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HomeMy WebLinkAboutCAG2020-112 - Amendment - #1 - TMG Services, Inc. - 2020 Annual Chlorine Equipment Maintenance - 06/09/2020ApprovalOriginator:Department: Date Sent:Date Required: Authorized to Sign: o Director or Designee o Mayor Date of Council Approval: Budget Account Number: Budget? o Yes o No Grant? o Yes o No Type:Review/Signatures/RoutingDate Received by City Attorney:Comments: Date Routed to the Mayor’s Office: Date Routed to the City Clerk’s Office:Agreement InformationVendor Name:Category: Vendor Number:Sub-Category: Project Name: Project Details: Agreement Amount: Start Date: Basis for Selection of Contractor: Termination Date: Local Business? o Yes o No* *If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace. Notice required prior to disclosure? o Yes o No Contract Number: Agreement Routing Form 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) Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20 140,0�* KE4 NT W A g N I N O T O N AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: CONTRACT NAME & PROJECT NUMBER: ORIGINAL AGREEMENT DATE: TMG Services Inc. 2020 Annual Chlorine E ui ment Maintenance April 72020 This Amendment is made between the City and the above -referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: The Vendor required additonal maintenance and parts to complete the annual 2020 Chlorination System Service Maintenance at Clark Springs, Kent Springs, East Hill Well, Seven Oaks, and Armstrong Springs not covered in original contract. For a description and Vendor's invoices, see Exhibit A which is attached and incorporated by this reference. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are modified as follows: Original Contract Sum, including applicable WSST Net Change by Previous Amendments including applicable WSST Current Contract Amount I including all previous amendments $8,209.00 $0.00 $8,209.00 Current Amendment Sum $542.75 Applicable WSST Tax on this $0.00 Amendment Revised Contract Sum $8,751.75 AMENDMENT - 1 OF 2 Original Time for Completion (insert date) July 31, 2020 Revised Time for Completion under prior Amendments (insert date) N/A Addl Days Required (+) for this Amendment 0 calendar days Revised Time for Completion (insert date) July 31, 2020 The Consultant or Vendor accepts all requirements of this Amendment by signing below, byits signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affectedby this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affiimed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties betow have executed this Amendment, which will become effective on the last date written below. coNsuITANT/VENDOR: By L{h on L-! Print e Q? Its (title) DATE: CITY OF KENT: By: (signature) Print Name: David A. Brock, P.,E, DATE: ATTEST: Kent City Clerk APPROVED AS TO FORM: (applicable if Mayorb signature required) Kent Law Department P:\Publlc\Admlnlstration\Contracts\Contrdcts prepared (Kathi)VMG Seryices Amendment AMENDMENT-2OF2 Exhibit A A Revised 05-06-20 Invoice 32i6 E. PotOand Avenue k M GTana, WA98404 40, SEAVICE5 253-779-4160 j''� SCANNE1.J Sold To: K9NT, CITY OF/WATER DEPARTMENT 220 FOURTH AVENUE SOUTH KENT. WA SM32 Invoke Number. 00450394N Irwoiae Deli: 4r274110) Order Number: Ober Date Salesperson: BY Custairw Number. 1105141 MAY 0 S 20 � TC1TY OF/WATER DEPARTMENT 220 FOURTH AVENUE SOUTH KENT WA 9803Y WCIIE - NP Pope: 1 antomerp; O. Ship VIA F.C.B. Terms sales Tax Code ` 158367 i NET 30 DAYS CM1715 Item Cos Unit Ordered Shipped Back Ordered Price Amount East HE Well 24525 104thAve SE Kent98030 NICE LABOR FIELD SERVICE LABOR HOUR 4.50 4.50 0.00 135.00 607.50 /SERVICE TRAVEL FIELD SERVICE TRAVEL TIME HOUR 1.00 1.00 0.00 135.00 135.00 !SERVICE MILES FIELD SERVICE MILEAGE MILE 40.00 40.00 0.00 0.80 3200 W�-2 VR FOR V10K 8 SICKSERVICE KIT Whsx 000 EACH 200 2.00 0.00 184.94 36988 W2T10062 AA81949 SEAT REGULATOR 11VN5e. 000 EACH 2.00 2.00 0.00 6.47 12.94 W2T11202 AI05355 RETAINER 11111m: 001 EACH 1.00 1.00 0.00 24.49 24A9 MIK-1 V10KIV2000500 PPD SERVICE KIT Vnew 000 EACH 1.00 1.00 0.00 111.66 111.66 w2T16924 P41212 ROTAMETER TOP -STOP CHLO Vihse: 000 EACH 1.00 1.00 0.00 8.30 &30 MK-5 3r4" STD INJECTOR SERVICE KIT VW=: 000 EACH 1.00 1.00 0.00 117.47 117.47 MK-4 S10K 5" ROTAMBTER SERVICE KIT Whse: 000 EACH 1.00 1.00 0.00 118.81 119.81 0535J-M 918- JG NATURAL TUBING YVhse: 000 FOOT 13.00 13.00 0.00 1.58 20.54 Clesnedlinspented/regasketed (2) 210S vacuum regulators. (1) SCU automatic VICK chlorinator (50 PPD), (1) V cwttrd unit (50 PPD) and (1) 314" injegtdf (193G). Replaced womtroken parts as necessary. Replaced all tubing. Tested system to ensure proper operation. Tested (1)16100 CL2 leak detectorfor proper response to the presence of chlomne gas and verified '-- sensor zero voltage. Cant rojed 111030 Invoice 3216 E. Portland Avenue kMGTacoma. WA98404 SERVICES 253-779-4180 Sold Ta KENT, CITY OFIWATER DEPARTMENT 220 FOURTH AVENUE SOUTH KEW. WA 98032 Immica Number: 00450394N Invoice Date. 412712020 Order Number. Order Date Salesperson: BY Customer Number: 1105141 Ship To: KENT, CITYOF/WATER DEPARTMENT 220 FOURTH AVENUE SOUTH KENT, WA 99032 Paw 2 Costomer P.O. IM67 Ship VIA _ ^-- -- F.OJB. Terms NET 30 DAYS Sales Tax Code 000001715 Nam Code Unit Ordered Sblppad Badc Ordered Price Amount Kent Spdrigs 2W3W 216th Ave SE Kent 98M !SERVICE LABOR FIELD SERVICE LABOR HOUR 7.00 7.00 0.00 135.00 945.00 /SERVICE TRAVEL FIELD SERVICE TRAVEL TIME HOUR 1.00 1.00 0.00 135.00 135.00 /SERVICE MILES FIELD SERVICE MILEAGE MILE 50.0D 50.00 0.00 0.80 40.DO MK--2 VR FOR VIDK 8 SI0K &RMCE KIT Whse: 000 EACH 200 200 0.00 194.94 389.88 w2T100W AAB1949 SEAT REGULATOR Whsr. 000 EACH 2.00 2.00 0.00 6.47 12.94 MK-1 VIOWV2000 SW PPD SERVICE KIT IR tm-. 000 EACH 2.00 2.00 OAO 111.66 223.32 W2T16924 P41212 ROTAMETFR TOP -STOP CHLO Votsw 000 EACH 2.00 2A0 0.00 9.30 16.60 W3T159667 P97034 VALVE STEM; PVC Whse: 000 EACH 2.00 2.00 0.00 22.20 44AD MK-5 3W STD INJECTOR SERVICE KIT Whsa: 000 EACH 1.60 100 0.00 117.47 117.47 05w-025 318" JG NATURAL TUBING Whse: 000 FOOT 20.00 20.00 0.00 1.58 31.60 W3T1081644 AA84694 OPERATING SHAFT SWITCH Whae: 001 EACH 1.00 1.00 0.00 120.86 120.8E MK-5 3/4" STD INJECTOR SERVICE 19T Whas: 000 EACH 1.00 1.00 0.00 117A7 117.47 CleanedIMSpectedtogaskNed (2) 21M vacuun regulators with ton containeradaptem (2) SFC eutometk V10K dAmir ators (30 PPD, 50 PPD) and (2) 3/4" Ir*xA r;s (140F). Replaced @ xftraken parts as neossawy- Replaced all robing. Tested system to ensue pmmper apma6am Continued Invoice T M G 3216 E. Portland Avenue Tacoma, WA98404 SERVICES 253-779.4160 Sold To: KENT, CITY OFIWATER DEPARTMENT 220 FOURTH AVENUE SOUTH 1ENT, WA 9=2 Invoice Number, W46039-IN lrvoice Bate 4n712620 Omer Number. Order Date Salesperson: BY Customer Number. 1105141 Sbip TO: KENT, CITY OFIWATER DEPARTMENT 220 FOURTH AVENUE SOUTH KENT, WA 98032 Page: 3 Customer P.O. Ship VIA 13� FAQ, Terms NET 30 DAYS Sales Tax Code D0000171S Morn Code Unit Ordered - - show flack Ordered Price Amount Tested (2) 1610E CL2 leak detectors for proper response to the presence of chlorine gas and verified proper sensor zero voltages. NOTE: 81 VR was extremely dirty iisile. Ihdy fimn tank debris carry wen, but the dripleg was (arty dean. Cleaned the dripleg anyway due to opening for inspection. Clark Springs 25120 SE Kant-Kengley Road Ke d M39 W-2 VR FOR V10K A S1 OK SERVICE Krr whse: 000 EACH 2.00 2.00 0.00 194.94 369.88 W2T10D62 AAS1949 SEAT REGULATOR whse: 000 EACH 2.00 2.00 0.00 6.47 12.94 MK-1 V10KN2M 500 PPD SERVICE IGT Whse: 000 EACH 1.00 1.00 0.00 111.66 111.66 W2T16924 P41212 ROTAMETER TOP -STOP CHLO Whse 000 EACH 2.00 2.00 DAD 9.30 16.60 MK-4 SIDK 5" ROTAMETER SERVICE Krf Vfim.- D00 EACH 1.00 1.00 O.DO 119.81 119.91 MK-5 3/4" STD INJECTOR SERVICE IQT 1111bse: 000 EACH 1.00 1.00 0.00 117.47 117A7 ► W15907 P970134 VALVE STEM; PVC Whse: OW EACH 1.00 1.00 0.00 P2.2D 22.20 Vd?T367090 ANM5366 STEM REGULATOR Wh"; 001 EACH 2.00 2.W 0.00 49.60 99.20 W3T168305 MANOMETER GAUGE Whse: 000 EACH 1.00 1.00 0.00 253.12 253.12 0535J-025 3B" JG WATURAL TUBING IAl =: DOD FOOT 17.00 17.00 0.00 1.58 26.96 50611-005 1/2" TU BALL VALVE OF EPDM Whse: OD1 EACH 1.0D 1.00 0.00 97.00 67.00 Continued Invoice 3216 E. Patttand Are�le kMGTacoma, WA98404 SERVICES 253-779-4160 Sold To: KEW. CITY OFIWATER DEPARTMENT 220 FOURTH AVENUE SOUTH KENT, WA 98032 CustomerM S*VIA F.O.B. 158367 krvake Number: 0045039-IN knolee Date: 4127rAM Order wonber: Order Date Salesperson: BY Customer Number. 1105141 Slip Ttx KENT, CITY OF/WATER DEPARTMENT Z20 FOURTH AVENUE SOUTH KENT, WA 98032 Page_ 4 Terms Sales Tax Code NET 30 DAYS 000001715 mom Code unk Ordered Shipped Sack ordered 3839-072 1f2"T x 114"T ROCK BUSH Whse: 001 EACH 1.00 1.00 0.00 W611-007 314" TU BALLVALVE OF EPDM Whae: 001 EACH 1.00 1.00 0.00 3938-098 314"S x 1147 ROM BUSH Whse: 001 EACH 1.00 1.00 0.00 W3T108083 AAA4497 BACKING PLATE whee: 000 EACH 1.00 1.00 0.00 Cleaned*upected1regasketed (2) 210S vacuum regulators with Ian containeradapters, (1) SFC automatic V10K d*wk% tw (50 PPD). (1) 5- remote raterne w (5D PPD) and (1) 3W injector (193G) - irmaled shelf spare injector. Replaced wvnvbroken parts as necessary. Replaced al hNng. Tested system to ensure proper operation. Replaced broker) ball valves. Tested (2) Acutec 35 CL2 leak detectors and (1)1610B CL2 leak deter for for proper response to the presence of chloride gas and verified sensor zero voltages. Arm*wV Springs 19025 SE 272nd St Covington 98042 /SERVICE LABOR FIELD SERVICE LABOR HOUR 4.00 4.D0 0.00 (SERVICE TRAVEL FIELD SERVICE TRAVEL TIME HOUR 1.OD 1.00 0.00 /SERVICE MILES FIELD SERVICE MILEAGE MILE 40.00 40.00 0.00 M1-2 VR FOR V14K 8 S10K SERVICE KIT Whse: ODD EACH 2.00 2.00 Ojai) W2T10062 AA91949 SEAT REGULATOR whsa: O00 EACH 2.00 2.00 0.00 price Amount 6.48 6.48 80.00 $0.00 1.SS 1.88 8453 94,53 135.00 540.00 135.00 135.00 0.80 32.00 184.94 369.68 &47 12.94 Continued Invoice TkMG3216 E. Portland Avenue Taoorna, WASS404 SERVICES 253779-4160 SOW To: KENT, CITY OFANATER DEPARTMENT 220 FOURTH AVENUE SOUTH KENT, WA 98032 Invoice Number_ 00460394N Invoice Date: 412712020 Order Number_ Order Dale Salesperson: BY Customer Number. 1105141 Ship To; KENT. CITY OFANATER DEPARTMENT 220 FOURTH AVENUE SOUTH KENT, WA 98032 Page: 5 Customer P.O. Ship VIA F.O.B. Terms 158M NET 30 DAYS Sales Tax Code OOM01715 Hsu coo Unit Ordered Shipped Bock Ordered Price Amount MK4 810K V ROTAMETER SERVICE KIT vam: 000 EACH 1.OD 1.00 0.00 119.81 119.81 W2T12010 PXA3WA8 ORING 014 VIT .062 Whso: 001 EACH 1.00 1.00 0.00 2.29 Z29 V75.114B 0.RINC6114 VITON, BLACK vase: 001 EACH 1.00 1.00 moo 0.50 0.50 YM16507 P34530 SHAFT SEAL Whse: 001 EACH 1.00 1.00 0.00 9,35 9,35 W2T19027 P4404504RRNG213 HYPALON Whse: ODI EACH 1.00 1.00 0.00 322 322 van S%57 1397034 VALVE STEM; PVC Whom 001 EACH 1.00 1.00 0.00 2220 2220 W3T159686 P97032 VALVE STEM; PVC 1Nhsx 001 EACH 1.00 1.00 0.00 11.67 11.67 O535,F025 3/8' JG NATURAL TUBING Whse: O00 FOOT 10.00 10.00 0.00 1.58 15.80 Cleanedfe regasketed (2) 210S vacuum regulators, (1) SFC automatic S1OK chlorinator (20 PPD) and (1) 3W injector (193S). ReplacedwGmPotnken parts as necessary. Replaced al %bing. Tested system to er oure proper opemlion (left tank off/evacuated as system is off-line now). Tested (1)18108 CL2 gas leak detector for proper response to the presence of chlorine gas and verified sensor zero voltage. Net Invoice: $ 6.398.40 Freight: 8 0.00 Sates Tax: $ 639.84 Total Irwalce: S 736 Invoice TMG 3216 E. Polt(and Avenue Tacoma, WA 98404 SERVICES 253-779A160 SCANNED Invoice Number. 004SO414N Invoice Date: 4272020 Order Number. Order Date Salesperson: BY Customer Number. 1105141 Page: 1 Sold To: APB 2 9 2Q20 Ship To: KENT, CITY OFIWATER DEPARTMENT KENT, CITY OF - SEVEN OAKS 220 FOURTH AVENUE SOUTH 11834 SE KENT KANGLEY ROAD KENT, WA M32 CE r AT KENT, WA 98030 FINAN customer P.O. Ship VIA F.B.B. Terms Sales Tax Code r 158367 NET 30 DAYS 000001715 `'tl nmP'C-6 Unit Ordered Shipped Back Ordered Price Amount !SERVICE LABOR FIELD SERVICE LABOR HOUR 5.50 5.50 0.00 135.00 742.60 !SERVICE TRAVEL FIELD SERVICE TRAVEL TIME HOUR 1.00 1.00 0.00 135= 135 DO /SERVICE MILES FIELD SERVICE MILEAGE MILE 40.00 40.OD 0.00 0.80 32.00 MK 2 VR FOR V10K 8 S10K SERVICE KIT Whse: 000 EACH 2.00 2-00 0.00 184.94 369,98 VQTIDO62 AAB1949 SEAT REGULATOR Whse: 000 EACH 2.00 2.00 0.00 6,47 12.94 MK-3 S10K Y ROTAMETER SERVICE KIT Whse: 000 EACH 1.00 1.00 0.00 97.13 97.13 MK-5 314' STD INJECTOR SERVICE KIT Whse: 000 EACH 1.00 1.00 0.D0 117.47 11747 06W505 in GRAB RING PLASTIC Whae: 001 EACH 1A0 1.00 0.00 1.00 1,00 OM-032 112' JG NATU RA L T U BI NG Whae: OW FOOT 6,00 6.00 0.00 223 13.38 0535J-025 3t8' JG NATURAL TUBING Whae: 000 FOOT 9.00 9.00 0.00 1,58 14.22 W3T15%57 P97034 VALVE STEM; PVC Whse: 001 EACH 1.00 1.00 0.00 2220 2220 Clean ed4nspectedtregasketad (2) E10K vacuum regulators, (1) 3" remote ratemeter (50 PPD) and (1) 3W' injector (140F). Replaced wumlbroken parts as necessary. Replaced all tubing. Tested system using air only. Verified integrity of VR's using -80 PSI air to ensure no venting. Tested (1) Acutec 35 CL2 gas leak detector for proper response to the presence of chlorine gas and verified sensor zero voltage. Net Invoice: S 1,55772 Freight $ 0:00 Sales Tax: S 155.77 Tout Invoice: $ 1.713.49 Dqoof-\ ACC)R0I CERTIFICATE OF LIABILITY INSURANCE DATE (MM DD YYYY) 04/07/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDJTIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Linda Doherty NAME: HENTSCHELL &ASSOC INC PH!CNONEo Ex, : (253) 272-1151 FAX (253) 272-1225 AAIC. No 1436 S. Union Ave. E-MAIL Linda Dohe hentschell.com annRL Linda_Doherty@hentschell.com INSURER(S) AFFORDING COVERAGE NAIC S Tacoma WA 98405-1925 INSURERA: Western National Assurance Co. INSURED INSURER B : SAIF Corporation TMG Services, Inc. INSURER C : 3216 E. Portland Ave. INSURER D : INSURER E : Tacoma WA 98404-4929 INSURER F : COVERAGES CERTIFICATE NUMBER- 19/20GL/Auto/Um/StpGp REVISION Nl1MRER- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADOL INSD SU51R WVD POLICYNUMBER POLICY EFF IMM/DDNYYYI POLICY EXP fMMIDDNYYY)LIMITS m X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_1 OCCUR EACH OCCURRENCE $ 1,000,000 PR EWSES?Ea ac,-vnr;x $ 100,000 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 A Y Y CPP112463405 12/02/2019 12/02/2020 AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 �GEN'L POLICY � PET ❑ LOC PRODUCTS-COMP/OPAGG $2,000,DOO Employee Benefits s 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Es accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y Y CPP112211705 12/02/2019 12/02/2020 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per aociden $ Uninsured motorist $ 1,000,000 UMBRELLA LIAB OCCUR '""""""" "'"y" ,"' FACH OCCURRENCE 5,000,000 $ AGGREGATE $ 5,000,000 A EXCESS LIAB In CLAIMS -MADE Y Y UMB102042005 12/02/2019 12/02/2020 DIED I X RETENTION $ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBCERIMEMBER EXCLUDED? (Mandatory in NH) NIA CPP112463405 12/02/2019 12/02/2020 PER OTH- STATUTE X ER State of Washington E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - FA EMPLOYEE $ 1,000,000 f yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT 1,000,000 $ Worker's Compensation -Oregon B 602214 - State of Oregon 03/01/2019 03/01/2020 Each Accident Disease Policy 500,000 500,000 Disease Ea Employee 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 2020 Maintenance Agreement. City of Kent is under Blanket Primary Non -Contributory Additional Insured with Waiver of Subrogation as required by written contract or agreement per WNGL49(07-15); WNGL50(05-15); WNGL39(08-18) and WNCA27(06-16) CtKI ll•IGAI t HULUtK CANCELLAIIUN City of Kent 400 West Gowe Kent WA 98032 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ADDITIONAL COVERAGES Ref # Limit 1 5,000 Ref # Description Medical payments Limit 2 Limit 3 Deductible Amount - Description Underinsured motorist combined single limit Coverage Code MEDPM Deductible Type j Coverage Code UNCSL Form No. Premium Form No. Edition Date Edition Date Limit 1 1,000,000 Limit 2 Limit 3 Deductible Amount i Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Ref # Limit 2 Description Limit 3 Deductible Amount i Deductible Type Coverage Code Premium Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Premium Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Ref # Limit 1 Limit 2 Description Limit 2 Limit 3 Limit 3 Deductible Amount Deductible Amount Deductible Type Coverage Code Deductible Type Premium Form No. Premium Edition Date Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Limit 1 Description Limit 2 Limit 3 Deductible Amount Coverage Code Deductible Type Form No. Premium Edition Date OFADTLCV Copyright 2001, AMS Services, Inc. Additional Named Insureds Other Named Insureds Thomas & Mary Gazdik Individual, Additional Named Insured DBA Engineered Control Product, Inc. C Corporation, Additional Named Insured OFAPPINF (0212007) COPYRIGHT 2007, AMS SERVICES INC POLICY NUMBER: CPP 112463405 COMMERCIAL GENERAL LIABLITY WN GL 50 0715 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — COMPLETED OPERATIONS PRIMARY AND NONCONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) ! Location And Description Of Completed Operations PER WRITTEN CONTRACT OR AGREE- MENT WHERE YOU AGREED TO NAME A PARTY OR PARTIES AS ADDITIONAL INSURED(S) AS REQUIRED BY WRITTEN CONTRACT f ation required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section It — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "prop- erty damage" caused, in whole or in part, by "your work" at the location designated and de- scribed in the schedule of this endorsement per- formed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional in- sured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to pro- vide for such additional insured. B. With respect to the insurance afforded to these ad- ditional insureds, the following additional exclusion applies: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or en- gineering activities. WN GL 50 07 15 Includes copyrighted material of Insurance Services office, Inc., with its permission. Page 1 of 2 This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, If the 'occurrence" which caused the "bodily injury" or "property dam- age", or the offense which caused the "person- al and advertising injury", involved the render- ing of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying serv- ices in your capacity as an engineer, architect or surveyor. C. With respect to the insurance afforded to these ad- ditional insureds, the following is added to Section fill — Limits Of Insurance: If coverage provided to the additional insured is re- quired by a contract or agreement, the most we Will pay on behalf of the additional insured is: 1. The minimum amount required by the contract or agreement; or 2. The Limits of Insurance shown in the Declara- tions; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. D. The following is added to the tither Insurance Condition and supersedes any provision to the contrary; Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other Insurance available to an additional insured under your policy pro- vided that; (1) The additional insured is a Named insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be pri- mary and would not seek contribution from any other insurance available to the addition- al insured. WN GL 50 07 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. page 2 of 2 COMMERCIAL GENERAL LIABILITY CPP112463405 WIN GL49 OT 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -- AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION ACREEI E`NT WITH YOU PRIMARY AND NONCONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom you are performing opera- --tions when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with re- spect to liability for "bodily injury", "property dam- age" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are complet- ed. However: 1. The insurance afforded to such additional in- sured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the in- surance afforded to such additional insured will not be broader than that which you are re- quired by the contract or agreement to provide for such additional Insured. WN GL 49 07 15 B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sion applies: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the ren- dering of, or the failure to render, any profes- sional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against an additional insured allege negli- gence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any profes- sional services by you with respect to your providing engineering, architectural or survey- ing services in your capacity as an engineer, architect or surveyor Includes copyrighted material of Insurance Services office, Inc., with its permission. Peg e 1 of 2 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment fumished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or or- ganization other than another contractor or subcontractor engaged in performing op- erations for a principal as a part of the same project, C. With respect to the Insurance afforded to these additional insureds, the following is added to Sec- tion: 11: — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: 1. The minimum amount required by the oontract or agreement; or 2. The Limits of Insurance shown in the Declara- tions; whichever is less. This endorsement shall not increase the applicable Limits of insurance shown in the Declarations. WN GL 49 0715 D. The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And noncontributory insurance This insurance is primary to and will not seek any contribution from any other insurance available to an additional Insured under your policy provided that; (1) The additional insured is a Famed Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance avallable to the additional insured. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 CPP112211705 BUSINESS AUTO ENHANCEMENT ENDORSEMENT WN CA 27 0616 The Business Auto Enhancement Endorsement is an optional endorsement that provides coverage enhancements. The following is a summary of broadened coverages provided by this endoreement No coverage Is provided by this summary, refer to following endorsement for changes In your policy. SUMMARY OF COVERAGES PAGE Accidents[ Alrbag Deployment. Coverage 4 Auto L eantL.ease Gap Coverage 4 Blanket Additional Insured 2 Blanket Waiver of Subrogatlon 8 Broadened Definition of Insured includes: • Newly Acquired Organizations for up to 160 Days 2 • Employees as Insureds 2 • Subsidiaries In Which You Own 60% or More 2 Deductible Waiver for Glass Repair 8 Employee Hired Auto 2,5 Follow Employee Coverage 3 Hired Auto Physical Damage Coverage 4 Knowledge of Accident, Claim, Suit or Loss 6 Lass Of Use Expenses - Amended a Personal Effects 3 Rental Reimbursement Coverage 4 Supplemsntary Payments -Amended: • Bali Bonds up to $6,000 2 ■ Loss of Earnings up to $WDM&y 2 Transportation Expense Limits —Amended 3 Unintentional Failure to Disclose Hazards 6 WN CA 27 0616 hwWdes copyrights raaieriai of Insurarree Serviaea Office, with its permWen Page S of 5 VVN CA 27 06 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BUSINESS AUTO ENHANCEMENT ENDORSEMENT This endorsement modifies the insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The SECTIONS of the Business Auto Coverage Form Identified In this endorsement will be amended as shown below. SECTION 11 — COVERED AUTOS LIABILITY COVERAGE AMENDMENTS A. Who is An Insured SECTION II — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who is An Insured is amended to add: d. Any legally incorporated subsidiary of yours in which you own more than 50% of the voting stock on the effective date of this coverage form However, "insured" does not include any subsidiary of yours that Is an "Insured" under any otter automobile liability policy, or would be an "insured" under such policy but for termination of such policy or the exhaustion on such policy's limits of insurance. e. Any organization which is newly acquired or formed by you and over which you maintain majority ownership. However, coverage under this provision: (1) is afforded only for the first 160 days after you acquire or form the organization or until the and of the policy period, whichever comes first; (2) does riot apply to "bodily Injury" or "property damage" that results from an "accident" that occurred before you formed or acquired the organization; (3) does not apply to any newly acquired or formed organization that Is a joint venture or partnemhlp; and (4) does not apply to an "insured" under any other automobile liability policy, or would be an "insured" under such a policy but for ter- mination of such policy or the exhaustion of such pollcy's limits of Insurance. f. Any "employee" of yours is an "Insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affalm. 9. Any "employee" of yours is an "Insured" while operating a covered "auto" hired or rented under a contract or agreement In the "employee's" name, with your permission, while performing duties related to the conduct of your business. B. Sianfcet Additional insured SECTION If — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, I. Who Is An Insured, paragraph c. is amended to add the following: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an additional insured is an "insured° for Liability Coverage, but only for damages to which this insurance applies and only to the extent that persons or organization qualifies as an "Insured" under the Who Is An Insured provision contained In Section It. C. Liability Coverage Extermlons — Supplementary Payments SECTION 11 — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Supplementary Payments is amended by replacing subparagraphs (2) and (4) with the following: (2) Up to $%000 for cost of ball bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) Ali reasonable expenses incurred by the 'Insured" at our request, Including actual loss of earnings up to $600 a day because of time off from work. WN CA 27 0616 Includes copyrighted mobw1el of insurance services Office, with its pwmisdon Page 2 of 5 D. Fellow Employee Coverage SECTION II — COVERED AUTOS LIABILITY COVERAGE, B. Exclusions, S. Fellow Employee, the following is added: Co -Employes Lawsuit Defense Cost Reimbursement If a suit seeking damages for "bodily injury" to any fellow "employee" of the "Insured" arising out of and in the course of the feller "employee's" emptoyment or while performing duties reed to the conduct of your business, or a suit seeldng damages brought by the spouse, child, parent, brother or sister of that fellow 'employes", Is brought against you, we will reimburse reasonable costs that you Incur in the defense of such matters. Any reimbursement made pursuant to this sub -section will be In addition to the limits of liability set forth in the Declarations. SECTION iII — PHYSICAL DAMAGE COVERAGE AMENDMENTS A. Transportation Expense — Limits Amended SECTION iII — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Trans- portation Expenses Is amended by replacing $20 per day/$9100 maximum limit with $50 per dayl$1000 maximum. 6. Hired Auto Physical Damage -- Loss Of Use Expenses — Limits Amended SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4, Coverage Extensions, b. Lase of Use Expenses is amended by replacing the $20 per dayl$600 maximum limit with $60 per day/060 maximum limit C. Personal Effects Coverage SECTION III — PHYSICAL DAMAGE COVERAGE, A. Overage, 4. Coverage Extensions is amended by adding the following: c. Personal Effects iNe will pay up to $S00 for "loss" to personal effects, which are: (1) Owned byan"Insured"; and (2) In or on your covered "auto." This coverage applies only In the event of the total theft of your covered "auto." No deductible applies to this coverage D. Glass Repair— Deductible Waiver SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 3. Glass Breakage — Hitting A Bird Or Animal — Falling Objects Or Missiles, Is amended by adding the following: No deductible will apply to glass breakage If such glass is repaired, In a manner acceptable to us, rather than replaced. E. Hired Auto Physical Damage SECTION III—PHYSICALDAMAGE COVERAGE, A. Coverage Is amended by adding the following: 6. }Bred Auto Physical Damage ft Wred "autos" are covered "autos" for Liability Coverage and If Comprehensive, Specified Causes or Loss; or Collision coverages are pro- vided under this coverage form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire of like kind and use, subject to the following; a. The most we will pay for any one "loss" Is $60,000 or the actual cash value or cost to repair or replace, whichever Is teas, minus a deductible; b. The deductible will be equal to the largest deductible applicable to any owned "auto' for that coverage. Any Comprehensive deductible does not apply to "loss" caused by fine or lightening; c. Hired Auto Physical Damage covemile Is excess over any other collectible Insurance; and d. Subject to the above limit, deductible and excess provisions we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. If a limit for Hired Auto Physical Damage is Indicated In the Declarations, then that limit replaces, and Is not added to, the $50,000 limit Indicated above. iNN CA 27 0610 Includes copyrighted materiel of Insurance Services Office, wish us permission Page 3 of a F, Rental Reimbursement SECTION III— PHYSICAL DAMAGE COVERAGE A. Coverage, Is amended by adding the following: 6. Rental Reimbursement This coverage applies only to a covered "auto" of the private passenger or light truck type as follows: a. We will pay for rend rehnbursmnent expenses Incurred by you for the rental of a private passenger or fight truck type "auto" because of WWI to a covered private passenger or light truck type auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered private passenger or light truck type "auto." No deductibles apply to this coverage. b. We will pay only for those expenses Incurred during the policy period beginning 24 hours after the "foss" and ending, regardless of the policy's expiration,- with the leaser of the following number of days: (1) The number of days reasonably re- quired to repair or replace the covered private passenger or light truck type "auto". If "loss" Is caused by theft, this number of days is added to the number of days it takes to locate the covered private passenger or light truck type "auto" and return it to you; or (2) 30 days. c. Our payment Is limited to the lesser of the following amounts: (1) Necessary and actual expenses Incurred, or (2) $60 per day, up to a maximum of $1,000. d. This coverage does not apply while there are spare or reserve private passenger or light truck type "autos" available to you for your operations. e. If 'loss" results from the total theft of a covered "auto" of the private passenger or light truck type, we will pay under this coverage only that amount of your rental rebribureement expenses which Is not already provided for under SECTION lit — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions. For the purposes of this Rental Reimbursement coverage, light truck Is defined as a truck with a gross vehicle weight of 10,000 lbs. or lose as defined by the manufacturer as the maximum loaded weight the auto Is designed to carry. G. Accidental Airbag Deployment Coverage SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage [a amended by adding the following: 7. Accidental Airbag Deployment Coverage We will pay to reset or replace factory installed alrbag(s) in any covered "auto" for accidental discharge, other than discharge due to a collision lose. This coverage is applicable only If comprehen- sive coverage applies to the covered "auto". This coverage Is excess over any other collecti- ble insurance or reimbursement by manufac- turers warranty. H. Auto Loan/Lease Gap Coverage SECTION III PHYSICAL DAMAGE COVERAGE, Item A., Coverage, is amended by adding the following; 8. Auto Loan/Lease Gap Coverage This coverage applies only to a covered "auto" described or designated in the Schedule or in the Declarations as including physical damage coverage. In the event of a covered total "loss" to a covered "auto" described or designated in the Schedule or In the Declarations, we will pay any unpaid amount due on the tease or loan for a covered "auto" less: a. The amount paid under the Physical Damage Coverage Section on the policy; and b. Any: (1) overdue IeaseRoan payments at the time of the "loss' (2) Financial penalties Imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (6) Carry-over balances from previous loans or leases. WN CA 27 08 16 Includes wpyrighted material of Insurance Smvrrks Office, w#fi Its parmisolon Page 4 of SECTION IV BUSINESS AUTO CONDITIONS AMENDMENTS A. Duties In The Event Of Accident, Claim, Suit Or Lose Amended SECTION IV — BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. duties In The Event Of Accident, Claim, Suit Or Loss, a, is amended by aiding the following: This condition applies only when the "accident" or "loss" Is known to: (1) You, If you are an individual; (2) A parMer, M you are a partnership: (3) An executive officer or Insurance manager, If you are a corporation; or (4) A member or manager, if you are a limited Ilablllty company. But, this section does not amend the provisions relating to notification of police, protection or examination of the property which was subject to the "loss'. B. Blanket Waiver of Subrogation Section IV — BUSINESS AUTO CONDITIONS, A. Loss Conditions, S. Transfer of Rights of Recovery Against Others to tie, Is amended by adding the following exception. However, we waive any right of recovery we may have against any person or organization to the extent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "lose" arlees out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract C. Unintentional Failure to Disclose Hazards SECTION IV — BUSINESS AUTO CONDITIONS, @I. General Conditions, 2. Concealment, Mlarepre. santation Or Fraud, is amended by adding the following paragraph: if you unintentionally fail to disoiose any hazards existing at the Inowtion date of the policy, or during the policy period In connection with any additional hazards, we will not deny coverage under this Cov- erage Part because of such failure. D. Employee Hired Auto SECTION IV — BUSINESS AUTO CONDITIONS, E, Ganeral Conditions, 5. Other Insurance, paragraph b. Is deleted and replace by the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be a covered "autos" you own: 11) Any covered "auto" you lease, hire, rent or borrow. (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, white performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto" WN CA V 0618 Includes copyripnted materiel of insurance Services office, with its permission Page a of 6 Department of Labor & Industries Certi ficate of Workers' Compens ation Coverage What does "Estimated Workers Reported" mean? Industrial Insurance Information Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation