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CAG2020-006 - Change Order - #1 - Nature's Way Tree Service, LLC - Tree Removal at Multiple Locations - 01/29/2020
Agreement Routing Form For Approvals,Signatures and Records Management This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms. K EN T w A S H I N G T o N (Print on pink or cherry colored paper) Originator: Department: Nancy Yoshitake for Joe Codiga Public Works Date Sent: Date Required: > 1/30/20 2/4/20 0 L �. Authorized to Sign: Date of Council Approval: 0 Director or Designee ❑ Mayor N/A Q Budget Account Number: Grant? ❑Yes 0 No 67005530.64119.7460 Budget? 0 Yes ❑ No Type: Vendor Name: Category: Nature's Way Tree Service, LLC Contract Vendor Number: Sub-Category: = 218589 Change Order 0 Project Name: Tree Removal E L 0 Project Details Remove trees at 21734 123rd Ave. SE. c a� E Agreement Amount: $2,200 Basis for Selection of Contractor: Bid Start Date: 1/29/20 Termination Date: 3/6/20 tM a Local Business? ❑Yes ❑ No* *If meets requirements per KCC3.70.100,please complete"Vendor Purchase-Local Exceptions"form on Cityspace. Notice required prior to disclosure? Contract Number: ❑Yes ❑No CA p 2�0 2_0 OO Co Date Received by City Attorney: Comments: C r 3 3 0 aIA •� i G! � tM Date Routed to the Mayor's Office: v1 Date Routed to the City Clerk's Office: 8c¢w22313_20 Visit Documents.KentWA.gov to obtain copies of all agreements • KENT WAS H I N G T G N CHANGE ORDER NO. 1 NAME OF CONTRACTOR: Nature's Way Tree Service, LLC ('Contractor") CONTRACT NAME & PROJECT NUMBER: Tree Removal ORIGINAL CONTRACT DATE: January 6, 2020 This Change Order amends the above-referenced contract; all other provisions of the contract that are not inconsistent with this Change Order shall remain in effect. For valuable consideration and by mutual consent of the parties, the project contract is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, Contractor shall provide all labor, materials, and equipment necessary to: Remove two Cottonwood trees and three dead Alder trees at 21734 123rd Avenue SE. For a description, see the Contractor's estimate which is attached as Exhibit A and incorporated by this reference. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are hereby modified as follows: Original Contract Sum, $1,334,50 (including applicable alternates and WSST) Net Change by Previous Change Orders $0 (incl. applicable WSST) Current Contract Amount $1,334.50 (incl. Previous Change Orders) Current Change Order $2,200.00 Applicable WSST Tax on this Change $220.00 Order Revised Contract Sum $3,754.50 CHANGE ORDER - 1 OF 3 Original Time for Completion 2/5/20 (insert date) Revised Time for Completion under n/a prior Change Orders (insert date) Days Required (f) for this Change 30 calendar days Order Revised Time for Completion 3/6/20 (insert date) Pursuant to the above-referenced contract, Contractor agrees to waive any protest it may have regarding this Change Order and acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Change Order, unless otherwise provided, does not relieve the Contractor from strict compliance with the guarantee and warranty provisions of the original contract, particularly those pertaining to substantial completion date. All acts consistent with the authority of the Agreement, previous Change Orders (if any), and this Change Order, prior to the effective date of this Change Order, are hereby ratified and affirmed, and the terms of the Agreement, previous Change Orders (if any), and this Change Order shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this contract modification, which is binding on the parties of this contract. 3. The Contractor will adjust the amount of its performance bond (if any) for this project to be consistent with the revised contract sum shown in section 2, above. IN WITNESS, the parties below have executed this Agreement, which will become effective on the last date written below. CONTRACTOR: CITY OF KENT: By: (signature) (signature) Print Name: Print Name: David A. Brock P.E. Its C) Its DeiDuty Director Operations Manager (title) (title) DATE: l _ ZLi zc zC`� DATE: / 2 Za CHANGE ORDER - 2 OF 3 ATTEST: APPROVED AS TO FORM: I&iL (applicable if Mayor's signature required) Kent City Clerk Kent Law Department Nature's Way Tree Sery-Tree Removal(46"Ave,145`"Ct,145"Ave,+123'Ave)CO 1/Codiga CHANGE ORDER - 3 OF 3 EXHIBIT A Natur 's Way Tree Service LLC } 5 -740 466 Natureswaytreeservice.com Estimate Customer information Date i Service's V-cytiV�-i �.\� ?K;'.,^•:,„;..^G--:..� 'y�.(.3 �'i l..P.%cam+ t LxJM. 1J•fit L^+. ,-•. \_/1/"C= Q..n.. �y, i Sub Total 2 z Tax ` t Payment is due at time of project completion. Payments received after 10 calendar clays will be charged a penalty of 2%per day compounding until paid in full, Contractor # NATURW*T923Z Certified Arborist# PN-6448A _. A "" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YVYY) 04/15/2019 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 endorsements. PRODUCER NCONT AM . Don Young Young Insurance Agency, LLC PHONE (253)333 2426 FAx AC No): (253)333-2431 415 1st Street NE Suite A E-MAIL don oun ins.net ADDRESS: @y g INSURERS AFFORDING COVERAGE NAIC# Auburn WA 98002 INSURER A: Wesco Insurance Company INSURED INSURER B Nature's Way Tree Service, LLC INSURER C 1019 184th Avenue Ct E INSURER D: INSURER E: Lake Ta rn ns WA 98391 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 ADDL SUBR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP MM/DD/VYYY MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE a - EACHOCCURRENCE $ 1,000,000 OCCUR PREMISES(Ea occur ence) $ 100,000 MED EXP(An one person) $ 5,000 A X WPP114355305 04/07/2019 04/07/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY❑ PRO ❑ GENERAL AGGREGATE $ 2,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 X OTHER: WA Slate Stop Gap a $ 1,000,000 I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ OWNED SCHEDULED ANY AUTO Ea accident BODILY INJURY(Per person) $ AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ P r Accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY PER ER OTH- V/N STATUTE ANV PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N!A E.L.EACH ACCIDENT $ . (Mandatory in NH) II yes,describe under E.L.DISEASE-EA EMPLOYE $ DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) The City of Kent is listed as additional insured on the General Liability policy per CG2010 attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Kent 499 West Gowe St AUTHORIZED REPRESENTATIVE Kent WA 98032 Pna of k+z;-" ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 'ACR CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/15/2019 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 Liberty Mutual Insurance CONTACT NAME PO Box 188065 PHONE FAX Fairfield, OH 45018 A/C No Ext: 800-962-7132 A/c No), 800-845-3666 AAIL DDRESS: BusinessService@LibertyMutual.com INSURERS AFFORDING COVERAGE NAIC k INSURER A: West American Insurance Company 44393 INSURED Nature's Way Tree Services LLC INSURER B 1019 184th Avenue Ct E INSURER C Lake Tapps WA 98391 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 48148761 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYVY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAUr I UHENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 11 PRO- El LOC PRODUCTS-COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY BAW56527308 3/14/2019 3/14/2020 EOMaBICNdEeDtSINGLE LIMIT $1 000 000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE J JER ;ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ElN/A EL EACH ACCIDENT $ (Mandatory in NH)If E.L.DISEASE-EA EMPLOYEE $ yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Certificate Holder is listed as Additional Insured per form CA2048. CERTIFICATE HOLDER CANCELLATION Zof Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE W Gowe THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Kent, WA 98032 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE e Adrienne Zolicoffer ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 48148761 1 56527308 1 19-20 Master Certificate I Adrienne Zolicoffer 1 4/15/2019 4:44:17 PM (CDT) I Page 1 of 2 POLICY NUMBER:WPP1143553 05 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations City of Kent 499 West Gowe Street, Kent, WA 98032 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage" occurring after: caused, in whole or in part, by. 1. Your acts or omissions; or 1. All work, including materials, parts or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the 1. The insurance afforded to such additional injury or damage arises has been put to its intended use by any person or organization insured only applies to the extent permitted by law; and other than another contractor or subcontractor engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III —Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 20 48 02 99 DESIGNATED INSURED ENDORSEMENT The endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement identifies person(s)or organization(s)who are"insureds"under the WHO IS AN INSURED provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective Policy Number BAW56527308 Named Insured Nature's Way Tree Services LLC Countersi ned b (Authorized Representative) SCHEDULE Name of Person(s)or Organizations) The City of Kent 499 W Gowe Kent, WA 98032 (If no entry appears above, information required to complete this endorsement will be shown in the Dec- larations as applicable to this endorsement.) Each person or organization shown in the Schedule is an"insured" for LIABILITY COVERAGE, but only to the extent that person or organization qualifies as an "insured" under the WHO IS AN INSURED provision contained in SECTION II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc„ 1998 Page 1 of 1 48148761 156527308 1 19-20 Master Certificate I Adrienne Z01ic0ffer 14/15/2019 4:44:17 PM (CDT) I Page 2 of 2