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HomeMy WebLinkAboutCAG2019-458 - Original - Evergreen Asphalt & Concrete, Inc. - Lake Fenwick Park Asphalt Work - 11/07/2019 Agreement Routing Form KE11 N T For Approvals,Signatures and Records Management Director initials WASHINGTON This form combines&replaces the Request for Mayor's signature and Contract Cover Sheet forms. (Print on pink or cherry colored paper) Manager initials Originator. ]an Applegate Department: Parks Date Sent: 11/4/2019 Date Required: as soon as possible To a Authorized - Director Date of 0 n/a a. to Sign: Council aMayor Approval: Budget P20010.64190.530 Grant? Yes ❑✓ No Account Number: 851 W Type: N/A Vendor Evergreen Asphalt & Concrete, Inc. Category: Contract Name: Vendor 213355 Sub-Category 0 Number: to Project E Lake Fenwick Park Asphalt Work on Walking Trail, Boat Launch and Disc Golf 3. Name: 0 c Project Remove &replace asphalt on walking trail and new approaches at boat launch and disc golf course. Z Details: c E Basis for Agreement $13,887.50 Selection of Other 10 Amount. Contractor. v+ a Start Date: As soon as possible%-7-11 Termination Date: 12/31/2019 Notice required prior to Yes No Contract Number: disclosure? Date Received by City Attorney: Comments: IM 0 0 N 41 L 3 i/ f1f � Date Routed to the Mayor's Office: N a3i Date Routed to the City Clerk's Office: ar Date Sent to Originator: Visit Documents.KentWA.gov to obtain copies of all agreements adccW22373_6_19 KENT W s II.ToI PUBLIC WORKS AGREEMENT between City of Kent and Evergreen Asphalt & Concrete, Inc. THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Evergreen Asphalt & Concrete, Inc. organized under the laws of the State of Washington, located and doing business at 27204 SE Kent-Kangley Road, Ravensdale WA 98051; Mailing address: P.O. Box 867, Ravensdale WA 98051. Contact: Shane Gilbertson, Phone: 425-584-7890, Cell: 253-670-9072 (hereinafter the "Contractor"). AGREEMENT The parties agree as follows: I. DESCRIPTION OF WORK. Contractor shall perform the following services for the City in accordance with the following described plans and/or specifications: Work to be done at Lake Fenwick Park located at 25828 Lake Fenwick Road, Kent WA 98032 as described in Proposal #7805 dated 10/31/2019 attached and marked as Exhibit A. Lake Fenwick Walking Trail - 600 square feet - asphalt remove and replace in one location. Owner to remove existing asphalt and tree roots. Contractor to provide new crushed rock and pave with 3 inch hot mix asphalt. Lake Fenwick Boat Launch - install new asphalt approach approximately 30 feet by 35 feet by 3 inches thick. Lake Fenwick Disc Golf - install 2 new asphalt approaches approximately 20 feet by 25 feet by 3 inches thick. Contractor 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 such services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon execution of this Agreement. Upon the effective date of this Agreement, Contractor shall complete the work described in Section I by December 31, 2019. III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed THIRTEEN THOUSAND EIGHT HUNDRED EIGHTY SEVEN DOLLARS AND FIFTY CENTS ($13,887.50), including any applicable Washington State Sales Tax, for the work and services contemplated in this Agreement. The City shall pay the Contractor eighty-five percent (85%) of the Contract amount upon completion and acceptance of the work by the City, or at such earlier time as the City may determine is appropriate. The City will pay the remaining Contract amount upon fulfillment of the conditions listed below and throughout this Agreement. PUBLIC WORKS AGREEMENT - 1 ($20K or Less and No Performance Bond) A. No Payment and Performance Bond. Because this contract, including applicable sales tax, is $150,000 or less, and pursuant to Chapter 39.08 RCW, the Contractor, in lieu of providing the City a payment and performance bond, has elected to have the City retain the final ten percent (10%) of the Contract amount for a period of thirty (30) days after the date of final acceptance, or until receipt of all necessary releases from the State Department of Revenue, the State Department of Labor & Industries, and the State Employment Security Department, and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. B. Retainaae. The City shall also hold back a retainage in the amount of five percent (5%) of any and all payments made to contractor for a period of sixty (60) days after the date of final acceptance, or until receipt of all necessary releases from the State Department of Revenue, the State Department of Labor & Industries, and the State Employment Security Department, and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. The amount retained shall be placed in a fund by the City pursuant to RCW 60.28.011(4)(a), unless otherwise instructed by the Contractor within fourteen (14) calendar days of Contractor's signature on the Agreement. C. Defective or Unauthorized Work. The City reserves its right to withhold payment from Contractor for any defective or unauthorized work. Defective or unauthorized work includes, without limitation: work and materials that do not conform to the requirements of this Agreement; and extra work and materials furnished without the City's written approval. If Contractor is unable, for any reason, to satisfactorily complete any portion of the work, the City may complete the work by contract or otherwise, and Contractor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Contract price specified above. The City further reserves its right to deduct the cost to complete the Contract work, including any Additional Costs, from any and all amounts due or to become due the Contractor. D. Final Payment: Waiver of Claims. THE CONTRACTOR'S ACCEPTANCE OF FINAL PAYMENT (EXCLUDING WITHHELD RETAINAGE) SHALL CONSTITUTE A WAIVER OF CONTRACTOR'S CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY CONTRACTOR AS UNSETTLED AT THE TIME FINAL PAYMENT IS MADE AND ACCEPTED. 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 Contractor has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Contractor maintains and pays for its own place of business from which Contractor's services under this Agreement will be performed. C. The Contractor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Contractor's services and is a service other than that furnished by the City, or the Contractor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Contractor 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. PUBLIC WORKS AGREEMENT - 2 ($20K or Less and No Performance Bond) E. The Contractor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Contractor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Contractor has a valid contractor registration pursuant to Ch. 18.27 RCW or an electrical contractor license pursuant to Ch. 19.28 RCW. G. The Contractor maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. The City may terminate this Agreement for good cause. "Good cause" shall include, without limitation, any one or more of the following events: A. The Contractor's refusal or failure to supply a sufficient number of properly skilled workers or proper materials for completion of the Contract work. B. The Contractor's failure to complete the work within the time specified in this Agreement. C. The Contractor's failure to make full and prompt payment to subcontractors or for material or labor. D. The Contractor's persistent disregard of federal, state or local laws, rules or regulations. E. The Contractor's filing for bankruptcy or becoming adjudged bankrupt. F. The Contractor's breach of any portion of this Agreement. If the City terminates this Agreement for good cause, the Contractor shall not receive any further money due under this Agreement until the Contract work is completed. After termination, the City may take possession of all records and data within the Contractor's possession pertaining to this project which may be used by the City without restriction. VI. PREVAILING WAGES. Contractor shall file a "Statement of Intent to Pay Prevailing Wages," with the State of Washington Department of Labor & Industries prior to commencing the Contract work. Contractor shall pay prevailing wages in effect on the date the bid is accepted or executed by Contractor, and comply with Chapter 39.12 of the Revised Code of Washington, as well as any other applicable prevailing wage rate provisions. The latest prevailing wage rate revision issued by the Department of Labor and Industries is attached. VII. CHANGES. The City may issue a written change order for any change in the Contract work during the performance of this Agreement. If the Contractor determines, for any reason, that a change order is necessary, Contractor must submit a written change order request to the person listed in the notice provision section of this Agreement, section XV(D), within fourteen (14) calendar days of the date Contractor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Contractor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Contractor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Contractor shall proceed with the change order work upon receiving either a written change order from the City or an oral order from the City before actually receiving the written change order. If the Contractor fails to require a change order within the time specified in this paragraph, the Contractor waives its right to make any claim or submit subsequent change order requests for that portion of the contract work. If the Contractor disagrees with the equitable adjustment, the Contractor must complete the change order work; however, the Contractor may elect to protest the adjustment as provided in subsections A through E of Section VIII, Claims, below. PUBLIC WORKS AGREEMENT - 3 ($20K or Less and No Performance Bond) The Contractor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by Contractor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. VIII. CLAIMS. If the Contractor disagrees with anything required by a change order, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Contractor may file a claim as provided in this section. The Contractor shall give written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14) calendar days of the date the Contractor knew or should have known of the facts or events giving rise to the claim, whichever occurs first . Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been waived by the Contractor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Contractor's written claim shall include the information set forth in subsections A, items 1 through 5 below. FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY. A. Notice of Claim. Provide a signed written notice of claim that provides the following information: 1. The date of the Contractor's claim; 2. The nature and circumstances that caused the claim; 3. The provisions in this Agreement that support the claim; 4. The estimated dollar cost, if any, of the claimed work and how that estimate was determined; and 5. An analysis of the progress schedule showing the schedule change or disruption if the Contractor is asserting a schedule change or disruption. B. Records. The Contractor shall keep complete records of extra costs and time incurred as a result of the asserted events giving rise to the claim. The City shall have access to any of the Contractor's records needed for evaluating the protest. The City will evaluate all claims, provided the procedures in this section are followed. If the City determines that a claim is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. C. Contractor's Duty to Complete Protested Work. In spite of any claim, the Contractor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Contractor also waives any additional entitlement and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Contractor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). IX. LIMITATION OF ACTIONS. CONTRACTOR MUST, IN ANY EVENT, FILE ANY LAWSUIT PUBLIC WORKS AGREEMENT - 4 ($20K or Less and No Performance Bond) ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK IS COMPLETE OR CONTRACTOR'S ABILITY TO FILE THAT CLAIM OR SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. X. WARRANTY. Contractor warrants that it will faithfully and satisfactorily perform all work provided under this Agreement in accordance with the provisions of this Agreement. The Contractor shall promptly correct all defects in workmanship and materials: (1) when Contractor knows or should have known of the defect, or (2) upon Contractor's receipt of notification from the City of the existence or discovery of the defect. In the event any parts are repaired or replaced, only original replacement parts shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for an additional year beyond the original warranty period applicable to the overall work. The Contractor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Contractor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Contractor shall pay all costs incurred by the City in order to accomplish the correction. XI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Contractor, its sub-contractors, or any person acting on behalf of the Contractor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Contractor 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. XII. INDEMNIFICATION. Contractor 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 Contractor'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 Contractor'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 Contractor and the City, its officers, officials, employees, agents and volunteers, the Contractor's duty to defend, indemnify, and hold the City harmless, and Contractor's liability accruing from that obligation shall be only to the extent of the Contractor's negligence, IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'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 Contractor 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 Contractor's part, then Contractor 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 Contractor's part. The provisions of this section shall survive the expiration or termination of this Agreement. PUBLIC WORKS AGREEMENT - 5 ($20K or Less and No Performance Bond) XIII. INSURANCE. The Contractor 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. XIV. WORK PERFORMED AT CONTRACTOR'S RISK. Contractor 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 Contractor's own risk, and Contractor 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. XV. 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 XII 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 Contractor. 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 Contractor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Contractor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. PUBLIC WORKS AGREEMENT - 6 ($20K or Less and No Performance Bond) i I public agency subject to I a��ni�r_�tgrords Act• The Contractor acknowledges that the,City is a p the Public Records Act codified in Chapter 42.56 thered by the Coised ntract of or n Washington performance o ethos notes, emails, and other records prepared or gaif those thered produced t Agreement may be subject to public review and dtdisclosure, isclr u eesven I cooperate fuloiy with the City in satisfying possessed by the City of Kent. As such, the City's duties and obligations under the Public Records Act. �it`wsiness ' 5& Retiuired. Prior to commencing the tasks described in Section I, J. Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 0 the Kent City Code. signatures by 1T.�X or mil• This Agreement may be executed in any K. o ntergans an Agreement, either party may deliver the signature page number of counterparts, each of which shall constitute an original, and all of which will together const�tu e this one Agreement. Further, upon executing this 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 p ffirmed, and the terms of the Agreement shall be deemed to its effective date are ratified and a to have applied. t _ CITY OF KENT: , CONTRACTOR: By' By. (signature) _ C) (signatures i �` Print Name- Brian Levenhagen Print Name: "w� Its: Parks Deputy Director Its DATE DATE: NOTICES TO BE SENT TO: OTICES TO BE SENT TO: CITY OF KEN CONTRACTOR: Andy Martin, omstruction Crew Lead MWIV Shane Gilbertson City of Kent 1 Evergreen Asphalt & Concrete, Inc. 220 Fourth Avenue South p.0. Box 867 Kent, WA 98032 Ravensdale, WA 98051 (253) 670-9072 (cell) or (253) 569-6940 (cell) or (425) 584-7890 (telephone) (253) 856-5124 (telephone) (253) 639-3779 (facsimile) (253) 856-6120 (facsimile) ATTES . Kent City Cler PUBLIC WORKS AGREEMENT - 7 ($20K or Less and No Performance Bond) PUBLIC WORKS AGREEMENT - 8 ($20K or Less and No Performance Bond) i DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORT4NITY POLICY I The City of Kent is committed to conform to Federal and State la s regarding equal opportunity. As such all contractors, subcontractors and suppliers who perf rm work with relations Agreement shall comply with the regulations of the City`s ual employment opportunity policies. essary for any The following questions specifically idennithis specific Ag eemen toy the requirements th I adhere stoeCAn affirmative contractor, subcontractor or supplier o Pbe response is required on all of the following gw�iifuiionsp sfepresents themseement lves es with valid regard to the If any contractor, subcontractor or supplier Y directives outlines, it will be considered a breach for allntract and it or part of the ill be ,enthe City`s sole determination regarding suspension or termination 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 will r d ao� all se psory, mental I in emloyment on toe physical cal basis of sex, race, color, national origin, age, o the presence disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. By: For: C_-- Title: Date: 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 BIDDER RESPONSIBILITY CRITERIA Certification of Compliance with Wage Payment Statutes This certification is required by state law (RCW 39.04.350(2)) to be submitted to the City before the contract can be awarded. The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date (October 31, 2019), the bidder is not a "willfu�" violator, as defined in RCW 49.48.082, of any provision of chapters 49.46, 49.48, or 49.52 �CW, as determined by a final and binding citation and notice of assessment issued by the Department of Labor and Industries or through a civil judgment entered by a court of limited or gener I jurisdiction. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Evergreen Asphalt & Concrete, Inc. By: Signature of Authorized Official* Printed Name: �,, 1�t•-'K-Title: Date: Date: City and State: t.-Jv"` *If a corporation, proposal must be executed in the corporate na�e by the president or vice- president (or any other corporate officer accompanied by eviden of authority to sign). If a co- partnership, proposal must be executed by a partner. BIDDER RESPONSIBILITY CRITERIA - 1 EXHIBIT A Evergreen Asphalt& PROPOSAL Concrete, Inc. P.O. Box 867 Date Proposal# Ravensdale, WA 98051 10/31/2019 7805 Ph: 425 584-7890 Fax: 253 639-3779 PROPOSAL SUBMITTED TO: City of Kent 220 Fourth Avenue Kent,WA 98032 Attn Nate Harper TERMS SUBMITTE... JOB ADDRESS Due on receipt SG Qty Description Rate Total Lake Fenwick Walking Trail 600 SQ FT Asphalt Remove and Replace in l Location. Owner to remove existing asphalt and tree 4.66667 2,800.00T roots. EAC to provide new crushed rock and pave with 3"HMA Lake Fenwick Boat Launch 1 Install new asphalt approach approximately 30'X 35'X 3"thick 5,325.00 5,325.00T Fenwick Disc Golf 1 Install 2 new asphalt approach approximately 20'X 25'X 3"thick 4,500.00 4,500.00T Sales Tax (10.0%) $1,262.50 The above prices,specifications and conditions are satisfactory and are herby accepted. You are authorized to do the work as specified. 50%Payment is due within 30 days. 1.5%PER Total S 13,887.50 MONTH SERVICE CHARGE ON ALL PAST DUE ACCOUNTS. IN THE EVENT LEGAL ACTION IS TAKEN TO COLLECT ANY AMOUNTS DUE,YOU AGREE TO PAY ALL LEGAL FEES&EXPENSES. THIS QUOTATION IS ONLY VALID FOR Signature THIRTY(30)DAYS. E-mail: Web Site: evergreen.dirkr comcast.net Evergreenasphalt.com 11/1/2019 about:blank State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Washington State Prevailing Wage The PREVAILING WAGES listed here include both the hourly wage rate and the hourly rate of fringe benefits. On public works projects, worker's wage and benefit rates must add to not less than this total. A brief description of overtime calculation requirements are provided on the Benefit Code Key. Journey Level Prevailing Wage Rates for the Effective Date: 11/1/2019 County. Trade Job Classification Wage Holiday Overtime Note *Risk Class King Laborers Air, Gas Or Electric Vibrating Screed $50.86 7A 4V 8Y View King Laborers Airtrac Drill Operator $52.44 7A 4V 8Y View King Laborers Ballast Regular Machine $50.86 7A 4V 8Y View King Laborers Batch Weighman $43.11 7A 4V 8Y View King Laborers Brick Pavers $50.86 7A 4V 8Y View King Laborers Brush Cutter $50.86 7A 4V 8Y View King Laborers Brush Hog Feeder $50.86 7A 4V 8Y View King Laborers Burner $50.86 7A 4V 8Y View King Laborers Caisson Worker $52.44 7A 4V 8Y View King Laborers Carpenter Tender $50.86 7A 4V 8Y View King Laborers Cement Dumper-paving $51.80 7A 4V 8Y View King Laborers Cement Finisher Tender $50.86 7A 4V 8Y View King Laborers Change House Or Dry Shack $50.86 7A 4V 8Y View King Laborers Chipping Gun (30 Lbs. And Over) $51.80 7A 4V 8Y View King Laborers Chipping Gun (Under 30 Lbs.) $50.86 7A 4V 8Y View King Laborers Choker Setter $50.86 7A 4V 8Y View King Laborers Chuck Tender $50.86 7A 4V 8Y View King Laborers Clary Power Spreader $51.80 7A 4V 8Y View King Laborers Clean-up Laborer $50.86 7A 4V 8Y View King Laborers Concrete Dumper/Chute Operator $51.80 7A 4V 8Y View King Laborers Concrete Form Stripper $50.86 7A 4V 8Y View King Laborers Concrete Placement Crew $51.80 7A 4V 8Y View King Laborers Concrete Saw Operator/Core Driller $51.80 7A 4V 8Y View King Laborers Crusher Feeder $43.11 7A 4V 8Y View King Laborers Curing Laborer $50.86 7A 4V 8Y View King Laborers Demolition: Wrecking Et Moving (Incl. $50.86 7A 4V 8Y View Charred Material) King Laborers Ditch Digger $50.86 7A 4V 8Y View King Laborers Diver $52.44 7A 4V 8Y View King Laborers Drill Operator(Hydraulic, Diamond) $51.80 7A 4V 8Y View King Laborers Dry Stack Walls $50.86 7A 4V 8Y View King Laborers Dump Person $50.86 7A 4V 8Y View King Laborers Epoxy Technician $50.86 7A 4V 8Y View King Laborers Erosion Control Worker $50.86 7A 4V 8Y View King Laborers Faller Et Bucker Chain Saw $51.80 7A 4V 8Y View King Laborers Fine Graders $50.86 7A 4V 8Y View King Laborers Firewatch $43.11 7A 4V 8Y View about:blank 1/3 11/1/2019 about:blank King Laborers Form Setter $50.86 7A 4V 8Y View King Laborers Gabian Basket Builders $50.86 7A 4V 8Y View King Laborers General Laborer $50.86 7A 4V 8Y View King Laborers Grade Checker Et Transit Person $52.44 7A 4V 8Y View King Laborers Grinders $50.86 7A 4V 8Y View King Laborers Grout Machine Tender $50.86 7A 4V 8Y View King Laborers Groutmen (Pressure) Including Post $51.80 7A 4V 8Y View Tension Beams King Laborers Guardrail Erector $50.86 7A 4V 8Y View King Laborers Hazardous Waste Worker (Level A) $52.44 7A 4V 8Y View King Laborers Hazardous Waste Worker (Level B) $51.80 7A 4V 8Y View King Laborers Hazardous Waste Worker (Level C) $50.86 7A 4V 8Y View King Laborers High Scaler $52.44 7A 4V 8Y View King Laborers Jackhammer $51.80 7A 4V 8Y View King Laborers Laserbeam Operator $51.80 7A 4V 8Y View King Laborers Maintenance Person $50.86 7A 4V 8Y View King Laborers Manhole Builder-Mudman $51.80 7A 4V 8Y View King Laborers Material Yard Person $50.86 7A 4V 8Y View King Laborers Motorman-Dinky Locomotive $51.80 7A 4V 8Y View King Laborers Nozzleman (Concrete Pump, Green $51.80 7A 4V 8Y View Cutter When Using Combination Of High Pressure Air Et Water On Concrete Et Rock, Sandblast, Gunite, Shotcrete, Water Blaster, Vacuum Blaster) King Laborers Pavement Breaker $51.80 7A 4V 8Y View King Laborers Pilot Car $43.11 7A 4V 8Y View King Laborers Pipe Layer Lead $52.44 7A 4V 8Y View King Laborers Pipe Layer/Tailor $51.80 7A 4V 8Y View King Laborers Pipe Pot Tender $51.80 7A 4V 8Y View King Laborers Pipe Reliner $51.80 7A 4V 8Y View King Laborers Pipe Wrapper $51.80 7A 4V 8Y View King Laborers Pot Tender $50.86 7A 4V 8Y View King Laborers Powderman $52.44 7A 4V 8Y View King Laborers Powderman's Helper $50.86 7A 4V 8Y View King Laborers Power Jacks $51.80 7A 4V 8Y View King Laborers Railroad Spike Puller- Power $51.80 7A 4V 8Y View �( King Laborers Raker- Asphalt $52.44 7A 4V 8Y View King Laborers Re-timberman $52.44 7A 4V 8Y View King Laborers Remote Equipment Operator $51.80 7A 4V 8Y View King Laborers Rigger/Signal Person $51.80 7A 4V 8Y View King Laborers Rip Rap Person $50.86 7A 4V 8Y View King Laborers Rivet Buster $51.80 7A 4V 8Y View King Laborers Rodder $51.80 7A 4V 8Y View King Laborers Scaffold Erector $50.86 7A 4V 8Y View King Laborers Scale Person $50.86 7A 4V 8Y View King Laborers Sloper (Over 20") $51.80 7A 4V 8Y View King Laborers SloperSprayer $50.86 7A 4V 8Y View King Laborers Spreader (Concrete) $51.80 7A 4V 8Y View King Laborers Stake Hopper $50.86 7A 4V 8Y View King Laborers Stock Piler $50.86 7A 4V 8Y View King Laborers Swinging Stage/Boatswain Chair $43.11 7A 4V 8Y View King Laborers Tamper Et Similar Electric, Air Et Gas $51.80 7A 4V 8Y View Operated Tools about:blank 2/3 11/1/2019 about blank King Laborers Tamper (Multiple Et Self-propelled) $51.80 7A 4V 8Y View King Laborers Timber Person - Sewer (Lagger, $51.80 7A 4V 8Y View Shorer Et Cribber) King Laborers Toolroom Person (at Jobsite) $50.86 7A 4V 8Y View King Laborers Topper $50.86 7A 4V 8Y View King Laborers Track Laborer $50.86 7A 4V 8Y View King Laborers Track Liner (Power) $51.80 7A 4V 8Y View King Laborers Traffic Control Laborer $46.10 7A 4V 9C View King Laborers Traffic Control Supervisor $46.10 7A 4V 9C View King Laborers Truck Spotter $50.86 7A 4V 8Y View King Laborers Tugger Operator $51.80 7A 4V 8Y View King Laborers Tunnel Work-Compressed Air Worker $120.61 7A 4V 9B View 0-30 psi King Laborers Tunnel Work-Compressed Air Worker $125.64 7A 4V 9B View 30.01-44.00 psi King Laborers Tunnel Work-Compressed Air Worker $129.32 7A 4V 9B View 44.01-54.00 psi King Laborers Tunnel Work-Compressed Air Worker $135.02 7A 4V 9B View 54.01-60.00 psi King Laborers Tunnel Work-Compressed Air Worker $137.14 7A 4V 9B View 60.01-64.00 psi King Laborers Tunnel Work-Compressed Air Worker $142.24 7A 4V 9B View 64.01-68.00 psi King Laborers Tunnel Work-Compressed Air Worker $144.14 7A 4V 9B View 68.01-70.00 psi King Laborers Tunnel Work-Compressed Air Worker $146.14 7A 4V 9B View 70.01-72.00 psi King Laborers Tunnel Work-Compressed Air Worker $148.14 7A 4V 9B View 72.01-74.00 psi King Laborers Tunnel Work-Guage and Lock Tender $52.54 7A 4V 8Y View King Laborers Tunnel Work-Miner $52.54 7A 4V 8Y View King Laborers Vibrator $51.80 7A 4V 8Y View King Laborers Vinyl Seamer $50.86 7A 4V 8Y View King Laborers Watchman $39.18 7A 4V 8Y View King Laborers Welder $51.80 7A 4V 8Y View King Laborers Well Point Laborer $51.80 7A 4V 8Y View King Laborers Window Washer/Cleaner $39.18 7A 4V 8Y View aboutblank 3/3 EXHIBIT B INSURANCE REQUIREMENTS FOR CONSTRUCTION PROJECTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Contractor shall obtain insurance of the types described below: 1. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 or its equivalent, with minimum limits of $3,000,000 per occurrence and in the aggregate for each 1 year policy period. This coverage may be any combination of primary, umbrella or excess liability coverage affording total liability limits of not less than $3,000,000 per occurrence and in the aggregate. Products and Completed Operations coverage shall be provided for a period of 3 years following Substantial Completion of the work. The Commercial General Liability insurance shall be endorsed to provide the Aggregate per Project Endorsement ISO form CG 25 03 11 85. The City shall be named as an Additional Insured under the Contactor's Commercial General Liability insurance policy with respect to the work performed for the City. All endorsements adding Additional Insureds shall be issued on form CG 20 10 11 85 or a form deemed equivalent, providing the Additional Insureds with all policies and endorsements set forth in this section. 2. 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. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Commercial General Liability insurance shall be written with minimum limits of $.3,000,000 per occurrence and in the aggregate for each 1 year policy period. This coverage may be any EXHIBIT B (Continued) combination of primary, umbrella or excess liability coverage affording total liability limits of not less than $3,000,000 per occurrence and in the aggregate. Products and Completed Operations coverage shall be provided for a period of 3 years following Substantial Completion of the work. 2. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 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: 1. The Contractor's insurance coverage shall be primary insurance as respect the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Contractor's Insurance for Other Losses The Contractor shall assume full responsibility for all loss or damage from any cause whatsoever to any tools, Contractor's employee owned tools, machinery, equipment, or motor vehicles owned or rented by the Contractor, or the Contractor's agents, suppliers or contractors as well as to any temporary structures, scaffolding and protective fences. EXHIBIT B (Continued) E. Waiver of Subrogation The Contractor and the City waive all rights against each other any of their Subcontractors, Sub-subcontractors, agents and employees, each of the other, for damages caused by fire or other perils to the extend covered by Builders Risk insurance or other property insurance obtained pursuant to the Insurance Requirements Section of this Contract or other property insurance applicable to the work. The policies shall provide such waivers by endorsement or otherwise. F. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. G. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the Automobile Liability and Commercial General Liability insurance of the Contractor before commencement of the work. H. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. EVERASP-02 MARMSTRONG CERTIFICATE OF LIABILITY INSURANCE DATEDIYYYY) 11/1/112/2019 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 Laura Buscio NAME: Hub International Northwest LLC PHONE FAX P.O.Box 3018 (A/C,No,Ext):(206)838-1015 (A/C,No): Bothell,WA 98041 EMAIL ADDRESS:laura.buscio@hubinternational.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Western National Assurance Company 24465 INSURED INSURER B:Western National Mutual Insurance Company 15377 Evergreen Asphalt&Concrete,Inc. INSURER C:Nationwide Mutual Insurance Company 23787 PO Box 867 INSURER D Ravensdale,WA 98051 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR IN SD WVD MM/DD/YYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CPP1213195 9/15/2019 9I15/2020 DAMAGE TO RENTED 100,000 X X PREMISES(Ea occurrence) _$ ME EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 POLICY X PEeT LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER WA Stop Gap $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO X X CPP1212799 9/15/2019 9/15/2020 BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS AUTOS ONLY AUOTOS ONLY PROPERTY r ccii t DAMAGE $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE UMB1035977 9/15/2019 9/15/2020 AGGREGATE $ 2,000,000 DED X RETENTIONS 10,000 $ A WORKERS AND EMPLOYERS COMPENSATION A I Y/N STATUTE PER X OTRH- ANYPROPRIETOR/PARTNER/EXECUTIVE CPP1213195 9115/2019 9/15/2020 1,000,000 E.L.EACH ACCIDENT $ O�FFICER/MEMBER EXCLUDED? N/A - (Mandstory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C IM-All Risk CIM3037050259 4/30/2019 4/30/2020 $100 ded 400,224 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Proposal#7805,Lake Fenwick Park(25828 Lake Fenwich Rd,Kent,WA 98032) City of Kent is included as Additional Insured on all policies as respects work performed by or on behalf of the contractor.The Contractor's insurance coverage shall be primary insurance as respect the City.Contractor includes all subcontractors as Additional Insureds under its policies.Any insurance, selfinsurance,or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute to it.Coverage is per project aggregate.Both ongoing operations and completed operations are included in coverage.Coverage shall not be canceled by either party,except after thirty(30)days prior written notice by certified mail,return receipt requested,has been given to the City.The Contractor shall assume full responsibility for all loss or damage from any cause whatsoever to any tools,Contractor's employee owned tools,machinery,equipment,or motor vehicles owned or rented by SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn Nate Harper ACCORDANCE WITH THE POLICY PROVISIONS. 220 4th Ave Kent,WA 98032 AUTHORIZED REPRESENTATIVE L;92.E ' ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: EVERASP-02 MARMSTRONG LOC#: 1 ACORO ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Hub International Northwest LLC Eve en Asphalt i£Concrete,Inc. PO B-ox 867 POLICY NUMBER Ravensdale,WA 98051 EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTME DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations[Vehicles: the Contractor, of the Contractor's agents,suppliers or contractors as well as to any temporary structures,scaffolding and protective fences.The Contractor and the City waive all rights against each other any of their Subcontractors,Sub-subcontractors, agents and employees,each of the other,for damages caused by fire or other perils to the extend covered by Builders Risk insurance or other property insurance obtained pursuant to the Insurance Requirements Section of their Contract or other property insurance applicable to the work. i it i i ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY WN GL 139 06 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - CONTRACTORS - OPERATIONS AND COMPLETED OPERATIONS - WITH ADDITIONAL INSURED REQUIREMENT IN CONSTRUCTION CONTRACT This endorsement modifies insurance provided under the following.- COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Additional Insured —Operations (2) That portion of "your work" out of which A. Section II —Who Is An Insured is amended the injury or damage arises has been put to include as an additional insured: to its intended use by any person or or- (1) Any person or organization for whom you ganization other than another contractor are performing operations when you and or subcontractor engaged in performing such person or organization have agreed operations for a principal as a part of the in writing in a contract or agreement that same project. such person or organization be added as 2. Additional Insured —Completed Operations an additional insured on your policy; and A. Section II —Who Is An Insured is amended (2) Any other person or organization you are to include as an additional insured: required to add as an additional insured (1) Any person or organization for whom you under the contract or agreement de- are performing operations when you and scribed in Paragraph 1. above. such person or organization have agreed Such person(s) or organization(s) is an add- in writing in a contract or agreement that tional insured only with respect to liability for such person or organization be added as "bodily injury", "property damage" or "per- an additional insured on your policy; and sonal and advertising injury"caused, in (2) Any other person or organization you are whole or in part, by: required to add as an additional insured a. Your acts or omissions; or under the contract or agreement de- b. The acts or omissions of those acting on scribed in Paragraph 1. above. your behalf; Such person(s) or organization(s) is an addi- in the performance of your ongoing opera- tional insured only with respect to liability for tions for the additional insured. "bodily injury", "property damage" or "per- sonal and advertising injury"caused, in whole B. With respect to Additional Insured - Opera- or in part, by: tions, coverage is limited as follows: a. Your acts or omissions; or This insurance does not apply to "bodily in- b. The acts or omissions of those acting on jury" or"property damage" occurring after: your behalf; (1) All work, including materials, parts or and included in the "products-completed op- equipment furnished in connection with erations hazard". such work, on the project(other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or WN GL 139 06 18 Page 1 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. B. With respect to Additional Insured — Com- D. With respect to the insurance afforded to pleted Operations,coverage is limited as fol- these additional insureds, the following is lows: added to Section III —Limits Of Insurance: (1) A person or organization's status as an in- If coverage provided to the additional insured sured under Additional Insured — Com- is required by a contract or agreement, the pleted Operations continues only for the most we will pay on behalf of the additional period of time required by any written con- insured is: tract or agreement. (1) The minimum amount required by the (2) The insurance provided to the additional contract or agreement; or insured does not apply to "bodily injury", (2) The Limits of Insurance shown in the Dec- "property damage" or "personal and ad- larations; vertising injury" arising out of"your work" for which a consolidated (wrap-up) insur- ance whichever is less. program has been provided by the This endorsement shall not increase the ap- prime contractor-project manager or plicable Limits of Insurance shown in the Dec- owner of the construction project in which larations. you are involved. E. With respect to the insurance afforded to 3. Primary and Noncontributory these additional insureds, the following addi- The following is added to the Other Insurance tional exclusion applies: Condition and supersedes any provision to the This insurance does not apply to: contrary: "Bodily injury", "property damage" or "per- Primary And Noncontributory Insurance sonal and advertising injury"arising out of the This insurance is primary to and will not seek con- rendering of, or the failure to render, any pro- tribution from any other insurance available to an fessional architectural, engineering or survey- additional insured under your policy provided that: ing services, including: (1) The additional insured is a Named Insured un- (1) The preparing, approving, or failing to der such other insurance; and prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- (2) You have agreed in writing in a contract or ders, change orders or drawings and agreement that this insurance would be pri- specifications; or mary and would not seek contribution from (2) Supervisory, inspection, architectural or any other insurance available to the additional engineering activities. insured. 4. Other Provisions Applicable to Additional In- This exclusion applies even if the claims sured — Operations and Additional Insured — against an additional insured allege negli- Completed Operations gence or other wrongdoing in the supervision, hiring, employment, training or monitoring of A. The Amendment of Insured Contract Defini- others by that insured, if the "occurrence" tion (Endorsement CG 24 26) does not apply which caused the "bodily injury" or "property to an additional insured. damage", or the offense which caused the B. The coverage provided under Paragraph f. of "personal and advertising injury", involved the the definition of"insured contract" under Sec- rendering of or failure to render any profes- tion V—Definitions does not apply to an ad- sional services by you with respect to your ditional insured under this endorsement un- providing engineering,architectural or survey- less required by a written contract or ing services in your capacity as an engineer, agreement. architect or surveyor. C. The insurance afforded to such additional in- sured only applies to the extent permitted by law; and If coverage provided to the additional insured is required by a contract or agreement, the in- surance afforded to such additional insured will not be broader than that which you are re- quired by the contract or agreement to provide for such additional insured. WN GL 139 06 18 Page 2 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. COMMERICAL GENERAL LIABILITY WN GL 39 08 18 COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT The Commercial General Liability Enhancement Endorsement is an optional endorsement that provides coverage en- hancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is pro- vided by this summary, refer to following endorsement for changes in your policy. SUMMARY OF COVERAGES PAGE Bodily Injury And Property Damage Liability • Non Owned Watercraft Up To 50 Feet ...............................................................................2 Property Damage Liability • Elevators..........................................................................................................................3 • Fire, Lightning, Explosion Or Sprinkler Leakage Exception .............. ...................................3 • Borrowed Equipment ($25,000 Per Occurrence, $50,000 Aggregate, $2,500 Deductible Per Occurrence ........................................................ ........................3 Supplementary Payments — Amended • Bail Bonds Up To $5,000...................................................................................................4 • Loss of Earnings Up To $500/Day ........................................................................ ............4 Who Is An Insured Amendments • Employee Bodily Injury To A Co-Employee.........................................................................4 • Newly Formed Or Acquired Organizations For Up To 180 Days ...........................................4 • Blanket Additional Insured —Vendors —As Required By Contract ........................................4 • Blanket Additional Insured — Lessor Of Leased Equipment..................................................6 • Blanket Additional Insured — Managers Or Lessors Of Premises..........................................6 • Blanket Additional Insured — State Or Governmental Agency Or Subdivision Or Political Subdivision— Permits Or Authorizations .........................................................7 • Blanket Additional Insured — State Or Governmental Agency Or Subdivision Or Political Subdivision — Permits Or Authorizations Relating To Premises ........................8 Damage To Premises Rented To You — $300,000.........................................................................9 Medical Payments Increased Limit — $10,000 Or Amount Shown on Declarations ...........................9 Conditions • Knowledge of Occurrence, Offense, Claim Or Suit Amended...............................................9 • Unintentional Failure To Disclose Hazards .........................................................................9 • Waiver of Subrogation..................................................................................................... 10 InsuredContract Amended.......................................................................................................... 10 Personal And Advertising Injury Redefined • Televised, Videotaped Or Electronic Publication ............................................................... 10 W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office. Inc.,w ith its permission Page 1 of 10 COMMERCIAL GENERAL LIABILITY WNGL390818 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. SECTION I— COVERAGES AMENDMENTS (3) Parking an "auto" on, or on the ways next to, COVERAGE A — BODILY INJURY AND PROPERTY premises you own or rent, provided the"auto" DAMAGE LIABILITY is not owned by or rented or loaned to you or the insured, A. Non Owned Aircraft Or Watercraft (4) Liability assumed under any "insured con- Item 2. Exclusions, Paragraph g. is replaced by the tract' for the ownership, maintenance or use following: of aircraft or watercraft, or g. Aircraft, Auto Or Watercraft (5) "Bodily injury" or "property damage" arising "Bodily injury" or"property damage" arising out of out of: the ownership, maintenance, use or entrustment (a) The operation of machinery or equipment to others of any aircraft, "auto" or watercraft that is attached to, or part of, a land owned or operated by or rented or loaned to any vehicle that would qualify under the insured. Use includes operation and "loading or definition of"mobile equipment' if it were unloading". not subject to a compulsory or financial This exclusion applies even if the claims against responsibility law or other motor vehicle any insured allege negligence or other wrong- insurance law where it is licensed or doing in the supervision, hiring, employment, principally garaged, or training or monitoring of others by that insured, if (b) The operation of any of the machinery or the 'occurrence" which caused the "bodily injury" equipment listed in Paragraph f. (2) or f. or "property damage" involved in the ownership, (3) of the definition of "mobile equip- maintenance, use or entrustment to others of any ment". aircraft, "auto" or watercraft that is owned or B. Damage To Property Coverage Extensions operated by or rented or loaned to any insured. Item 2. Exclusions, Paragraph j. is replaced by the This exclusion does not apply to: following: (1) A watercraft while ashore on premises you j. Damage To Property own or rent: (2) A watercraft you do not own that is: "Property damage" to: (a) Less than 50 feet long; and (1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or (b) Not being used to carry persons or prop- any other person, organization or entity, for erty for a charge; repair, replacement, enhancement, restora- This Subparagraph (2) applies to any person, tion or maintenance of such property for any who with your expressed or implied consent, reason, including prevention of injury to a either uses or is responsible for the use of the person or damage to another's property, watercraft, (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises, WN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission. Page 2 of 10 (3) Property loaned to you; The insurance provided for "property damage" from (4) Personal property in the care, custody or con- the use of elevators and for "property damage" to trol of the insured; borrowed equipment is excess over any other valid (5) That particular part of real property on which and collectible property insurance (including any de- you or any contractors or subcontractors ductible portion thereof) available to the insured working directly or indirectly on your behalf whether primary, excess, contingent or on any other are performing operations, if the "property basis. damage" arises out of those operations; or C. Damage To Premises Rented To You (6) That particular part of any property that must Item 2. Exclusions, the last paragraph is replaced by be restored, repaired or replaced because the following: "your work" was incorrectly performed on it. Exclusions c. through n. do not apply to damage by Paragraphs (1), (3) and (4) of this exclusion do not fire, lightning, explosion or sprinkler leakage to apply to "property damage" (other than damage by premises while rented to you or temporarily occupied fire, lightning, explosion or sprinkler leakage) to by you with permission of the owner. A separate limit premises, including the contents of such premises, of insurance applies to this coverage as described in rented to you for a period of seven or fewer Paragraph 6. of SECTION III — LIMITS OF consecutive days. A separate limit of insurance INSURANCE. applies to Damage To Premises Rented To You as described in SECTION III—LIMITS OF INSURANCE. COVERAGE B — PERSONAL AND ADVERTISING However, the provisions of this paragraph do not INJURY LIABILITY apply if coverage for Damage To Premises Rented To D. Personal And Advertising Injury You is excluded by endorsement. Paragraph (2) of this exclusion does not apply if the Item 2. Exclusions is amended by replacing Sub- premises are "your work" and were never occupied, rented or held for rental by you. b. Material Published With Knowledge Of Falsity Paragraphs (3) and (4) of this exclusion do not apply "Personal and advertising injury" arising out of to the use of elevators. oral, written, televised, videotaped or electronic publication, in any manner, of material, if done by Paragraphs (3), (4), (5) and (6) of this exclusion do or at the direction of the insured with knowledge not apply to liability assumed under a sidetrack of its falsity. agreement. c. Material Published Prior To Policy Period Paragraph (4) of this exclusion does not apply to "Personal and advertising injury" arising out of "property damage" to borrowed equipment while not oral, written, televised, videotaped or electronic being used to perform operations at the jobsite. publication, in any manner, of material whose first Subject to Paragraph 2. of SECTION III—LIMITS OF publication took place before the beginning of the INSURANCE, the rules below fix the most we will pay for "property damage" under this provision: policy period. (1) $25,000 any one 'occurrence", regardless of the SUPPLEMENTARY PAYMENTS —COVERAGES A number of persons or organizations who sustain AND B damages because of that 'occurrence"; E. Supplementary Payments —Coverages A and B (2) $50,000 annual aggregate; and Item 1. is amended by replacing Subparagraphs b. (3) We will pay only for damages in excess of$2,500 and d. with the following: as a result of any one "occurrence", regardless of b. Up to $5,000 for cost of bail bonds required be- the number of persons or organizations who cause of accidents or traffic law violations arising sustain damages because of that "occurrence". out of the use of any vehicle to which the Bodily We may, or if required by law, pay all or any part Injury Liability Coverage applies. We do not have of any deductible amount, if applicable, to effect to famish these bonds. settlement of any claim or "suit'. Upon notice of our payment of a deductible amount, you shall d. All reasonable expenses incurred by the insured promptly reimburse us for the part of the at our request to assist us in the investigation or deductible amount we paid. defense of the claim or"suit', including actual loss of earnings up to $500 a day because of time off Paragraph (6) of this exclusion does not apply to from work. "property damage" included in the "products-com- pleted operations hazard". WN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission. Page 3 of 10 SECTION II—WHO IS AN INSURED AMENDMENTS The following are added: A. Employee Bodily Injury To A Co-Employee C. Blanket Additional Insured — Vendors — As Re- Paragraph 2. a. (1) is replaced by the following: quired By Contract However, none of these "employees" or "volunteer 1. Section II — Who Is An Insured is amended to workers" are insureds for "bodily injury" or "personal include as an additional insured any person(s) or and advertising injury": organization(s) (referred to throughout this (a) To you, to your partners or members (if you are a endorsement as vendor) with whom you have partnership or joint venture), to your members (if agreed in a written contract, executed prior to you are a limited liability company), to a co- loss, to name as an additional insured, but only "employee" while in the course of his or her with respect to "bodily injury" or "property employment or performing duties related to the damage" arising out of"your products" which are conduct of your business, or to your other distributed or sold in the regular course of the "volunteer workers" while performing duties vendor's business. related to the conduct of your business; However, (b) To the spouse, child, parent, brother or sister of a. The insurance afforded to such vendor only the co-"employee" or "volunteer worker" as a applies to the extent permitted by law; and consequence of Paragraph (1)(a) above; b. If coverage provided to the vendor is required (c) For which there is any obligation to share by a contract or agreement, the insurance damages with or repay someone else who must afforded to such vendor will not be broader pay damages because of the injury described in than that which you are required by the Paragraph (1)(a) or (b) above; or contract or agreement to provide for such (d) Arising out of his or her providing or failing to vendor. provide professional health care services. 2. With respect to the insurance afforded to these However, if a suit seeking damages for "bodily injury" vendors, the following additional exclusions or "personal and advertising injury" to any co- apply: "employee" or other "volunteer worker" arising out of a. The insurance afforded the vendor does not and in the course of the co-"employee's" or"volunteer apply to: worker's" employment or while performing duties (1) "Bodily injury" or "property damage" for related to the conduct of your business, or a suit which the vendor is obligated to pay dam- seeking damages brought by the spouse, child, ages by reason of the assumption of parent, brother or sister of the co-"employee" or other liability in a contract or agreement. This "volunteer worker', is brought against you or a co- exclusion does not apply to liability for "employee" or a "volunteer worker", we will reimburse damages that the vendor would have in the reasonable costs that you incur in providing a the absence of the contract or defense to the co-"employee" or "volunteer worker" agreement; against such matters. Any reimbursement made (2) Any express warranty unauthorized by pursuant to this sub-section will be in addition to the you; limits of liability set forth in the Declarations. (3) Any physical or chemical change in the B. Newly Acquired Organizations product made intentionally by the vendor; Paragraph 3. a. is replaced by the following: (4) Repackaging, except when unpacked a. Coverage under this provision is afforded only solely for the purpose of inspection, until the 180th day after you acquire or form the demonstration, testing, or the organization or the end of the policy period, substitution of parts under instructions whichever is earlier; from the manufacturer, and then repackaged in the original container; WN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 4 of 10 (5) Any failure to make such inspections, 4. With respect to the insurance afforded to these adjustments, tests or servicing as the vendors, the following is added to Section III — vendor has agreed to make or normally Limits Of Insurance: undertakes to make in the usual course If coverage provided to the vendor is required by of business, in connection with the a contract or agreement, the most we will pay on distribution or sale of the products; behalf of the vendor is: (6) Demonstration, installation, servicing or repair operations, except such a. The minimum amount required by the operations performed at the vendor's contract or agreement; or premises in connection with the sale of b. The Limits of Insurance shown in the the product; Declarations; (7) Products which, after distribution or sale whichever is less. by you, have been labeled or relabeled or used as a container, part or ingredient of This endorsement shall not increase the any other thing or substance by or for the applicable Limits of Insurance shown in the vendor; or Declarations. (8) "Bodily injury or "property damage" 5. With respect to the insurance afforded to these arising out of the sole negligence of the additional insureds, the following additional vendor for its own acts or omissions or exclusion applies: those of its employees or anyone else This insurance does not apply to: acting on its behalf. However, this a. "Bodily injury", "property damage" or exclusion does not apply to: "personal and advertising injury" arising out (i) The exceptions contained in of the rendering of, or the failure to render, Subparagraphs (4) or (6); or any professional architectural, engineering or (ii) Such inspections, adjustments, tests surveying services, including: or servicing as the vendor has (1) The preparing, approving, or failing to agreed to make or normally prepare or approve, maps, shop undertakes to make in the usual drawings, opinions, reports, surveys, course of business, in connection field orders, change orders or drawings with the distribution or sale of the and specifications; or products. 2( ) Supervisory, ry, inspection, architectural or 3. This Provision C. does not apply: engineering activities. a. To any insured person or organization from This exclusion applies even if the claims whom you have acquired such products, or against an additional insured allege any ingredient, part or container, entering negligence or other wrongdoing in the into, accompanying or containing such supervision, hiring, employment, training products; or monitoring of others by that insured, if b. To any vendor for which coverage as an addi- the 'occurrence" which caused the tional insured specifically is scheduled by "bodily injury" or "property damage", or endorsement; or the offense which caused the "personal c. When liability included within the "products- and advertising injury", involved the completed operations hazard" has been ex- rendering of or failure to render any cluded for such product either by the provi- professional services by you with respect sions of the coverage part or by endorse- to your providing engineering, ment. architectural or surveying services in your capacity as an engineer, architect or surveyor. WN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission. Page 5 of 10 4. With respect to the insurance afforded to these D. Blanket Additional Insured — Lessor Of Leased additional insureds, the following additional Equipment exclusion applies: 1. Section II —Who Is An Insured is amended to This insurance does not apply to: include as an additional insured any person(s) or organization(s) from whom you lease equipment a. "Bodily injury", "property damage" or when you and such person(s) or organization(s) "personal and advertising injury" arising out have agreed in writing in a contract or agreement, of the rendering of, or the failure to render, executed prior to loss, that such person(s) or any professional architectural, engineering or organization(s) be added as an additional insured surveying services, including: on your policy. Such person(s) or organization(s) (1) The preparing, approving, or failing to is an insured only with respect to liability for prepare or approve, maps, shop "bodily injury", "property damage" or "personal drawings, opinions, reports, surveys, and advertising injury"caused, in whole or in part, field orders, change orders or drawings by your maintenance, operation or use of and specifications; or equipment leased to you by such person(s) or organization(s). (2) Supervisory, inspection, architectural or However, the insurance afforded to such engineering activities. additional insured: This exclusion applies even if the claims against an additional insured allege a. Only applies to the extent permitted by law; negligence or other wrongdoing in the and supervision, hiring, employment, training or b. Will not be broader than that which you are monitoring of others by that insured, if the required by the contract or agreement to "occurrence" which caused the"bodily injury" provide for such additional insured. or "property damage", or the offense which A person's or organization's status as an addi- caused the "personal and advertising injury", tional insured under this endorsement ends when involved the rendering of or failure to render their contract or agreement with you for such any professional services by you with respect leased equipment ends. to your providing engineering, architectural or 2. With respect to the insurance afforded to these surveying services in your capacity as anengineer, architect or surveyor. additional insureds, this insurance does not apply to any "occurrence" which takes place after the E. Blanket Additional Insured — Managers Or Les- equipment lease expires. sors Of Premises 3. With respect to the insurance afforded to these 1. Section II — Who Is An Insured is amended to additional insureds, the following is added to include as an additional insured any person(s) or Section III— Limits Of Insurance: organization(s) with whom you have agreed in a If coverage provided to the additional insured is written contract, executed prior to loss, to name required by a contract or agreement, the most we as an additional insured, but only with respect to will pay on behalf of the additional insured is: liability arising out of the ownership, maintenance a. The minimum amount required by the or use of that part of the premises leased to you, contract or agreement; or subject to the following additional exclusions: b. The Limits of Insurance shown in the This insurance does not apply to: Declarations; a. Any"occurrence" which takes place after you whichever is less. cease to be a tenant in that premises. This endorsement shall not increase the b. Structural alterations, new construction or applicable Limits of Insurance shown in the demolition operations performed by or on Declarations. behalf of such additional insured. WN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 6 of 10 However: F. Blanket Additional Insured — State Or a. The insurance afforded to such additional Governmental Agency Or Subdivision Or Political insured only applies to the extent permitted Subdivision — Permits Or Authorizations by law; and Section II — Who Is An Insured is amended to in- b. If coverage provided to the additional insured clude as an additional insured any state or is required by a contract or agreement, the govemmental agency or subdivision or political insurance afforded to such additional insured subdivision with whom you have agreed in a written will not be broader than that which you are contract, executed prior to loss, to name as an required by the contract or agreement to additional insured, subject to the following provisions: provide for such additional insured. 1. This insurance applies only with respect to op- 2. With respect to the insurance afforded to these erations performed by you or on your behalf for additional insureds, the following is added to which the state or govemmental agency or sub- Section III—Limits Of Insurance: division or political subdivision has issued a If coverage provided to the additional insured is permit or authorization. required by a contract or agreement, the most we However: will pay on behalf of the additional insured is: a. The insurance afforded to such additional a. The minimum amount required by the insured only applies to the extent permitted contract or agreement; or by law; and b. The Limits of Insurance shown in the b. If coverage provided to the additional insured Declarations; is required by a contract or agreement, the whichever is less. insurance afforded to such additional insured will not be broader than that which you are This endorsement shall not increase the required by the contract or agreement to applicable Limits of Insurance shown in the provide for such additional insured. Declarations. 2. This insurance does not apply to: 3. With respect to the insurance afforded to these additional insureds, the following additional a. "Bodily injury", "property damage" or 'per- exclusion applies: sonal and advertising injury" arising out of op- erations performed for the federal govern- This insurance does not apply to: ment, state or municipality; or a. "Bodily injury", "property damage" or b. "Bodily injury" or "property damage" included "personal and advertising injury" arising out within the "products-completed operations of the rendering of, or the failure to render, hazard". any professional architectural, engineering or 3. With respect to the insurance afforded to these surveying services, including: additional insureds, the following is added to (1) The preparing, approving, or failing to Section III— Limits Of Insurance: prepare or approve, maps, shop If coverage provided to the additional insured is drawings, opinions, reports, surveys, required by a contract or agreement, the most we field orders, change orders or drawings will pay on behalf of the additional insured is: and specifications; or (2) Supervisory, inspection, architectural or a. The minimum amount required by the engineering activities. contract or agreement; or This exclusion applies even if the claims b. The Limits of Insurance shown in the against an additional insured allege Declarations; negligence or other wrongdoing in the whichever is less. supervision, hiring, employment, training or This endorsement shall not increase the monitoring of others by that insured, if the applicable Limits of Insurance shown in the "occurrence" which caused the "bodily injury" Declarations. or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. WN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission. Page 7 of 10 4. With respect to the insurance afforded to these b. The construction, erection or removal of additional insureds, the following additional elevators; or exclusion applies: c. The ownership, maintenance or use of any This insurance does not apply to: elevators covered by this insurance. a. "Bodily injury", "property damage" or However, "personal and advertising injury" arising out a. The insurance afforded to such additional of the rendering of, or the failure to render, insured only applies to the extent permitted any professional architectural, engineering or by law; and surveying services, including: b. If coverage provided to the additional insured (1) The preparing, approving, or failing to is required by a contract or agreement, the prepare or approve, maps, shop insurance afforded to such additional insured drawings, opinions, reports, surveys, will not be broader than that which you are field orders, change orders or drawings required by the contract or agreement to and specifications; or provide for such additional insured. (2) Supervisory, inspection, architectural or 2. With respect to the insurance afforded to these engineering activities. additional insureds, the following is added to This exclusion applies even if the claims Section III— Limits Of Insurance: against an additional insured allege If coverage provided to the additional insured is negligence or other wrongdoing in the required by a contract or agreement, the most we supervision, hiring, employment, training or will pay on behalf of the additional insured is: monitoring of others by that insured, if the "occurrence" which caused the"bodily injury" a. The minimum amount required by the or "property damage", or the offense which contract or agreement; or caused the "personal and advertising injury", b. The Limits of Insurance shown in the involved the rendering of or failure to render Declarations; any professional services by you with respect to your providing engineering, architectural or whichever is less. surveying services in your capacity as an This endorsement shall not increase the engineer, architect or surveyor. applicable Limits of Insurance shown in the G. Blanket Additional Insured — State Or Declarations. Governmental Agency Or Subdivision Or Political 3. With respect to the insurance afforded to these Subdivision — Permits Or Authorizations Relating additional insureds, the following additional To Premises exclusion applies: Section 11 — Who Is An Insured is amended to in- This insurance does not apply to: clude as an additional insured any state or a. "Bodily injury", "property damage" or governmental agency or subdivision or political "personal and advertising injury" arising out subdivision with whom you have agreed in a written of the rendering of, or the failure to render, contract, executed prior to loss, to name as an any professional architectural, engineering or additional insured, subject to the following provision: surveying services, including: 1. This insurance applies only with respect to the fol- (1) The preparing, approving, or failing to lowing hazards for which the state or prepare or approve, maps, shop governmental agency or subdivision or political drawings, opinions, reports, surveys, subdivision has issued a permit or authorization field orders, change orders or drawings in connection with premises you own, rent or and specifications; or control and to which this insurance applies: (2) Supervisory, inspection, architectural or a. The existence, maintenance, repair, engineering activities. construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission. Page 8 of 10 This exclusion applies even if the claims SECTION IV — COMMERCIAL GENERAL LIABILITY against an additional insured allege CONDITIONS AMENDMENTS negligence or other wrongdoing in the supervision, hiring, employment, training or A. Knowledge Of Occurrence monitoring of others by that insured, if the Item 2. Duties In The Event Of Occurrence, Of- "occurrence" which caused the "bodily injury" fense, Claim or Suit is amended by adding the fol- or "property damage", or the offense which lowing: caused the "personal and advertising injury", e. You must give us or our authorized representa- involved the rendering of or failure to render tive prompt notice of an "occurrence", claim or any professional services by you with respect loss only when the "occurrence", claim or loss is to your providing engineering, architectural or known to: surveying services in your capacity as an engineer, architect or surveyor. (1) You, if you are an individual, (2) A partner, if you are a partnership, SECTION III—LIMITS OF INSURANCE AMENDMENTS (3) An executive officer or insurance manager, if you are a corporation, or A. Damage To Premises Rented To You (4) A member or manager, if you are a limited Paragraph 6. is replaced by the following: liability company. 6. Subject to Paragraph 5. above, the most we will B. Other Insurance pay under Coverage A for damages because of Item 4. Other Insurance, b. Excess Insurance (1) "property damage" to any one premises, while rented to you, or in the case of damage by fire, (a) (ii) is replaced by the following: lightning, explosion or sprinkler leakage, while (ii) That is fire, lightning, explosion or sprinkler leak- rented to you or temporarily occupied by you with age insurance for premises rented to you or permission of the owner is the greater of: temporarily occupied by you with permission of the owner; a. $300,000, or C. Unintentional Failure To Disclose Hazards b. The amount shown next to the Damage To Item 6. Representations is replaced by the following: Premises Rented To You Limit in the Decla- rations. 6. Representations And Unintentional Failure To However, the provisions of this paragraph do not Disclose Hazards apply if Damage To Premises Rented To You a. By accepting this policy, you agree: Coverage is excluded by endorsement. (1) The statements in the Declarations are B. Medical Expense Limit accurate and complete, Paragraph 7. is replaced with the following. (2) Those statements are based upon repre- 7. Subject to Paragraph 5. above, the most we will sentations you made to us, and pay under Coverage C for all medical expenses (3) We have issued this policy in reliance because of "bodily injury" sustained by any one upon your representations. person is the greater of: b. If you unintentionally fail to disclose any haz- a. $10,000, or ards existing at the inception date of your policy, we will not deny coverage under this b. The amount shown next to the Medical Ex- Coverage Part because of such failure. pense Limit in the Declarations. However, this provision does not affect our This insurance does not apply if coverage for right to collect additional premium or exercise Medical Expenses is excluded either by the pro- our right of cancellation or non-renewal. visions of the coverage part or by endorsement. W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission. Page 9 of 10 D. Waiver of Subrogation SECTION V — DEFINITIONS AMENDMENTS Item 8. Transfer of Rights of Recovery Against A. Insured Contract Amended Others to Us is hereby amended by the addition of the following: Paragraph 9. a. is replaced by the following: We waive any right of recovery we may have because a. A contract for a lease of premises. However, that of payments we make for injury or damage arising out portion of the contract for a lease of premises that of your ongoing operations or"your work" done under indemnifies any person or organization for damage by fire, lightning, explosion or sprinkler a written contract, executed prior to loss, requiring leakage to premises while rented to you or such waiver with that person or organization and included in the "products-completed operations temporarily occupied by you with permission of hazard". However, our rights may only be waived the owner is not an "insured contract"; prior to the "occurrence" giving rise to the injury or B. Personal And Advertising Injury Redefined damage for which we make payment under this Paragraph 14. d. and e.are replaced by the following: Coverage Part. The insured must do nothing after a loss to impair our rights. At our request, the insured d. Oral, written, televised, videotaped or electronic will bring "suit"or transfer those rights to us and help publication of material that slanders or libels a us enforce those rights. person or organization or disparages a person's or organization's goods, products or service; e. Oral, written, televised, videotaped or electronic publication of material that violates a person's right of privacy, WN GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission Page 10 of 10 m'60 4= N M 0 r f Ol-.�... C m O « 0 3 .mEy Z �" i -E- .a. c N a d a m y Q e m m m a c d 0 v o. 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' E | : °! `«° - _°£� 22�,a;`! qk !■ �■;« . ; « « < i <, \k§; ! a.§13 fee §Wa to-j; raE E E . m: C- MU)m 2Owao -« a ■ G Policy#GLD03037050259 COMMERCIAL GENERAL LIABILITY CIS 73231216 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ENHANCEMENT PLUS ENDORSEMENT INCLUDING MEDICAL PAYMENTS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Lost Key Coverage D. Expanded Property Damage Coverage 1. Under Section I — Coverages, Coverage A 1. For the purposes of this endorsement only: Bodily Injury And Property Damage Section I — Coverages, Coverage A Liability, coverage is extended to include Bodily Injury And Property Damage the following: Liability, 2. Exclusions, Exclusion j. If a customer's master or grand key, Damage To Property is amended as follows: excluding electronic key card, is lost, a. Paragraphs(3), (5), and(6) are deleted damaged or stolen while in your care, in their entirety. custody or control we will pay the cost of b. Paragraph (4) is deleted in its entirety replacing the keys, including the master lock and replaced with: and all keys used in the same lock, the cost (4) Personal property in the care, of adjusting locks to accept the new keys, or custody, or control of the insured: the cost to replace the locks, whichever is less. (a) for storage or sale at premises 2. Limit of Insurance—For the purpose of this you own, rent or occupy; or coverage the most we will pay is $ 10,000 (b) while being transported by any per"occurrence". aircraft, "auto" or watercraft B. Voluntary Property Damage owned or operated by or rented to or loaned to any insured. 1. Section I — Coverages,Coverage A Bodily c. The coverage provided by this Injury And Property Damage Liability endorsement does not apply to coverages extendedo includethefollowing: "property damage": At your request, we will pay for "property damage"to propertyof others caused by you (1) Arising out of the disappearance or and while in your possession,risingoutof your loss of use of personal property;or business operationsand occurring during the (2) Included in the "products-completed policyperiod. operations hazard". 2. Limit of Insurance—For the purpose of this 2. Limit of Insurance - The most we will pay coverage the most we will pay is $1,500 per for loss arising out of any one "occurrence" "occurrence". is$5,000. C. Non-Owned Watercraft 3. Deductible - Our obligation to pay for a Under Section I — Coverages, Coverage A covered loss applies only to the amount of Bodily Injury And Property Damage Liability, loss in excess of$250. 2. Exclusions, Exclusion g. Aircraft, Auto Or We will pay the deductible amount to effect Watercraft Paragraph(2) (a) is replaced with: settlement of any claim or "suit" and, upon (a) Less than 51 feet long; and notification of this action having been taken, you shall promptly reimburse us for the deductible as has been paid by us. CG 73 23 12 16 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 5 with its permission. ACP GLD03027050259 518E 17128 INSURED COPY 47 0018262 CIS 73 23 12 16 This insurance is primary to any expanded d. All reasonable expenses incurred by the property damage coverage provided by a insured at our request to assist us in the separate endorsement attached to this investigation or defense of the claim or policy, and it will supplant any deductible in "suit", including actual loss of earnings up to said endorsement $500 a day because of time off from work. E. Damage To Premises Rented To You G. Newly Formed And Acquired Organizations 1. Under Section I —Coverages, Coverage A Under SECTION II — WHO IS AN INSURED Bodily Injury And Property Damage Paragraph 3.a.is replaced with: Liability, the last paragraph of 2. a. Coverage under this provision is afforded Exclusions is replaced with: only until the 180th day after you acquire or If Damage To Premises Rented To You is form the organization or the end of the policy not otherwise excluded, Exclusions c. period,whichever is earlier; through n. do not apply to damage by fire, H. Additional Insured — Automatic Status When lightning, explosion, smoke, or sprinkler Required In An Agreement Or Contract With leakage to premises while rented to you or You temporarily occupied by you with permission Section II —Who Is An Insured is amended to of the owner. include: 2. Under Section III — Limits Of Insurance, 1. Any person(s)or organization(s)described Paragraph 6 is replaced with: in Paragraph a.—d. below with whom you 6. Subject to 5. above, the Damage To have agreed in writing in a contract or Premises Rented To You Limit is the written agreement that such person or most we will pay under Coverage A for organization be added as an additional damages because of"property damage" insured on your policy during the policy to any one premises, while rented to period shown in the Declarations. you, or in the case of damage by fire, 2. Any other person or organization you are lightning, explosion, smoke or sprinkler required to add as an additional insured leakage, while rented to you or under the contract or agreement described temporarily occupied by you with in Paragraph 1. above. permission of the owner. The limit is increased to$1,000,000. The person or organization added as an insured by this endorsement is an insured 3. Under Section IV — Commercial General only for liability due to: Liability Conditions, 4. Other Insurance, b. a. Lessors of Leased Equipment — with Excess Insurance (1) (a) (ii) is replaced respect to their liability for"bodily injury", with: (ii) That is Fire, Lightning, Explosion, Smoke "property damage", or "personal and or Sprinkler leakage insurance for advertising injury", caused in whole or in premises rented to you or temporarily part by your maintenance, operation, or use of equipment leased to you by such occupied by you with permission of the person(s) or organization(s). This owner. insurance does not apply to any F. Supplementary Payments "occurrence"which takes place after the Under Section I — Coverages, Supplementary equipment lease expires. Payments — Coverages A and B Paragraphs However, their status as additional 1.b and 1.d. are replaced with: insured under this policy ends when b. Up to $2,500 for cost of bail bonds required their lease, contract, or agreement with because of accidents or traffic law violations you for such leased equipment expires. arising out of the use of any vehicle to which b. Managers or Lessors of Premises — the Bodily Injury Liability Coverage applies. with respect to liability arising out of the We do not have to furnish these bonds. ownership, maintenance, or use of that part of the premises you own, rent, lease, or occupy. Page 2 of 5 Includes copyrighted material of Insurance Services Office, Inc., CG 73 23 12 16 with its permission. ACP GLD03027050259 51BE 17128 INSURED COPY 47 0018263 CG73231216 This insurance does not apply to: (1) Your acts or omissions; or (1) Any "occurrence"which takes place (2) The acts or omissions of those after you cease to be a tenant in acting on your behalf; in the that premises. performance of your ongoing (2) Structural alterations, new con- operations performed for that struction, or demolition operations additional insured, whether the work performed by or on behalf of the is performed by you or on your person or organization. behalf. However, their status as additional The insurance does not apply to: insured under this policy ends when you (1) "Bodily injury", "property damage", cease to be a tenant of such premises. or "personal and advertising injury" c. State or Political Subdivision — arising out of the rendering of or the Permits Relating to Premises — with failure to render any professional respect to the following hazards for architectural, engineering, or survey which the state or political subdivision services,including: has issued a permit or authorization in (a) The preparing, approving, or connection with premises you own, rent, failing to prepare or approve or control and to which this insurance maps, shop drawings, opinions, applies. reports, survey, field orders, (1) The existence, maintenance, repair, change orders, or drawings and construction, erection, or removal of specifications; or advertising signs, awnings, (b) Supervisory, inspection, archi- canopies, cellar entrances, coal tectural or engineering activities. holes, driveways, manholes, This exclusion applies even if marquees, hoist away openings, the claims against any insured sidewalk vaults, street banners, or allege negligence or other decorations and similar exposures; wrongdoing in the supervision, or hiring, employment, training or (2) The construction, erection, or monitoring of others by that removal of elevators;or insured, if the "occurrence" (3) The ownership maintenance or use which caused the "bodily injury" of any elevators covered by this or "property damage", or the insurance. offense which caused the This insurance does not apply to: "personal and advertisinginjury", involved the rendering (1) "Bodily injury" or "property damage" of, or failure to render, any or "personal or advertising injury" professional, architectural, arising out of operations performed engineering, or surveying for the state or municipality;or services. (2) "Bodily injury" or "property damage" (2) "Bodily injury" or "property damage" included within the "products- occurring after: completed operations hazard". (a) All work, including materials, However, such state or political parts, or equipment furnished in subdivision's status as additional connection with such work, on insured under this policy ends when the the project (other than service, permit ends. maintenance, or repairs) to be d. Owners, Lessees, or Contractors — performed by or on behalf of the with respect to liability for "bodily injury", additional insured(s) at the location of the covered "property damage", or "personal and operations has been completed; advertising injury" caused in whole or in or part, by: CG 73 23 12 16 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 5 with its permission. ACP GLD03027050259 51BE 17128 INSURED COPY 47 0018264 CIS 73231216 (b) That portion of "your work" out b. You have agreed in writing in a contract of which the injury or damage or agreement that this insurance would arises has been put to its be primary and would not seek intended use by any person or contribution from any other insurance organization other than another available to the additional insured. contractor or subcontractor I. Employee Bodily Injury To Another Employee engaged in performing operations for a principal as a Under Section II — Who Is An Insured The part of the same project. following is added to Paragraph 2.a.(1): However, a person or organization's Paragraphs 2.a.(1) (a), (b) and (c) do not apply status as additional insured under to "bodily injury" to a co-"employee" in the this policy ends when your course of the co-"employee's" employment by operations for that additional insured you, or to "bodily injury" to a co-"volunteer are completed. worker" while performing duties related to the With respect to the insurance afforded to conduct of your business. such additional insureds a. — d. described J. Broad Form Named Insured above, the following is added to Section III Under Section II — Who Is An Insured The —Limits Of Insurance: following is added to Paragraph 2.: If coverage provided to the additional e. Any business entity incorporated or insured is required by a contract or organized under the laws of the United State agreement,the most we will pay on behalf of of America (including any State thereof), its the additional insured is the amount of territories or possessions, or Canada insurance: (including any Province thereof)in which the 1. Required by the contract or agreement; Named Insured shown in the Declarations or 2. Available under the applicable Limits of owns,during the policy period, an interest of PP more than fifty percent. If other valid Insurance shown in the Declarations: collectible insurance is available to any whichever is less. business entity covered by this solely by This endorsement shall not increase the reason of ownership by the Named Insured applicable Limits of Insurance shown in the shown in the Declarations in excess of fifty Declarations. percent, this insurance is excess over the However, the insurance afforded to such other insurance, whether primary, excess, additional insureds a.—d. described above: contingent,or on any other basis. 1. Only applies to the extent permitted by K. Aggregate Limit Per Location law;and Under Section III — Limits Of Insurance the 2. Will not be broader than that which you following is added to Paragraph 2: are required by the contract or The General Aggregate Limit under Section III agreement to provide for such additional Limits Of Insurance applies separately to each insured. of your locations owned by or rented to you or 3. Primary and Noncontributory — Other temporarily occupied by you with the permission Insurance Conditions of the owner. For the purposes of this provision, The following is added to the Other location means premises involving the same or Insurance Condition and supersedes any connecting lots, or premises whose connection provisions to the contrary: is interrupted only by a public street, roadway, Primary and Noncontributory Insurance waterway or railroad right-of-way. This insurance is primary to and will not L. Aggregate Limit Per Project seek contribution from any other insurance Under Section III — Limits Of Insurance The available to an additional insured under your following paragraph is added to Paragraph 2: policy provided that: The General Aggregate Limit under Section III a. The additional insured is a Named Limits Of Insurance applies separately to each Insured under such other insurance;and of your construction projects away from premises owned by or rented to you. Page 4 of 5 Includes copyrighted material of Insurance Services Office, Inc., CIS 73 23 12 16 with its permission. ACP GLD03027050259 51BE 17128 INSURED COPY 47 0018265 CG 73 23 12 16 M. Medical Payments inception date of the policy shall not Under Section III — Limits Of Insurance, prejudice the coverage afforded by this Paragraph 7. is replaced with: policy provided such failure to disclose all 7. Subject to 5. above,the higher of: hazards or prior"occurrences"or offenses is not intentional. This provision does not a. $10,000;or affect our right to collect additional premium b. The amount shown in the Declarations or exercise our right of cancellation or non- for Medical Expense Limit is the most renewal. we will pay under Coverage C for all P. Waiver Of Subrogation medical expenses because of "bodily Under Section IV — Commercial General injury"sustained by one person. Liability Conditions, 8. Transfer Of Rights Of This coverage does not apply if Coverage C Recovery Against Others To Us the following — Medical Payments is excluded either by paragraph is added: the provisions of any coverage forms If required by a written contract executed prior to attached to the policy or by endorsement. loss, we waive any right of subrogation we may N. Knowledge Of An Occurrence have against the contracting person or Under Section IV — Commercial General organization because of payments we make for Liability Conditions, the following is added to injury or damage arising out of your ongoing 2. Duties In The Event Of Occurrence, operations or"your work" done under a contract Offense, Claim Or Suit: with that person or organization and included in e. Knowledge of an occurrence, offense, claim the"products-completed operations hazard". or suit by an agent or employee of any Q. Liberalization insured shall not in itself constitute Under Section IV — Commercial General knowledge of the insured unless you, a Liability Conditions, the following partner, if you are a partnership; or an paragraph is added: executive officer or insurance manager, if 10. Liberalization you are a corporation receives such notice of an occurrence, offense, claim or suit from If we revise this coverage form to provide more the agent or employee. coverage without additional premium charge, f. The requirements in Paragraph b. will not your policy will automatically provide the be considered breached unless there is additional coverage as of the day the revision is knowledge of occurrence as outlined in effective in your state. Paragraph e. above. R. Broadened Bodily Injury Definition (Mental O. Unintentional Failure To Disclose Hazard Anguish) Under Section IV — Commercial General Under Section V — Definitions Definition 3. Liability Conditions, Condition 6. "Bodily Injury"is replaced with: Representations the following paragraph is 3. "Bodily injury" means physical injury, added: sickness, or disease to a person and if d. Your failure to disclose all hazards or prior arising out of the foregoing, mental anguish, "occurrences"or offenses existing as of the mental injury, shock, or humiliation, including death at any time resulting therefrom. All terms and conditions of this policy apply unless modified by this endorsement. CG 73 23 12 16 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 5 with its permission. ACP GLD03027050259 51BE 17128 INSURED COPY 47 0018266 City of Kent Business License EVERGREEN ASPHALT&CONCRETE INC PO BOX 1567 KENT,WA 98035 Please tear at perforation ------------------------------- BUSINESS LICENSE Per RCW 82.14 local sales and use tax must be coded LICENSE MUST BE PAID ANNUALLY BY No. 1715 for all qualified JANUARY 1st TO AVOID PENALTY sales within the city of Issuance of License Does Not Imply Licensee's Kent. Compliance with State and Local Laws THIS LICENSE MUST BE POSTED IN A CONSPICUOUS 2019 PLACE.NOT TRANSFERABLE OR ASSIGNABLE F E AND ADDRESS OF BUSINESS 38N ASPHALT&CONCRETE INC MAYOR 18744 SE 282ND ST Tax Registration The City of Kent KENT. WA 98042 Endorsement At 2204T11 AVE SO KEW.WASHINGTON 98032