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HomeMy WebLinkAboutCAG2019-359 - Original - KBA, Inc. - S 228th St UPRR Grade Separation Bridge & Roadway Phase 5 - 07/03/2019 Agreement Routing Form KEN T For Approvals, Signatures and Records Management W AI H INCT.N This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms. (Print on pink or cherry colored paper) Originator: Nancy Y. for Jason Barry Department: Public Works Date Sent: 7/3/19 Date Required. 7/10/19 To c Authorized Director or Designee Date of 0. to Sign: Council 7/2/19 aMayor Approval: Budget R90067 Grant? Yes No Account Number: Type: N/A Vendor Name: KBA, Inc. Category. Contract C Vendor 1089599 Sub-Category 0 Number: a Project E Name: S. 228th St. UPRR Grade Separation Bridge & Roadway - Phase 5 L.0 = Project C Details: Provide construction management services for the project. E Agreement 717 000 Basis for y Amount: Selection of Other L Contractor. v� a Start Date: Date of Mayor's signature Termination Date: 6/30/21 Notice required prior to � Yes � No Contract Number: disclosure? cligC-iZAi.,j — Date R MeN atwiwComments: M.%a uptV D 0 oC N KENT LAW DE Ti L 3 .I.r M Date Routed to the Mayor's Office: - N air Da Routed to the City C erk's Office: Date Sent to'Originator: Visit Documents.KentWA.gov to obtain copies of all agreements adccW22373_6_19 KENT DATE: July 2, 2019 TO: Kent City Council SUBJECT: Consultant Services Agreement for the South 228th Street UPRR Grade Separation Bridge and Roadway Phase 5 Project with KBA, Inc - Authorize MOTION: Authorize the Mayor to sign a contract with KBA, Inc. for contract administration, contract management, quality control, and inspection in the amount of $717,000. for the South 228th Union Pacific Railroad Grade Separation Bridge and Roadway project, subject to final terms and conditions acceptable to the City Attorney and Public Works Director. SUMMARY: The S. 228th Union Pacific Railroad Grade Separation Bridge and Roadway project is located on S. 228th St between 4th Ave N. and the west limits of Interurban Trail. This is the 5th and final phase of the S 228th St Grade Separation project that will provide geosynthetic and structural earth retaining wall with rock filled wire facing and shotcrete facing, geofoam block fill, load distribution slab, a two span bridge structure over the UPRR and interurban trail, traffic barriers, pedestrian barriers, bridge railing, water quality storm vaults, storm filters, storm pipe, catch basins, manholes, concrete and HMA pavement, street lighting, conduit, loops, channelization, signing, various driveway improvements, landscaping and irrigation. This consultant contract is needed to provide a resident engineer, inspector, and subconsultant to perform contract administration, construction management, quality control, and inspection on this project. Through our selection process following WSDOT LAG Manual guidelines we have selection KBA, Inc. to provide this staff in addition to a subconsultant to provide quality control. KBA is a firm based in Bellevue, WA that specializes in providing construction management and contract administration on federally funded capital improvement projects for local municipalities throughout the Puget Sound region. BUDGET IMPACT: The project will be paid for with funds from Washington State's "Connect Washington" program, the Washington State Transportation Improvement Board, and Business and Occupation Funds. SUPPORTS STRATEGIC PLAN GOAL: Evolving Infrastructure ATTACHMENTS: 1. Consultant Services Agreement with KBA, Inc. (PDF) 06/17/19 Public Works Committee RECOMMENDED TO COUNCIL RESULT: RECOMMENDED TO COUNCIL [UNANIMOUS]Next: 7/2/2019 7:00 PM MOVER: Brenda Fincher, Councilmember SECONDER: Toni Troutner, Councilmember AYES: Dennis Higgins, Brenda Fincher, Toni Troutner 1� KENT CONSULTANT SERVICES AGREEMENT between the City of Kent and KBA, Inc. THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and KBA, Inc. organized under the laws of the State of Washington, located and doing business at 11201 SE 8th St., Suite 160, Bellevue, WA 98004-6455, Phone: (425) 455-9720, Contact: Sam Schuyler (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 Services for the S. 228th St. Union Pacific Railroad Grade Separation Bridge and Roadway - Phase 5 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 June 30, 2021. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not t:o exceed Seven Hundred Seventeen Thousand Dollars ($717,000), for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit 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 dei:ails 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 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. 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. 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 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. 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 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. 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 to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. CONSULTANT: CITY OF j_02LQ­- By: �� l I ( i �� [ - By: (signa Lure) (signa ture) Print Name: Kristen M. Overleese,PE Print Name: Dana Ralph Its President Its Mayor _ (it DATE: DATE: NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Sam Schuyler Timothy J. LaPorte, P.E. KBA, Inc. City of Kent 11201 SE 8" St., Suite 160 220 Fourth Avenue South Bellevue, WA 98004-6455 Kent, WA 98032 (425) 455-9720 (telephone) (253) 856-5500 (telephone) N/A (facsimile) (253) 856-6500 (facsimile) APPROVED AS TO FORM: Kent Law Department ATTES . Kent CIN Cle k K13A-228'Ph 5/13arry 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 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 14 1 y: t rist n OverleesE, FE For: KBA,Inc. Title: President Date: -T 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 KBA, Inc. June 4, 2019 EXHIBIT A SCOPE OF SERVICES Construction Management Services For S. 228th St. Union Pacific Railroad Grade Separation Project— Phase V KBA, Inc. (Consultant)will provide Construction Management(CM) services to The City of Kent(City)for the Project known as 228th St. Union Pacific RR Grade Separation Phase V (Project). These services will include consultation, contract administration, field observation, documentation, and material testing, as required during the construction of the Project, as detailed below. Project Description: The project consists of the construction of a grade separation between the Union Pacific Railroad (UPRR) tracks and S. 2281h Street. It will require the installation of a geosynthetic and structural earth retaining wall with rock filled wire facing and shotcrete facing, geofoam block fill, load distribution slab, a two span bridge structure over the UPRR and interurban trail, traffic barriers, pedestrian barriers, bridge railing, water quality storm vaults, storm filters, storm pipe, catch basins, manholes, concrete and HMA pavement, street lighting, conduit, loops, channelization, signing, various driveway improvements, landscaping and irrigation. The Designer of Record on this project is HDR (Designer). I. CONSTRUCTION MANAGEMENT SERVICES A. Consultant Contract and Team Management. Provide overall day-to-day management of the consultant contract and team, including: 1. Decide on best modes and frequency of communication with City and Designer. Liaison and coordinate with City on a regular basis to discuss Project issues and status. 2. Manage Consultant Team, comprised of Consultant's staff and subconsultants. Organize and layout work for Consultant Team 3. Review monthly expenditures and Consultant Team scope activities. Prepare and submit to City monthly, an invoice and progress report describing Consultant Team services provided that month. Prepare and submit reporting required by funding source(s), if any. 4. Communication on consultant contractual issues will be with the City. Communication on day-to-day construction activities and issues will be directly between the Consultant and the City. The City will be an active member of the Project team and consulted on design issues, and will be provided with information affecting Project progress. Deliverables • Monthly invoices and progress reports B. Preconstruction Services 1. Review Contract Documents to familiarize team with Project requirements. C. Construction Phase Services — Contract Administration 1. Liaison with the City, construction contractor, Designer, appropriate agencies, property owners, and utilities. 2. Schedule Review: a. Review construction contractor's schedules for compliance with Contract Documents. b. Monitor the construction contractor's conformance to schedule and require revised schedules when needed. Advise City of schedule changes. 1 of 6 KBA, Inc. June 4, 2019 3. Progress Meetings. Lead regular(usually weekly) progress meetings with the construction contractor, including City pre-briefing. Prepare weekly meeting agenda and meeting notes, and distribute copies to attendees. Track outstanding issues on a weekly basis. 4. Manage Submittal Process. Track and review, or cause to be reviewed by other appropriate party, work plans, shop drawings, samples, test reports, and other data submitted by the construction contractor, for general conformance to the Contract Documents. 5. Record of Materials. Manage Record of Materials indicating anticipated material approvals, material compliance documentation, and materials testing requirements. Maintain records of material compliance documentation received and advise of any known deficiencies. 6. Prepare weekly statement of working days and distribute to the City and Contractor. 7. Manage RFI (Request for Information) process. Track and review/evaluate, or cause to be reviewed/evaluated by other appropriate party, RFIs. Manage responses to RFIs. 8. Change Management. Evaluate entitlement, and prepare scope, impact, and independent estimate for change orders. Facilitate resolution of change orders. 9. Monthly Pay Requests. Prepare monthly requests for payment and/or review payment requests submitted by the construction contractor. Review with City and construction contractor, and recommend approval, as appropriate. 10. Evaluate construction contractor's Schedule of Values for lump sum items. Review the Contract Price allocations and verify that such allocations are made in accordance with the requirements of the Contract Documents. 11. Notify construction contractor and City of work failing to meet contract requirements. . 12. Prevailing Wage Monitoring: a. Monitor Payroll Compliance. Review Statements of Intent to Pay Prevailing Wage against the Contract Document requirements. Collect, record, and check weekly certified payrolls and conduct on-site wage interviews, both at a frequency documented in accordance with Agency guidelines. 13. Assist the City in the investigation of malfunctions or failures during construction. 14. Public Information. Provide information for City to prepare media communications and public notices on Project status. Provide information for City's inclusion into a Project website and/or newsletters, if requested. 15. Record Drawings. Review not less than monthly, the construction contractor's redline set of contract plans. Maintain a CM Team set of conformed drawings tracking plan changes, location of discovered anomalies and other items, as encountered by the CM team. Use these markups to check the progress of the Contractor-prepared Record Drawings. 16. Document Control. Establish and maintain document filing and tracking systems, following City guidelines and meeting funding agency requirements. Collect, organize, and prepare documentation on the Project. a. One hard copy of files will be kept in the Project field office. b. Electronic documentation will be stored in a Project Website, using SharePoint software, managed and hosted by the Consultant. The City will be provided with up to two licenses for their and the construction contractor's use of the SharePoint website during the Project. Consultant will provide one training session each for City and construction contractor users of the SharePoint system. c. The Project SharePoint site will transition to "read-only" access upon expiration of the Agreement, or upon project completion and transfer of final records, whichever occurs first. Transference of final records will include a digital copy of the files stored in the Project SharePoint site. Access to SharePoint will expire following that date. 2of6 KBA, Inc. June 4, 2019 17. Project Closeout. Prepare Letters of Substantial (including punch list), Physical, and Final Completion for City approval and signature. Prepare final pay estimate and Final Contract Voucher Certification for City approval and processing. 18. Final Records. Compile and convey final Project records, transferring to the City for archiving at final acceptance of the Project. Records will consist of hard copy originals and electronic records on electronic storage medium. Deliverables • Monthly Construction Progress Reports • Schedule Review Comments • Meeting Agendas and Notes • Submittal Log • Record of Materials • RFI Log • Change Order(s) • Progress Pay Requests • Letters of Substantial, Physical, and Final Completion • Final estimate and Final Contract Voucher Certification • Final records— hard copy and electronic D. Construction Phase Services— Field 1. Observe the technical conduct of the construction, including providing day-to-day contact with the construction contractor, City, utilities, and other stakeholders, and monitor for adherence to the Contract Documents. The Consultant's personnel will act in accordance with Sections 1-05.1 and 1-05.2 of the WSDOT/APWA Standard Specifications. 2. Inspect material, workmanship, and construction areas for compliance with the Contract Documents and applicable codes. Advise the construction contractor and City of any non- conforming work observed. 3. Prepare Inspector Daily Reports (IDRs), recording the construction contractor's operations as actually observed by the Consultant; includes quantities of work placed that day, contractor's equipment and crews, and other pertinent information. 4. Interpret Construction Contract Documents, in coordination with Designer. 5. Evaluate issues which may arise as to the quality and acceptability of material furnished, work performed, and rate of progress of work performed by the construction contractor. 6. Establish communications with adjacent property owners. Respond to questions from property owners and the general public. 7. Coordinate with permit holders on the Project to monitor compliance with approved permits, ii applicable. 8. Prepare Field Note Records, Daily Records of Force Account Worked, and other documents to help facilitate administration of the Project in accordance with funding agency requirements. 9. Attend and actively participate in regular on-site meetings. 10. Take periodic digital photographs during the course of construction. Photographs to be labeled and organized. 11. Punch List. Upon substantial completion of work, coordinate with the City and affected agencies, to prepare a 'punch list' of items to be completed or corrected. Coordinate final inspection with those agencies. 3of6 KBA, Inc. June 4, 2019 12. Testing. Conduct or cause to be conducted, materials and laboratory tests. Coordinate the work of the Field Representative(s) and testing laboratories in the observation and testing of materials used in the construction; document and evaluate results of testing; and inform City and construction contractor of deficiencies. Deliverables • IDRs with Project photos—submitted on a weekly basis • Field Note Records and Daily Records of Force Account Worked • Punch List(s) • Test reports E. Assumptions 1. Budget: a. Staffing levels are anticipated in accordance with the attached budget estimate. Consultant services are budgeted for a 240 construction contractor working day period plus 10 days project startup and 20 days project closeout. Overtime has not been figured into the budget. b. Consultant will work up to the limitations of the authorized budget. If additional budget is needed to cover such instances as the following, City and Consultant will negotiate a supplement to this Agreement: i. The contractor's schedule requires inspection coverage of extra crews and shifts. ii. The construction contract runs longer than the time period detailed above. iii. Any added scope tasks. iv. The work is anticipated to be performed during daytime hours. Should night work be necessary, a 15 percent differential for labor will be applied to all night shift hours worked by Consultant's employees. c. The budget allocations shown on Exhibit B are itemized to aid in Project tracking purposes only. The budget may be transferred between people, or between labor and expenses, provided the total contracted amount is not exceeded without prior authorization. d. The budget assumes that Consultant's standard forms, logs, and processes will be used on the Project SharePoint site. Any customization to meet specialized City requirements will be Extra Work. e. Should Consultant's level of effort extend beyond the time period detailed in the attached Exhibit B - Estimate, and into a new year, labor rates will adjust annually on January 1, with 30-day written notice to Agency. 2. Items and Services City will provide: a. Meeting arrangements and facilities for pre-bid and preconstruction meetings. Prepare and distribute meeting notes from pre-bid meeting(s), if any. b. Field office, including: i. workstations (desk, chair, and storage)for two staff ii. conference table and chairs iii. combination printer/copier/scanner machine with these capabilities: 11x17 size, color iv. miscellaneous office supplies v. utilities and sanitary facilities c. Retain Engineer of Record for shop drawing review, RFIs, design changes, and final record drawings. 4of6 KBA, Inc. June 4, 2019 d. Coordination with and enforcement of utility franchise agreements and/or contracts and schedules for services related to this Project. e. Verify that the required permits, bonds, and insurance have been obtained and submitted by the construction contractor. Obtain all permits not required to be provided by construction contractor. f. Construction Survey. Provide project control survey and staking that is not already assigned to the construction contractor. 3. Scope: a. The SharePoint tool being used on this Project is proprietary to the Consultant(KBA, Inc.), and may not be used by any other party or on any other project without the written permission and involvement of KBA, Inc. b. Consultant will provide inspection services for the days/hours that its' Inspector(s) personnel is/are on-site. The Inspector(s)will not be able to observe or report construction activities, or collect documentation, during the time they are not on-site. c. The Consultant's monitoring of the construction contractor's activities is to ascertain whether or not they are performing the work in accordance with the Contract Documents; in case of noncompliance, Consultant will reject non-conforming work and pursue the other remedies in the interests of the City, as detailed in the Contract Documents. The Consultant cannot guarantee the construction contractor's performance, and it is understood that Consultant shall assume no responsibility for proper construction means, methods, techniques, Project site safety, safety precautions or programs, or for the failure of any other entity to perform its work in accordance with laws, contracts, regulations, or City's expectations. d. Definitions and Roles. The use of the term "inspect" in relation to Consultant services is synonymous with "construction observation," and reference to the "Inspector" role is synonymous with "Field Representative," and means: performing on-site observations of the progress and quality of the Work and determining, in general, if the Work is being performed in conformance with the Contract Documents; and notifying the City if Work does not conform to the Contract Documents or requires special inspection or testing. Where "Specialty Inspector" or"specialty inspection" is used, it refers to inspection by a Building Official or independent agent of the Building Official, or other licensed/certified inspector who provides a certified inspection report in accordance with an established standard. e. Because of the prior use of the Project site, there is a possibility of the presence of toxic or hazardous materials. Consultant shall have no responsibility for the discovery, presence, handling, removal or disposal of toxic or hazardous materials, or for exposure of persons to toxic or hazardous materials in any form at the Project site, including but not limited to asbestos, asbestos products, polychlorinated biphenyl (PCB), or other toxic substances. If the Consultant suspects the presence of hazardous materials, they will notify the City immediately for resolution. f. Review of Shop Drawings, samples, and other submittals will be for general conformance with the design concept and general compliance with the requirements of the contract for construction. Such review will not relieve the Contractor from its responsibility for performance in accordance with the contract for construction, nor is such review a guarantee that the work covered by the shop drawings, samples and submittals is free of errors, inconsistencies or omissions. g. Any opinions of probable construction cost provided by the Consultant will be on the basis of experience and professional judgment. However, since Consultant has no control over competitive bidding or market conditions, the Consultant cannot and does not warrant that bids or ultimate construction costs will not vary from these opinions of probable construction costs. 5of6 KBA, Inc. June 4, 2019 h. Development of construction schedules and/or sequencing, and/or reviewing and commenting on contractor's schedules, is for the purpose of estimating number of days to complete a project, and for identifying potential schedule and coordination challenges and determining compliance with the construction contract. It is not a guarantee that a construction contractor will complete the Project in that sequence or timeline, as means and methods are the responsibility of the construction contractor. i. Consultant is not responsible for any costs, claims or judgments arising from or in any way connected with errors, omissions, conflicts or ambiguities in the Contract Documents prepared by others. The Consultant does not have responsibility for the professional quality or technical adequacy or accuracy of the design plans or specifications, nor for their timely completion by others. j. Consultant's indemnity and defense obligations are limited to the extent of those damages directly caused by the negligent acts, errors, or omissions of the Consultant. Any damages and/or costs that may be recovered shall be limited to the total amount authorized for this Project. k. City agrees to include a statement in the construction Bid Documents for this Project, requiring construction contractor to name KBA, Inc. as an additional insured via CG 2010 & CG 2037 10/01, or their equivalent, endorsements to the contractor's commercial general liability and automobile insurance policies. I. RCW 4.24.115 is applicable to Consultant's services provided under this Agreement. m. Services provided by the Consultant under this Agreement will be performed in a manner consistent with that degree of care and skill ordinarily exercised by members of the same profession currently practicing under similar circumstances, in the same geographical area and time period. Nothing in the Agreement is intended to create, nor shall it be construed to create, a fiduciary duty owed by either party to the other. n. City agrees that Consultant will not be held liable for the completeness, correctness, readability, or compatibility of any electronic media submitted to City, after an acceptance period of 30 days after delivery of the electronic files, because data stored on electronic media can deteriorate undetected or can be modified without Consultant's knowledge. o. Consultant will not be liable for any damage to the field office premises or utilities provided by City, unless caused by Consultant's own negligence. II. OPTIONAL SERVICES All services not detailed above, are considered Optional Services, which, along with any other Extra Work: requested by the City, will be performed only when a mutually negotiated Supplement to this Agreement is executed, specifying scope of services and budget. 6 of Ei Z 2 Z N ffi m �' N to y ss m � O O N O O O N �i � ' •O M " O �_N_�O O [qf� th " ' �I�m i "� � � ao j LL LL �I " m .p of m z i�lgg 77 —77 fi �� b = BhPe4o9 max` w�'a R R R R N R a Q o 5 V H F F V w 2- " mm C N � 8888� Z z •p cQ < � a a_c4 inw5— Q uxc� oS�n aa�tt a U y ^^^tt O a a w W a O 2 e o20IT z Q w n J w Amow OCao -2 �mTm nNN � w R 'K a�. Y `n a U C C7 m' O i ti N m' U y ¢ bbnLLnsni- s c°� - a` i 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 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. 2. 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. 3. 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 $2,000,000 each occurrence, $4,000,000 general aggregate. EXHIBIT C (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 ANII. 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. AC�ORO® CERTIFICATE OF LIABILITY INSURANCE P ATE(MM/DD/YYYY) 6/24/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Dealey, Renton &Associates NAME: P. O. Box 12675 IPA/ E ; 510-465-3090 FAX No 452-2193:510 Oakland CA 94604-2675 E-MAIL ADDRESS: certificates@dealeyrenton.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Travelers IndemnityCompany of America 25666 INSURED KBAINC KBA, Inc. INSURER B:XL Special Speciaq Insurance Co. 37885 11201 SE 8th Street, Ste 160 INSURER C:Phoenix Insurance Company 25623 Bellevue WA 98004 INSURER D:Travelers Property Casualty Cc of Ameri 25674 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:369351353 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. INSR ADDL SUBR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP Wvn MM/DD/YYYY MM DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 6806NO33449 5/10/2019 5/10/2020 EACH OCCURRENCE TO E $1,000,000 J CLAIMS-MADEEXI OCCUR PREMISES(Ea occurrence) $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X❑ PRO- ❑ JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ C AUTOMOBILE LIABILITY Y Y BA6N034864 5/10/2019 5/10/2020 COMBINED SINGLE LIMIT $1,000,000 X ANY AUTO Ea accident OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ D X UMBRELLA LIAB X OCCUR Y Y CUP6N036187 5/10/2019 5/10/2020 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED X I RETENTION$ $ A WORKERS COMPENSATION Y 680IN033449 5/10/2019 5/10/2020 PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I i ER �ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT OFFICERIMEMBEREXCLUDED? ❑ N/A $1.000,000 (Mandatory in NH) If yes' E.L.DISEASE-EA EMPLOYEE $1,000,000 yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Professional Liability DPR9941979 5/10/2019 5/10/2020 $2,000,000 $4,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Project No.B17057-03-S 228th St Union Pacific Railroad Grade Separation—Phase 5 The City of Kent is named as an additional insured as respects general and auto liability as required per written contract or agreement.General and Auto Liability are Primary/Non-Contributory per policy form wording.Severability of Interest applies to General and Auto Liability. SEVERABILITY OF INTERESTS(Per CG 00 01 10 01) 7.Separation of Insureds-Except With respect to the Limits of Insurance,and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: See Attached... 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. Attn: Nancy Yoshitake 220 Fourth Avenue, South AUTHORIZED REPRESENTATIVE Kent WA 98032 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: KBAINC _ LOC#: A�oRfl� ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Dealey, Renton&Associates KBA, Inc. 11201 SE 8th Street,Ste 160 POLICY NUMBER Bellevue WA 98004 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE a.As if each Named Insured were the only Named Insured;and b.Separately to each insured against whom claim is made or suit is brought. 30 Day Notice of Cancellation ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy: BA6N034864 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM The following is added to Paragraph c. in A.1., Who between you and that person or organization, that is Is An Insured, of SECTION II — COVERED AUTOS signed by you before the "bodily injury" or "property LIABILITY COVERAGE in the BUSINESS AUTO damage" occurs and that is in effect during the policy COVERAGE FORM and Paragraph e. in A.1.,Who Is period, to name as an additional insured for Covered An Insured, of SECTION II — COVERED AUTOS Autos Liability Coverage, but only for damages to LIABILITY COVERAGE in the MOTOR CARRIER which this insurance applies and only to the extent of COVERAGE FORM, whichever Coverage Form is that person's or organization's liability for the conduct part of your policy: of another"insured". This includes any person or organization who you are required under a written contract or agreement CA T4 37 02 16 ©2016 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL GENERAL LIABILITY POLICY NUMBER 6806N033449 ISSUED DATE: 6/24/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Names of Additional Insured Person(s) or Organization(s): Any person or organization that you agree in a written contract, on this Coverage Part, provided that such written contract was signed and executed by you before, and is in effect when the "bodily injury" or"property damage" occurs or the"personal injury' or"advertising injury' offense is committed. Location of Covered Operations: Any project to which an applicable written contract with the described in the Name of Additional Insured Person(s) or Organization(s) section of this Schedule applies. (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) A. Section II —Who Is An Insured is amended to in- This insurance does not apply to "bodily injury' or clude as an additional insured the person(s) or "property damage" occurring, or "personal injury" organization(s) shown in the Schedule, but only or "advertising injury' arising out of an offense with respect to liability for"bodily injury', "property committed, after: damage", "personal injury' or "advertising injury' 1. All work, including materials, parts or equip- caused, in whole or in part, by: ment furnished in connection with such work, 1. Your acts or omissions; or on the project (other than service, mainte- 2. The acts or omissions of those acting on your nance or repairs) to be performed by or on behalf; behalf of the additional insured(s) at the loca- in the performance of your ongoing operations for tion of the covered operations has been com- the additional insured(s) at the location(s) desig- pleted; or nated above. 2. That portion of "your work" out of which the B. With respect to the insurance afforded to these injury or damage arises has been put to its in- additional insureds, the following additional exclu- tended use by any person or organization sions apply: other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project. CG D3 61 03 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. NAMED INSURED: KBA, Inc. COMMERCIAL GENERAL LIABILITY COVERAGE POLICY NUMBER: 6806NO33449 ADDITIONAL COVERAGES BY WRITTEN CONTRACT OR AGREEMENT This is a summary of the coverages provided under the following forms (complete forms available): Excerpt from COMMERCIAL GENERAL LIABILITY COVERAGE (FORM #CG T1 00 02 19) SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS 4. OTHER INSURANCE - d. PRIMARY AND NON-CONTRIBUTORY INSURANCE IF REQUIRED BY WRITTEN CONTRACT: If you specifically agree in a written contract or agreement that the insurance afforded to an insured under this Coverage Part must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such insured which covers such insured as a named insured, and we will not share with that other insurance, provided that: (1) The "bodily injury" or"property damage"for which coverage is sought occurs; and (2) The "personal and advertising injury"for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreement by you. Excerpt from XTEND ENDORSEMENT FOR ARCHITECTS, ENGINEERS AND SURVEYORS (FORM #CG D3 79 02 19) PROVISION M. - BLANKET WAIVER OF SUBROGATION - WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT: If the insured has agreed in a written contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a. "Bodily injury" or"property damage"that occurs; or b. "Personal and advertising injury" caused by an offense that is committed; subsequent to the signing of that contract or agreement. Page 1 COMMERCIAL GENERAL LIABILITY POLICY NUMBER: 6806NO33449 ISSUED DATE: 6/24/2019 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part for"bodily injury" or"property damage" included in the "products- completed operations hazard", provided that such contract was signed and executed by you before, and is in effect when, the bodily injury or property damage occurs. Location And Description Of Completed Operations Any project to which an applicable contract described in the Name of Additional Insured Person(s) or Organization(s) section of this Schedule applies. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- location designated and described in the schedule of clude as an additional insured the person(s) or or- this endorsement performed for that additional in- ganization(s) shown in the Schedule, but only with sured and included in the "products-completed opera- respect to liability for "bodily injury" or "property dam- tions hazard". age" caused, in whole or in part, by"your work" at the CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 TRAVELERS : WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76(00) — 001 POLICY NUMBER: 6806NO33449 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 3.00 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description ALL PERSONS OR ORGANIZATIONS THAT ARE PARTIE TO A CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT, PROVIDED YOU EXECUTED THE CONTRACT BEFORE THE LOSS. DATE OF ISSUE: 6/24/2019 ST ASSIGN: CA 017106