HomeMy WebLinkAboutCAG2020-029 - Original - Styro Recycle LLC - 2020 Recycling Events - 01/23/2020 400 Agreement Routing Form
• For Approvals,Signatures and Records Management
KENT This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms.
WASH IN O T O N (Print on pink or cherry colored paper)
Originator: Department:
Nancy Yoshitake for Tony Donati Public Works
Date Sent: Date Required:
> 1/24/20 1/28/20
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�- Authorized to Sign: Date of Council Approval:
O' 0 Director or Designee ❑ Mayor N/A
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Budget Account Number: Grant? ❑Yes [] No
47005245.64110.7910
Budget? 0 Yes ❑ No Type:_; al
Vendor Name: Category:
Styro Recycle LLC Contract
Vendor Number: Sub-Category:
O 442602
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Z Project Name: 2020 Recycling Events
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= Project Details:Styrofoam recycling services.
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E Agreement Amount: $1,950 Basis for Selection of Contractor:
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Start Date: 1/23/20 Termination Date: 11/30/20
Q Local Business? Yes ❑ No*
*Ifineets requirements per KCC3.10.100,please complete"Vendor Purchase-Local Exceptions"form on Cityspoce.
Notice req ired prior to disclosure? Contract Number:
❑Yeso
Date Received by City Attorney: ents:
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Date Routed to the City Clerk's Office:
dd«W22373_1_20 Visit Documents.KentWA.gov to obtain copies of all agreements
KENT
W A s H i N G T O H
GOODS & SERVICES AGREEMENT
between the City of Kent and
Styro Recycle LLC
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Styro Recycle LLC organized under the laws of the State of Washington,
located and doing business at 23418 68th Ave. S., Kent, WA 98032, Phone: (253) 838-9555, Contact:
Marilyn Lauderdale (hereinafter the "Vendor").
AGREEMENT
I. DESCRIPTION OF WORK.
Vendor shall provide the following goods and materials and/or perform the following services for
the City:
The Vendor shall provide styrofoam recycling services at three 2020 City of Kent Recycling
Events. For a description, see the Vendor's Scope of Work which is attached as Exhibit A
and incorporated by this reference.
Vendor acknowledges and understands that it is not the City's exclusive provider of these goods,
materials, or services and that the City maintains its unqualified right to obtain these goods, materials,
and services through other sources.
II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete
the work and provide all goods, materials, and services by November 30, 2020.
III. COMPENSATION. The City shall pay the Vendor an amount not to exceed One Thousand,
Nine Hundred Fifty Dollars ($1,950), including applicable Washington State Sales Tax, for the goods,
materials, and services contemplated in this Agreement. The City shall pay the Vendor the following
amounts according to the following schedule:
Vendor shall be paid an amount not to exceed $650 per recycling event after submittal of
invoice.
If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option
to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make
every effort to settle the disputed portion.
GOODS & SERVICES AGREEMENT - 1
($20,000 or Less, ind. WSST)
A. Defective or Unauthorized Work. The City reserves its right to withhold payment from
Vendor for any defective or unauthorized goods, materials or services. If Vendor is unable,
for any reason, to complete any part of this Agreement, the City may obtain the goods,
materials or services from other sources, and Vendor shall be liable to the City for any
additional costs incurred by the City. "Additional costs" shall mean all reasonable costs,
including legal costs and attorney fees, incurred by the City beyond the maximum
Agreement price specified above. The City further reserves its right to deduct these
additional costs incurred to complete this Agreement with other sources, from any and all
amounts due or to become due the Vendor.
B. Final Payment: Waiver of Claims. VENDOR'S ACCEPTANCE OF FINAL PAYMENT SHALL
CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE
AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR FINAL PAYMENT
IS MADE.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in
accordance with Ch. 51.08 RCW, the parties make the following representations:
A. The Vendor has the ability to control and direct the performance and details of its
work, the City being interested only in the results obtained under this Agreement.
B. The Vendor maintains and pays for its own place of business from which Vendor's
services under this Agreement will be performed.
C. The Vendor has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed before the City
retained Vendor's services, or the Vendor is engaged in an independently established
trade, occupation, profession, or business of the same nature as that involved under
this Agreement.
D. The Vendor is responsible for filing as they become due all necessary tax documents
with appropriate federal and state agencies, including the Internal Revenue Service
and the state Department of Revenue.
E. The Vendor has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by Vendor's
business, and has obtained a Unified Business Identifier (UBI) number from the
State of Washington.
F. The Vendor maintains a set of books dedicated to the expenses and earnings of its
business.
V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party thirty (30) days written notice at its address set forth on the signature block of
this Agreement.
VI. CHANGES. The City may issue a written amendment for any change in the goods,
materials or services to be provided during the performance of this Agreement. If the Vendor determines,
for any reason, that an amendment is necessary, Vendor must submit a written amendment request to
the person listed in the notice provision section of this Agreement, section XIV(D), within fourteen (14)
calendar days of the date Vendor knew or should have known of the facts and events giving rise to the
requested change. If the City determines that the change increases or decreases the Vendor's costs or
time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to
reach agreement with the Vendor on all equitable adjustments. However, if the parties are unable to
agree, the City will determine the equitable adjustment as it deems appropriate. The Vendor shall
proceed with the amended work upon receiving either a written amendment from the City or an oral order
from the City before actually receiving the written amendment. If the Vendor fails to require an
GOODS & SERVICES AGREEMENT - 2
($20,000 or Less, including WSST)
amendment within the time allowed, the Vendor waives its right to make any claim or submit subsequent
amendment requests for that portion of the contract work. If the Vendor disagrees with the equitable
adjustment, the Vendor must complete the amended work; however, the Vendor may elect to protest the
adjustment as provided in subsections A through E of Section VII, Claims, below.
The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a separate
acceptance, or (3) not protesting in the way this section provides. An amendment that is accepted by
Vendor as provided in this section shall constitute full payment and final settlement of all claims for
contract time and for direct, indirect and consequential costs, including costs of delays related to any
work, either covered or affected by the change.
VII. CLAIMS. If the Vendor disagrees with anything required by an amendment, another
written order, or an oral order from the City, including any direction, instruction, interpretation, or
determination by the City, the Vendor may file a claim as provided in this section. The Vendor shall give
written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the events
giving rise to the claims, or within fourteen (14) calendar days of the date the Vendor knew or should
have known of the facts or events giving rise to the claim, whichever occurs first . Any claim for
damages, additional payment for any reason, or extension of time, whether under this Agreement or
otherwise, shall be conclusively deemed to have been waived by the Vendor unless a timely written claim
is made in strict accordance with the applicable provisions of this Agreement.
At a minimum, a Vendor's written claim shall include the information set forth in subsections A,
items 1 through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN
THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN
ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED
BY THAT DELAY.
A. Notice of Claim. Provide a signed written notice of claim that provides the following
information:
1. The date of the Vendor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions in this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that estimate
was determined; and
5. An analysis of the progress schedule showing the schedule change or
disruption if the Vendor is asserting a schedule change or disruption.
B. Records. The Vendor shall keep complete records of extra costs and time incurred as a
result of the asserted events giving rise to the claim. The City shall have access to any of
the Vendor's records needed for evaluating the protest.
The City will evaluate all claims, provided the procedures in this section are followed. If the
City determines that a claim is valid, the City will adjust payment for work or time by an
equitable adjustment. No adjustment will be made for an invalid protest.
C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall proceed
promptly to provide the goods, materials and services required by the City under this
Agreement.
D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor
also waives any additional entitlement and accepts from the City any written or oral order
(including directions, instructions, interpretations, and determination).
E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this
section, the Vendor completely waives any claims for protested work and accepts from the
GOODS & SERVICES AGREEMENT - 3
($20,000 or Less, including WSST)
City any written or oral order (including directions, instructions, interpretations, and
determination).
VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING
FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE
CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT SHALL BE FOREVER BARRED.
THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD.
IX. WARRANTY. Vendor warrants that it will faithfully and satisfactorily perform all work
provided under this Agreement in accordance with the provisions of this Agreement. In addition to any
other warranty provided for at law or herein, this Agreement is additionally subject to all warranty
provisions established under the Uniform Commercial Code, Title 62A, Revised Code of Washington.
Vendor warrants goods are merchantable, are fit for the particular purpose for which they were obtained,
and will perform in accordance with their specifications and Vendor's representations to City. The Vendor
shall promptly correct all defects in workmanship and materials: (1) when Vendor knows or should have
known of the defect, or (2) upon Vendor's receipt of notification from the City of the existence or
discovery of the defect. In the event any part of the goods are repaired, only original replacement parts
shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for
that portion of the work shall extend for an additional year beyond the original warranty period applicable
to the overall work. The Vendor shall begin to correct any defects within seven (7) calendar days of its
receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a
reasonable time as determined by the City, the City may complete the corrections and the Vendor shall
pay all costs incurred by the City in order to accomplish the correction.
X. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the
Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national
origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who
is qualified and available to perform the work to which the employment relates.
Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration,
Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached
Compliance Statement.
XI. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers,
officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or
suits, including all legal costs and attorney fees, arising out of or in connection with the Vendor's
performance of this Agreement, except for that portion of the injuries and damages caused by the City's
negligence.
The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds
to avoid any of these covenants of indemnification.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER 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 Vendor refuses tender of defense in any suit or any claim, if that tender was made
pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having
jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Vendor's part, then Vendor
shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable
attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the
Vendor's part.
The provisions of this section shall survive the expiration or termination of this Agreement.
GOODS & SERVICES AGREEMENT - 4
($20,000 or Less, including WSST)
XII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement,
insurance of the types and in the amounts described in Exhibit B attached and incorporated by this
reference.
XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary precautions
and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of
the contract work and shall utilize all protection necessary for that purpose. All work shall be done at
Vendor's own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other
articles used or held for use in connection with the work.
XIV. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price
preference may be available for any designated recycled product.
B. Non-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 XI 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 Vendor.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative
of the City, and such statements shall not be effective or be construed as entering into or forming a part
of or altering in any manner this Agreement. All of the above documents are hereby made a part of this
Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any
language contained in this Agreement, the terms of this Agreement shall prevail.
H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and municipal
laws, rules, and regulations that are now effective or in the future become applicable to Vendor's business,
equipment, and personnel engaged in operations covered by this Agreement or accruing out of the
performance of those operations.
GOODS & SERVICES AGREEMENT - 5
($20,000 or Less, including WSST)
I. Public Records Act. The Vendor acknowledges that the City is a public agency subject to the
Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes,
emails, and other records prepared or gathered by the Consultant in its performance of this Agreement
may be subject to public review and disclosure, even if those records are not produced to or possessed by
the City of Kent. As such, the Vendor agrees to cooperate fully with the City in satisfying the City's duties
and obligations under the Public Records Act.
J. City Business License Required. Prior to commencing the tasks described in Section I,
Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of
the Kent City Code.
K. Counterparts and Signatures by Fax or Email. This Agreement may be executed in any
number of counterparts, each of which shall constitute an original, and all of which will together constitute
this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page
to the other by fax or email and that signature shall have the same force and effect as if the Agreement
bearing the original signature was received in person.
IN WITNESS, the parties below execute this Agreement, which shall become effective on
the last date entered below. All acts consistent with the authority of this Agreement and prior
to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed
to have applied.
VENDOR: CITY OF KENT:
By:_7AZa�-Izl By:
(signature) (signature)
Print Name: Marilyn Lauderdale Print Name: Michael Mactutis, P.E.
Its: Owner Its: Environmental Engineering Manager
(title) '
DATE: 01-22-2020 DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
VENDOR: CITY OF KENT:
Marilyn Lauderdale Timothy J. LaPorte, P.E.
Styro Recycle LLC City of Kent
23418 68th Ave. S. 220 Fourth Avenue South
Kent, WA 98032 Kent, WA 98032
(253) 838-9555 (telephone) (253) 856-5500 (telephone)
N/A (facsimile) (253) 856-6500 (facsimile)
VT
:
44�
,
Kent City Clerk
Styro Recycle-Recycling Events 4/Donati
GOODS & SERVICES AGREEMENT - 6
($20,000 or Less, including WSST)
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
By:
For: Styro Recycle LLC
Title: Owner
Date: o1-22-202o
EEO COMPLIANCE DOCUMENTS - 1 of 3
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2 of 3
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered into on
the (date), between the firm I represent and the City of
Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 3 of 3
EXHIBIT A
Donati, Tony
Subject: KENT Recycling event from Styro Recycle Ilc
From: Marilyn Lauderdale [rrtailtomarilynCa�styrorecycle.com]
Sent: Monday, October 21, 2019 9:15 AM
To: Donati,Tony
Subject: RE: KENT Recycling event from Styro Recycle Ilc
EXTERNAL
You are welcome Tony,
As I mentioned for 2020 budget there is an increase. As we managed 2019 there was a great loss on our bottom line due
to labor cost increase, along with the increase truck insurances& repairs, cost rental cost just to name a few items.
This increase is not isolated to just your event,these increases are all across the board per events.
So our 2020 participation fee for the City of Kent recycling event will be$650 per event, please advise us moving
forward in any date changes.
We appreciate your understanding, let us know if you have any questions
Shank you
, riltyn Lauderttale
Owner/Consultant
t ,ro Rec vc_lo Ilc
Kent,WA 98032
Cell 253-347-5396
1
EXHIBIT B
INSURANCE REQUIREMENTS FOR
SERVICE CONTRACTS
Insurance
The Contractor shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Contractor, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
1. Automobile Liability insurance covering all owned, non-owned,
hired and leased vehicles. Coverage shall be written on Insurance
Services Office (ISO) form CA 00 01 or a substitute form providing
equivalent liability coverage. If necessary, the policy shall be
endorsed to provide contractual liability coverage.
2. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability arising from
premises, operations, independent contractors, products-completed
operations, personal injury and advertising injury, and liability
assumed under an insured contract. The Commercial General
Liability insurance shall be endorsed to provide the Aggregate Per
Project Endorsement ISO form CG 25 03 11 85. The City shall be
named as an insured under the Contractor's Commercial General
Liability insurance policy with respect to the work performed for the
City using ISO additional insured endorsement CG 20 10 11 85 or a
substitute endorsement providing equivalent coverage.
3. Workers' Compensation coverage as required by the Industrial
Insurance laws of the State of Washington.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Automobile Liability insurance with a minimum combined single
limit for bodily injury and property damage of $1,000,000 per
accident.
2. Commercial General Liability insurance shall be written with limits
no less than $1,000,000 each occurrence, $2,000,000 general
aggregate and a $2,000,000 products-completed operations
aggregate limit.
EXHIBIT B (Continued )
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
insurance:
1. The Contractor's insurance coverage shall be primary insurance as
respect the City. Any Insurance, self-insurance, or insurance pool
coverage maintained by the City shall be excess of the Contractor's
insurance and shall not contribute with it.
2. The Contractor's insurance shall be endorsed to state that coverage
shall not be cancelled by either party, except after thirty (30) days
prior written notice by certified mail, return receipt requested, has
been given to the City.
3. The City of Kent shall be named as an additional insured on all
policies (except Professional Liability) as respects work performed
by or on behalf of the contractor and a copy of the endorsement
naming the City as additional insured shall be attached to the
Certificate of Insurance. The City reserves the right to receive a
certified copy of all required insurance policies. The Contractor's
Commercial General Liability insurance shall also contain a clause
stating that coverage shall apply separately to each insured against
whom claim is made or suit is brought, except with respects to the
limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than ANII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Contractor before commencement of the work.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Contractor.
�® DATE(MM/DD/YYYY)
A
C CERTIFICATE OF LIABILITY INSURANCE 03/08/2019
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 Brittany Bryan
NAME:
HUMBLE&DAVENPORT INS BROKERS INC PHONE (425)226-8221 FAX 425 255-9342
A/C No Ext: A/C,No): ( )
3500 Maple Valley Hwy E-MAIL brittany@humbledavenport.com
ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
Renton WA 98058 INSURERA: Western National Assurance 24465
INSURED
INSURER B
Styro Recycle LLC
INSURER C
PO Box 834
INSURER D
INSURER E
Milton WA 98354 INSURER F
COVERAGES CERTIFICATE NUMBER: CL192723142 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 AUUL5UBH POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE IN SD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
D T RENTED 100,000
CLAIMS-MADE X OCCUR PREMISES Ea occurrence $
MED EXP(Any one person) $ 5,000
A Y Y CPP101969011 03/25/2019 03/25/2020 PERSONAL&ADV INJURY $ 1,000,000
GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY � PRO ❑ 2,000,000
JECT LOC PRODUCTS-COMP/OP AGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
Ea accident
ANYAUTO BODILY INJURY(Per person) $
A OWNED IX
SCHEDULED Y Y CPP 1019286 11 03/25/2019 03/25/2020 BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
X HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
X UMBRELLA LIAB M
OCCUR EACH OCCURRENCE $ 2,000,000
A EXCESS LIAB CLAIMS-MADE Y Y UMB 1005659 10 03/25/2019 03/25/2020 AGGREGATE $ 2,000,000
DED I X1 RETENTION $ 10,000 $
WORKERS COMPENSATION PER OTH- WA State Stop Gap
AND EMPLOYERS'LIABILITY Y/N STATUTE X ER
A ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A CPP101969011 03/25/2019 03/25/2020 E.L.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED?
(Mandatory 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
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Certificate holder is included as additional insured with respects to work performed by the named insured per WNGL49 on the General Liability and WNCA27
on the auto.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
City of Kent ACCORDANCE WITH THE POLICY PROVISIONS.
220 Fourth Avenue South
AUTHORIZED REPRESENTATIVE
Kent WA 98032 g �_
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
`
-.
' POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
CPPl01969011 CG2603B5O8
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
���U������� ����������U��� ���� N������
DESIGNATED CONSTRUCTION ox���� u o��n� x ox��~�u-�� " x��»
GENERAL AGGREGATE UUMAlF
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Construction Project(s):
PER WRITTEN CONTRACT OR AGREE-
MENT WHERE YOU AGREED TO PRO-
VIDE A SEPERATE GENERAL AGGRE-
GATE LIMIT FOR EACH PROJECT
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. For all sums which the insured becomes |e' gate Limit for that designated construction
gaUy obligated to pay as damages neunod by prnjoot. Such payments shall not reduce
^oucurranoeo^ under Section | - Coverage A. the General Aggregate Limit shown in the
and for all medical expenses omuaod by auoi' Declarations nor shall they reduce any
dents under Section | - Coverage C. which other Designated Construction Project
can be attributed only to ongoing operations General Aggregate Limit for any other
at n single designated construction project designated construction project shown in
shown in the Schedule above: the Schedule above.
1. A separate Designated Construction Proj- 4, The limits shown in the Declarations for
oot General Aggregate Limit applies to Each Docunonna' Damage To plern|moo
each designated construction project, and Rented To You and K4odiva| Expense
that limit in equal to the amount of the continue to apply. However, instead of
General Aggregate Limit shown in the being subject to the General Aggregate
Declarations. Limit shown in the Declarations, such
2. The Designated Construction Project Gen- limits will be subject to the applicable
oral Aggregate Limit is the most we will Designated Construction Project General
Pay for the sum of all damages under Aggregate Limit, �
Coverage A. except damages because of B. For alluums which the insured becomes
"bodily injury" or "property damage" legally obligated to pay as damages caused by
included in the "prod ucta'oompletod opor' ^ouournanoao^ under Section | - Coverage A,
atinna hazard", and for medical expenses and for all medical expenses caused by
under Coverage C rogapd|aeo of the accidents under Section U - Coverage C.
number of: vvh|oh cannot be attributed only to ongoing
m- Insureds; operations at a single designated construction
b. Claims made or "suits" brought; or project shown in the Schedule above:
I. Any payments made under Coverage /�
o. Persona or organizations making for domugeo or under Coverage C for |
claims or bringing "suits", |
' medical expenses shall reduce the amount
3. Any payments made under Coverage /\ ovm||ab[o under the Gonono| Aggregate
for damages or under Coverage C for Limit or the Produoto'oump|etod Opera-
medical expenses shall ro6uun the Des[g' tiono Aggregate Limit whichever in ap-
nutad Construction Project General 4ggre' pUuab|a, and
CG 25030509 1 Insurance Services Office, Inc- 2008 Page 1 of
2. Such payments shall not reduce any Des- D. If the applicable designated construction proj-
ignated Construction Project General ect has been abandoned, delayed, or aban-
Aggregate Limit. doned and then restarted, or if the authorized
C. When coverage for liability arising out of the contracting parties deviate from plans, blue-
"products-completed operations hazard" is prints, designs, specifications or timetables,
provided, any payments for damages because the project will still be deemed to be the same
of "bodily injury" or "property damage" in- construction project.
eluded in the "products-completed operations E. The provisions of Section III Limits Of In-
hazard" will reduce the Products-completed surance not otherwise modified by this
Operations Aggregate Limit, and not reduce endorsement shall continue to apply as
the General Aggregate 'Limit nor the Desig- stipulated.
nated Construction Project General Aggregate
Limit.
i
Page 2 of 2 1 Insurance Services Office, Inc., 2008 GG 25 03 05 09
COMMERCIAL GENERAL LIABILITY
WNGL490715
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS WHEN
REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU
PRIMARY AND NONCONTRIBUTORY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II —Who Is An Insured is amended to in- B. With respect to the insurance afforded to these ad-
clude as an additional insured any person or or- ditional insureds, the following additional exclusion
ganization for whom you are performing opera- applies:
tions when you and such person or organization This insurance does not apply to:
have agreed in writing in a contract or agreement
that such person or organization be added as an 1. "Bodily injury", "property damage" or "personal
additional insured on your policy. Such person or and advertising injury" arising out of the ren
organization is an additional insured only with re- dering of, or the failure to render, any profes-
spect to liability for "bodily injury", "property darn- sional architectural, engineering or surveying
age" or "personal and advertising injury" caused, services, including:
in whole or in part, by: a. The Pre preparing, approving, or failing to pre-
1. Your acts or omissions; or pare or approve, maps, shop drawings,
2. The acts or omissions of those acting on your opinions, reports, surveys, field orders,
behalf: change orders or drawings and specifica-
tions: or
in the performance of your ongoing operations for h, Supervisory, inspection, architectural or
the additional insured. engineering activities.
A person's or organization's status as an additional This exclusion applies even if the claims
insured under this endorsement ends when your against an additional insured allege negligence
operations for that additional insured are com-
pleted. or other wrongdoing in the supervision, hiring,
employment, training or monitoring of others
However: by that insured, if the "occurrence" which
1. The insurance afforded to such additional in- caused the "bodily injury' or "property dam-
sured only applies to the extent permitted by age", or the offense which caused the "person-
law; and al and advertising injury', involved the render-
ing of or failure to render any professional
2. If coverage provided to the additional insured services by you with respect to your providing
is required by a contract or agreement, the in- engineering, architectural or surveying serv-
surance afforded to such additional insured ices in your capacity as an engineer, architect
will not be broader than that which you are re- or surveyor.
quired by the contract or agreement to provide
for such additional insured.
WN GL 49 07 15 Includes copyrighted material of InsUrance Services Office,Inc., with its permission. Page 1 of 2
2. "Bodily injury" or "property damage" occurring D. The following is added to the Other Insurance
after: Condition and supersedes any provision to the
a. All work, including materials, parts or contrary:
equipment furnished in connection with Primary And Noncontributory Insurance
such work, on the project (other than serv- This insurance is primary to and will not seek
ice, maintenance or repairs) to be per- any contribution from any other insurance
formed by or on behalf of the additional in- available to an additional insured under your
sured(s) at the location of the covered op-
erations has been completed; or policy provided that:
b. That portion of "your work" out of which (1) The additional insured is a Named Insured
the injury or damage arises has been put under such other insurance; and
to its intended use by any person or or- (2) You have agreed in writing in a contract or
ganization other than another contractor or agreement that this insurance would be
subcontractor engaged in performing oper- primary and would not seek contribution
ations for a principal as a part of the same from any other insurance available to the
project. additional insured.
C. With respect to the insurance afforded to these ad-
ditional insureds, the following is added to Section
III—Limits Of Insurance.-
If coverage provided to the additional insured is re-
quired by a contract or agreement, the most we
will pay on behalf of the additional insured is:
1. The minimum amount required by the contract
or agreement: or
2. The Limits of Insurance shown in the Declara-
tions;
whichever is less.
This endorsement shall not increase the applicable
Limits of insurance shown in the Declarations.
WIN GL 49 07 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2
W N CA 27 06 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
BUSINESS AUTO ENHANCEMENT ENDORSEMENT
This endorsement modifies the insurance provided under the following:
BUSINESS AUTO 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 Business Auto Coverage Form identified in this endorsement
will be amended as shown below.
SECTION 11 — COVERED AUTOS LIABILITY g. Any "employee" of yours is an "insured" while
COVERAGE AMENDMENTS operating a covered "auto" hired or rented
under a contract or agreement in the
A. Who Is An Insured "employee's" name, with your permission,
SECTION II — COVERED AUTOS LIABILITY while performing duties related to the conduct
COVERAGE,A. Coverage, 1. Who Is An Insured of your business,
is amended to add: B. Blanket Additional Insured
d. Any legally incorporated subsidiary of yours in SECTION 11 — COVERED AUTOS LIABILITY
which you own more than 50% of the voting COVERAGE, A. Coverage, 1. Who Is An
stork on the effective date of this coverage Insured, paragraph c. is amended to add the
form. following:
However, "insured" does not include any Any person or organization who is required under a
subsidiary of yours that is an "insured" under written contract or agreement between you and
any other automobile liability policy, or would that person or organization, that is signed and
be an "insured" under such policy but for executed by you before the "bodily injury" or
termination of such policy or the exhaustion on .,property darnage" occurs and that is in effect
such policy's limits of insurance. during the policy period, to be named as an
e. Any organization which is newly acquired or additional insured is an "insured" for Liability
formed by you and over which you maintain Coverage, but only for damages to which this
majority ownership. However, coverage under insurance applies and only to the extent that
this provision: persons or organization qualifies as an "insured"
under the Who Is An Insured provision contained in
(1) is afforded only for the first 180 days after Section ll,
you acquire or form the organization or
until the end of the policy period, C. Liability Coverage Extensions —Supplementary
whichever comes first; Payments
(2) does not apply to "bodily injury" or SECTION 11 — COVERED AUTOS LIABILITY
"property damage" that results from an COVERAGE, A. Coverage, 2. Coverage
"accident"that occurred before you formed Extensions, a. Supplementary Payments is
or acquired the organization; amended by replacing subparagraphs (2) and (4)
(3) does not apply to any newly acquired or with the following:
formed organization that is a joint venture (2) Up to $5,000 for cost of bail bonds (including
or partnership; and bonds for related traffic law violations) required
hecause of an"accident"we cover. We do not
(4) does not apply to an 'insured" under any have to furnish these bonds,
other automobile liability policy, or would
be an "insured"under such a policy but for (4) All reasonable expenses incurred by the
termination of such policy or the "insured" at our request, including actual loss
exhaustion of such policy's limits of of earnings up to S500 a day because of time
insurance. off from work.
f. Any "employee" of yours is an "insured" while
using a covered "auto" you don't own, hire or
borrow in your business or your personal
affairs.
WN CA 27 06 16 includes copyrighted material of insurance Services Oftice,Inc.,with its permission. Page 2 Of 5
D. Fellow Employee Coverage D. Glass Repair—Deductible Waiver
SECTION II — COVERED AUTOS LIABILITY SECTION III — PHYSICAL DAMAGE
COVERAGE, B. Exclusions, S. Fellow COVERAGE, A. Coverage, 3. Glass Breakage—
Employee,the following is added: Hitting A Bird Or Animal — Falling Objects Or
Co-Employee Lawsuit Defense Cost Missiles, is amended by adding the following:
Reimbursement No deductible will apply to glass breakage if such
glass is repaired, in a manner acceptable to us,
If a suit seeking damages for "bodily injury'to any rather than replaced.
fellow "employee' of the "insured" arising out of
and in the course of the fellow "employee's" E. Hired Auto Physical Damage
employment or while performing duties related to
the conduct of your business, or a suit seeking SECTION III — PHYSICAL DAMAGE
damages brought by the spouse, child, parent, COVERAGE, A. Coverage is amended by adding
brother or sister of that fellow "employee", is the following:
brought against you, we will reimburse reasonable 5. Hired Auto Physical Damage
costs that you incur in the defense of such
matters. Any reimbursement made pursuant to If hired "autos"are covered"autos"for Liability
this sub-section will be in addition to the limits of Coverage and if Comprehensive. Specified
liability set forth in the Declarations. Causes of Loss, or Collision coverages are
provided under this coverage form for any
SECTION III — PHYSICAL DAMAGE COVERAGE "auto" you own. then the Physical Damage
AMENDMENTS Coverages provided are extended to "autos"
you hire of like kind and use, subject to the
A. Transportation Expense—Limits Amended following:
SECTION III — PHYSICAL DAMAGE a. The most we will pay for any one "loss" is
COVERAGE, A. Coverage, 4. Coverage S50,000 or the actual cash value Or cost to
Extensions, a. Transportation Expenses is repair or replace, whichever is less, minus
amended by replacing S20 per day/$600 maximum a deductible;
limit with$50 per day/$1000 maximum. b. The deductible will be equal to the largest
deductible applicable to any owned "auto"
B. Hired Auto Physical Damage — Loss Of Use for that coverage. Any Comprehensive
Expenses—Limits Amended deductible does not apply to "loss"caused
SECTION III — PHYSICAL DAMAGE by fire or lightening;
COVERAGE, A. Coverage, 4. Coverage c. Hired Auto Physical Damage coverage is
Extensions, b. Loss of Use Expenses is excess over any other collectible
amended by replacing the $20 per day/$600 insurance; and
maximum limit with $50 per day/$750 maximum
limit. d. Subject to the above limit, deductible and
excess provisions we will provide
C. Personal Effects Coverage coverage equal to the broadest coverage
SECTION III — PHYSICAL DAMAGE applicable to any covered"auto"you own.
COVERAGE, A. Coverage, 4. Coverage If a limit for Hired Auto Physical Damage is
Extensions is amended by adding the following: indicated in the Declarations, then that limit
replaces, and is not added to, the $50,000 limit
c. Personal Effects indicated above.
We will pay up to $500 for "loss" to personal
effects,which are:
(1) Owned by an"insured"; and
(2) In or on your covered"auto"
This coverage applies only in the event of the total
theft of your covered "auto." No deductible applies
to this coverage
WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, Inc.,wrih its permission. Page 3 of 5
F. Rental Reimbursement G. Accidental Airbag Deployment Coverage
SECTION III—PHYSICAL DAMAGE COVERAGE SECTION III — PHYSICAL DAMAGE
A.Coverage, is amended by adding the following: COVERAGE, A. Coverage is amended by adding
6. Rental Reimbursement the following:
This coverage applies only to a covered "auto" 7. Accidental Airbag Deployment Coverage
of the private passenger or light truck type as We will pay to reset or replace factory installed
follows: airbag(s) in any covered "auto" for accidental
a. We will pay for rental reimbursement discharge, other than discharge due to a
expenses incurred by you for the rental of collision loss.
a private passenger or light truck type This coverage is applicable only if
"auto" because of "loss" to a covered comprehensive coverage applies to the
private passenger or light truck type covered"auto".
"auto". Payment applies in addition to the
otherwise applicable amount of each This coverage is excess over any other
coverage you have on a covered private collectible insurance or reimbursement by
passenger or light truck type "auto." No manufacturer's warranty.
deductibles apply to this coverage.
H. Auto Loan/Lease Gap Coverage
b. We will pay only for those expenses SECTION 111 PHYSICAL DAMAGE COVERAGE
incurred during the policy period beginning
24 hours after the "loss" and ending, Item A., Coverage, is amended by adding the
regardless of the policy's expiration, with following:
the lesser of the following number of days: g_ Auto Loan/Lease Gap Coverage
(1) The number of days reasonably This coverage applies only to a covered "auto
required to repair or replace the described or designated in the Schedule or in
covered private passenger or light the Declarations as including physical damage
truck type "auto". If "loss" is caused coverage,
by theft, this number of days is added
to the number of days it takes to In the event of a covered total "loss" to a
locate the covered private passenger covered "auto" described or designated in the
or light truck type "auto' and return it Schedule or in the Declarations, we will pay
to you;or any unpaid amount due on the lease or loan
(2) 30 days for a covered"auto"less:
c. Our payment is limited to the lesser of the a. The amount paid under the Physical
following amounts: Damage Coverage Section on the policy;
and
(1) Necessary and actual expenses
incurred, or b. Any:
(2) $50 per day, up to a maximum of (1) Overdue lease/loan payments at the
$1,000. time of the"loss";
d. This coverage does not apply while there (2) Financial penalties imposed under a
are spare or reserve private passenger or lease for excessive use, abnormal
light truck type"autos"available to you for wear and tear or high mileage;
your operations. (3) Security deposits not returned by the
e. If "loss" results from the total theft of a lessor;
covered"auto" of the private passenger or Costs for extended warranties, Credit(4)
light truck type, we will pay under this Life Insurance, Health. Accident or
coverage only that amount of your rental Life I it Insurancepurchased with
reimbursement expenses which is not y
already provided for under SECTION III — the loan or lease;and
PHYSICAL DAMAGE COVERAGE, A. (5) Carry-over balances from previous
Coverage,4.Coverage Extensions. loans or leases.
For the purposes of this Rental
Reimbursement coverage, light truck is
defined as a truck with a gross vehicle weight
of 10,000 lbs. or less as defined by the
manufacturer as the maximum loaded weight
the auto is designed to carry,
WN CA 27 06 16 includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 4 of 5
SECTION IV — BUSINESS AUTO CONDITIONS C. Unintentional Failure to Disclose Hazards
AMENDMENTS
SECTION IV — BUSINESS AUTO CONDITIONS,
A. Duties In The Event Of Accident, Claim, Suit Or B. General Conditions, 2. Concealment.
Loss Amended Misrepresentation Or Fraud, is amended by
SECTION IV — BUSINESS AUTO CONDITIONS, adding the following paragraph:
A. Loss Conditions, 2. Duties In The Event Of If you unintentionally fail to disclose any hazards
Accident,Claim, Suit Or Loss, a. is amended by existing at the inception date of the policy, or
adding the following: during the policy period in connection with any
This condition applies only when the "accident" or additional hazards, we will not deny coverage
"loss"is known to: under this Coverage Part because of such failure.
(1) You, if you are an individual; D. Employee Hired Auto
(2) A partner, if you are a partnership; SECTION IV — BUSINESS AUTO CONDITIONS,
B. General Conditions, 5. Other Insurance,
(3) An executive officer or insurance manager, if paragraph b. is deleted and replace by the
you are a corporation;or following:
(4) A member or manager, if you are a limited b. For Hired Auto Physical Damage Coverage,
liability company. the following are deemed to be a covered
"aUtos"you own:
But, this section does riot amend the provisions
relating to notification of police, protection or (1) Any covered "auto"you lease, hire, rent or
examination of the property which was subject to borrow.
the"loss".
(2) Any covered"auto" hired or rented by your
B. Blanket Waiver of Subrogation "employee" under a contract in that
individual "employee's" name, with ynrrr
Section IV— BUSINESS AUTO CONDITIONS, A. permission,while performing duties related
Loss Conditions, 5. Transfer of Rights of to the conduct of your business.
Recovery Against Others to Us, is amended by
adding the following exception: However, any "auto" that is leased, hired,
rented or borrowed with a driver is not a
However, we waive any right of recovery we may covered"auto".
have against any person or organization to the
extent required of you by a written contract signed
and executed prior to any "accident" or "loss",
provided that the "accident" or "loss" arises out of
operations contemplated by such contract. The
waiver applies only to the person or organization
designated in such contract.
WN CA 27 06 16 Includes copyrighted material of Insurance Services office,Inc., with its permission. Page 5 of 5
Policy No. CPP101969011
COMMERCIAL GENERAL LIABILITY
WN GL 84 07 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS -
AUTOMATIC STATUS WHEN REQUIRED IN
CONSTRUCTION AGREEMENT WITH YOU
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II —Who Is An Insured is amended to in- a. The preparing, approving, or failing to pre-
clude the following: pare or approve, maps, shop drawings,
opinions, reports, surveys, field orders,
Any person(s) or organizations(s) for whom you change orders or drawings and specifica-
have performed operations is also an additional tions; or
insured, if you and such person(s) or
organization(s) have agreed in writing in a contract b. Supervisory, inspection, architectural or
or agreement that such person(s) or engineering activities.
organization(s) be added as an additional insured
on your policy for completed operations. Such This exclusion applies even if the claims
person(s) or organization(s) is an additional in- against an additional insured allege negligence
sured only with respect to liability for"bodily injury" or other wrongdoing in the supervision, hiring,
or "property damage" caused, in whole or part, by employment, training or monitoring of others
"your work" at the location specified in the written by that insured, if the "occurrence" which
contract or agreement and included in the "prod- caused the "bodily injury" or "property dam-
ucts-completed operations hazard". age", or the offense which caused the "person-
al and advertising injury', involved the render-
However, the insurance afforded to such additional ing of or failure to render any professional
insured: services by you with respect to your providing
engineering, architectural or surveying serv-
1. Only applies to the extent permitted by law; ices in your capacity as an engineer, architect
and or surveyor.
2. Will not be broader than that which you are re- 2. "Bodily injury" or "property damage" that oc-
quired by the contract or agreement to provide curs prior to the execution of, or subsequent to
for such additional insured. the expiration of, the contract or agreement in
which you agreed that such person(s) or or-
B. With respect to the insurance afforded to these ad- ganization(s) be added as an additional in-
ditional insureds, the following additional exclu- sured.
sions apply:
This insurance does not apply to:
1. "Bodily injury", "property damage" or "personal
and advertising injury" arising out of the ren-
dering of, or the failure to render, any profes-
sional architectural, engineering or surveying
services, including:
WN GL 84 07 15 Includes copyrighted material of Insurance Services Office, Inc- with its permission. Page 1 of 2
C. With respect to the insurance afforded to these 1. The minimum amount required by the con-
additional insureds, the following is added to tract or agreement; or
Section III—Limits Of Insurance: 2. The Limits of Insurance shown in the Decla-
rations;
If coverage provided to the additional insured is
required by a contract or agreement, the most we whichever is less.
will pay on behalf of the additional insured is: This endorsement shall not increase the applica-
ble Limits of Insurance shown in the Declara-
tions.
WN GL 84 07 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2