HomeMy WebLinkAboutCAG2020-204 - Original - Northwest Cascade, Inc. - Flagging/Traffic Control - 06/19/2020ApprovalOriginator: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
KENT POLICE SERVICES AGREEMENTWAtHr¡61oN
THIS AGREEMENT is made between the_ City of Kent, a Washington municipal corporation
(hereinafter "Kent"), and NoPrÊr-r€Ér CÀsel+ÈÉ, t'.¡4- , orgãnized under the laws of
the State of Washington, located and doing business at lgrlr¿ Jq.r*t ÉAa$-lAxÌ¡er.À, ¡¡¡é*1 €tSn-
(hereinafter the "Contractor"). P.;u¡*r-uoP, *A 4tS?4
X. TERM *AGREEMENT" FURTHER DEFINED - INCORPORATION OF ATTACHMENTS
AND INSURANCE EXHIBIT. The term "Agreement" as used throughout this document shall
mean this document, and any and all Scope of Services Attachments (hereinafter
"Attachments") which describe the scope of services to be peformed. The Attachments are
hereby incorporated into this Agreement by this reference. It is recognized that the Contractor
may request police services on several occasions, and therefore, while this main Agreement will
only be signed one time, there may be multiple Attachments to this Agreement. This Agreement
shall be enforceable with regard to each instance of work performed pursuant to each
Attachment. In the event of a conflict between the terms of this Agreement and any
Attachment, the terms of this Agreement shall prevail.
The Insurance exhibit as required by Section IX of this Agreement shall also be incorporated into
this Agreement as if set fofth herein in full.
IL SCOPE OF SERVICES. Contractor desires to utilize the services of a commissioned Kent
police officer who will be dedicated to performing the services described in the Attachment(s) to
this Agreement.
Police officers shall only be permitted to provide police-related services durlng the performance
of the work called for herein, and Contractor shall not ask or solicit such police officers to
perform work that is not police-related.
III. COST OF SERVICES AND PAYMENT
A. Hourly Rate. Contractor shall pay to the Kent Police Depaftment a sum for each
hour of worked performed by a commissioned police officer. The Chief of Police or his or her
designee shall have the authority to determine the hourly rate that will be specified in the
Attachrnent.
B. Four Hour Minimum Payment Requirement. There shall be a four (4) hour
minimum payment required for each instance that a police officer performs services under this
Agreement. Therefore, Contractor shall be required to pay to Kent the greater sum of four (4)
hours of work or the actual number of hours worked during each instance that a police officer
peforms services. For example, if Contractor needs two (2) police officers to work on the same
day and at the same time for two (2) hours of work each, Contractor will be required to pay Kent
for four (4) hours for each police officer, for a total of eight (8) hours. If Contractor needs two
(2) police officers for six (6) hours each, Contractor shall pay for six (6) hours for each police
officer for a total of twelve (12) hours.
C. Holiday Shifts and Shifts in Excess of Ten Hours. Shifts performed on holidays
shall be subject to an increased hourly rate that will be specified in the Attachment. Shlfts that
POLICE SERVICES AGREEMENT. 1 (Form Verslon: 1/201ó)
last in excess of ten (10) hours will be subject to a higher hourly rate for all work performed in
excess of ten (10) hours. The hourly rate for work performed in excess of ten (10) hours may
not be specified in the Attachment, but will be approximately at a rate of one and one-half (1,5)
times the regular hourly rate charged on that day, The Contractor will be billed and shall pay
the rate for work over ten (10) hours even if not specified in the Attachment,
D. Method and Time of Payment. Kent shall, within a reasonable time, submit a bill
to Contractor for amounts owing for services performed. Contractor shall, within fourteen (14)
calendar days of receipt of such bill, pay the amount owing to Kent, All payments shall be made
to the "City of Kent" and shall be delivered to:
City of Kent
Attn: Customer Services
220 Foufth Avenue South
Kent, WA 98032
E. Late Payment Penalties. If Contractor fails or neglects to pay any invoice within
thirty (30) calendar days from the date shown on the invoice as the "invoice date," a service
charge of one percent (10/o) of the amount of the unpaid balance on the account or two dollars
($2.00), whichever sum is greater, will be imposed one (1) month from the date payment was
due, and at the end of each succeeding monthly period, until all past due amounts are paid in
full.
Any invoice or service charge due under this Agreement and unpaid shall constitute a debt
owed to Kent. Kent may, pursuant to Chapter 3.10 of the Kent City Code and Chapter 19.16 of
the Revised Code of Washington, use a collection agency to collect outstanding debts, or it may
seek collection by couft proceedings, which remedies shall be in addition to all other remedies.
At the discretion of the Chief of Police or his or her designee, services may not be
provided to Contractors who have delinquent payments.
IV. EMERGENCY INTERRUPTIONS IN SERVICE. Police officers performing services called
for in this Agreement shall at all times be subject to the rules, regulations, and policies of Kent
and its Police Department, and shall be required to follow the orders of superuisors and
command staff. Contractor understands that police officers performing services pursuant to this
Agreement may, from time to time, be required to perform traditional police duties for the
benefit of the greater public. Therefore, from time to time, police officers performing services
for Contractor may be required to respond to emergencies and abandon the services being called
for under this Agreement. In the event of this occurrence, Contractor shall not be relieved of
providing full payment; provided, that in the event the interruption lasts longer that one half of
ône houi (i.e., more than thifty (30) continuous minutes), Kent and Contractor will agree to an
amount of a reduction in the costs of services to account for the police officer's time not
performing services under this Agreement.
V. INDEMNIFICATION.
A. General. Contractor shall defend, indemnify, and hold Kent, its officers, offlcials,
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 Kent's
peformance of this Rgrèement, except for that portion of the injuries and damages caused by
the sole negligence of Kent or lts officers or employees.
POLICE SERVTCES AGREEMENT. 2 (Form Verslon: t12076)
regulat¡ons appl¡cable to Contractor's business. Moreover, Contractor shall not, by reason of
race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory,
mental, or physical disability, discriminate against any person in violation of any laws of the
State of Washington or the United States,
fX. INSURANCE. Contractor shall at all times during Kent's performance of the services
called for in this Agreement procure and maintain insurance of the types and in the amounts
described in Exhibit A attached and incorporated by this reference.
X. CONTRACTOR'S BUSINESS PERFORMED AT ITS OWN RISK. Contractor shal] take all
necessary precautions and shall be responsible for the safety of its employees, agents, guests,
and all persons on Contractor's property and invitees at all times when a police officer is
pelforming services pursuant to this Agreement.
XI. MISCETLANEOUSPROVISIONS.
A. Non-Waiver of Breach. The failure of Kent 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.
B. Resolution of Disputes and Governing Law. This Agreement shall be governed
by and construed in accordance with the laws of the State of Washington. If the parties are
unable to settle any dispute, difference, or claim arising from the parties' performance of this
Agreement, the exclusive means of resolving that dÍspute, difference, or claim, shall only be by
filing suit exclusively under the venue, rules, and jurisdiction of the King County Superior Couft,
King County, Washington, unless the pafties 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; provigl_ed, however, nothing in this paragraph shall be construed to limit the
Kent's right to indemnification under Section V.B. of this Agreement.
C. Written Notice. All communications regarding this Agreement shall be sent to the
pafties 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.
D. Assignment. Any assignment of this Agreement by either party without the
written consent of the non-assigning pafty 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.
E, 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
Kent and Contractor.
F. Entire Agreement. The written provisions and terms of this Agreement, together
with any Exhibits or Attachments attached hereto or referenced herein, shall supersede all prior
POLICE SERVICES AGREEMENT - 4 (Form Version: U20t6)
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'S WAIVER OF
TMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF
THIS INDEMNIFICATION, THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
NEGOTIATED THIS WAIVER.
B. Indemnification and the Public Duty Doctrine. Contractor understands that,
pursuant to the legal doctrine in Washington called the "public duty doctrine," Kent, its Police
Depaftment, and its officers and employees of the Kent Police Department, owe a general duty
to the public and not a specific duty of protection or care to the Contractor, Contractor
understands that by entering into this Agreement, the Police Department's and the police
officer's duties remain to the public in general, and neither Kent, its Police Depaftment, nor any
of its officers or employees have a specific duty of protection or care to the Contractor, its
employees, subcontractors, and agents, or any of its guests, or other people on the premises of
the Contractor. Moreover, neither Kent, its Police Depaftment, nor any officer or employee of
Kent guarantees, in any way, the safety of any person or propefty as a result of the work
performed under this Agreement. In the event of injury to any person or property, Contractor
shall not assert that Kent, its Police Depaftment, or its police officer owed any special duty to
protect persons or propefty or provide care for such persons or propefty or had any special
relationship with the owner or any other person to protect persons or property. This Agreement
shall in no way create a duty for Kent, its Police Department, or any of its officers or employees
where none previously existed. In the event Kent is sued, and a court determines that the
public duty doctrine does not apply, or an exception to the public duty doctrine exists with
relation to an injury to the person or propefty of any employee, subcontractor, guest, or other
person on the premises of Contractor, Contractor shall specifically indemnify, hold harmless, and
defend Kent, its Police Department, and each and every officer and employee thereof to the full
extent permitted by law.
C. Survival. The provisions of this Section V shall survive the expiration or
termination of this Agreement and the obligations contained therein will continue to apply
beyond the provision of services called for in any Attachment.
VI. PARTIES ARE INDEPENDENT. The parties agree that neither shall be considered an
employee or agent of the other.
VIL TERMINATION, ALTERATION, OR RESCHEDULING. In the event Kent is unable to
obtain the services of a Kent Police Officer to perform the seruices called for in the Agreement,
Kent will contact Contractor, and advise Contractor that Kent is unable to peform the services
called for herein. Notice by way of telephone, email, writing, or in-person shall be adequate
notice of such cancellation of services, and Kent shall not be liable for the cost of Contractor
obtaining replacement services.
In the event Contractor must cancel, alter, or reschedule the services called for by this
Agreement, Contractor must provide at least ten and one-half (10.5) hours advance notice to
the Police Department by contacting its on-duty sergeant line at (253) 856-5840. A failure to
cancel, alter, or reschedule at least ten and one-half (10.5) hours before the seruices are called
for shall result in the Contractor paying the minimum four (4) hours of service provided for in
Section III.B. above, regardless of whether such services are provided at a later or rescheduled
date and time.
VIII. CONTRACTOR SHATL ABIDE BY LAWS AND SHALL NOT DISCRIMINATE. At AII
times during Kent's peformance of this Agreement, Contractor shall abide by all laws and
POLICE SERVICES AGREEMENT - 3 (Form verslon: Ll20t6)
verbal statements of any officer or other representative of Kent, 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 paft of this Agreement. However,
should any language in any of the Exhibits or Attachments to this Agreement conflict with any
language contained in this Agreement, the terms of this Agreement shall prevail. Further, the
representative signing this Agreement on behalf of Contractor swears and affirms that he or she
is authorized to enter into this Agreement on behalf of Contractor and that action is binding on
the Contractor.
G. Compliance with Laws. Contractor agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable
to Contractor's business, equipment, and personnel engaged in operations covered by this
Agreement or accruing out of the peformance of those operations.
H. Gounterparts. This Agreement may be executed in any number of counterpafts,
each of which shall constitute an original, and all of which will together constitute this one
Agreement.
. IN WITNESS, the parties below execute this Agreement, which shall become
effective on the last date entered below.
CONTRACTORT
By
Print Name:
Its rIP cef: darçrrtr¡fo t
DATE:
(titte)þ2p
KENT:
By F¿L
(signature)
Print Name: Rafael.PAdilla _Its Police Chief
DATE:
NOTICES TO BE SENT TO:
CONTRACTOR:
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NOTICES TO BE SENT TO:
CITY OF KENT:
sgt.SGT Matf Sta nsfi e
City of Kent
220 Fourth Avenue South
Kent, WA 98032
(253) 856- s809 (telephone)
(253) 856-6802 (facsimile)
t:ç¡drulËþF ¡ildt¡ú4.f dldÍ.ù\o*dd&üÉ údo sdb! ÁE6M fô¡otrÞuv w#s
POLICE SERVICES AGREEMENT. 5 (Form Versloni L|2OL6)
KENT SCOPE OF SERVICES ATTACHMENT
To Police Services AgreementwaaHt¡oto¡
lnts of Services chment shall be ln corporated into the Police
by
T,
(hereinafter "Conträctor")
DESCRIPTION OF SERVICES. Contractor requests the seruices of a commissioned police
offlcerwho will be dedicated to performing the following services (check box that applies):Jlg FlaggingÆraffic Control
tr Security for Entertainment Venue or Event
n Securlty for Retail Establishment
tr Guarding of Property, Buildings, Possessions, or Equipment
tr other
Police officers shall only be permltted to provlde police-related services during the
performance of the work called for hereln, and Contractor shall not ask or solicit such police
officers to perform work that is not police-related.
HOURLY RATE & NUMBER OF OFFICERIS REQUIRED. The work called for hereln shall be
paid by Contractor at the following hourly rates and the Contractor requests the following
Services Agrqement signedon ultat fpzo
n.
r of officers:
Extra-Duty Work: Officer
Up to $80 per hour.x
SCOPE OF SERVICES ATTACHMENT TO POLICE SERVICES AGREEMENT
Page 1 of 2
numbe
{
i
I
Number of Officers Required:
Extra-Duty Work: Superuisor
Up to $100 per hour.*Number of Supervisors Required:_
* Note: Hourly rates are quoted "up to" a specified amount. Officers are paid different rates
based on factors such as time in service, assignment, education, etc. The rate quoted is the
maximum rate that will be bllled subject to overtime holiday rates specified below.
Contractor's rate may be lower.
A.Four Hour Minimum. There shall be a four (4) hour min¡mum payment required for
each instance that a police officer performs services under the Agreement. Therefore,
Contractor shall be required to pay to Kent the greater sum of four (4) hours of work
or the actual number of hours worked during each instance that a police officer
performs serulces. For example, if Contractor needs two (2) officers to work on the
same day and at the same time for two (2) hours of work each, Contractor will be
required to pay Kent for four (4) hours for each police officer, for a total of eight (8)
hours. If Contractor needs two (2) officers for slx (6) hours each, Contractor shall pay
for six (5) hours for each police officer for a total of twelve (12) hours.
(Form Verslon: t2l20t7
B.
c.
III. LOCATION OF SERVICES.
location:
'trtúçQÈs6.¿rttro^l .
sig
The services called for herein shall be performed at the following
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Overtime Rate. Contractor shall be required to pay the rate of one and one half (1.5)
times the rate specified above for any time worked by a police officer in excess of ten
(10) hours in a shift, Therefore, if a police officer works ten (10) hours, he or she
shall be paid at the rate specified above. tf the officer works twelve (12) hours, he or
she shall be paid at the rate specified above for the first ten (10) hours, and at a rate
of one and one half (1.5) times the rate specified above for the remainlng two (2)
hou rs.
Haliday Rate, The following holidays are observed by Kent police officers: New Year's
Day, Martin Luther King Day, President's Day, Memorlal Day, Independence Day,
Labor Day, Veteran's Day, Thanksglving Day, Day after Thanksgiving, and Christmas.
Except as otherwise provided in this section, all hours worked during an observed
holiday, or during 15:00 hours to 23:59 hours on Christmas Eve or New Year's Eve,
wlll be billed at one and a half (1.5) times the rate specified above. All hours worked
on Thanksglvlng Day or Christmas Day will be billed at a rate of two (2.0) times the
rate speclfied above.
Contractor's Termination. Alteration or Rescheduling of Services. Cancellation,
alteration, or rescheduling of police officer services by the Contractor for a specific
date must be made at least ten and a one-half (10.5) hours prior to the scheduled
start time for that date. If Contractor fails to provide ten and one-half (10.5) hours
advance notice from the scheduled sta¡t time, Contractor will be billed for a minimum
payment of four (4) hours per officer scheduled for that date in accordance with
Section II.A. above. Cancellation, alteration, or rescheduling notification can be made
by phone or email.
A police officer will arrive at the above location on the date and time specified below
police officer provide servicesKentJrv..rJè 23,zUEt
By signing below, t understand that I am entering a contract to hire police officers to perform the
work described above, I agree to the terms of this Scope of Services Attachment and all of the terms
contained within the Police Services Agreement referenced herein, and finally if I am slgning this
Scope of Seruices Attachment on behalf of an organization, I swear and affirm that I am authorized
to n and that actlon is binding on the Contractor.
DATE AND TIME FOR SERVICES. Contractor requests a
fromf'3rO amlø rl \¡^¡p ,23,20Æ,¡s 6'ôD @/pm
SCOPE OF SERVICES ATTACHMENT TO POLICE SERVICES AGREEMENT
Page 2 of 2
b tq 2,,A2Å
Date
Approved by:
,ã"A
Kent Police Department Date
(-e,{AS>
Prlnt Name
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Address
(Form Verslon: L2l 20t7)
Glient#: 12831 NORTCASCl
ACORD," CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD¡YYYY}
5t08t2020
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 CERT¡FICATE HOLDER.
IMpORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer any rights to the cert¡ficate holder in lieu of such endorsement(s).
PRODUCER
Propel lnsurance
Tacoma Gommercial lnsurance
1201 Pacific Ave, Suite 1000
Tacoma, WA 98402
Gasondra Mossuto
ljlS*,u." "*,, 8oo 499-0933 866 577-1326
Casond nsuranGe,com
INSURER(S} AFFOROING COVERAGE NAIC #
lNsuRER a: Zurich Amer¡can lnsurance Gompany 16535
¡NSURED
Northwest Gascade lnc. dba FloHawks
Honey Buckets & North Bay Portables
PO Box 73399
Puyallup, WA 98373
tNsuRER s . Navigators Excess Gasualty Division 42307
tNsuRER c . Axis Surplus lnsurance Gompany 26620
INSURER D
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
THIS IS TO CERT¡FY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVEBEENISSUED TOTHE INSURED NAMEDABOVE FORTHE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITIONOF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE ADDItNcÞ SUBF POLICY NUMBER
POLIGY EF!'
IMM/DD/YYYYI
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$300,000
IVIED EXP (Any one person)s 10,000
PERSONAL & ADV INJURY s 1.000.000
GENERAL AGGREGATE s2.000.000
PRODUCTS. COMP/OP AGG s2.000.000
$
A AUTOMOBILE LIABILITY
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AUTOS ONLY
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cLAo1 3642405 lol01l20't9 't0t01t2020 COMtsINED SINGLI LIMII s1,000,000
BODILY INJURY (Per person)$
BODILY INJURY (Per accident)$
PROPERTY DAI\¡AGE
lPér ãcc¡dentì $
$
B UMBRELLA LIAB
EXCESS LIAB
x OCCUR
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SEl9EXCZO346EQN t0t01t2019 1010'U2024 EACH OCCURRENCE $5.000.000
X AGGREGATE s5.000.000
DED RETENTION $$
A WORKERS COMPENSATION
ANO EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICEFYMEMBER EXCLUDED?
(Mandatory ¡n NH)
lf yes, descr¡be under
DESCRIPTION OF OPERATIONS beIoW
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wc013642505
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10t01t2019 10t01t2020 x PER OTH.
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Ê.1. DISEASE - EA E¡/PLOYEE s1.000.000
E.L. DISEASE - POLICY LIMIT s1.000.000
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lnst. Floater
cP002899032019
cPP0r3642705
10t01t2019
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'lu0'll202o
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$1,000,000 / $25K Ded.
Job Site: $100k
Transit $25k Temo $25k
DESCRTPTTON OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Add¡tional Remarks Schedule, may be attached ¡f more space ¡s required)
RE: #19-3006 / 76th Avenue South lmprovements.
Additional lnsured Status applies per attached form(s).
RTIFICA
AcoRD 25 (2016/03) I of 1
#s41221141M41 18108
O 1988.2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are reg¡stered marks of AGORD
KTROO
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
â.¡*-" A. Y{o-. *ø*4*-
AUTHORIZED REPRESÊNTATIVE
Gity of Kent
400 West Gowe
Kent, WA 98032
This page has been left blank intentionally.
Additional Insured - Automatic - Owners, Lessees Or
Contractors
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ZURICH
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Pol¡cy No.Eff. Date of Pol.Exp. Date of Pol Eff. Date of End Producer No Add'|. Prem Return Prem
3LA-o136424-05 10t01t2019 10t01t2020
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named lnsured:
Address (including ZIP Gode):
This endorsement modifies insurance provided under the
Commercial General Liability Coverage Part
A. Section ll - Who ls An lnsured is amended to include as an additional insured any person or organization whom you
are required to add as an additional insured on this policy under a written contract or written agreement. Such person
or organization is an additional insured only with respect to liability for "bodily injury", "property damage" 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 or "your work" as included in the "products-completed operations
hazard", which is the subject of the written contract or written agreement.
However, the insurance afforded to such additional insured:
1. Only applies to the extent permitted by law; and
2. Will not be broader than that which you are required by the written contract or wriften agreement to provide for
such additional insured.
B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies:
This insurance does not apply to:
"Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to
render, any professional architectural, engineering or surveying services including:
a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders, change orders or drawings and specifications; or
b. Supervisory, inspection, architectural or engineering activities.
This exclusion applies even if the claims against any 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 damage", or the offense which caused the "personal and advertising injury", involved the
rendering of or the failure to render any professional architectural, engineering or surveying services.
u-GL-1 175-F CW (04/13)
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C. The following is added to Paragraph 2. Duties ln The Event Of Occurrence, Offense, Claim Or Suit of Section lV -
Gommercial General Liability Gonditions:
The additional insured must see to it that:
1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim;
2. We receive written notice of a claim or "suit" as soon as practicable; and
3. A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by
another insurer under which the additional insured may be an insured in any capacity. This provision does not
apply to insurance on which the additional insured is a Named lnsured if the written contract or written agreement
requires that this coverage be primary and non-contributory.
D. For the purposes of the coverage provided by this endorsement:
1. The following is added to the Other lnsurance Condition of Section lV - Gommercial General Liability
Conditions:
Primary and Noncontributory insurance
This insurance is primary to and will not seek contribution from any other insurance available to an additional
insured provided that:
a. The additional insured is a Named lnsured under such other insurance; and
b. You are required by written contract or written agreement that this insurance be primary and not seek
contribution from any other insurance available to the additional insured.
2. The following paragraph is added to Paragraph 4.b. of the Other lnsurance Condition of Section lV - Commercial
General Liability Conditions:
This insurance is excess over:
Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional
insured, in which the additional insured on our policy is also covered as an additional insured on another policy
providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy
in which the additional insured is a Named lnsured on such other policy and where our policy is required by a
written contract or written agreement to provide coverage to the additional insured on a primary and non-
contributory basis.
E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement
showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to
that identified additional insured.
F. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to
Section lll - Limits Of lnsurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the written contract or written agreement referenced in Paragraph A. of this endorsement; or
2. Available under the applicable Limits of lnsurance shown in the Declarations,
whichever is less.
This endorsement shall not increase the applicable Limits of lnsurance shown in the Declarations.
All other terms and conditions of this policy remain unchanged
u-GL-1175-F CW (04/13)
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Ø
Waiver Of Subrogation (Blanket) Endorsement ZURICH
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition:
Ifyou are required by a written contract or agreement, which is executed before a loss, to waive your rights ofrecovery from oth-
ers, we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a waiver with respect to any other
operations in which the insured has no contractual interest.
U-GL-925-B CW (12101)
Page I of I
Policy No.Eff. Date of Pol.Exp. Date of Pol.Eff. Date ofEnd.Producer Add'I. Prem Return Prem.
GLA-0136424-05 t0/0112019 t0/0v20t0 $$
POLICY NUMBER: GLA-O1 36424-05 COMM ERCIAL GENERAL LIABILITY
cG 25 03 05 09
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
DESTGNATED CONSTRUCTION PROJ ECT(S)
GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designated Gonstruction Project(s):
ANY CONSTRUCTION PROJECT EXCEPT A CONSTRUCTION PROJECT FOR WHICH A
coNSoLtDATED (WRAp-Up) OR STM|LAR TNSURANCE PROGRAM HAS BEEN PROVIDED
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. For all sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under Section I - Coverage A, and for all
medical expenses caused by accidents under
Section | - Coverage G, which can be attributed
only to ongoing operations at a single designated
construction project shown in the Schedule
above:
1. A separate Designated Construction Project
General Aggregate Limit applies to each des-
ignated construction project, and that limit is
equal to the amount of the General Aggregate
Limit shown in the Declarations.
2. The Designated Construction Project General
Aggregate Limit is the most we will pay for the
sum of all damages under Coverage An ex-
cept damages because of "bodily injury" or
"property damage" included in the "products-
completed operations hazard", and for medi-
cal expenses under Coverage C regardless of
the number of:
a. lnsureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits".
3. Any payments made under Coverage A for
damages or under Coverage C for medical
expenses shall reduce the Designated Con-
struction Project General Aggregate Limit for
that designated construction project. Such
payments shall not reduce the General Ag-
gregate Limit shown in the Declarations nor
shall they reduce any other Designated Con-
struction Project General Aggregate Limit for
any other designated construction project
shown in the Schedule above.
4. The limits shown in the Declarations for Each
Occurrence, Damage To Premises Rented To
You and Medical Expense continue to apply.
However, instead of being subject to the
General Aggregate Limit shown in the Decla-
rations, such limits will be subject to the appli-
cable Designated Construction Project Gen-
eralAggregate Limit.
@ lnsurance Services Office, lnc., 2008 Page I of 2
Wolters Kluwer F¡nancial Serv¡ces I Uniform FormsrM
cG 25 03 05 09
B. For all sums which the insured becomes legally
obligated to pay as damages caused by "occur-
rences" under Section I - Coverage A, and for all
medical expenses caused by accidents under
Section I - Coverage G, which cannot be at-
tributed only to ongoing operations at a single
designated construction project shown in the
Schedule above:
1. Any payments made under Coverage A for
damages or under Coverage C for medical
expenses shall reduce the amount available
under the General Aggregate Limit or the
Products-completed Operations Aggregate
Limit, whichever is applicable; and
2. Such payments shall not reduce any Desig-
nated Construction Project General Aggre-
gate Limit.
G. When coverage for liability arising out of the
"products-completed operations hazard" is pro-
vided, any payments for damages because of
"bodily injury",or "property damage" included in
the "products-completed operations hazard" will
reduce the Products-completed Operations Ag-
gregate Limit, and not reduce the General Ag-
gregate Limit nor the Designated Construction
Project General Aggregate Limit.
D. lf the applicable designated construction project
has been abandoned, delayed, or abandoned
and then restarted, or if the authorized contract-
ing parties deviate from plans, blueprints, de-
signs, specifications or timetables, the project will
still be deemed to be the same construction pro-
ject.
E. The provisions of Section lll - Limits Of lnsur-
ance not otherwise modified by this endorsement
shall continue to apply as stipulated.
Page 2 o1 2 @ lnsurance Services Office, lnc., 2008 cG 25 03 05 09
Contractors Liabilify Supplemental Coverages And
Conditions
ñ,-J
ZURICH
Policy No.Eff. Date of Pol.Exp. Date of Pol.Eff. Date of End.Producer No.Add'|. Prem Return Prem.
3LA-0136424-05 10t01t2019 1010112020
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
This endorsement modifies insurance provided under the:
Gommercial General Liability Goverage Part
NON.OWNED WATERCRAFT SCHEDULE
Watercraft Length: _ feet
(lf no amount is shown above, 51 feet applies.)
A. Non-owned Watercraft Liability Extended Coverage
Paragraph (2) of Exclusion 2.9. Aircraft, Auto Or Watercraft under Section I - Coverage A - Bodily lnjury And
Property Damage Liability is replaced by the following:
(2) A watercraft you do not own that is:
(a) Less than the length shown in the Non-Owned Watercraft Schedule of this endorsement; and
(b) Not being used to carry persons or property for a charge;
B. Damage To Premises Rented Or Occupied By You
1. The last paragraph under Paragraph 2. Exclusions of Section I - Goverage A - Bodily lnjury And Property
Damage Liability is replaced by the following:
Exclusions c. through n. do not apply to damage by "specific perils" to premises while rented to you or temporarily
occupied by you with permission of the owner. A separate Damage to Premises Rented To You Limit of
lnsurance applies to this coverage as described in Section Ill - Limits Of lnsurance.
2. The paragraph directly following Paragraph (6) in Exclusion j. of Section | - Goverage A - Bodily lnjury And
Property Damage Liability is replaced by the following:
Paragraphs (f ), (3) and (4) of this exclusion do not apply to "property damage" to premises (other than damage
by "specific perils"), including "property damage" to the contents of such premises, rented to you under a rental
agreement for a period of 14 or fewer consecutive days. A separate Limit of lnsurance applies to Damage to
Premises Rented to You as described in Section lll- Limits Of lnsurance.
3. Paragraph 6. of Section lll - Limits Of lnsurance is replaced by the following:
6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under
Coverage A for damages because of "property damage" to any one premises while rented to you, or in the
case of damage by one or more "specific perils" to any one premises, while rented to you or temporarily
occupied by you with permission of the owner.
4. Paragraph a. of the "insured contract" definition under the Definitions Section is replaced by the following:
u-GL-1060-E CW (04/13)
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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 "specific perils" to premises while rented to you or
temporarily occupied by you with permission of the owner is not an "insured contract";
5. Paragraph (ii) under Paragraph 4.b.(1) of the Other lnsurance Condition under Section lV - Commercial
General Liability Gonditions is replaced by the following:
(ii) That is property insurance providing coverage for "specific perils" for premises rented to you or temporarily
occupied by you with permission of the owner;
6. The following definitions are added to the Definitions Section:
"Specific perils" means fire, lightning, explosion, windstorm or hail, smoke, aircraft or vehicles, riot or civil
commotion, vandalism, leakage from fire extinguishing equipment, weight of snow, ice or sleet or "water damage".
'Water damage" means accidental discharge or leakage of water or steam as the direct result of the breaking or
cracking of any part of a system or appliance containing water or steam.
G. Additional Insured - Lessor Of Leased Equipment - Automatic Status When Required ln Lease Agreement
With You
1. Section ll - Who ls An Insured is amended to include as an additional insured any person(s) or organization(s)
from whom you lease equipment when you and such person(s) or organization(s) have agreed in a written
contract or written agreement that such person(s) or organization(s) be added as an additional insured on your
policy. Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury",
"property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance,
operation or use of equipment leased to you by such person(s) or organization(s).
However, the insurance afforded to such additional insured:
a. Only applies to the extent permitted by law; and
b. Will not be broader than that which you are required by the contract or agreement to provide for such
additional insured.
A person's or organization's status as an additional insured under this endorsement ends when their contract or
agreement with you for such leased equipment ends.
2. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any
"occurrence" which takes place after the equipment lease expires.
3. With respect to the insurance afforded to these additional insureds, the following is added to Section lll - Limits
of lnsurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
a. Required by the written contract or written agreement you have entered into with the additional insured; or
b. Available under the applicable Limits of lnsurance shown in the Declarations;
whichever is less.
The insurance provided by this Paragraph C. shall not increase the applicable Limits of lnsurance shown in the
Declarations.
D. Additional Insured - Managers Or Lessors Of Premises
1. Section ll - Who ls An lnsured is amended to include as an additional insured any person(s) or organization(s)
that you have agreed in a written contract or written agreement to name as an additional insured, but only with
respect to liability arising out of the ownership, maintenance or use of that part of premises leased to you and
subject to the following additional exclusions:
This insurance does not apply to:
a. Any "occurrence" which takes place after you cease to be a tenant in that premises.
b. Structural alterations, new construction or demolition operations performed by or on behalf of the additional
insured manager or lessor of the premises leased to you.
However, the insurance afforded to such additional insured:
a. Only applies to the extent permitted by law; and
u-GL-1060-E CW (04/13)
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b. Will not be broader than that which you are required by the contract or agreement to provide for such
additional insured.
2. With respect to the insurance afforded to these additional insureds, the following is added to Section lll - Limits
of lnsurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
a. Required by the written contract or written agreement you have entered into with the additional insured; or
b. Available under the applicable Limits of lnsurance shown in the Declarations;
whichever is less.
The insurance provided by this Paragraph D. shall not increase the applicable Limits of lnsurance shown in the
Declarations.
E. Additional lnsured - State Or Governmental Agency Or subdivision Or Political Subdivision - Permits Or
Authorizations
1. Section ll - Who ls An lnsured is amended to include as an additional insured any state or governmental agency
or subdivision or political subdivision that you have agreed in a written contract or written agreement or that you
are required by statute, ordinance or regulation to name as an additional insured, subject to the following
provisions:
a. This insurance applies only with respect to operations performed by you or on your behalf for which the state
or governmental agency or subdivision or political subdivision has issued a permit or authorization.
b. This insurance does not apply to:
(l ) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed
for the federal government, state or municipality; or
(2) "Bodily injury" or "property damage included within the "products-completed operations hazard".
However, the insurance afforded to such additional insured:
a. Only applies to the extent permitted by law; and
b. Will not be broader than that which you are required by the contract or agreement to provide for such
additional insured.
2. With respect to the insurance afforded to these additional insureds, the following is added to Section lll - Limits
of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
a. Required by the wriften contract or written agreement you have entered into with the additional insured; or
b. Available under the applicable Limits of lnsurance shown in the Declarations;
whichever is less.
The insurance provided by this Paragraph E. shall not increase the applicable Limits of lnsurance shown in the
Declarations.
F. Personal And Advertising lnjury Goverage - Assumed Under Gontract Or Agreement
1. Exclusion e. of Section I - Goverage B - Personal And Advertising lnjury Liability is replaced by the following:
2. Exclusions
This insurance does not apply to:
e. Contractual Liability
"Personal and advertising injury" for which the insured has assumed liability in a contract or agreement.
This exclusion does not apply to:
(l) Liability for damages that the insured would have in the absence of the contract or agreement; or
(2) Liability for "personal and advertising injury" if:
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(a) The liability pertains to your business and is assumed in a contract or agreement that is an
"insured contract"; and
(b) The "personal and advertising injury" occurs subsequent to the execution of the contract or
agreement.
Solely for the purposes of liability so assumed in such "insured contract", reasonable attorney fees
and necessary litigation expenses incurred by or for a party other than an insured are deemed to be
damages because of "personal and advertising injury", provided:
(¡) Liability to such party for, or for the cost of, that party's defense has also been assumed in
the same contract or agreement; and
(ii) Such attorney fees and litigation expenses are for defense of that party against a civil or
alternative dispute resolution proceeding in which damages to which this insurance applies
are alleged.
2. For purposes of this "personal and advertising injury" coverage only:
Paragraph d. and the second to last paragraph under Paragraph 2. of Supplementary Payments - Coverages
A and B are replaced by the following:
d. The allegations in the "suit" and the information we know about the "occurrence" or offense are such that no
conflict appears to exist between the interests of the insured and the interest of the indemnitee;
So long as the above conditions are met, attorneys' fees incurred by us in the defense of that indemnitee,
necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at
our request will be paid as Supplementary Payments. Such payments will not be deemed to be damages for
"bodily injury", "property damage" or "personal and advertising injury" and will not reduce the limits of
insurance.
G. lnsured Contract Amendment
Paragraph f. and f.(1) through f.(3) of the "insured contract" definition under the Definitions Section is replaced by
the following:
f. That part of any other contract or agreement pertaining to your business (including an indemnification of a
municipality in connection with work performed for a municipality) under which you assume the tort liability of
another to pay for "bodily injury", "property damage" or "personal and advertising injury" 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:
(1) That indemnifies a railroad for "bodily injury", "property damage" or "personal and advertising injury" arising
out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad
bridge or trestle, tracks, road-beds, tunnel, underpass or crossing;
(2) 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
(b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or
damage;
(3) Under which the insured, 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 (2)
above and supervisory, inspection, architectural or engineering activities;
(4) That indemnifies a person or organization for "personal and advertising injury":
(a) Arising out of advertising, publishing, broadcasting or telecasting done for you or on your behalf; or
(b) To an "employee" of such person or organization that does advertising, publishing, broadcasting or
telecasting for you or on your behalf; or
(5) That indemnifies a labor leasing firm for "bodily injury" to "leased workers".
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H. Medical Payments - lncreased Reporting Period
Paragraph a. of Section l- Goverage C - Medical Payments is replaced by the following:
a. We will pay medical expenses as described below for "bodily injury" caused by an accident:
(1) On premises you own or rent;
(2) On ways next to premises you own or rent; or
(3) Because of your operations;
provided that:
(a) The accident takes place in the "coverage territory" and during the policy period;
(b) The expenses are incurred and reported to us within three years of the date of the accident; and
(c) The injured person submits to examination, at our expense, by physicians of our choice as often as we
reasonably require.
l. Broad Bail Bond Coverage
Paragraph l.b. under Supplementary Payments - Coverages A And B is replaced by the following:
b. The cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle
to which the Bodily lnjury Liability Coverage applies. We do not have to furnish these bonds.
J. Amendment - Duties ln The Event of Occurrence, Offense, Claim or Suit
The following paragraphs are added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit
of Section lV - Commercial General Liability Conditions:
Notice of an "occurrence" or of an offense which may result in a claim under this insurance or notice of a claim or
"suit" shall be given to us as soon as practicable after knowledge of the "occurrence", offense, claim or "suit" has
been reported to your officer, manager, partner or an "employee" authorized by you to give or receive such notice.
Knowledge by "employees" other than your officer, manager, partner or "employee" authorized by you to give or
receive such notice of an "occurrence", offense, claim or "suit" does not imply that you also have such knowledge.
ln the event that an insured reports an "occurrence" to your workers compensation carrier and this "occurrence" later
develops into a General Liability claim, covered by this Coverage Part, the insured's failure to report such
"occurrence" to us at the time of the "occurrence" shall not be deemed to be a violation of this Condition. You must,
however, give us notice as soon as practicable after beíng made aware that the particular claim is a General Liability
rather than a Workers Compensation claim.
K. Unintentional Failure To Disclose Or Describe Hazards
Paragraph 6. Representations of Section lV - Commercial General Liability Conditions is replaced by the
following:
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.
Coverage will continue to apply if you unintentionally:
(l ) Fail to disclose all hazards existing at the inception of this policy; or
(2) Make an error, omission or improper description of premises or other statement of information stated in
this policy.
You must notify us in writing as soon as possible after the discovery of any hazards or any other information that
was not provided to us prior to inception of this Coverage Part.
L. Bodily lnjury Redefined
The "bodily injury" definition under the Definitions Section is replaced by the following:
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M
"Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of
these at any time. This includes mental anguish, mental injury, shock, fright or death resulting from bodily injury,
sickness or disease.
Two Or More Of Our Coverage Parts/Policies
The following is added to Section lll - Limits of Insurance:
1. Subject to Paragraph 2. or 3. above, whichever applies, if this Coverage Part and any other Commercial General
Liability Coverage Part or policy providing Commercial General Liability insurance issued to you by us or any
other Zurich underwriting company affiliated with us apply to the same "occurrence", only the highest available
Each Occurrence Limit under any such Coverage Part or policy applies to such "occurrence".
2. Subject to Paragraph 2. above, if this Coverage Part and any other Coverage Part or policy providing Commercial
General Liability insurance issued to you by us or any other Zurich underwriting company affiliated with us apply
to the same offense, only the highest available Personal And Advertising lnjury Limit under any such Coverage
Part or policy applies to such offense.
3. Under this Coverage Part and all other Zurich underwriting company Coverage Parts or policies to which
Paragraphs 1. and 2. above combined apply, the most we will pay for all injury or damage because of "bodily
injury" or "property damage" "occurrences", "personal and advertising injury" offenses and medical expenses is:
a. The single highest Coverage Part or policy GeneralAggregate Limit; or
b. The single highest Coverage Part or policy Products-Completed Operations Aggregate Limit,
whichever applies, whether such "occurrence", offenses or medical expenses are covered by one or more than
one Zurich underwriting company policy.
4. Any existing provisions under Paragraph 4. Other Insurance under Section lV - Gommercial General Liability
Conditions that may be contrary to the provisions of this endorsement are amended to comply with the changes
in coverage as stipulated in Paragraphs 1.,2., and 3. above.
This provision does not apply to any Coverage Part or policy issued by us or any other Zurich undenvriting company
affiliated with us specifically to apply as excess insurance over this Coverage Part.
Your Work Redefined
Paragraph a.(1) of the "your work" definition under the Definitions Section is replaced by the following:
22. "Your work":
a. Means:
(l) Work or operations performed by you or on your behalf, but does not include work or operations
performed by another entity who joined with you to form a partnership or joint venture not shown as a
Named lnsured in the Declarations, which terminated or ended prior to the effective date of this policy;
and
All other terms and conditions of this policy remain unchanged
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N
lncludes copyrighted mater¡al of lnsurance Services Office, lnc., with its permission
Coverage Extension Endorsement
Ø
ZURICH
Policy No.Eff. Date of Pol.Exp. Date of Pol.Eff. Date of End.Producer No.Add'|. Prem Return Prem.
3LA-0136424-05 101o112019 10t01t2020
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Business Auto Goverage Form
Motor Garrier Coverage Form
A. Amended Who Is An lnsured
1. The following is added to the Who ls An Insured Provision in Section ll - Govered Autos Liability Goverage
The following are also "insureds":
a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts
performed within the scope of employment by you. Any "employee" of yours is also an "insured" while
operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your
permission, while performing duties related to the conduct of your business.
b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or
borrow to transport your clients or other persons in activities necessary to your business.
c. Anyone else who furnishes an "auto" referenced in Paragraphs A.l.a. and 4.1.b. in this endorsement.
d. Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract
or wriften agreement with you executed prior to any "accident", including those person(s) or organization(s)
directing your work pursuant to such written contract or written agreement with you, provided the "accident"
arises out of operations governed by such contract or agreement and only up to the limits required in the
written contract or written agreement, or the Limits of lnsurance shown in the Declarations, whichever is less.
2. The following is added to the Other lnsurance Condition in the Business Auto Coverage Form and the Other
Insurance - Primary and Excess lnsurance Provisions Condition in the Motor Carrier Coverage Form:
Coverage for any person(s) or organization(s), where required by written contract or written agreement with you
executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained
by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond
the terms and conditions of the Coverage Form.
B. Amendment - Supplementary Payments
Paragraphs a.(2) and a.(4) of the Goverage Extensions Provision in Section ll - Covered Autos Liability
Goverage are replaced by the following:
(2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an
"accident" we cover. We do not have to furnish these bonds.
(4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a
day because of time off from work.
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C. Fellow Employee Goverage
The Fellow Employee Exclusion contained in Section ll- Govered Autos Liability Coverage does not apply.
D. Driver Safety Program Liability and Physical Damage Coverage
1. The following is added to the Racing Exclusion in Section ll - Govered Autos Liability Coverage:
This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not
limited to, auto or truck rodeos and other auto or truck agility demonstrations.
2. The following is added to Paragraph 2. in the Exclusions of Section lll - Physical Damage Goverage of the
Business Auto Coverage Form and Paragraph 2.b. in the Exclusions of Section lV - Physical Damage
Coverage of the Motor Carrier Coverage Form:
This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not
limited to, auto or truck rodeos and other auto or truck agility demonstrations.
E. Lease or Loan Gap Goverage
The following is added to the Coverage Provision of the Physical Damage Goverage Section:
Lease Or Loan Gap Goverage
ln the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered
"auto", less:
a. Any amount paid under the Physical Damage Goverage Section of the Coverage Form; and
b. Any:
(1) Overdue lease or loan 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
(5) Carry-over balances from previous leases or loans.
F. Towing and Labor
Paragraph 4.2. of the Physical Damage Goverage Section is replaced by the followlng:
We will pay up to $75 for towing and labor costs incurred each time a covered "auto" of the private passenger type is
disabled. However, the labor must be performed at the place of disablement.
G. Extended Glass Coverage
The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section:
lf glass must be replaced, the deductible shown in the Declarations will apply. However, if glass can be repaired and
is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass
repaired rather than replaced.
H. Hired Auto Physical Damage - lncreased Loss of Use Expenses
The Coverage Extension for Loss Of Use Expenses in the Physical Damage Coverage Section is replaced by the
following:
Loss Of Use Expenses
For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for
loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We
will pay for loss of use expenses if caused by:
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(1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered
"auto";
(2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided
for any covered "auto"; or
(3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto".
However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $3000.
l. Personal Effects Coverage
The following is added to the Goverage Provision of the Physical Damage Goverage Section:
Personal Effects Goverage
a. We will pay up to $750 for "loss" to personal effects which are:
(1) Personal property owned by an "insured"; and
(2) ln or on a covered "auto".
b. Subject to Paragraph a. above, the amount to be paid for "loss" to personal effects will be based on the lesser of:
(1) The reasonable cost to replace; or
(2) The actual cash value.
c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered
"auto". No deductible applies to this coverage. However, we will not pay for "loss" to personal effects of any of
the following:
(1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other
documents of value.
(2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches,
precious or semi-precious stones.
(3) Paintings, statuary and other works of art.
(4) Contraband or property in the course of illegal transportation or trade.
(5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment.
Any coverage provided by this Provision is excess over any other insurance coverage available for the same "loss".
J. Tapes, Records and Discs Coverage
1. The Exclusion in Paragraph 8.4.a. of Section lll - Physical Damage Goverage in the Business Auto Coverage
Form and the Exclusion in Paragraph 8.2.c. of Section lV - Physical Damage Coverage in the Motor Carrier
Coverage Form does not apply.
2. The following is added to Paragraph l.a. Comprehensive Goverage under the Goverage Provision of the
Physical Damage Coverage Section:
We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic
equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices:
(a) Are the property of an "insured"; and
(b) Are in a covered "auto" at the time of "loss".
The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical
Damage Coverage Deductible Provision does not apply to such "loss".
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K. Airbag Coverage
The Exclusion in Paragraph 8.3.a. of Section lll - Physical Damage Goverage in the Business Auto Coverage Form
and the Exclusion in Paragraph 8.4.a. of Section lV - Physical Damage Goverage in the Motor Carrier Coverage
Form does not apply to the accidental discharge of an airbag.
L. Two or More Deductibles
The following is added to the Deductible Provision of the Physical Damage Coverage Section:
lf an accident is covered both by this policy or Coverage Form and by another policy or Coverage Form issued to you
by us, the following applies for each covered "auto" on a per vehicle basis:
1. lf the deductible on this policy or Coverage Form is the smaller (or smallest) deductible, it will be waived; or
2. lf the deductible on this policy or Coverage Form is not the smaller (or smallest) deductible, it will be reduced by
the amount of the smaller (or smallest) deductible.
M. Physical Damage - Comprehensive Coverage - Deductible
The following is added to the Deductible Provision of the Physical Damage Coverage Section:
Regardless of the number of covered "autos" damaged or stolen, the maximum deductible that will be applied to
Comprehensive Coverage for all "loss" from any one cause is $5,000 or the deductible shown in the Declarations,
whichever is greater.
N. Temporary Substitute Autos - Physical Damage
1. The following is added to Section l- Govered Autos:
Temporary Substitute Autos - Physical Damage
lf Physical Damage Coverage is provided by this Coverage Form on your owned covered "autos", the following
types of vehicles are also covered "autos" for Physical Damage Coverage:
Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered
"auto" you do own but is out of service because of its:
1. Breakdown;
2. Repair;
3. Servicing;
4. "Loss"; or
5. Destruction.
2. The following is added to the Paragraph A. Goverage Provision of the Physical Damage Goverage Section:
Temporary Substitute Autos - Physical Damage
We will pay the owner for "loss" to the temporary substitute "auto" unless the "loss" results from fraudulent acts or
omissions on your part. lf we make any payment to the owner, we will obtain the owner's rights against any other
party.
The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it
replaces.
O. Amended Duties ln The Event Of Accident, Glaim, Suit Or Loss
Paragraph a. of the Duties ln The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following:
a. ln the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice
of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or
"loss" is known to you (if you are an individual), a partner (if you are a partnership), a member (if you are a limited
liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any
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agent, servant or employee of the "insured" to notify us of any "accident", claim, "suit" or "loss" shall not invalidate
the insurance afforded by this policy.
lnclude, as soon as practicable:
(l) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written
notice of the claim or "suit" including, but not limited to, the date and details of such claim or "suit";
(2) The "insured's" name and address; and
(3) To the extent possible, the names and addresses of any injured persons and witnesses.
lf you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your
failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon
as practicable after the fact of the delay becomes known to you.
P. Waiver of Transfer Of Rights Of Recovery Against Others To Us
The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition:
This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or
"loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only
applies to the person or organization designated in the contract.
Q. Employee Hired Autos - Physical Damage
Paragraph b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f. of the Other
Insurance - Primary and Excess lnsurance Provisions Condition in the Motor Carrier Coverage Form are replaced
by the following:
For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own:
(l) Any covered "auto" you lease, hire, rent or borrow; and
(2) Any covered "auto" hired or rented under a written contract or written agreement entered into by an "employee" or
elected or appointed official with your permission while being operated within the course and scope of that
"employee's" employment by you or that elected or appointed official's duties as respect their obligations to you.
However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto".
R. Unintentional Failure to Disclose Hazards
The following is added to the Goncealment, Misrepresentation Or Fraud Condition:
However, we will not deny coverage under this Coverage Form if you unintentionally:
(f ) Fail to disclose any hazards existing at the inception date of this Coverage Form; or
(2) Make an error, omission, improper description of "autos" or other misstatement of information.
You must notify us as soon as possible after the discovery of any hazards or any other information that was not
provided to us prior to the acceptance of this policy.
S. Hired Auto - World Wide Coverage
Paragraph 7a.(5) of the Policy Period, Coverage Territory Condition is replaced by the following:
(5) Anywhere in the world if a covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less,
T. Bodily lnjury Redefined
The definition of "bodily injury" in the Definitions Section is replaced by the following:
"Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish,
resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease.
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U. Expected Or lntended lnjury
The Expected Or lntended Injury Exclusion in Paragraph B. Exclusions under Section ll- Govered Auto Liability
Coverage is replaced by the following:
Expected Or Intended lnjury
"Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does
not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or
property.
V. Physical Damage - Additional Temporary Transportation Expense Goverage
Paragraph 4.4.a. of Section lll - Physical Damage Goverage is replaced by the following:
4. Goverage Extensions
a. Transportation Expenses
We will pay up to $50 per day to a maximum of $1,000 for temporary transportation expense incurred by you
because of the total theft of a covered "auto" of the private passenger type. We will pay only for those
covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will
pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and
ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its
"loss".
W. Replacement of a Private Passenger Auto with a Hybrid or Alternative Fuel Source Auto
The following is added to Paragraph A. Goverage of the Physical Damage Goverage Section:
ln the event of a total "loss" to a covered "auto" of the private passenger type that is replaced with a hybrid "auto" or
"auto" powered by an alternative fuel source of the private passenger type, we will pay an additional 10% of the cost
of the replacement "auto", excluding tax, title, license, other fees and any aftermarket vehicle upgrades, up to a
maximum of $2500. The covered "auto" must be replaced by a hybrid "auto" or an "auto" powered by an alternative
fuel source within 60 calendar days of the payment of the "loss" and evidenced by a bill of sale or new vehicle lease
agreement.
To qualify as a hybrid "auto", the "auto" must be powered by a conventional gasoline engine and another source of
propulsion power. The other source of propulsion power must be electric, hydrogen, propane, solar or natural gas,
either compressed or liquefied. To qualify as an "auto" powered by an alternative fuel source, the "auto" must be
powered by a source of propulsion power other than a conventional gasoline engine. An "auto" solely propelled by
biofuel, gasoline or diesel fuel or any blend thereof is not an "auto" powered by an alternative fuel source.
X. Return of Stolen Automobile
The following is added to the Coverage Extension Provision of the Physical Damage Goverage Section:
lf a covered "auto" is stolen and recovered, we will pay the cost of transport to return the "auto" to you. We will pay
only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage.
All other terms, conditions, provisions and exclusions of this policy remain the same
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WORKERS COMPENSATION AND EMPLOYERS LIABILIW INSURANCE POLICY wcmß13
(Ed.4-&+)
we have,he rsh,,",::::::ffiï::;lJï* *i:;::J ffi:ï::iiïi:ïy wew n., enf.rce
our right against the person or organization narned in the Schedule. (This agreement applies only to the extent that you
perform work under a written contracl that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not narned in the Schedule.
Schedule
ALL PERSONS AI{D/OR ORGAT{TZATTONS TIIAT ARE REgUIRED BY WRITTEN
CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE
ACCIDENT OR LOSS, THAT WAI\¡ER OF SUBROGATION BE PROVIDED TNDER THIS
POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AI{D/OR ORGAI\TIZATION.
This endorsement changes the policy to which it is attached and is effective on the date issued unless othen¡vise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy')
Endorsement Effective Policy No. Endorsement No.
lnsured premium $
lnsurance Company
wc 00 03 13
(Ed.4-84)
Copyright 1983 National Council on Compensation lnsurance
Countersigned By