HomeMy WebLinkAboutCAG2020-103 - Original - GeoEngineers, Inc. - Midway Creek Bridge Abutment - 03/26/2020Agreement Routing Form
KENT For Approvals, Signatures and Records Management
This form combines & replaces the Request for Mayor's Signature and Contract Cover Sheet forms.
(Print on pink or cherry colored paper)WaSHTNGToN
f
oLcc
Originator:
Nancy Yoshitake for Mark Madfai
Department:
Public Works
Date Sent:
3t26t20
Date Required
3t30t20
Authorized to Sign:
E Director or Designee E Mayor
Date of Council Approval
N/A
Budget Account Number:
Budget? EYes ENo
Grant? EYes E No
Type
tro
IHo
ELorF
E
iPtro
Eogt-trl
Vendor Name:
GeoEngineers, lnc.
Category:
Contract
Vendor Number:
33039
Sub-Category:
Project trtame: Midway Creek Bridge Abutment Restoration
Project Details:Provide visual geotechnical evaluation for the project
Agreement Amount: $9,906
Start Date: 3126120
Basis for Selection of Contractor:
Termination Date: 12131120
Local Business? EYes El No*
*lf meets requirements per KCC3.70.100, please complete "Vendor Purchase-Local Exceptions" form on Aryspace.
Notice required prior to disclosure?
EYes E No
Contract Number:
cvYa70-t0a
oltr
{:,f\ro
=E5\i-v I,l-t s,o=c,8
Gctrl
th
Date Received by City Attorney:Comments:
Date Routed to the Mayor's Office:
Date Routed to the City Clerk's Office:
adc(W22l7l I 20 Visit Documents.KentwA.gov to obtain copies of all agreements
KENT
WASHTNGToN
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
GeoEngineers, Inc.
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and GeoEngineers, Inc. organized under the laws of the State of Washington,
located and doing business at 1101 S. Fawcett Ave., Suite 200, Tacoma, WA 98402, Phone: (253) 383-
4940, Contact: Lyle Stone (hereinafter the "Consultant").
I.DESCRIPTION OF WORK.
Consultant shall perform the following services for the City in accordance with the following
described plans and/or specifications:
The Consultant shall provide a visual geotechnical evaluation for the Midway Creek Bridge
Abutment Restoration Project. For a description, see the Consultant's Scope of Work which
is attached as Exhibit A and incorporated by this reference.
Consultant further represents that the services furnished under this Agreement will be performed in
accordance with generally accepted professional practices within the Puget Sound region in effect at the
time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in
Section I above immediately upon the effective date of this Agreement. Consultant shall complete the
work described in Section I by December 31, 2O2O.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed
Nine Thousand, Nine Hundred Six Dollars ($9,906), for the services described in this
Agreement. This is the maximum amount to be paid under this Agreement for the work
described in Section I above, and shall not be exceeded without the prior written
authorization of the City in the form of a negotiated and executed amendment to this
agreement. The Consultant agrees that the hourly or flat rate charged by it for its services
contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1)
year from the effective date of this Agreement. The Consultant's billing rates shall be as
delineated in Exhibit B.
B. The Consultant shall submit monthly payment invoices to the City for work performed, and
a final bill upon completion of all services described in this Agreement. The City shall
provide payment within forty-five (45) days of receipt of an invoice. If the City objects to
all or any portion of an invoice, it shall notify the Consultant and reserves the option to only
pay that portion of the invoice not in dispute. In that event, the parties will immediately
make every effort to settle the disputed portion.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in
accordance with Ch. 51.08 RCW, the parties make the following representations:
CONSULTANT SERVICES AGREEMENT - 1
($20,000 or Less)
The Consultant has the ability to control and direct the performance and details of its
work, the City being interested only in the results obtained under this Agreement.
The Consultant maintains and pays for its own place of business from which
Consultant's seryices under this Agreement will be performed.
The Consultant has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed before the City
retained Consultant's services, or the Consultant is engaged in an independently
established trade, occupation, profession, or business of the same nature as that
involved under this Agreement.
The Consultant is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, including the Internal
Revenue Service and the state Department of Revenue.
The Consultant has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by Consultant's
business, and has obtained a Unified Business Identifier (UBI) number from the
State of Washington.
F The Consultant maintains a set of books dedicated to the expenses and earnings of
its business.
V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party thirty (30) days written notice at its address set forth on the signature block of
this Agreement. After termination, the City may take possession of all records and data within the
Consultant's possession pertaining to this project, which may be used by the City without restriction. If
the City's use of Consultant's records or data is not related to this project, it shall be without liability or
legal exposure to the Consultant.
VI. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the
Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation,
national origin, or the presence of any sensory, mental, or physical disability, discriminate against any
person who is qualified and available to perform the work to which the employment relates, Consultant
shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with
City Administrative Policy t.2, and upon completion of the contract work, file the attached Compliance
Statement.
VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its officers,
officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or
suits, including all legal costs and attorney fees, arising out of or in connection with the Consultant's
performance of this Agreement, except for that portion of the injuries and damages caused by the City's
negligence.
The City's inspection or acceptance of any of Consultant's work when completed shall not be
grounds to avoid any of these covenants of indemnification,
Should a court of competent jurisdiction determine that this Agreement is subject to RCW
4.24.I15, then, in the event of liability for damages arising out of bodily injury to persons or damages to
property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers,
officials, employees, agents and volunteers, the Consultant's duty to defend, indemnify, and hold the City
harmless, and Consultant's liability accruing from that obligation shall be only to the extent of the
Consultant's negligence.
CONSULTANT SERVICES AGREEMENT - 2
($20,000 or Less)
A
B,
c.
D
E
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL
INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES
FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER.
In the event Consultant refuses tender of defense in any suit or any claim, if that tender was made
pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having
jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant's part, then
Consultant shall pay all the City's costs for defense, including all reasonable expert witness fees and
reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful
refusal on the Consultant's part.
The provisions of this section shall survive the expiration or termination of this Agreement.
VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit C attached and incorporated by
this reference.
IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide
reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the
work under this Agreement.
X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings,
designs, reports, or any other records developed or created under this Agreement shall belong to and
become the property of the City. All records submitted by the City to the Consultant will be safeguarded
by the Consultant. Consultant shall make such data, documents, and files available to the City upon the
City's request. The Consultant acknowledges that the City is a public agency subject to the Public Records
Act codified in Chapter 42.56 of the Revised Code of Washington. As such, the Consultant agrees to
cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act.
The City's use or reuse of any of the documents, data, and files created by Consultant for this project by
anyone other than Consultant on any other project shall be without liability or legal exposure to
Consultant.
XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor
with the authority to control and direct the performance and details of the work authorized under this
Agreement, the work must meet the approval of the City and shall be subject to the City's general right of
inspection to secure satisfactory completion.
XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary
precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the
performance of the contract work and shall utilize all protection necessary for that purpose. All work shall
be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to
materials, tools, or other articles used or held for use in connection with the work.
XIII. MISCELLANEOUS PROVISIONS.
A. Recvclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price
preference may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this
Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those
covenants, agreements or options, and the same shall be and remain in full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any
dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means
CONSULTANT SERVICES AGREEMENT - 3
($20,000 or Less)
of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules
and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred
in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or
award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section VII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at
the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written
notice hereunder shall become effective three (3) business days after the date of mailing by registered or
certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this
Agreement or such other address as may be hereafter specified in writing.
E, Assignment. Any assignment of this Agreement by either party without the written consent
of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment,
the terms of this Agreement shall continue in full force and effect and no further assignment shall be
made without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of the City
and Consultant.
G. Entire Aoreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative
of the City, and such statements shall not be effective or be construed as entering into or forming a part
of or altering in any manner this Agreement. All of the above documents are hereby made a part of this
Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any
language contained in this Agreement, the terms of this Agreement shall prevail.
H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable to
Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or
accruing out of the performance of those operations.
I. Public Records Act. The Consultant acknowledges that the City is a public agency subject to
the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents,
notes, emails, and other records prepared or gathered by the Consultant in its performance of this
Agreement may be subject to public review and disclosure, even if those records are not produced to or
possessed by the City of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying
the City's duties and obligations under the Public Records Act.
J. City Business License Required. Prior to commencing the tasks described in Section I,
Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of
the Kent City Code.
//
//
//
t/
/t
/t
CONSULTANT SERVICES AGREEMENT - 4
($20,000 or Less)
K. Counteroarts and Signatures by Fax _oJ: Emall. 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 dellver 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.
6eo€nginee6 - Midway creeklM.dfbl
CONSULTANT SERVICES AGREEMENT . 5
($2A,000 ar Less)
CONSULTANT:
By
Print Name
(signature)
: Lrilc- I'r^,u
Its
j (tttte)
DATE
CITY KENT:
Print Name:
Its:
Tim J. LaPorte, P.E.
Public Works Director
March 26,2O2O
DATE:
NOTICES TO BE SENT TO:
Lyle Stone
GeoEngineers, Inc.
1101 S. Fawcett Ave., Suite 200
Tacoma, WA 98402
(2s3) 383-4940 (telephone)
facsimile
CONSULTANT:
NOTICES TO BE SENT TO:
Timothy J. LaPorte, P.E.
City of Kent
220 Fourth Avenue South
Kent, WA 98032
(253) 856-s500 (telephone)
CITY OF KENT:
00 mlle
ATT
Clerk
DECLARATION
crTY oF KENT EQUAL EMPLOYMENT OPPORTUNTW pOLrCy
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who pedorm 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.
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.
During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
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 a ree to fulfill the five requirements referenced above
By:
For:
Title
C-*zt nntil*'Q.1
tl{*-.-.*'fr
Date
3
4
5
EEO COMPLIANCE DOCUMENTS - 1
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: L.2 EFFECTIVE DATE: January 1, 1998
SUBJECT:MINORIW AND WOMEN
CONTRACTORS
I/
SUPERSEDES: April 1, 1996
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 COMPTETION of this project by the Contractor awarded the
Agreement.
I,theundersigned,adulyrepresentedagentof
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as
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 L.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
By
For:
Title:
Date:
that was entered into on
EEO COMPLIANCE DOCUMENTS . 3
GeoErucrN rr^yQ
1101 South Fawcett Avenue, Suite 200
Tacoma, Washington 98402
253.383,4940
EXHIBIT A
SCOPE OF SERVICES
CIWOF KENT
NORTH FRAGER ROAD BRIDGE GEOTECHNICAL ASSESSMENT
KENT, WASHINGTON
MARCH L3",,2A2O
FtLE NO. 0410-2L5-00
INTRODUCTION
The purpose of this project is to provide a visual geotechnical evaluation of the existing foundations,
abutments and embar'tkment slopes of the North Frager Road Bridge over Midway Creek. We understand
that movement of the embankment slopes Eld>lettlement of soll around the existlng timber pile
foundatlons and b-elow the abutments of the b{dejfas been observed. The project site is located on the
Frager Road tratts6ffirof Veterans Drive in Kentt-Wasnington. Our understanding of the project is based
on our conversations with City of Kent (City) Engineers and information provided, including photos of the
exjsting bridge and a structural bridge inspection report prepared by Shearer Design dated February 28,
2020.
As requested, we have prepared a scope and budget estlmate for performing a geotechnical evaluation of
the slopes around the bridge, assessing the current risk of slope movements impacting the structure and
developing alternatives to mitigate or repair the observed slope movement. Our scope of services is
described in the section below.
SCOPE OF SERVICES
t. Review the structural bridge inspection report, original bridge design plans ancl our relevant in-house
files for existing geotechnical information in the project vicinity.
2. Complete a visual reconnaissance of the site to assessthe slope surroundingthe bridge and document
the observed slope conditions.
3. Provide our opinion on the current stability of the approach embankment. We will inform the City if we
believe there is any concern for near term instability or rapid deterioration of the current stability.
4. Provide an alternatives analysis to evaluate posslble repalr alternat{rP, the slopes surrounding the
bridge. We will develop aiternatives for both 'short-term" and "long-t6im" repairs.
5. Prepare an alternatives analysis report. The repoft will include a summary of our site reconnaissance
and a discussion of the difierent repair alternatlves evalualed.
BEl.:US:mce
Attachment:
Exhibit B Fee Estimate
D lscla lmer: Any electronlc form, facsimlle or ha rd co py 0l the oriSina I doc{rnent (email, text, table, andlor figure}, if prcvided, and a ny attachments are only a copy
of the orignal docuntent^ The qriginal documcnt is storod by GeoEngineers, lnc. and will serue as the officlal document 0f rccord.'"'"'"GeoEn INEERO
Flle No.0410-215{0
Match 1-1",2O2O
EXHIBIT B
FEE ESTIMATE
CITY OF KENT
GEOTECHN ICAL ENGINEERI NG SERVICES
North Frager Road Bridge Geotechnical Assessment
KENT, WASHINGTON
FtLE NO.0410-215-00
Personnel Hours X Rate Cost
Associate Geotechnical Engineer (Lyle Stone)
Project Engineer 2 (Brelt Larabee)
Staff Engineer 2 (Various)
Suppoft (Various)
8.0
30.0
!2.O
4.O
X
X
X
x
$240
$190
$742
$108
$1,920
$5,700
$7,704
$432
Subtotal Personnel Cost (direct costs)$9,756
0ther Expenses
Reproduction, Mileage, other Expenses $150
Subtotal (indirect costs)$15o
Total Estimated Costs $9,906
Page I of I GsoENcr NEe*,tg
Midway Creek Bridge Abutment Restoration/ Consultant Selection
Type of Services: Geotechnical Engineering
The firms listed below are members of the MRSC Rosters. Evaluate each firm's
summary and website, and rate each of them using the criteria below, The firm
receiving the highest total score will be selected to prepare the recommendations
report for the abutment restoration for the this project.
Rating based onl
Category 1 - Firm qualifications (5 pts)
Category 2 - Responsiveness on previous projects (5 pts max)
Category 3 - Experience with steep slopes and valley soils (L0 pts max)
Category 4 - Qualifications of key personnel (10 pts max)
Firms Mark Madfai Susanne
Smith Joe Araucto Total Score
GeoEngineers Inc.28.5 29.5 29.5 87.5
HWA Geosciences Inc 26 26.5 28,5 8'l
Shannon & Wilson, Inc.24 27.5 28 79.5
Mark Madfai Category 1
{5pts)
Category 2
(spts)
Category 3
(10pts)
Category 4
{1opts)Total
GeoEngineers Inc.5 5 9 9.5 28.s
HWA GeoSciences Inc,5 4 B 9 26
Shannon & Wilson, Inc.4 4 I 8 24
Susanne Smith Category 1
(5pts)
Category 2
{5pts)
Category 3
(1opts)
Category 4
{10pts)Total
GeoEnqineers Inc 5 5 10 9.5 29.s
HWA Geosciences Inc.5 4 8.5 9 26.5
Shannon & Wilson, inc 5 5 8.5 9 27.s
.loe Araucto Category 1
(5pts)
Category 2
{5pts}
Category 3
(10pts)
Category 4
(L0pts)Total
GeoEngineers Inc.5 5 9.5 10 29.5
HWA GeoSciences Inc 5 5 9 9,5 28.5
Shannon & Wilson, Inc.5 4.5 8.5 10 28
EXHIBIT C
INSURANCE REQUIREMENTS FOR
CONSULTANT SERVICES AGREEM ENTS
fnsurance
The Consultant shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Consultant, their agents, representatives, employees or
subcontractors,
A. Minimum Scope of Insurance
Consultant shall obtain insurance of the types described below:
1. Automobile Liability insurance covering all owned, non-owned,
hired and leased vehicles, Coverage shall be written on Insurance
Services Office (ISO) form CA 00 01 or a substitute form providing
equivalent liability coverage. If necessary, the policy shall be
endorsed to provide contractual liability coverage.
2. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability arising from
prem ises, operations, independent co ntractors, prod ucts-com pleted
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 Consultant's Commercial General
Liability insurance policy with respect to the work performed for the
City using ISO additional insured endorsement CG 20 10 11 85 or a
substitute endorsement providing equivalent coverage.
3. Workers'Compensation coverage as required by the Industrial
Insurance laws of the State of Washington.
4, Professional Liability insurance appropriate to the Consultant's
profession.
B. Minimum Amounts of Insurance
Consultant shall maintain the following insurance limits:
1 Automobile Liabilitv insurance with a minimum combined single
limit for bodily injury and property damage of 91,000,000 per
accident.
2. Commercial General Liabilitv insurance shall be written with limits
no less than $3,000,000 each occurrence, $3,000,000 general
aggregate.
c.
EXHIBIT C (Continued)
3. Professional Liability insurance shall be written with limits no less
than $3,000,000 per claim and $3,000,000 policy aggregate limit.
Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
insurance:
1. The Consultant's insurance coverage shall be primary insurance as
respect the City. Any Insurance, self-insurance, or insurance pool
coverage maintained by the City shall be excess of the Consultant's
insurance and shall not contribute with it.
2, The Consultant's insurance shall be endorsed to state that coverage
shall not be cancelled by either party, except after thirty (30) days
prior written notice by certified mail, return receipt requested, has
been given to the City.
3. The City of Kent shall be named as an additional insured on all
policies (except Professional Liability) as respects work performed
by or on behalf of the Consultant and a copy of the endorsement
naming the City as additional insured shall be attached to the
Certificate of Insurance. The City reserves the right to receive a
certified copy of all required insurance policies. The Consultant's
Commercial General Liability insurance shall also contain a clause
stating that coverage shall apply separately to each insured against
whom claim is made or suit is brought, except with respects to the
limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than A:VIL
E. Verification of Coverage
Consultant shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Consultant before commencement of the work.
F. Subcontractors
Consultant shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Consultant.
Glient#:326119 GEOENINC2
ACORD,. CERTIFICATE OF LIABILITY INSURANCE
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
DATE (MM'OD/YYYYI
3t25t2020
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 TNSURANCE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE |SSUING TNSURER(S), AUTHORTZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lf the certificate holder is an ADDITIONAL INSUREO, the policy(ies) must have ADDITIONAL INSURED provisions or be endorced.
lf SUBROGATION lS WAIVED, subiect to the torms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
USI lnsurance Services NW PR
601 Union Street, Suite 1000
Seattle, WA 98101
fiNilil"' Tracy Taylor
Ii{}8.Nr,rEo. e,tr, 206 441-6300 610-362-8530
.com
INSURERTSI AFFORDING COVERAGE NAIC f
tNsuRER A ' Continental lnsurance Gompany 35289
INSURED
GeoEngineerc, lnc.
17425 NE Union HillRoad, Suite 250
Redmond, WA 98052
;N5URER B: Travelers Property Cas. Go. of America 25674
tNsURER c : Liberty lnsurance Corporation 42404
;NSURER D: National Fire lnsurance Co. of Hartford 20478
INSURER E :
INSURER F
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVEBEENISSUED TOTHE INSURED NAMEDABOVE FORTHE POLICYPERIOD
INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITIONOF ANY CONTRACTOR OTHER DOCUMENT WTH RESPECT TO WIICH 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 SHOV\A MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE NEF ,BRvn POLICY NUMBER LIMITS
A COMMERCIAL GENERAL LIABILITY
.LATMS-.\,ADE fil o."r*
Stop Gap WA OH ND
GEN'L AGGREGATE LIMIT APPLIES PER:
,or"r l-il5$oi
OTHER:
LOC
x x 60231 1 3030 06/30/2019 06t30t202t EACH OCCURRENCE $ 1.000.000
t
F
EDrrene)$500.000
MED EXP (Anv one person)s15.000
PERSONAL & ADV INJURY s 1.000.000
GENERAL AGGREGATE s2.000.000
PRODUCTS - COMP/OP AGG s2,000,000
Stop Gap/EL $1,000,000
D AUTOMOBILE LIABILITY
x ANY AUTO
OVVNED
AUTOS ONLY
HIRED
AUTOS ONLY
SCHEDULED
AUTOS
NON-OVVI'IED
AUTOS ONLYxx
x x 6023117823 0613012019 o6t30t2024 s1.000,000
BODILY INJURY (P€r person)$
BODILY INJURY (Per arcident)$
$
I
B x UMBRELLA LIAB
EXCESS LIAB
x OCCUR
CLAIMS-MADE
x x zuPgtN1582919NF t6/3012019 06t30t202c EACH OCCURRENCE s2.000.000
AGGREGATE s2.000.000
DED x nerer.rrlor,r s10000 $
c WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERYEXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
lf yes, describe under
DESCRIPTION OF OPERATIONS below
Y'N
N N'A
x wc7291470641019
(AOS: Includes
MEL'USL&H
)613012019 06t30r202(x PERcTlit tatr IOTH-lEo
E L EACH ACCIDENT s1.000.000
E.L. DISEASE - EA EIUPLOYEE s1.000.000
E.L, DISEASE - POLICY LIMIT s1.000.000
DESCRIPTION OF OPERATIONS , LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be aftached if more space is requiredl
RE: GeoEngineers Project No. 0410-215-00; Project Name and Location: North Frager Road at Midway Creek,
Kent, Washington.
The General Liability and Automobile Liability policies include an automatic Additional lnsured endorcement
that provides Additional lnsured status to the Gertificate Holder, City of Kent, Washington, only
(See Attached Descriptions)
SHOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE wlLL BE DELIVERED IN
ACCORDANCE wlTH THE POLICY PROVISIONS.
City of Kent
Aftn: Tim LaPorte PE
220 Fourth Avenue South;
Kent, WA 98032
q'*a' &*,-
AUTHORIZED REPRESENTATIVE
AGORD 25 (2016/03) 1 ol2
#s28311704tM25979478
@ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are rogistered marks of ACORD
SRSJV
DESCRIPTIONS (Gontinued from Page 1)
when there is a written contract that requires such status, and only with regard to work performed on
behalf of the named insured.
The General Liability policy includes Per Project Aggregate Limits and a Separation of lnsureds Provision,
when required by written contract.
The General Liability and Automobile Liability policies contain a special endorsement with "Primary and
Noncontributory" wording, when required by written contract.
The General Liability, Automobile Liability and Workers Compensation policies includes an endorsement
providing that 30 days notice of cancellation will be given to the Certificate Holder by the lnsurance
Garrier.
The Umbrella Liability policy follows form of underlying liability
SAGITTA 25.3 (2016/03) 2 ol2
#s28311704tM25979478
N@
oo
o
o
oooN
o
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
It is understood and agreed that this endorsement amends the GOMMERCIAL GENERAL LIABILITY COVERAGE PART
as follows. lf any other endorsement attached to this policy amends any provision also amended by this endorsement,
then that other endorsement controls with respect to such provision, and the changes made by this endorsement with
respect to such provision do not apply.
CNA74858XX (1-15) Policy No: 6023113030
Page 1 of 18 Endorsement No:
The Continental Tnsurance co. EffectiveDate: 06/30/2019
lnsured Name: GEoENGTNEERS, rNc.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Omce, lnc., with its permission.
-
TABLE OF CONTENTS
1. Additionallnsureds
2. Additional lnsured - Primary And Non-Contributory To Additional lnsured's lnsurance
3. Additional lnsured - Extended Coverage
4. Boats
5. Bodily lnjury - Expanded Definition
6. Broad Knowledge of Occurrence/ Notice of Occurrence
7. Broad Named lnsured
8. Contractual Liability - Railroads
9. Estates, Legal Representatives and Spouses
10. Expected Or lntended lnjury - Exception for Reasonable Force
11. General Aggregate Limits of lnsurance - Per Location
12. ln Rem Actions
13. lncidental Health Care Malpractice Coverage
I 4. Joi nt Ventures/Partnersh ip/Limited Liabi lity Gompan ies
15. Legal Liability - Damage To Premises
16. Liquor Liability
17. MedicalPayments
18. Non-owned Aircnft Coverage
19. Non-owned Watercraft
20. PersonalAnd Advertising lnjury - Discrimination or Humiliation
21. PersonalAnd Advertising lnjury - Contractual Liability
22. Propefi Damage - Elevatorc
23. Retired Partnerc, Memberc, Directors And Employees
24. Supplementary Payments
25. Unintentional Failure To Disclose Hazards
26. Waiver of Subrogation - Blanket
27. Wnp-Up Extension: OCIP, CCIP or Consolidated (Wnp-Up) lnsurance Programs
CNA CNA PARAMOUNT
Architects, Engineers and Surueyors General Liability
Extension Endorsement
1. ADDITIONAL INSUREDS
a. WHO lS AN INSURED is amended to include as an lnsured any person or organization described in paragraphs
A. through l. below whom a Named Insured is required to add as an additional insured on this Coverage Part
under a written contract or written agreement, provided such contract or agreement:
(l ) is currently in effect or becomes effective during the term of this Goverage Part; and
(2) was executed prior to:
(a) the bodily injury or property damage; or
(b) the offense that caused the personal and advertising injury,
for which such additional insured seeks coverage.
b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the lnsurer
will not provide such additional insured with:
(1) a higher limit of insurance than required by such contract or agreement; or
(2) coverage broader than required by such contract or agreement, and in no event broader than that described
by the applicable paragraph A. through l. below.
Any coverage granted by this endorsement shall apply only to the extent permissible by law.
A. Controllinglnterest
Any person or organization with a controlling interest in a Named lnsured, but only with respect to such person or
organization's liability for bodily injury, proper$ damage or perconal and advertising injury arising out of:
l. such person or organization's financial control of a Named lnsured; or
2. premises such person or organization owns, maintains or controls while a Named lnsured leases or
occupies such premises;
provided that the coverage granted by this paragraph does not apply to structural alterations, new construction or
demolition operations performed by, on behalf of, or for such additional insured.
B. Co-owner of lnsured Premises
A co-owner of a premises co-owned by a Named lnsured and covered under this insurance but only with respect
to such co-owne/s liabili$ for bodily injury, property damage or perconal and advertising injury as co-owner
of such premises.
C. Engineerc, Architects or Surveyors Engaged By You
An architect, engineer or surveyor engaged by the Named lnsured, but only with respect to liability for bodily
injury, property damage or personal and advertising injury caused in whole or in part by the Named lnsured's
acts or omissions, or the acts or omissions of those acting on the Named lnsured's behalf:
a. in connection with the Named lnsured's premises; or
b. in the performance of the Named lnsured's ongoing operations.
But the coverage hereby granted to such additional insureds does not apply to bodily injury, propefi damage
or perconal and advertising injury arising out of the rendering of or failure to render any professional services
by, on behalf of, or for the Named lnsured, including but not limited to:
CNA74858XX (1-15) Policy No: 6023113030
Page 2 of 18 Endorsement No:
The Continental Insurance Co. Effective Date: 06/30/2019
lnsured Name: GEoENGINEERS, rNC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, lnc., with its permission.
@
oo
o
N
I
oooNoo
I
-
CNA GNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
1. the preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; or
2. supervisory, inspection, architectural orengineering activities.
D. Lessor of Equipment
Any person or organization from whom a Named lnsured leases equipment, but only with respect to liability for
bodily injury, proper$ damage or personal and advertising injury caused, in whole or in part, by the Named
lnsured's maintenance, operation or use of such equipment, provided that the occurrence giving rise to such
bodily injury, proper$ damage or the offense giving rise to such personal and advertising injury takes place
prior to the termination of such lease.
E. Lessorof Land
Any person or organization from whom a Named lnsured leases land but only with respect to liability for bodily
injury, property damage or perconal and advertising injury arising out of the ownership, maintenance or use
of such land, provided that the occurrence giving rise to such bodily injury, property damage or the offense
giving rise to such perconal and advertising injury takes place prior to the termination of such lease. The
coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by, on behalf of, or for such additional insured.
F. Lessor of Premises
An owner or lessor of premises leased to the Named Insured, or such owner or lesso/s real estate manager, but
only with respect to liability for bodily injury, property damage or perconal and advertising injury arising out of
the ownership, maintenance or use of such part of the premises leased to the Named lnsured, and provided that
the occurrence giving rise to such bodily injury or property damage, or the offense giving rise to such personal
and advertising injury, takes place prior to the termination of such lease. The coverage granted by this
paragraph does not apply to structural alterations, new construction or demolition operations performed by, on
behalf of, or for such additional insured.
G. Mortgagee, Assignee or Receiver
A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receiver's
liability for bodily injury, property damage or personal and advertising injury arising out of the Named
Insured's ownership, maintenance, or use of a premises by a Named Insured.
The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by, on behalf of, or for such additional insured.
H. State or Governmental Agency or Subdivision or Political Subdivisions - Permits
A state or governmental agency or subdivision or political subdivision that has issued a permit or authorization but
only with respect to such state or governmental agency or subdivision or political subdivision's liabilig for bodily
injury, property damage or perconal and advertising injury arising out of:
1. the following hazards in connection with premises a Named lnsured owns, rents, or controls and to which
this insurance applies:
a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings,
canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk
vaults, street banners, or decorations and similar exposures; or
b. the construction, erection, or removal of elevators; or
c. the ownership, maintenance or use of any elevators covered by this insurance; or
CNA74858XX (1-15) Policy No: 6023r-r-3030Page3of18 EndorsementNo: -
The Cont.inenta] Insurance Co. EffectiveDate: 0613012019
Insured Name: GEOENGINEERS, INC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, lnc., with ib permission.
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
2. the permitted or authorized operations performed by a Named lnsured or on a Named Insured's behalf.
The coverage granted by this paragraph does not apply to:
a. Bodily injury, proper$ damage or personal and advertising injury arising out of operations performed
for the state or governmental agency or subdivision or political subdivision; or
b. Bodily injury or property damage included within the products-completed operations hazard.
With respect to this provision's requirement that additional insured status must be requested under a written
contract or agreement, the lnsurer will treat as a written contract any governmental permit that requires the
Named lnsured to add the governmental entity as an additional insured.
Trade Show Event Lessor
With respect to a Named lnsured's participation in a trade show event as an exhibitor, presenter or displayer,
any person or organization whom the Named Insured is required to include as an additional insured, but only
with respect to such person or organization's liability for bodily injury, property damage or personal and
advertising injury caused by:
a. the Named Insured's acts or omissions; or
b. the acts or omissions of those acting on the Named lnsured's behalf,
in the performance of the Named lnsured's ongoing operations at the trade show event premises during the
trade show event.
2. The coverage granted by this paragraph does not apply to bodily injury or property damage included within
the products-completed operations hazard.
2. ADDITIONAL INSURED . PRIMARY AND NON.CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE
The Other lnsurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended to
add the following paragraph:
lf the Named lnsured has agreed in writing in a contract or agreement that this insurance is primary and non-
contributory relative to an additional insured's own insurance, then this insurance is primary, and the lnsurer will not
seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own
insurance means insurance on which the additional insured is a named insured. Otherwise, and notwithstanding
anything to the contrary elsewhere in this Condition, the insurance provided to such person or organization is excess
of any other insurance available to such person or organization.
3. ADDITIONAL INSURED- EXTENDED COVERAGE
When an additional insured is added by this or any other endorsement attached to this Coverage Part, WHO lS AN
INSURED is amended to make the following natural persons lnsureds.
lf the additional insured is:
a. An individual, then his or her spouse is an lnsured;
b. A partnership or joint venture, then its partners, members and their spouses are Insureds;
c. A limited liability company, then its members and managers are lnsureds; or
d. An organization other than a partnership, joint venture or limited liability company, then its executive officers,
directors and shareholders are Insureds;
CNA74858XX (1-15) Policy No: 502311-3030
Page 4 of 18 Endorsement No:
The Continental rnsurance co. Effective Date: 06/30/2019
Insured Name: GEOENGINEERS, INC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, lnc., with ib permission.
L
oo
o
No@o
oooN
o
CNA CNA PARAMOUNT
Architects, Engineers and Suweyors General Liability
Extension Endorsement
but only with respect to locations and operations covered by the additional insured endorsement's provisions, and only
with respect to their respective roles within their organizations.
Please see the ESTATES, LEGAL REPRESENTATIVES, AND SPOUSES provision of this endorsement for
additional coverage and restrictions applicable to spouses of natural person lnsureds.
4. BOATS
Under COVERAGES, Coverage A - Bodily lnjury And Property Damage Liability, the paragraph entitled
Exclusions is amended to add the following additional exception to the exclusion entitled Aircraft, Auto or
Watercraft:
This exclusion does not apply to:
Any watercraft owned by the Named lnsured that is less than 30 feet long while being used in the course of the
Named lnsured's inspection or surveying work.
5. BODILY INJURY - EXPANDED DEFINITION
Under DEFINITIONS, the definition of bodily injury is deleted and replaced by the following:
Bodily injury means physical injury, sickness or disease sustained by a person, including death, humiliation, shock,
mental anguish or mental injury sustained by that person at any time which results as a consequence of the physical
injury, sickness or disease.
6. BROAD KNOWLEDGE OF OCCURRENCE/ NOTICE OF OCCURRENCE
Under CONDITIONS, the condition entitled Duties in The Event of Occurrence, Offense, Glaim or Suit is amended
to add the following provisions:
A. BROAD KNOWLEDGE OF OCCURRENCE
The Named lnsured must give the lnsurer or the lnsurer's authorized representative notice of an occurrence,
offense or claim only when the occurrence, offense or claim is known to a natural person Named lnsured, to a
partner, executive officer, manager or member of a Named lnsured, or to an employee designated by any of the
above to give such notice.
B. NOTICE OF OCCURRENCE
The Named lnsured's rights under this Coverage Part will not be prejudiced if the Named Insured fails to give
the lnsurer notice of an occurrence, offense or claim and that failure is solely due to the Named lnsured's
reasonable belief that the bodily injury or property damage is not covered under this Coverage Part. However,
the Named Insured shall give written notice of such occurrence, offense or claim to the lnsurer as soon as the
Named lnsured is aware that this insurance may apply to such occurrence, offense or claim.
7. BROAD NAMED INSURED
WHO lS AN INSURED is amended to delete its Paragraph 3. in its entirety and replace it with the following:
3. Pursuant to the limitations described in Paragraph 4. below, any organization in which a Named Insured has
management control:
a. on the effective date of this Coverage Part; or
b. by reason of a Named lnsured creating or acquiring the organization during the policy period,
qualifies as a Named Insured, provided that there is no other similar liability insurance, whether primary,
contributory, excess, contingent or otherwise, which provides coverage to such organization, or which would have
-
-
CNA74858XX (1-15) Policy No:
Page 5 of 18 Endorsement No:
The Continental Insurance Co. Effective Date:
lnsured Name: GEoENGTNEERS, rNc.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, lnc., with its permission.
_5
02311_3 03 0
06/30/2019
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
provided coverage but for the exhaustion of its limit, and without regard to whether its coverage is broader or
narrower than that provided by this insurance.
But this BROAD NAMED INSURED provision does not apply to:
(a) any partnership, limited liability company or joint venture; or
(b) any organization for which coverage is excluded by another endorsement attached to this Coverage Part.
For the purpose of this provision, management control means:
A. owning interests representing more than 50% of the voting, appointment or designation power for the
selection of a majority of the Board of Directors of a corporation; or
B. having the right, pursuant to a written trust agreement, to protect, control the use of, encumber or transfer or
sell property held by a trust.
4. With respect to organizations which qualiflT as Named lnsureds by virtue of Paragraph 3. above, this insurance
does not apply to:
a. bodily injury or propefi damage that first occurred prior to the date of management control, or that first
occurs after management control ceases; nor
b. perconal or advertising injury caused by an offense that first occurred prior to the date of management
control or that first occurs after management control ceases.
5. The insurance provided by this Coverage Part applies to Named Insureds when trading under their own names
or under such other trading names or doing-business-as names (dba) as any Named lnsured should choose to
employ.
CONTRACTUAL LIABILITY - RAILROADS
With respect to operations performed within 50 feet of railroad property, the definition of insured contract is replaced
by the following:
Insured Gontract means:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies
any person or organization for damage by fire to premises while rented to a Named lnsured or temporarily
occupied by a Named lnsured you with permission of the owner is not an insured contract;
b. A sidetrack agreement;
c. Any easement or license agreement;
d. An obligation, as required by ordinance, to indemnifu a municipality, except in connection with work for a
municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement pertaining to the Named lnsured's business (including an
indemnification of a municipality in connection with work performed for a municipali$) under which the Named
lnsured assumes the tort liability of another party to pay for bodily injury or property damage to a third person
or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or
agreement.
Paragraph f. does not include that part of any contract or agreement:
8.
CNA74858XX (1-15) Policy No:
Page 6 of 18 Endorsement No:
The Continental Insurance co. EffectiveDate:
INSUTCd NAME: GEOENGINEERS, INC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, lnc., with ib permission.
602311_3030
06/30/2019
-
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
(l) That indemnifies an architect, engineer or surveyor for injury or damage arising out of:
(a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; or
r/r Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or
damage;
(2) Under which the lnsured, if an architect, engineer or surveyor, assumes liability for an injury or damage
arising out of the insured's rendering or failure to render professional services, including those listed in (1)
above and supervisory, inspection, architectural or engineering activities.
9. ESTATES, LEGAL REPRESENTATIVES, AND SPOUSES
The estates, executors, heirs, legal representatives, administrators, trustees, beneficiaries and spouses of any
natural person lnsured or living trust shall also be insured under this policy; provided, however, coverage is afforded
to such estates, executors, heirs, legal representatives, administrators, trustees, beneficiaries and spouses only for
claims arising solely out of their capacity or status as such and, in the case of a spouse, where such claim seeks
damages from marital community properly, jointly held property or property transferred from such natural person
lnsured to such spouse. No coverage is provided for any act, error or omission of an estate, heir, legal
representative, or spouse outside the scope of such person's capacity or status as such, provided, however, that the
spouse of a natural person Named lnsured, and the spouses of members or partners of joint venture or partnership
Named Insureds are lnsureds with respect to such spouses' acts, errors or omissions in the conduct of the Named
lnsured's business.
10. EXPECTED OR INTENDED INJURY- EXCEPTION FOR REASONABLE FORCE
Under GOVERAGES, Coverage A - Bodily lnjury And Property Damage Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Expected or lntended lnjury and replace it with the following:
This insurance does not apply to:
Expected or lntended Injury
Bodily injury or propefi damage expected or intended from the standpoint of the lnsured. This exclusion does not
apply to bodily injury or property damage resulting from the use of reasonable force to protect persons or property.
11. GENERAL AGGREGATE LIMITS OF INSURANCE . PER LOCATION
A. A separate Location General Aggregate Limit, equal to the amount of the General Aggregate Limit, is the most the
lnsurer will pay for the sum of:
1. All damages under Goverage A, except damages because of bodily injury or propefi damage included in
the products-completed opentions hazard; and
2. All medical expenses under Coverage C,
that arise from occurrences or accidents which can be attributed solely to ongoing operations at that location.
Such payments shall not reduce the General Aggregate Limit shown in the Declarations, nor the Location General
Aggregate Limit of any other location.
B. AII:
1. Damages under Goverage B, regardless of the number of locations involved;
CNA74858XX (1-15)
Page 7 of 18
The Continental Insurance Co.
lnsured Name: GEoENGTNEERS, rNc.
Copyright CNA All Rights Reserved.
Policy No:
Endorsement No:
Effective Date:
6 02311_3 03 0
06t30t2019
lncludes copyrighted material of lnsurance Services Office, lnc., with ib permission.
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
2. Damages under Coverage A, caused by occurrences which cannot be attributed solely to ongoing
operations at a single location, except damages because of bodily injury or proper$ damage included in
the prod ucts-complctcd opcrationc hazard ; and
3. Medical expenses under Coverage C caused by accidents which cannot be attributed solely to ongoing
operations at a single location,
will reduce the General Aggregate Limit shown in the Declarations.
C. For the purpose of this GENERAL AGGREGATE LIMITS OF INSURANCE - PER LOCATION Provision,
"location" means:
1. a premises the Named lnsured owns or rents; or
2. a premises not owned or rented by any Named lnsured at which the Named lnsured is performing
operations pursuant to a contract or written agreement. lf operations at such a location have been
discontinued and then restarted, or if the authorized parties deviate from plans, blueprints, designs,
specifications or timetables, the location will still be deemed to be the same location.
For the purpose of determining the applicable aggregate limit of insurance, premises involving the same or
connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way
of a railroad shall be considered a single location.
D. The limits shown in the Declarations for Each Occurrence, for Damage To Premises Rented To You and for
Medical Expense continue to apply, but will be subject to either the Location General Aggregate Limit or the
GeneralAggregate Limit, depending on whether the occurrence can be attributed solely to ongoing operations at
a particular location.
E. \Men coverage for liability arising out of the products-completed operations hazard is provided, any payments
for damages because of bodily injury or property damage included in the products-completed operations
hazard, regardless of the number of locations involved, will reduce the Products-Completed Operations
Aggregate Limit shown in the Declarations.
F. The provisions of LIMITS OF INSURANCE not otherwise modified by this GENERAL AGGREGATE LIMITS OF
INSURANCE - PER LOCATION Provision shall continue to apply as stipulated.
12. IN REM ACTIONS
A quasi in rem action against any vessel owned or operated by or for the Named lnsured, or chartered by or for
the Named Insured, will be treated in the same manner as though the action were in personam against the Named
Insured.
I3. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE
Solely with respect to bodily injury that arises out of a health care incident:
A. Under COVERAGES, Coverage A - Bodily lnjury And Property Damage Liability, the lnsuring Agreement is
amended to replace Paragraphs f .b.(l) and 1.b.(2)with the following:
b. This insurance applies to bodily injury provided that the professional health care services are incidental to
the Named lnsured's primary business purpose, and only if:
(1) such bodily injury is caused by an occurrence that takes place in the coverage territory.
(2) the bodily injury first occurs during the policy period. All bodily injury arising from an occurrence will
be deemed to have occurred at the time of the first act, error, or omission that is part of the occurrence;
and
CNA74858XX (1-15) Policy No: 50231-l-3030
Page 8 of 18 Endorsement No:
The Continental Insurance co. EffectiveDate: 06/30/2019
lnsured Name: GEOENGTNEERS, INc.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, lnc., with ib permission.
oo
o
NoI
oooNoo
I
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
B. Under COVERAGES, Coverage A - Bodily lnjury And Property Damage Liability, the paragraph entitled
Exclusions is amended to:
i. add the following to the Employers Liability exclusion:
This exclusion applies only if the bodily injury arising from a health care incident is covered by other
liability insurance available to the lnsured (or which would have been available but for exhaustion of its
limits).
ii. delete the exclusion entitled Contractual Liability and replace it with the following:
This insurance does not apply to:
Gontractual Liability
the lnsured's actual or alleged liability under any oral or written contract or agreement, including but not
limited to express warranties or guarantees.
iii. to add the following additional exclusions:
This insurance does not apply to:
Discrimination
any actual or alleged discrimination, humiliation or harassment, including but not be limited to claims based
on an individual's race, creed, color, age, gender, national origin, religion, disability, marital status or sexual
orientation.
Dishonesty or Crime
Any actual or alleged dishonest, criminal or malicious act, error or omission.
Medicare/Medicaid Fraud
any actual or alleged violation of law with respect to Medicare, Medicaid, Tricare or any similar federal, state
or local governmental program.
Services Excluded by Endorsement
Any health care incident for which coverage is excluded by endorsement.
C. DEFINITIONS is amended to:
i. add the following definitions:
Health care incident means an act, error or omission by the Named lnsured's employees or volunteer
workers in the rendering of:
a. professional health care services on behalf of the Named lnsured or
b. Good Samaritan services rendered in an emergency and for which no payment is demanded or received.
Professional health care seryices means any health care services or the related furnishing of food,
beverages, medical supplies or appliances by the following providers in their capacity as such but solely to
the extent they are duly licensed as required:
a. Physician;
CNA74858XX (1-15) Policy No:
Page 9 of 18 Endorsement No:
The Continental Insurance Co. Effective Date:
INsured Name: GEOENGINEERS, INC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, lnc., with its permission.
5023113030
o6t30t2019
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
b. Nurse;
c. Nurse practitioner;
d. Emergencymedicaltechnician;
e. Paramedic;
f. Dentist;
g. Physicaltherapist;
h. Psychologist;
i. Speech therapist;
j. Other allied health professional; or
Professional health care services does not include any services rendered in connection with human clinical
trials or product testing.
ii. delete the definition of occurrence and replace it with the following:
Occurrence means a health care incident. All acts, errors or omissions that are logically connected by any
common fact, circumstance, situation, transaction, event, advice or decision will be considered to constitute a
single occurrence;
iii. amend the definition of lnsured to:
a. add the following:
the Named lnsured's employees are Insureds with respect to:
(l) bodily injury to a co-employee while in the course of the co-employee's employment by the
Named lnsured or while performing duties related to the conduct of the Named lnsured's
business; and
(2) bodily injury to a volunteer worker while performing duties related to the conduct of the
Named lnsured's business;
when such bodily injury arises out of a health care incident.
the Named lnsured's volunteer workers are Insureds with respect to:
(1) bodi[ injury to a co-volunteer worker while performing duties related to the conduct of the
Named lnsured's business; and
(2) bodily injury to an employee while in the course of the employee's employment by the Named
lnsured or while performing duties related to the conduct of the Named lnsured's business;
when such bodily injury arises out of a health care incident.
b. delete Subparagraphs (a), (b), (c) and (d) of Paragraph 2.a.(1) of WHO lS AN INSURED.
D. The Other lnsurance condition is amended to delete Paragraph b.(1) in its entirety and replace it with the
following:
Other lnsurance
CNA74858XX (1-15) Policy No: 6023113030
Page 10 of 18 Endorsement No:
The continenta] rnsurance Co. EffectiveDate: 06/30/2019
lnsured Name: GEOENGTNEERS, rNC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, Inc., with ib permission.
I
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
b. Excess lnsurance
(1) To the extent this insurance applies, it is excess over any other insurance, self insurance or risk transfer
instrument, whether primary, excess, contingent or on any other basis, except for insurance purchased
specifically by the Named lnsured to be excess of this coverage.
14. JOINT VENTURES / PARTNERSHIP / LIMITED LIABILITY COMPANIES
A. Past Joint Ventures, Partnerships, Limited Liability Companies
The following is added to WHO lS AN INSURED:
lf the Named Insured was a joint venturer, partner, or member of a limited liability company and such joint
venture, partnership or limited liability company terminated prior to or during the policy period, such Named
lnsured is an Insured with respect to its interest in such joint venture, partnership or limited liability company but
only to the extent that:
a. any offense giving rise to perconal and advertising iniury occurred prior to such termination date, and the
perconal and advertising injury arising out of such offense, first occurred after such termination date;
b. the bodily injury or property damage first occurred after such termination date; and
c. there is no other valid and collectible insurance purchased specifically to insure the partnership, joint venture
or limited liability company.
lf the joint venture, partnership or limited liability company is or was insured under a consolidated (wrap-up)
insurance program, then such insurance will always be considered valid and collectible for the purpose of
paragraph c. above. But this provision will not serve to exclude bodily injury, property damage or perconal and
advertising injury that would otherwise be covered under the Architects, Engineerc And Surveyors General
Liability Extension Endorsement provision entitled WRAP-UP EXTENSION: OCIP, CCIP, OR
CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS. Please see that provision for the definition of
consolidated (wrap-up) insurance program.
B. Participation ln Gurrent Professional Joint Ventures
The following is added to WHO lS AN INSURED:
The Named lnsured is also an lnsured for participation in a current joint venture that is not named on the
Declarations, but only if such joint venture meets all of the following criteria:
a. Each and every one of the Named lnsured's co-venturers are architectural, engineering or surveying firms
only; and
b. There is no other valid and collectible insurance purchased specifically to insure the joint venture.
However, the Named lnsured is an lnsured only for the conduct of such Named lnsured's business within such
a joint venture. The Named lnsured is not insured for liability arising out of the acts or omissions of other co-
venturers, nor of their partners, members or employees.
C. WHO lS AN INSURED is amended to delete its last paragraph and replace it with the following:
Except as provided under this Architects, Engineers And Surueyorc General Liability Extension
Endorcement or by the attachment of another endorsement (if any), no person or organization is an lnsured with
respect to the conduct of any current or past partnership, joint venture or limited liability company that is not
shown as a Named lnsured in the Declarations.
CNA74858XX (1-15) Policy No:
Page 11 of 18 Endorsement No:
The Continental Insurance co. EffectiveDate:
lnsured Name: GEoENGINEERS, rNC.
Copyright CNA All Rights Resorved. lncludes copyrighted material of lnsurance Services Office, lnc., with ib permission.
5023 LL3 03 0
06/30/2019
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
15. LEGAL LIABILITY - DAMAGE TO PREMISES / ALIENATED PREMISES / PROPERW IN THE NAMED
INSURED'S CARE, CUSTODY OR CONTROL
A. Under COVERAGES, Coverage A - Bodily lnjury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete exclusion j. Damage to Propefi in its entirety and replace it with the following:
This insurance does not apply to:
j. Damage to Propefi
Property damage to:
(1) Property the Named lnsured owns, rents, or occupies, including any costs or expenses incurred by you,
or any other person, organization or entity, for repair, replacement, enhancement, restoration or
maintenance of such property for any reason, including prevention of injury to a person or damage to
another's property;
(2) Premises the Named lnsured sells, gives away or abandons, if the property damage arises out of any
part of those premises;
(3) Property loaned to the Named lnsured;
(4) Personal property in the care, custody or control of the lnsured;
(5) That particular part of real property on which the Named lnsured or any contractors or subcontractors
working directly or indirectly on the Named lnsured's behalf are performing operations, if the property
damage arises out of those operations; or
(6) That particular part of any property that must be restored, repaired or replaced because your work was
incorrectly performed on it.
Paragraphs (f ), (3) and (4) of this exclusion do not apply to property damage (other than damage by fire) to
premises rented to the Named lnsured or temporarily occupied by the Named lnsured with the permission of
the owner, nor to the contents of premises rented to the Named lnsured for a period of 7 or fewer
consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described
in LIMITS OF INSURANCE.
Paragraph (2) of this exclusion does not apply if the premises are your work.
Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack
agreement.
Paragraph (6) of this exclusion does not apply to property damage included in the products-completed
operations hazard.
Paragraphs (3) and (4) of this exclusion do not apply to property damage to:
i. tools, or equipment the Named lnsured borrows from others, nor
ii. other personal property of others in the Named lnsured's care, custody or control while being used in the
Named lnsured's operations away from any Named lnsured's premises.
However, the coverage granted by this exception to Paragraphs (3) and (4) does not apply to:
a. property at a job site awaiting or during such property's installation, fabrication, or erection;
b. property that is mobile equipment leased by an lnsured;
CNA74858XX (1-15) Policy No: 60231-l-3030
Page 12 of 18 Endorsement No:
The Continental Insurance Co. Effective Date: 06/30/2019
INSurEd NaME: GEOENGINEERS, INC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, lnc., with its permission.
@
oo
o
NoI
ooo
oo
I
CT{A CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
c. property that is an auto, aircraft or watercraft;
d. property in transit; or
e. any portion of propefi damage for which the lnsured has available other valid and collectible
insurance, or would have such insurance but for exhaustion of its limits, or but for application of one of itsexclusions. I
A separate limit of insurance and deductible apply to such property of others. See LIMITS OF INSURANCE
as amended below.
B. Under GOVERAGES, Coverage A - Bodily lnjury and Properg Damage Liability, the paragraph entitled
Exclusions is amended to delete its last paragraph and replace it with the following:
Exclusions c. through n. do not apply to damage by fire to premises while rented to a Named Insured or
temporarily occupied by a Named lnsured with permission of the owner, nor to damage to the contents of
premises rented to a Named lnsured for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to this coverage as described in LIMITS OF INSURANCE.
C. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5. above, $25,000 is the most the lnsurer will pay under Coverage A for damages arising out of any
one occurrence because of the sum of all propefi damage to borrowed tools or equipment, and to other
personal property of others in the Named lnsured's care, custody or control, while being used in the Named
lnsured's operations away from any Named Insured's premises. The lnsurer's obligation to pay such property
damage does not apply until the amount of such property damage exceeds $1,000. The lnsurer has the right but
not the duty to pay any portion of this $1,000 in order to effect settlement. lf the lnsurer exercises that right, the
Named lnsured will promptly reimburse the lnsurer for any such amount.
D. Paragraph 6., Damage To Premises Rented To You Limit, of LIMITS OF INSUMNGE is deleted and replaced by
the following:
6. Subject to Paragraph 5. above, (the Each Occurrence Limit), the Damage To Premises Rented To You Limit
is the most the lnsurer will pay under Coverage A for damages because of property damage to any one
premises while rented to the Named Insured or temporarily occupied by the Named lnsurcd with the
permission of the owner, including contents of such premises rented to the Named lnsured for a period of 7
or fewer consecutive days. The Damage To Premises Rented To You Limit is the greater of:
a. $500,000; or
b. The Damage To Premises Rented To You Limit shown in the Declarations.
E. Paragraph 4.b.(1)(a)(ii) of the Other lnsurance Condition is deleted and replaced by the following:
(ii) That is property insurance for premises rented to the Named lnsured, for premises temporarily occupied by
the Named lnsurcd with the permission of the owner; or for personal property of others in the Named
lnsured's care, custody or control;
16. LIQUOR LIABILITY
Under COVERAGES, Coverage A - Bodily lnjury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Liquor Liability.
This LIQUOR LlABll-lTY Provision does not apply to any person or organization who otherwise qualifies as an
additional insured on this Goverage Part.
CNA74858XX (1-15)
Page 13 of 18
The Continental Insurance Co.
lnsured Name: GEoENGTNEERS, rNc.
Copyright CNA All Rights Reserved.
Policy No: 5023113030
Endorsement No:
Effective Date: 06/30/2019
lncludes copyrighted material of lnsurance Services Office, lnc., with ib permission.
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
I7. MEDICAL PAYMENTS
A. LIMITS OF INSURANGE is amended to delete Paragraph 7. (the Medical Expense Limit) and replace it with the
following:
7. Subject to Paragraph 5. above (the Each Occurrence Limit), the Medical Expense Limit is the most the
lnsurer will pay under Coverage C for all medical expenses because of bodily injury sustained by any one
person. The Medical Expense Limit is the greater of:
(1) $15,000 unless a different amount is shown here: $N,NNN,NNN,NNN; or
(2) the amount shown in the Declarations for Medical Expense Limit.
B. Under GOVERAGES, the lnsuring Agreement of Coverage C - Medical Payments is amended to replace
Paragraph f .a.(3)(b) with the following:
(b) The expenses are incurred and reported to the lnsurer within three years of the date of the accident; and
18. NON-OWNED AIRCRAFT
Under COVERAGES, Coverage A - Bodily lnjury and Propefi Damage Liability, the paragraph entitled
Exclusions is amended as follows:
The exclusion entitled Aircraft, Auto or Watercraft is amended to add the following:
This exclusion does not apply to an aircraft not owned by any Named lnsured, provided that:
1. the pilot in command holds a currently effective certificate issued by the duly constituted authority of the United
States of America or Canada, designating that person as a commercial or airline transport pilot;
2. the aircraft is rented with a trained, paid crew to the Named lnsured; and
3. the aircraft is not being used to carry persons or property for a charge.
19. NON.OWNED WATERCRAFT
Under COVERAGES, Goverage A - Bodily lnjury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete subparagraph (2) of the exclusion entitled Aircraft, Auto or Watercraft, and
replace it with the following.
This exclusion does not apply to:
(2) a watercraft that is not owned by any Named lnsured, provided the watercraft is:
(a) less than 75 feet long; and
(b) not being used to carry persons or property for a charge.
20. PERSONAL AND ADVERTISING INJURY-DISCRIMINATION OR HUMILIATION
A. Under DEFINITIONS, the definition of perconal and advertising injury is amended to add the following tort:
Discrimination or humiliation that results in injury to the feelings or reputation of a natural person.
B. Under GOVERAGES, Coverage B - Perconal and Advertising lniury Liability, the paragraph entitled
Exclusions is amended to:
1. delete the Exclusion entitled Knowing Violation Of Rights Of Another and replace it with the following:
CNA74858XX (1-15) Policy No:
Page 14 of 18 Endorsement No:
The Continental Insurance co. Effective Date:
Insured Name: GEOENGINEERS, INC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsuran@ Services ffice, lnc., with ib permission.
6 023 113 03 0
06/30/2019
@
oo
o
NoI
oooNoo
-
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
This insurance does not apply to:
Knowing Violation of Rights of Another
Perconal and advertising injury caused by or at the direction of the lnsured with the knowledge that the act
would violate the rights of another and would inflict personal and advertising injury. This exclusion shall not
apply to discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but
only if such discrimination or humiliafion is not done intentionally by or at the direction of:
(a) the Named lnsured;or
(b) any executive officer, director, stockholder, partner, member or manager (if the Named lnsured is a
limited liabili$ company) of the Named lnsured.
2. add the following exclusions:
This insurance does not apply to:
Employment Related Discrimination
discrimination or humiliation directly or indirectly related to the employment, prospective employment, past
employment or termination of employment of any person by any lnsured.
Premises Related Discrimination
discrimination or humiliation arising out of the sale, rental, lease or sub-lease or prospective sale, rental,
lease or sub-lease of any room, dwelling or premises by or at the direction of any lnsured.
Notwithstanding the above, there is no coverage for fines or penalties levied or imposed by a governmental entity
because of discrimination.
The coverage provided by this PERSONAL AND ADVERTISING INJURY -DISCRIMINATION OR HUMILIATION
Provision does not apply to any person or organization whose status as an lnsured derives solely from
Provision 1. ADDITIONAL INSURED of this endorsement; or
attachment of an additional insured endorsement to this Goverage Part.
21. PERSONAL AND ADVERTISING INJURY - CONTRACTUAL LIABILITY
A. Under GOVERAGES, Goverage B -Perconal and Advertising lnjury Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Contractual Liability.
B. Solely for the purpose of the coverage provided by this PERSONAL AND ADVERTISING INJURY - LIMITED
CONTRACTUAL LIABILITY provision, the following changes are made to the section entitled
SUPPLEMENTARY PAYMENTS - COVERAGES A AND B:
1. Paragraph 2.d. is replaced by the following:
d. The allegations in the suit and the information the lnsurer knows about the offense alleged in such suit
are such that no conflict appears to exist between the interests of the lnsured and the interests of the
indemnitee;
2. The first unnumbered paragraph beneath Paragraph 2.f.(2xb) is deleted and replaced by the following:
So long as the above conditions are met, attorney's fees incurred by the lnsurer in the defense of that
indemnitee, necessary litigation expenses incurred by the lnsurer, and necessary litigation expenses incurred
CNA74858XX (1-15) Policy No: Go231t 3o3o
Page 15 of 18 Endorsement No:
The Continental Insurance Co. EffectiveDate: 06/30/2019
INSUTCd NAME: GEOENGINEERS, INC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, lnc., with ib permission.
CTTA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
by the indemnitee at the lnsurer's request will be paid as defense costs. Such payments will not be deemed
to be damages for perconal and advertising injury and will not reduce the limits of insurance.
C. This PERSONAL AND ADVERTISING INJURY - LIMITED CONTRACTUAL LIABILITY Provision does not apply
if Coverage B -Perconal and Advertising lnjury Liability is excluded by another endorsement attached to this
Coverage Part.
This PERSONAL AND ADVERTISING INJURY - CONTRACTUAL LIABILITY Provision does not apply to any
person or organization who otherwise qualifies as an additional insured on this Coverage Part.
22. PROPERW DAMAGE _ ELEVATORS
A. Under COVERAGES, Coverage A - Bodily lnjury and Property Damage Liability, the paragraph entitled
Exclusions is amended such that the Damage to Your Product Exclusion and subparagraphs (3), (4) and (6) of
the Damage to Property Exclusion do not apply to proper$ damage that results from the use of elevators.
B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE - ELEVATORS Provision, the
Other lnsurance conditions is amended to add the following paragraph:
This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other
basis that is Property insurance covering property of others damaged from the use of elevators.
23. RETIRED PARTNERS, MEMBERS, DIRECTORSAND EMPLOYEES
WHO lS INSURED is amended to include as lnsureds natural persons who are retired partners, members, directors
or employees, but only for bodily injury, proper$ damage or personal and advertising injury that results from
services performed for the Named lnsured under the Named lnsured's direct supervision. All limitations that apply to
employees and volunteer workerc also apply to anyone qualifying as an lnsured under this Provision.
24. SUPPLEMENTARY PAYMENTS
The section entitled SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended as follows:
A. Paragraph 1.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5,000.
limit;and
B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a
$1,000.|imit.
25. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
lf the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named
lnsured's Goverage Part, the lnsurer will not deny coverage under this Coverage Part because of such failure.
26. WAIVER OF SUBROGATION - BLANKET
Under CONDITIONS, the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to
add the following:
The lnsurer waives any right of recovery the lnsurer may have against any person or organization because of
payments the lnsurer makes for injury or damage arising out of:
1. the Named lnsured's ongoing operations; or
2. your work included in the products-completed operations hazard.
However, this waiver applies only when the Named lnsured has agreed in writing to waive such rights of recovery in
a written contract or written agreement, and only if such contract or agreement:
CNA74858XX (1-15) Policy No:
Page 16 of 18 Endorsement No:
The Continental Insurance Co. Effective Date:
lnsured Name: GEoENGTNEERS, rNC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services ffice, lnc., with its permission.
5 02311_3 03 0
06/30/2019
I
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
f . is in effect or becomes effective during the term of this Coverage Part; and
2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise to the
claim.
27. WRAP-UP EXTENSION: OGIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS
Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to any
construction project in the state of Alaska, that is not permitted to be insured under a consolidated (wrap-up)
insurance program by applicable state statute or regulation.
lf the endorsement EXGLUSION - CONSTRUCTION WRAP-UP is attached to this policy, or another exclusionary
endorsement pertaining to Owner Controlled lnsurance Programs (O.C.l.P.) or Contractor Controlled lnsurance
Programs (C.C.l.P.) is attached, then the following changes apply:
A. The following wording is added to the above-referenced endorsement:
With respect to a consolidated (wrap-up) insurance program project in which the Named Insured is or was
involved, this exclusion does not apply to those sums the Named lnsured become legally obligated to pay as
damages because of:
1. Bodily injury, propefi damage, or personal or advertising injury that occurs during the Named lnsured's
ongoing operations at the project, or during such operations of anyone acting on the Named lnsured's
behalf; nor
2. Bodily injury or property damage included within the products-completed operations hazard that arises
out of those portions of the project that are not residential structures.
B. Condition 4. Other lnsurance is amended to add the following subparagraph a.b.(1)(c):
This insurance is excess over:
(c) Any of the other insurance whether primary, excess, contingent or any other basis that is insurance available
to the Named Insured as a result of the Named lnsured being a participant in a consolidated (wrap-up)
insurance program, but only as respects the Named lnsured's involvement in that consolidated (wrap-up)
insurance program.
C. DEFINITIONS is amended to add the following definitions:
Gonsolidated (wrap-up) insurance program means a construction, erection or demolition project for which the
prime contractor/project manager or owner of the construction project has secured general liability insurance
covering some or all of the contractors or subcontractors involved in the project, such as an Owner Controlled
lnsurance Program (O.C.l.P.) or Contractor Controlled lnsurance Program (C.C.l.P.).
Residential structurc means any structure where 30% or more of the square foot area is used or is intended to
be used for human residency, including but not limited to:
1. single or multifamily housing, apartments, condominiums, townhouses, co-operatives or planned unit
developments; and
2. the common areas and structures appurtenant to the structures in paragraph 1. (including pools, hot tubs,
detached garages, guest houses or any simihr structures).
However, when there is no individual ownership of units, residential structure does not include military housing,
college/university housing or dormitories, long term care facilities, hotels or motels. Residential structure also
does not include hospitals or prisons.
CNA74858XX (1-15) Policy No:
Page 17 of 18 Endorsement No:
The Continental Insurance Co. Effective Date:
Insured Name: GEOENGINEERS, INC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, lnc., with ib permission.
6023113030
06/30/2019
CNA CNA PARAMOUNT
Architects, Engineers and Surveyors General Liability
Extension Endorsement
This WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS Provision
does not apply to any person or organization who otherwise qualifies as an additional insured on this Goverage Part.
All other terms and conditions of the Policy remain unchanged
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated lnsurers, takes effect
on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and
expires concurrently with said Policy.
CNA74858XX (1-15) Policy No:
Page 18 of 18 Endorsement No:
The Continental Insurance co. Effective Date:
INSuTEd NAME: GEOENGINEERS, INC.
Copyright CNA All Rights Reserved. lncludes copyrighted material of lnsurance Services Office, lnc., with its permission.
5 023 113 03 0
06/30/201 9
o
oo
o
oI
oooN
o
!! !mrm0231 13030
CNA CNA PARAMOUNT
Commercial General Liability Coverage Part
lf any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this
method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits
of insurance of all insurers.
5. Premium Audit
a. We will compute all premiums for this Goverage Part in accordance with our rules and rates.
b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit
period we will compute the earned premium for that period and send notice to the Firct Named lnsured. The due
date for audit and retrospective premiums is the date shown as the due date on the bill. lf the sum of the advance
and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to
the First Named lnsurcd.
c. The First Named lnsured must keep records of the information we need for premium computation, and send us
copies at such times as we may request.
6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are accurate and complete;
b. Those statements are based upon representations you made to us; and
c. We have issued this policy in reliance upon your representations.
7. Separation Of Insureds
Except with respect to the Limits of lnsurance, and any rights or duties specifically assigned in this Goverage Part to
the Firct Named lnsured, this insurance applies:
a. As if each Named Insured were the only Named lnsured; and
b. Separately to each lnsured against whom claim is made or suit is brought.
8. Transfer Of Rights Of Recovery Against Otherc To Us
lf the lnsured has rights to recover all or part of any payment we have made under this Goverage Part, those rights
are transferred to us. The lnsured must do nothing after loss to impair them. At our request, the lnsured will bring suit
or transfer those rights to us and help us enforce them.
9. When We Do Not Renew
lf we decide not to renew this Goverage Part, we will mail or deliver to the First Named lnsured shown in the
Declarations written notice of the nonrenewal not less than 30 days before the expiration date.
lf notice is mailed, proof of mailing will be sufiicient proof of notice.
SECTION V- DEFINITIONS
1. Advertisement means a notice that is broadcast or published to the general public or specific market segments about
your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this
definition:
a. Notices that are published include material placed on the lnternet or on similar electronic means of
communication; and
b. Regarding web sites, only that part of a web site that is about your goods, products or services for the purposes of
attracting customers or supporters is considered an advertisement.
2. Auto means:
a. A land motor vehicle, trailer or semitrailer designed for travel on public roads, including any attached machinery or
equipment;or
CG0001 04-13 Page 15 of20
-
Copyright lnsurance Services Office, lnc., 2012
CNA
cNA68021XX (Ed. 02/13)
Page 1 of 1
CNA68O21XX
(Ed.02113)
NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS
It is understood and agreed that:
lf you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has
issued a Certificate of lnsurance, and if we cancel a policy term described on that Certificate of lnsurance for any reason
other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days
in advance of the date cancellation is effective.
lf notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of
Record will be sufficient to prove notice.
Any failure by us to notiff such persons or organizations will not extend or invalidate such cancellation, or impose any
liability or obligation upon us or the Agent of Record.
o
N
F
o
ENoooN
o
-I
-
Copyright, CNA All Rights Reserved.
tr! !mtm02311!m3
CNA CNA PARAMOUNT
Earlier Notice of Gancellation Provided
bv the lnsurer Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
LIQUOR LIABILITY COVEMGE PART
PRO D U CTS/COM PLETED OP ERATI ONS LIABI LITY COVERAG E PART
EMPLOYEE BENEFITS LIABILITY COVERAGE PART
STOP GAP LIABILIry COVEMGE PART
TECHNOLOGY ERRORS AND OMISSIONS LIABILITY COVERAGE PART
SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY - NEWYORK DEPARTMENT OF TMNSPORTATION
SCHEDULE
Number of Days' Notice: ogo
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations
For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of
cancellation, as provided in paragraph A. of either the CANCELLATION/NONRENEWAL section of the COMMMON
TERMS AND CONDITIONS or as amended by an applicable state cancellation endorsement, is increased to the
number of days shown in the Schedule above.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated lnsurers, takes effect
on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and
expires concurrently with said Policy.
I
cNA746s8XX (1-15)
Page 1 of 1
The Continental Insurance Co.
Insured Name: GEOENGINEERS, INC.
Copyright CNA All Rightrs Reserved.
Policy No:
Endorsement No:
Effective Date:
6023r_13030
39
03 /37 / 20]-8
lncludes copyrighled material of lnsurance Services ffice, lnc., with ib permission
CNA CNA71527XX
(Ed.10t12)
ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY
It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows:
SCHEDULE
Name of Additional Insured Percons Or Organizations
ANY PERSON OR ORGANIZATION, BUT ONLY ]F YOU ARE
REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT
TO MAKE THAT PERSON OR ORGANIZATION AN ADDITIONAL
]NSURED UNDER THIS POLICY.
1. ln conformance with paragraph A.1.c. of Who ls An lnsured of Section ll - LIABILITY COVERAGE, the person or
organization scheduled above is an insured under this policy.
2. The insurance afforded to the additional insured under this policy will apply on a primary and non-contributory basis if
you have committed it to be so in a written contract or written agreement executed prior to the date of the "accident"
for which the additional insured seeks coverage under this policy.
All other terms and conditions of the Policy remain unchanged
I
-
I
cNA71527XX (10t12)
Page 1 of 1
Policy No: 602311Ut23
Endorsement No:
Effective Date: 06/30/2019
lnsured Name: GEOENGTNEERS, rNC
Copyright CNA All Rights Reserved
POLICY NI'MBER
c 6023LL7823
POLTCY CEAN@Sffi
Chalrman ot thc Boed
INSI'RED IIAI{E AIID ADDRESS
GEOENGINEERS, INC.
8410 154TH AVE NE
REDMOND, WA 98052-3800
'lltrir Change Endorcesnt changer the Policy. Please read it carefully.Ihit Orange Endorsent is a part of your Policy and tekec effect on theeffective date of your Pol.icy, unlesr another effectirre dlte ic chorn.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED BLANKET
ANY PERSON OR ORGANIZATION THAT IHE NAMED INSURED IS OBLIGATED TO
PROVIDE INSURANCE V|IHERE REQUIRED BY A WRITTEN CONTRACT OR AGREEMENT
IS AN INSURED, BUT ONLY WITH RESPECT TO LEGAI RESPONSIBILITY FOR
ACTS OR OMISSIONS OF A PERSON OR ORGANIZATION FOR WHOM LIABILITY
COVERAGE IS AFFORDED UNDER THIS POLICY.
--
-
etr{
G-s601s-B (ED. Lr/gr','
Socrst ry
g
o
o
o
N
I
I
CNA CNA PARAMOUNT
General Aggregate Limit - Per Project Endorsement
This endorsement modilies insurance provided under the following:
COMMERCIAL GENERAL LIABILIry COVERAGE PART
It is understood and agreed as follows:
l. For each single construction or service project away from premises the Named lnsured owns or rents, a separate
Project GeneralAggregate Limit, equal to the amount of the General Aggregate Limit shown in the Declarations, is the
most the Insurer will pay for the sum of:
A. all damages under Coverage A, except damages because ol bodily injury or property damage included in the
products-completed operations hazard; and
B. all medical expenses under Coverage C;
that arise from occurrences or accidents which can be attributed solely to ongoing operations at that project. Such
payments shall not reduce the General Aggregate Limit shown in the Declarations, nor the Project General Aggregate
Limit applicable to any other project.
il. Ail:
A. damages under Goverage B, regardless of the number ol locations or proiects involved;
B. damages under Coverage A, caused by occurrences which cannot be attributed solely to ongoing operations at
a single project, except damages because of bodily injury or property damage included in the products-
completed operations hazard; and
C. medical expenses under Coverage C, caused by accidents which cannot be attributed solely to ongoing
operations at a single project,
will reduce the General Aggregate Limit shown in the Declarations.
lll, The limits shown in lhe Declarations for Each Occurrence, for Damage To Premises Rented To You and lor Medical
Expense continue to apply, but will be subject to either the Project General Aggregate Limit or the General Aggregate
Limit shown in the Declarations, depending on whether the occurrence can be attributed solely to ongoing operations
at a particular project.
lV. When coverage lor liability arising out of the products-completed operatlons hazard is provided, any payments for
damages because of bodlly inlury or property damage included in the products-completed operations hazard will
reduce the Products-Completed Operations Aggregate Limit shown in the Declarations, regardless ol the number of
projects involved.
V. ll a single construction or service project away from premises owned by or rented to the Named Insured has been
abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs,
specifications or timetables, such project will still be deemed to be the same project.
Vl. The provisions of LIMITS OF INSURANGE not otherwise modified by this endorsement shall continue to apply as
stipulated.
All other terms and conditions ol the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated lnsurers, takes effect
on the etfective date of said Policy at lhe hour stated in said Policy, unless another effective date is shown below, and
expires concurrently with said Policy.
CNA75061XX (1-15) Policy No: 6023113030
Page 1 of 1 Endorsement No:
The Continental Insurance Co. EffectiveDate: 06/30/2019
lnsured Name: GEoENGTNEERS, rNc.
Copfhht CNA All RighE Rosawed. lncludes copyrighted material of lnsuranca SeMces Otfice, lnc., wih its p€rmbsion.
NOTICE OF CANCELLATION TO THIRD PARTIES
A. lf we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or
organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at
least 10 days, or the number of days listed below, if any, before cancellation becomes effective. ln no event
does the notice to the third party exceed the notice to the first named insured.
B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to
provide such advance notification will not extend the policy cancellation date nor negate cancellation of the
policy.
Name of Other Person(s) /
Organization(s):
Schedule on file with Company
lssued by Liberty lnsurance Corporation 21814
For attachment to Policy No. WC7-291-470641-019
lssued to GeoEngineers lnc
wc 99 20 75
Ed.12t01t2016
All other terms and conditions of this policy remain unchanged
SCHEDULE
EmailAddress or mailing address
Schedule on file with Company
Effective Date
Number Days Notice:
30
O 2016 Liberty Mutual lnsurance
Premium $
Page 1 of 1
POLICY NUMBER: zUP-91N15829-19-NF
THIS ENDOBSEMENT CHANGES THE POLICY
This endorsement modifies insurance provided under the following:
EXCESS FOLLOW-FORM AND UMBRELLA LIABILITY INSURANCE
UMBRELLA
ISSUE DATE: 07 /15/19
PLEASE BEAD IT CABEFUIIY.
SCHEDULE OF UNDERLYING INSURANCE
Commercial General Liability
Carrier: VALLEy FgRGE INSURANCE CgltpANy
Limits 0f tiability
General Aggregate $z , ooo, ooo
$1,ooo,ooo't
$L,ooo,ooor.
Policy
Number:
Policy
Number:
Policy
Number:
Policy Period
From: 07 /Ot/ZOLq
tot 07 /oL/2020
Automobile tiability
Carrier: NATIONAL FIRE INSURANCE OF
HARTFORD
AS PER SCHEDULE ON FILE WITH
THE COMPANY
AS PER SCHEDULE ON FILE WITH
THE COMPANY
AS PER SCHEDULE ON FILE WITH
THE COI{PANY
Products-Completed
Operations Aggregate $2 , ooo, ooo
Personal and
Advertising lnjury $1 , ooo, ooo
Each Occurrence $1,ooo,ooo
limits 0f Liability
Bodily lnjury And Property Damage
Combined Single Limit $1 ,000,000
Bodily lnjury EachPerson $
Bodily lnjury Each
Accident
Property Damage Each
Accident
limits 0f tiability
Bodily lnjury By Accident
Each Acc ident $ 1 , 000, 000r.
Bodily lnjury By Disease
Policy Period
From: 07 /0t/20t9
to: Ot /Ot/2020
Employers Liability
Carrier VALLEy FORGE INSURANCE Cgl,IpANy
$
$
Policy Period
From: 07 /0L/20t9
to: 07 /0t/2020
Policy Limit
Each Employee
'KUNLI}IITED IN THE STATE OF NEW YORK FOR SUBJECT EI{PLOYEES
PRODUCER: USI KIBBLE & PRENTICE OFFICE: SEATTLE,
EU 00 03 08 18 o 20 18 The Travelers lndemnity Company. All rights reserved.
WA
Page 1of 1
UMBRELLA
POLICY NUMBER: zup-91N15829-19-NF ISSUE DATE: 07/t5/L9
TI{IS ETIIDOBSEMENT CHAilGES THE POLICY. PTEASE BEAD IT CABEFUILY.
SCHEDULE OF UNDERLYING INSURANCE CONTINUED
This endorsement modifies insurance provided under the following:
EXCESS FOLLOW-FORM AND UMBRELLA LIABILITY INSURANCE
Type 0f Goverage: EMpLoyEE BENEFTTS LrABrLrry
Carrier: vALLEy FORGE INSURANCE COMpANy
Iimits 0f tiability
$1,000,000 EACH cLArH
$2,000,000 AccREcATE
Policy
Number:
AS PER SCHEDULE ON FILE WITH THE
COMPANY
Policy Period
From: 07 /0L/20t9
toi 07 /0L/2020
Type 0f Coverage:
Carrier:
limits 0f tiability
Policy
Number:
Policy Period
From:
to:
Type 0f Goverage:
Carrier
Limits 0f tiability
Policy
Number:
Policy Period
From:
to:
PRODUCER: USI KIBBLE & PRENTICE OFFICE: SEATTLE, WA
EU 00 04 07 16 o 2016 The Travelers lndemnity Company. All rights reserved. Page 1of 1
Terra lnsurance Company
(A Risk Retention Grou p)
Two Fifer Avenue, Suite IOO
Corte Madera, CA 94925
DATE
03123120
TERRA
INSURANCE COMPANY
CERTIFICATE OF INSURANCE
CERTIFICATE HOLDER
City of Kent
Attn: Timothy LaPorte, PE
220 Fourth Avenue South
Kent, Washington 98032
This certifies that the "claims made" insurance policy (described below by policy number) written on forms in
use by the Company has been issued. This certificate is not a policy or a binder of insurance and is issued as a
matter of information only, and confers no rights upon the certificate holder. This certificate does not alter,
amend or extend the coverage afforded by this policy,
The policy of insurance listed below has 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 policy described herein is
subject to all the terms, exclusions and conditions of such policy. Aggregate limits shown may have been
reduced by paid claims.
TYPE OF INSURANCE Professional Liability
POLICY NUMBER
220019
EFFECTIVE DATE
0t/0|20
EXPIRATION DATE
t2t3|20
LIMITS OF LIABILITY $3,000,000
$3,000,000
EACH CLAIM
ANNUAL AGGREGATE
PROJECT DESCRIPTION
North Frager Road at Midway Creek, City of Kent, GeoEngineers NO. 0410-215-00
CANCELLATION: lf the described policy is cancelled by the Company before its expiration date,
the Company will mail written notice to the certificate holder thirty (30) days in advance, or ten
(10) days in advance for non-payment of premium. lf the described policy is cancelled by the
insured before its expiration date, the Company will mail written notice to the certificate holder
within thirty (30) days of the notice to the Company from the insured.
NAME AND ADDRESS OF INSURED
ISSUING COMPANY:
TERRA INSURANCE COMPANY
(A Risk Retention Group)
GeoEngineers, Inc.
1l0l S. Fawcett Avenue, Suite 200
Tacoma, WA 98402
President
GEOENGINEERS INC Page I of2
sir lf,ortv stlt{GtoN
Department of Labor & lndustries
Certificate of Workers' Compensation Coverage
March 25,2020
WA UBI No.
L&lAccount lD
Legal Business Name
Doing Business As
Workers' Comp Premium Status:
Estimated Workers Reported
(See Description Below)
Account Representative
Licensed Contractor?
License No.
License Expiration
600 375 010
429,351-00
GEOENGINEERS INC
GEOENGINEERS INC
Account is current.
Quarter 4 of Year 2019 "Greater than
100 Workers"
Employer Services Help Line, (360)
902-4817
Yes
GEOENI*11OJE
05t09t2021
What does "Estimated Workers
Reported" mean?
Estimated workers reported represents the
number of full time position requiring at least
480 hours of work per calendar quarter. A single
480 hour position may be filled by one person,
or several part time workers.
lndustrial Insurance Information
Employers report and pay premiums each
quarter based on hours of employee work
already performed, and are liable for premiums
found later to be due. lndustrial insurance
accounts have no policy periods, cancellation
dates, limitations of coverage or waiver of
https://secure.lni.wa.gov/verify/Details/liabilityCertificate.aspx?UBI:600375010&LIC:G... 312512020
GEOENGTNEERS INC Page2 of 2
subrogation (See RCW 5l .12.050 and
5r.r 6.r 90).
https://secure.lni.wa.gov/verify/Details/liabilityCertificate.aspx?UBI=600375010&LIC:G... 312512020