 220 Fourth Avenue South
Renton, WA 98057 Kent, WA 98032
i
(406) 799-7259 (telephone) 253-856-5061 (telephone)
N/A facsimile 253-856-6070 facsimile
ATTEST:
VW�,
Kent Clt Clerk
CONSULTANT SERVICES AGREEMENT- 5
($20,000 or Less)
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of sex,
race, color, national origin, age, or the presence of all sensory, mental or physical disability.
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.
B i
y:
For:
Title: ' L t r�c1 V
Date: 19
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.
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 6n5L)1.Wt _1 1 ie5that was entered into on
the ' �``! (date) between the firm I represent and the City of
=—r—
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: � ` 1► t t 1- , re (`J-o y-
Date:
Exhibit A
KENT Scope and Schedule of Work
w.e� wo*ow
PARKS, RECREATION S 2019-2020 Consultant Services Agreement
COMMUNITY SERVICES
Agency: _ANEW 2019 Funding 10 000
Pro ram: Construction Trades 2020 Funding: 10 000
This funding the Trades Rotation program and employment $20,000
will provide: supports including assistance with applications, Total:
resumes and interviewing for Kent residents seeking
a family wage job or apprenticeshi
Annual Program Service Units: Program Outcomes:
Unduplicated Kent Residents = 6 _ Employment
Trainin /Worksho s classes 4`
Employment Services i 4
Pursuant to Item I. of the Consultant Services Agreement (CSA) executed on January 1, 2019 Consultant shall
provide the approximate number of City of Kent clients with the following services each year of the CSA:
Quarter Service Unit # of Units Cumulative
Total
t let Unduplicated City of Kent clients served 1 I 1
Trainin Worksho s/classes 1 1
Employment Services 1 1
2nd Unduplicated City of Kent clients served 1 2
"Trainin Worksho s/classes 1 2
Employment Services 1 2
3rd Unduplicated City of Kent clients served 2 1 4
Traininn /Workshops/classes 1 3
Em to ment Services 1 3
F4t h Unduplicated City of Kent clients served 2 6
Training/Workshops/classes 1 1
_�- Employment Services 1 1
The above services shall be provided by December 31, 2019 for year one of the two-year agreement and
December 31, 2020 for year two of the agreement.
Contract Administration
- The Consultant shall notify the City, in writing, within ten (10) days of any changes in program
personnel or board membership.
- The Consultant shall provide the City with a current list of its board of directors, general or limited
partners, as applicable.
- All records related to the CSA must be retained for three (3) years plus the current year.
Exhibit A (continued)
• Scope and Schedule of Work
KENT w.s��»o.o» 2019-2020 Consultant Services Agreement
PARKS. RECREATION &
COMMUNITY SERVICES
Agency: ANEW 2019 Funding: 10 000
Program: Construction Trades 2020 Funding: $10,000
This funding the Trades Rotation program and employment $20,000
will provide: supports including assistance with applications, Total:
resumes and interviewing for Kent residents seeking
a family wage job or apprenticeship
Reporting Requirements and Timeline
All data and required forms shall be submitted electronically.
Service Unit Report - Data from this form will be used to track each program's progress toward meeting
the goals stipulated in the Scope of Work. It shall be submitted quarterly, no later than the 15th of the
month following the end of the quarter (i.e. April 15, July 15, Oct 15, Jan 15), along with the
Reimbursement Request.
Reimbursement Request -This form will be filled out electronically and serve as the invoicing mechanism
for payment to your agency/program. It shall be submitted quarterly, no later than the 15th of the month
following the end of the quarter(i.e. April 15, July 15, Oct 15, ]an 8), unless otherwise specified.
Demographic Data Report -The agency shall collect and retain the data requested on this form from the
persons served through this contract. Data should be tracked in an ongoing manner and submitted annually
(by January 15).
Annual Outcome Data Report- Outcome data shall be submitted no later than the 15th following the end
of the second quarter (i.e. July 15). Data should demonstrate the program's progress toward Outcomes
specified in the Scope of Work.
Repprt Due Date
Service Unit Report and Reimbursement s 15th day following each quarter
Request _
Final Reimbursement Request (41h Qtr) January 8th, 2020/January 8th, 2021
Demographic Data Report January 1511, 2020/January 15th, 2021
Annual Outcome Data Report January 15th, 2020/January 15th, 2021
Signature
Please sign below to indicate acceptance of the Year 2019 and Year 2020 Performance Measures listed
above.
Karen Dove, Executive Director, ANEW Date
Merfig Wson—, Hum An rvices Manager Date
- All records related to this CSA must be retained for three (3) years plus the current year.
EXHIBIT B
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 Liability insurance covering all owned, non-owned, hired and leased
vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA
00 01 or a substitute form providing equivalent liability coverage. If necessary,
the policy shall be endorsed to provide contractual liability coverage.
Commercial General Liability insurance shall be written on ISO occurrence form
CG 00 01. The City shall be named as an Additional 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.
2. Workers' Compensation coverage as required by the Industrial Insurance laws of
the State of Washington.
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
$1,000,000 each occurrence, $2,000,000 general aggregate.
EXHIBIT B (Continued)
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following provisions for
Automobile Liability and Commercial General Liability insurance:
1. The 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.
ANEW20
Non Profit Insurance Program
CERTIFICATE OF COVERAGE Issue Date: 02/18/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUE A CONTRACT
BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTAT IVE OR PRODUCER,AND THE CERT IFICATE HOLDER.
------------------------------------------------------------------------------------------------
IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed If SUBROGRATION IS WAIVED,subject to the terms and conditions of
the policy,certain coverage may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER COMPANIES AFFORDING COVERAGE
GENERAL LIABILITY
Clear Risk Solutions American Alternative Insurance Corporation,et al.
451 Diamond Drive
Ephrata, WA 98823 AUTOMOBILE LIABILITY
American Alternative Insurance Corporation, et al.
INSURED
PROPERTY
ANEW American Alternative Insurance Corporation,et al.
PO Box 4217 MISCELLANEOUS PROFESSIONAL LIABILITY
Renton, WA 98057 Princeton Excess and Surplus Lines Insurance Company
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP DESCRIPTION LIMITS
DATE DATE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY N1-A2-RL-0000013-09 06/01/2018 06/01/2020 PER OCCURRENCE $2,000,000
OCCURRENCE FORM PER MEMBER AGGREGATE $4,000,000
INCLUDES STOP GAP PRODUCT-CO MP/OP $2,000,000
PERSONAL&ADV.INJURY $2,000,000
(LIABILITY IS SUBJECT TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $50,000,000
AUTOMOBILE LIABILITY
ANY AUTO N1-A2-RL-000001 3-09 06/01/2018 06/01/2020 COMBINED SINGLE LIMIT $2,000,000
(LIABILITY IS SUBJECT TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
PROPERTY
N1-A2-RL-0000013-09 06/01/2018 06/01/2020 ALL RISK PER OCC EXCL EQ&FL $75,000,000
EARTHQUAKE PER OCC $1,000,000
FLOOD PER OCC $1,000,000
(PROPERTY IS SUBJECT TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
MISCELLANEOUS PROFESSIONAL LIABILITY
N1-A3-RL-0000060-09 06/01/2018 06/01/2020 PER CLAIM $2,000,000
(LIABILITY IS SUBJECT TO A $50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/SPECIAL ITEMS
Regarding Consultant Services Agreement between the City of Kent and ANEW. City of Kent is named as Additional Insured
regarding this agreement only and is subject to policy terms, conditions, and exclusions. Additional Insured endorsement is
attached. NPIP is primary and non-contributory.
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
WITH THE POLI CY PROVISIONS.
CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE
Attn: Lori Guilfoyle
City of Kent Q�rt
220 Fourth Avenue South
Kent,WA 98032
3504744
AMERICAN ALTERNATIVE
INSURANCE COMPANY
ADDITIONAL INSURED— DESIGNATED PERSON OR ORGANIZATION
(GENERAL LIABILITY)
Named Insured
Non Profit Insurance Program IVPIP)
Policy Number Endorsement Effective
N 1-A2-RL-0000013-09 6/1/2018
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
This endorsement modifies insurance provided under the following:
GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above.
Schedule
Person or Organization(Additional Insured): As Per Schedule on file with Clear Risk Solutions, Underwriting Administrator
Attn: Lori Guilfoyle
City of Kent
220 Fourth Avenue South
Kent,WA 98032
Regarding Consultant Services Agreement between the City of Kent and ANEW.City of Kent is named as Additional Insured
regarding this agreement only and is subject to policy terms,conditions,and exclusions.Additional Insured endorsement is
attached. NPIP is primary and non-contributory.
A. With respects to the General Liability Coverage Part only,the definition of Insured in the Liability Conditions, Definitions
and Exclusions section of this policy is amended to include as an Insured the Person or Organization shown in the above
Schedule.Such Person or Organization is an Insured only with respect to liability for Bodily Injury,Property Damage,or
Personal and Advertising Injury caused in whole or in part by your acts or omissions or the acts or omissions of those
acting on your behalf:
1. In performance of your ongoing operations;or
2. In connection with your premises owned or rented to you.
B. The Limits of Insurance applicable to the additional Insured are those specified in either the:
1. Written contract or written agreement;or
2. Declarations for this policy,
whichever is less.These Limits of Insurance are inclusive and not in addition to the Limits Of Insurance shown in the Declarations.
All other terms and conditions remain unchanged.
Includes copyrighted material of the Insurance Services Office,Inc.,with its permission.
RL 2163 12112 Page 1 of 1
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KENT Exhibit C
PARKS. RECREATION it
CONMUNITY SERVICES City of Kent
Certification Regarding Debarment and Suspension
ANEW Construction Trades
Agency Name of Program
Certification A: Certification Regarding Debarment, Suspension, and Other Responsibility Matters
- Primary Covered Transactions
1. The prospective primary participant certifies to the best of its knowledge and belief that its principals;
a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from covered transactions by any Federal debarment or agency;
b) Have not within a three-year period preceding this proposal, been convicted of or had a civil judgment
rendered against them for commission of fraud or a criminal offense in connection with obtaining,
attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a
public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft,
forgery, bribery, falsification, or destruction of records, making false statements, or receiving stolen
property;
c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity(Federal,
State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this
certification; and
d) Have not within a three-year period preceding this application/ proposal had one or more public
transactions (Federal, State, or local) terminated for cause or default.
2. Where the prospective primary participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Instructions for Certification (A)
1. By signing and submitting this proposal,the prospective primary participant is providing
the certification set out below,
2. The inability of a person to provide the certification required below will not necessarily
result in denial of participation in this covered transaction. The prospective participant
shall submit an explanation of why it cannot provide the certification set out below. The
certification or explanation will be considered in connection with the department or
agency's determination whether to enter into this transaction. However, failure of the
prospective primary participant to furnish a certification or an explanation shall
disqualify such person from participation in this transaction.
3. The certification in this clause is a material representation of fact upon which reliance
was placed when the department or agency determined to enter into this transaction.
If it is later determined that the prospective primary participant knowingly rendered an
erroneous certification, in addition to other remedies available to the Federal
Government/City of Kent, the department or agency may terminate this transaction for
cause of default.
4. The prospective primary participant shall provide immediate written notice to the
department or agency to whom this proposal is submitted if at any time the prospective
primary participant learns that its certification was erroneous when submitted or has
become erroneous by reason of changed circumstances.
5. The terms covered transaction, debarred, suspended, ineligible, lower tier
covered transaction, participant, person, primary covered transaction,
principal, proposal, and voluntarily excluded, as used in this clause, have the
meanings set out in the Definitions and Coverage sections of the rules implementing
Executive Order 12549. You may contact the department or agency to which this
proposal is being submitted for assistance in obtaining a copy of these regulations.
6. The prospective primary participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter into any
lower tier covered transaction with a person who is debarred, suspended, declared
ineligible, or voluntarily excluded from participation in this covered transaction, unless
authorized by the department or agency entering into this transaction.
7. The prospective primary participant further agrees by submitting this proposal that it
will include the clause titled "Certification Regarding Debarment, Suspension,
Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction,"provided by the
department or agency entering into this covered transaction, without modification, in
all lower tier covered transactions and in all solicitations for lower tier covered
transactions.
8. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended,
ineligible, or voluntarily excluded from the covered transaction, unless it knows that
the certification is erroneous. A participant may decide the method and frequency by
which it determines this eligibility of its principals. Each participant may, but is not
required to, check the Non-procurement List.
9. Nothing contained in the foregoing shall be construed to require establishment of a
system of records in order to render in good faith the certification required by this
clause. The knowledge and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary course of business
dealings.
10.Except for transactions authorized under paragraph (6) of these instructions, if a
participant in a covered transaction
11.Knowingly enters into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government/City of Kent, the
department or agency may terminate this transaction for cause of default.
Certification B: Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion - Lower Tier Covered Transactions
1. The prospective lower tier participant certifies, by submission of this proposal, that neither
it nor its principals is presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from participation in this transaction by any Federal
department or agency.
2. Where the prospective lower tier participant is unable to certify to any of the statements
in this certification, such prospective participant shall attach an explanation to this
proposal.
Instructions for Certification (B)
1. By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed
when this transaction was entered into. If it is later determined that the prospective lower tier
participant knowingly rendered an erroneous certification, in addition to other remedies available to
the Federal Government/City of Kent, the department or agency with which this transaction originated
may pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant shall provide immediate written notice to the person to which
this proposal is submitted if at any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered
transaction, participant, person, primary covered transaction, principal, proposal, and
voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to which
this proposal is submitted for assistance in obtaining a copy of these regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed
covered transaction be entered into, it shall not knowingly enter into any lower tier covered
transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded
from participation in this covered transaction, unless authorized by the department or agency with
which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will include
this clause titled"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion
- Lower Tier Covered Transaction,"without modification, in all lower tier covered transactions and in
all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded
from the covered transaction, unless it knows that the certification is erroneous. A participant may
decide the method and frequency by which it determines the eligibility of its principals. Each
participant may, but is not required to, check the Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of records
in order to render in good faith the certification required by this clause. The knowledge and information
of a participant is not required to exceed that which is normally possessed by a prudent person in the
ordinary course of business dealings.
9. Except for transactions authorized under paragraph (5) of these instructions, if a participant in a lower
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government/City of Kent, the department or
agency with which this transaction originated may pursue available remedies including suspension
and/or debarment.
Executive Director (Print) Title Date
Sign4ture of Executive Director Title Date
1
(3/98)
Adopted from HUD Form-2992
09/04
EEO COMPLIANCE DOCUMENTS - 1