HomeMy WebLinkAboutCAG2020-334 - Original - Multi-Service Center (MSC) - Cares Funding for Utility Assistance - 10/23/2020ApprovalOriginator:Department:
Date Sent:Date Required:
Authorized to Sign:
Director or Designee Mayor
Date of Council Approval:
Budget? Yes No
Grant? Yes 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? Yes No*
*If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace.
Notice required prior to disclosure?
Yes 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
Budget Account Number:
Molly Bartlemay
✔
✔
V00010.6xxxx.1310
✔State
MSC Grant: Non-Real Property
34755 Other
Cares Funding for Utility Assistance
Provide CARES funding to MSC to distribute to City of Kent utility
customers financially impacted by COVID-19.
$ 77,543.01 Other
N/A
✔
✔
10/12/2020 10/14/2020
10/14/2020
10/21/2020
Finance
Okay to sign.
CAG2020-334
GRANT DISTRIBUTION SERVICES AGREEMENT
between the City of Kent and Multi-service Center (MSC)
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Multi-Service Center (MSC) a public benefit nonprofit corporation
organized under the laws of the State of Washington, located and doing business at 1200 S
336th St. Federal Way WA 98003.(hereinafter the "Contractor").
Exhibits incorporated as part of this contract:
Exhibit A = Scope of Work
Exhibit B = Declaration, City of Kent Equal Employment Opportunity Policy
Exhibit C = Insurance
I. DESCRIPTION OF WORK. Contractor will administer a utility assistance grant
program for the benefit of City of Kent residential utility customers that have been financially
impacted by COVID-19 as provided in Exhibit A. Contractor will be provided CARES Act grant
funds that the City has received from the Washington State (WA) Department of Commerce.
II. APPROVAL REQUIRED. Pursuant to the terms of the WA State Department of
Commerce Interagency Agreement, this Agreement shall be subject to the written approval of
the Washington Department of Commerce unless the Washington Department of Commerce
determines, in writing, that such approval is not required or waives such approval, The City shall
be responsible for obtaining such approval or waiver.
III. TIME OF COMPLETION. The parties agree that work will begin on the tasks
described in Section I above immediately upon the effective date of this Agreement. Contractor
shall complete the work described in Section I by November 30,2020.
IV. COMPENSATION AND GRANT FUNDS.
A Compensation. The City shall pay the Contractor up to a total amount of
$7,543.OL in compensation for providing grant administration services as
described Section I ("Service Fee"). The Service Fee is the maximum amount
to be paid under this Agreement for the work described in Section I above,
and shall not be exceeded without the prior written authorization of the City
in the form of a negotiated and executed amendment to this Agreement. The
City shall disburse these funds promptly following receipt of an invoice from
Contractor for incurred costs.
The City shall disburse to MSC the CARES Act grant funds, totaling up to
$70,000 from the WA Department of Commerce ("Grant Funds"), as the
funds are awarded to grantees.
V. MARKETING AND COMMUNICATION. It is anticipated that over the term of the
agreement, opportunities for performing community outreach, communications and/or co-
marketing may arise - whether initiated by the City or the Contractor, In general, the
Contractor and City will work collaboratively on message development and communication
planning for such efforts. Specifically, a process for collaborative development of
communication materials and outreach that impacts the project could include:
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As appropriate, a summary of the opportunity will be sent via email by the
City to the Contractor, or vice versa' for review and approval;
The Contractor will be provided a draft of all marketing materials, press
releases, websites, grant application forms, grant application agreements,
social media plans, and other communication material developed for review
and approval no less than three business days prior to publication and use by
the City; and
The City and Contractor agree to acknowledge involvement of each other, if
appropriate, when discussing the program with media outlets or elected
ofticials.
The Contractor agrees that any publications (written, visual, or sound) but excluding press
releases, newsletters, and issue analyses, issued by the Contractor describing programs or
projects funded in whole or in part with federal funds under this Contract, shall contain the
following statements:
This project was supported by a grant awarded by US Department of the Treasury.
Points of view in this document are those of the author and do not necessarily
represent the official position or policies of the US Department of the Treasury.
Grant funds are administered by the Local Government Coronavirus Relief Fund
thru the Washington State Department of Commerce.
VI. DEBARMENT.
A Contractor certifies by signing this Agreement that to the best of its
knowledge and belief that it:
1) Is not presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from covered transactions
by any federal department or agency;
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2)Has not within a three-year period preceding this Contract, been
convicted of or had a civil judgment rendered against it for commission
of fraud or a criminal offense in connection with obtaining, attempting
to obtain, or performing a public or private agreement or transaction,
violation of federal or state antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of
records, making false statements, tax evasion, receiving stolen
property, making false claims, or obstruction of justice;
Is not presently indicted for or otherwise criminally or civilly charged
by a governmental entity (federal, state, or local) with commission of
any of the offenses enumerated in paragraph (1Xb) of federal
Executive Order L2549; and
Has not within a three-year period preceding the signing of this
Contract had one or more public transactions (federal, state, or local)
terminated for cause of default.
3)
4)
Where the Contractor is unable to certify to any of the statements in this
Contract, the Contractor shall attach an explanation to this Contract.
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The Contractor agrees by signing this Contract that it shall not knowingly
enter into any transaction with a person or entity debarred, suspended,
declared ineligible, or voluntarily excluded from participation in this covered
transaction, unless authorized by the Washington Department of Commerce.
The terms covered transaction, debarred, suspended, ineligible, lower tier
covered transaction, person, primary covered transaction, principal, and
voluntarily excluded, as used in this section, have the meanings set out in
the Definitions and Coverage sections of the rules implementing Executive
Order L2549. See the Washington Department of Commerce for assistance in
obtaining a copy of these regulations.
VII. MAINTENANCE OF RECORDS.
A. The Contractor shall retain for a period of six (6) years from the termination
of this Agreement unless required otherwise by law:
1) All financial, statistical, participant, and other records (including
medical and treatment records) and supporting documentation;
2) All records for nonexpendable personal property;
3) All records to document performance of all acts required by law,
regulation, or this Agreement;
4) All records to demonstrate accounting procedures and practices that
sufficiently and properly document the Contractor's invoices to the
City under this Agreement; and
5) All records sufficient to substantiate the Contractor's statement of its
organization's structure, tax status, capabilities, and performance.
B. If any litigation or audit is initiated, or if a claim is instituted involving this
Agreement, the Contractor shall retain all related records until the litigation,
audit, or claim has been finally resolved.
VIII. FISCAL ACCOUNTABILIW STANDARDS. During the Agreement performance
period, the Contractor agrees to maintain financial systems which will assure the following for
this Agreement. The Fiscal Accountability Standards are specific to the "Grants" and does not
apply to the "Service Fee":
A. Accurate, current, and complete disclosure of all direct and indirect costs;
B. Records that identify all sources and application of funds;
C. Control and accountability for all funds, property, and other assets;
D. Procedures that ensure comparison of actual costs with approved budgets;
E. Procedures to assure timely disbursement of funds received by the
Contractor from the City;
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Procedures to assure all costs are allowable, reasonable, and are properly
allocated to each funding source;
Source documentation that supports all accounting records; and
Procedures for timely and appropriate resolution of audit findings and
recommendations.
All fiscal books, records, documents, reports, and other data relating to this Agreement
shall be maintained and reported in a manner consistent with BARS. The Contractor agrees that
any City, state, federal, or other funding agency; any local, state, or federal regulatory body;
and the Office of State Auditor shall have full access to and right to examine any fiscal books,
records, documents, and other materials relevant to this Agreement at all reasonable times.
IX. MONITORING AND REPORTING REQUIREMENTS. Pursuant to General Terms
and Conditions Section 15, Subcontracting of the Interagency Agreement, the Contractor must
adhere to requirements established through 2 CFR Part 200, Subpaft F Audit Requirements.
These requirements include, but are not limited to the following:
A. Monitoring
The City will monitor the activities of the Contractor from award to close-out.
The Contractor understands and agrees that it is subject to monitoring by the
City and the Washington State Department of Commerce from time to time
to assure compliance with all terms and conditions of this Agreement, and all
applicable local, state, and federal laws, regulations, and promulgated
policies. Monitoring by the City under this Grant Agreement may include,
but not be limited to on-site inspections by City staff. The City reserves the
right to contract with another local government or other contracting party to
perform this service.
The Contractor shall provide to the City a copy of any Commerce Department
monitoring report no later than thirty (30) days after the issuance of the
report to the Contractor. The Contractor shall provide to the City its
response and corrective action plan for all areas of concern contained in the
monitoring report.
Fiscal Reporting Responsibilities
The Contractor shall provide fiscal statements or reports as may be required
from time to time by the City, which statements or reports, or both, must
indicate the status of all accounts and funds being used to perform under this
Grant Agreement. The Contractor shall maintain proper documentation and
records of all expenditures incurred pursuant to the terms of this Agreement
in a manner as will facilitate auditing by the Department of the Treasury, the
Washington State Department of Commerce, and/or the City.
Audits
1)If the Contractor expends a total of $750,000 or more in federal
financial assistance and has received federal financial assistance from
the City during its fiscal year, it shall have an independent audit
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conducted of its financial statement and conditions, which shall comply
with the requirements of generally accepted auditing standards
(GAAS); General Accounting Office (GAO's) Standards for Audits of
Governmental Organizations, Programs, Activities, and Functions; and
the Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards aka the Uniform Guidance (2 CFR
Part 200), as amended, and as applicable.
The Contractor shall provide a copy of the audit report to the City no
later than thirty (30) days after the audit's completion or (6) months
subsequent to the end of the Contractor's fiscal year, whichever date
is sooner. The Contractor shall provide to the City its response and
corrective action plan for all findings and reportable conditions
contained in its audit. When reference is made in its audit to a
Management Letter or other correspondence made by the auditor, the
Contractor shall provide copies of those communications and the
Contractor's response and corrective actions plan.
2) The Catalog of Federal Domestic Assistance (CFDA) number for the
Coronavirus Relief Fund for Local Governments program is 21.99.
X. INDEPENDENT CONTRACTOR. The parties intend that an Independent
Contractor-Employer Relationship will be created by this Agreement. By their execution of this
Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following
representations:
A. The Contractor has the ability to control and direct the performance and
details of its work, the City being interested only in the results obtained
under this Agreement.
B. The Contractor maintains and pays for its own place of business from which
Contractor's services under this Agreement will be performed.
The Contractor is engaged in an independently established trade, occupation,
profession, or business of the same nature as that involved under this
Agreement.
The Contractor is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, including the Internal
Revenue Service and the state Department of Revenue.
The Contractor has registered its business and established an account with
the state Department of Revenue and other state agencies as may be
required by Contractor's business, and has obtained a Unified Business
Identifier (UBI) number from the State of Washington.
F The Contractor maintains a set of books dedicated to the expenses and
earnings of its business.
XI. TERMINATION.
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A. Suspension or Termination for Lack of Fundinq
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1)The City may suspend or terminate this Agreement, in whole or in
part, upon five (5) business days'written notice in the event expected
or actual funding from a State, federal, or other Source is withdrawn,
reduced, or limited in any way prior to Agreement expiration. The
suspension or termination shall be effective on the date specified in
the written notice.
2)In the event of suspension under this clause, the City shall provide
the Contractor written notice stating when services may be resumed.
The City shall be liable only for payment in accordance with the terms
of this Agreement for services rendered prior to the effective date of
suspension and after the date that services may be resumed.
3)In the event of termination under this clause, the City shall be liable
only for payment in accordance with the terms of the Contract for
services rendered prior to the effective date of termination. The City
may pay an amount mutually agreed by the parties for partially
completed work and services.
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1)In the event the City determines the Contractor has failed to comply
with the terms or conditions of this Agreement in a timely manner, or
has otherwise breached any provision or condition of this Agreement,
the City has the right to suspend or terminate this Agreement
immediately upon issuance of written notice.
2)The City may suspend all or any part of this Agreement, and withhold
further payments or prohibit the Contractor from incurring additional
obligations thereunder, during investigation of suspected
noncompliance. The City may also take these actions pending
corrective action by the Contractor or pending a decision by the City
to terminate the Agreement.
3) The rights and remedies of the City provided in this Agreement are
not exclusive and are in addition to any other rights and remedies
provided by law.
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1)The City reserves the right to suspend or terminate all or part of this
Agreement, to withhold further payments, or to prohibit the Contractor
from incurring additional obligations of funds, if the City has reason to
believe that fraud, abuse, or violation of law has occurred on the part
of the Contractor in the performance of this Agreement or any other
contract.
XII. DISCRIMINATION. In the hiring of employees for the performance of work under
this Agreement or any subcontract, the Contractor, its subcontractors, or any person acting on
behalf of the Contractor or subcontractor shall not, by reason of race, religion, color, sex, age/
sexual orientation, national origin, or the presence of any sensory, mental, or physical disability,
discriminate against any person who is qualified and available to perform the work to which the
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employment relates. Contractor shall execute the City of Kent Equal Employment Opportunity
Policy Declaration, Comply with City Administrative Policy t.2, and upon completion of the
contract work, file the attached Compliance Statement, attached hereto as Exhibit B and
incorporated by this reference.
XIII. INDEMNIFICATION. Contractor shall defend, indemnify and hold the City, its
officers, officials, employees, agents and volunteers harmless from any and all claims, injuries,
damages, losses or suits, including all legal costs and attorney fees, arising out of or in
conneition with the Contractor's performance of this Agreement, except for that portion of the
injuries and damages caused by the City's sole negligence. The City shall defend, indemnify and
hold the Contractor, its officers, officials, employees, agents and volunteers harmless from any
and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees,
arising out of or in connection with the City's performance of this Agreement, except for that
portion of the injuries and damages caused by the Contractor's sole negligence.
The City's inspection or acceptance of any of Contractor's work when completed shall not
be grounds to avoid any of these covenants of indemnification.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'S WAIVER OF
IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF
THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
N EGOTIATED THIS WAIVER.
In the event Contractor refuses tender of defense in any suit or any claim, if that tender
was made pursuant to this indemnification clause, and if that refusal is subsequently determined
by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the
Contractor's pdrt, then Contractor shall pay all the City's costs for defense, including all
reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and
fees incurred because there was a wrongful refusal on the Contractor's paft.
The provisions of this section shall survive the expiration or termination of this
Agreement.
XIV. LIMITATION OF LIABILITY. The Department of Commerce and the State of
Washington are not liable for claims or damages arising from a Contractor's performance
pursuant to this contract.
XV. INSURANCE. The Contractor shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit C attached and
incorporated by this reference.
XVI. EXCHANGE OF INFORMATION. The City will provide its best effofts to provide
reasonable accuracy of any information supplied by it to Contractor for the purpose of
completion of the work under this Agreement.
XVII. PUBLIC RECORDS. The Contractor acknowledges that the City is a public agency
subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington
and documents, notes, emails, and other records prepared or gathered by the Contractor in its
performance of this Agreement may be subject to public review and disclosure, even if those
records are not produced to or possessed by the City of Kent. Contractor agrees to cooperate
fully with the City in satisfying the City's duties and obligations under the Public Records Act.
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XVIII. CITY'S RIGHT OF INSPECTION. Even though Contractor is an
independent contractor with the authority to control and direct the performance and details of
the work authorized under this Agreement, the work must meet the approval of the City and
shall be subjectto the City's general right of inspection to secure satisfactory completion.
XIX. WORK PERFORMED AT CONTRACTOR'S RISK. Contractor shall take all
necessary precautions and shall be responsible for the safety of its employees, agents, and
subcontractors in the performance of the contract work and shall utilize all protection necessary
for that purpose. All work shall be done at Contractor's own risk, and Contractor shall be
responsible for any loss of or damage to materials, tools, or other articles used or held for use in
connection with the work.
XX. MISCELLANEOUSPROVISIONS.
A.Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the
City requires its contractors and Contractors to use recycled and recyclable
products whenever practicable.
Non-Waiver of Breach. The failure of the City to insist upon strict
performance of any of the covenants and agreements contained in this
Agreement, or to exercise any option conferred by this Agreement in one or
more instances shall not be construed to be a waiver or relinquishment of
those covenants, agreements or options, and the same shall be and remain
in full force and effect.
Resolution of Disputes and Governing Law. This Agreement shall be
governed by and construed in accordance with the laws of the State of
Washington. If the parties are unable to settle any dispute, difference or
claim arising from the parties' performance of this Agreement, the exclusive
means of resolving that dispute, difference or claim, shall only be by filing
suit exclusively under the venue, rules and jurisdiction of the King County
Superior Court, King County, Washington, unless the pafties agree in writing
to an alternative dispute resolution process. In any claim or lawsuit for
damages arising from the pafties' performance of this Agreement, each party
shall pay all its legal costs and attorney's fees incurred in defending or
bringing such claim or lawsuit, including all appeals, in addition to any other
recovery or award provided by law; provided, however, nothing in this
paragraph shall be construed to limit the City's right, or the Contractor's
right, to indemnification under this Agreement or the terms of the
Indemnification section of this Agreement,
Written Notice. All communications regarding this Agreement shall be sent
to the parties at the addresses listed on the signature page of the
Agreement, unless notified to the contrary. Any written notice hereunder
shall become effective on the date served or five (5) 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.
Assignment. Any assignment of this Agreement by either party without the
written consent of the non-assigning party shall be void. If the non-assigning
party gives its consent to any assignment, the terms of this Agreement shall
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continue in full force and effect and no further assignment shall be made
without additional written consent.
Modification. No waiver, alteration, or modification of any of the provisions
of this Agreement shall be binding unless in writing and signed by a duly
authorized representative of the City and Contractor.
Entire Agreement. The written provisions and terms of this Agreement,
together with any Exhibits attached hereto, shall supersede all prior verbal
statements of any officer or other representative of the City, and such
statements shall not be effective or be construed as entering into or forming
a part of or altering in any manner this Agreement. All of the above
documents are hereby made a part of this Agreement. However, should any
language in any of the Exhibits to this Agreement conflict with any language
contained in this Agreement, the terms of this Agreement shall prevail.
Compliance with Laws. The 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 performance of this Agreement,
and its business, equipment, and personnel engaged in operations covered
by this Agreement or accruing out of the performance of those operations.
City Business License Required. Contractor agrees to obtain and provide
proof of a current city of Kent business license pursuant to Chapter 5.01 of
the Kent City Code.
Counterparts and Signatures by Fax or Email. This Agreement may be
executed in any number of counterparts, each of which shall constitute an
original, and all of which will together constitute this one Agreement.
Further, upon executing this Agreement, either party may deliver the
signature page to the other by fax or email and that signature shall have the
same force and effect as if the Agreement bearing the original signature was
received in person.
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IN WITNESS, the parties below execute this Agreement, which shall become
effective on the last date entered below. All acts consistent with the authority of this
Agreement and prior to its effective date are ratified and affirmed, and the terms of
the Agreement shall be deemed to have applied.
CONTRACTOR:
BY:
(signature)
Print Name
(titte)
DATE:
CITY OF KENT:
By
(signature)
Dana RalohPrint Name
DATE
NOTICES TO BE SENT TO:
CONTRACTOR:
Maju Qureshi
MSC Economic Stability Director
1200 s. 335th St
Federal Way, WA 98003
(253) B3B-6810 (telephone)
(253) 87 4-7 B3I (facsimile)
NOTICES TO BE SENT TOr
CITY OF KENT:
Molly Bartlemay
City of Kent Customer Service
220 Fourth Avenue South
Kent, WA 98032
(253) 856-5206 (telephone)
(253) 856-6200 (facsimile)
Multi-Service Center
CEO Robin Corak
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10/20/2020 10/23/2020
EXHIBIT A
SCOPE OF WORK . UTILITY ASSISTANCE GRANT PROGRAM
Multi-service Center ("Contractor") shall utilize City of Kent CARES Act funding to
perform the activities specified below, Such services shall be provided in a manner which
fully complies with all applicable federal, state and local laws, statutes, rules and
regulations, as are now in effect or may be hereafter amended.
1) Project Budget
Contractor shall apply the following funds to the project based on the assumption that
$70,000.00 in direct resident assistance will be provided through grants:
Budqet
Personnel $4,952.50
Facilities $843.63
Administrative Costs $1,735,88
Direct Resident Assistance $70,ooo.oo
2) Performance Measures
A. Number Served
The City agrees to provide the following number of grants
Number of Grants Distrusted
60
Averaqe Grant Amount $r,166.67
Project Title: CARES Act Funding for Residential Utility Assistance
Funding will provide utility assistance to City of Kent residents financially impacted by the
COVID-19 pandemic. The CARES Act funding shall be used to provide utility assistance
grants to cover unpaid water, sewer, and storm drainage charges to keep Kent residents
connected to essential utilities during the pandemic. In addition, funds shall pay for a
portion of the salaries of MSC staff for its administration of the City's residential utility
assistance qrant proqram,
Project Manager: Maju Qureshi, Economic Stability Director
Telephone: 253.835 .7 67 B Fax: 253.87 4.783t E-mail : maiuq@mschelps.orq
City Contact: Molly Bartlemay
Telephone: 253.856.5206 Fax: 253,856.6200 E-mail: mbartlemav@kentwa.qov
City of Kent - CARES Act grants for utility assistance- Page 1
B. Definition of Services
Utility Assistance: Contractor provides payment to the utility to be applied directly to the
residential utility account. Utility assistance provided cannot exceed the total amount
billed on the utility account between March 2O2O and the current date.
3) Eligibility Confirmation
Contractor will confirm eligibility before utility assistance is provided. Eligibility confirmation
will include the following:
o Applicant name matches the name on the utility account;. The account has been in their name since March 2020;o The applicant has provided documentation to prove they have been financially
impacted by COVID-19. This may be satisfied by providing a declaration, under the
penalty of perjury, that the applicant has suffered negative financial impacts as a
result of the COVID-19 pandemic and/or related government restrictions;. The assistance is for any combination of water, sewer, or drainage charges;r The applicant has not received utility assistance from other sources that were
awarded CDBG funding,
City of Kent - CARES Act grants for utility assistance- Page 2
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment oppoftunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2 During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set fotth
above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this day of ,200-.
By:
For:
Title:
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Date
CEO
Multi-Service Center
DocuSign Envelope ID: 7AC99E74-3E95-4855-B87C-823070BF488C
20th 2020October
10/20/2020
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: L.2 EFFECTIVE DATE: January 1, 1998
SUBJECT:
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, musttake the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines
MINORITY AND WOMEN
CONTRACTORS
SUPERSEDES: April 1, 1996
APPROVED BY lim White, Mayor
1
DocuSign Envelope ID: 7AC99E74-3E95-4855-B87C-823070BF488C
CITY OF KENT
EQUAL EM PLOYM ENT OPPORTU NITY COM PLIANCE STATE M ENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered into on the
(date). between the firm I re present and the City of Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
Dated this
-
day of 200
By
For:
Title:
Date:
CEO
Multi-Service Center
COVID 19
Multi-Service Center
DocuSign Envelope ID: 7AC99E74-3E95-4855-B87C-823070BF488C
202020th
10/20/2020
10/20/2020
October
EXHIBIT C
INSURANCE REQUIREMENTS FOR
CONSULTANT SERVICES AGREEM ENTS
Insurance
The Consultant shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Consultant, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Consultant shall obtain insurance of the types described below:
1. Automobile Liability insurance covering all owned, non-
owned, hired and leased vehicles. Coverage shall be written
on Insurance Services Office (ISO) form CA 00 01 or a
substitute form providing equivalent liability coverage. If
necessary, the policy shall be endorsed to provide
contractual liability coverage.
Commercial General Liability insurance shall be written on
ISO occurrence form CG 00 01. The City shall be named as
an Additional Insured under the Consultant's Commercial
General Liability insurance policy with respect to the work
performed for the City using ISO additional insured
endorsement CG 20 L0 11 85 or a substitute endorsement
providing equivalent coverage.
2. Workers'Compensation coverage as required by the
Industrial Insurance laws of the State of Washington.
B. Minimum Amounts of fnsurance
Consultant shall maintain the following insurance limits:
1. Automobile Liability insurance with a minimum combined
single limit for bodily injury and property damage of
$1,000,000 per accident.
2. Commercial General Liability jnsurance shall be written with
limits no less than $1,000,000 each occurrence, $2,000,000general aggregate.
EXHIBIT C (Continued)
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
insurance:
1. The Consultant's insurance coverage shall be primary insurance as
respect the City. Any Insurance, self-insurance, or insurance pool
coverage maintained by the City shall be excess of the Consultant's
insurance and shall not contribute with it.
2. The Consultant's insurance shall be endorsed to state that coverage shall
not be cancelled by either party, except after thirty (30) days prior
written notice by certified mail, return receipt requested, has been given
to the City.
3. The City of Kent shall be named as an additional insured on all policies
(except Professional Liability) as respects work performed by or on behalf
of the Consultant and a copy of the endorsement naming the City as
additional insured shall be attached to the Certificate of Insurance. The
City reserves the right to receive a certified copy of all required insurance
policies. The Consultant's Commercial General Liability insurance shall
also contain a clause stating that coverage shall apply separately to each
insured against whom claim is made or suit is brought, except with
respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M, Best rating of not
less than A:VII.
E. Verification of Coverage
Consultant shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Consultant before commencement of the work.
F. Subcontractors
Consultant shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Consultant.
OP lD: SR
--A,CQRD'*'CERTIFICATE OF LIABILITY INSURANCE DATE (MM/OD/YYYY)
03t02t2020
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:lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
Sprague lsrael Giles
1501 Fourth Avenue, Suite 730
Seaftle, WA 98101-3225
John M. Policar MULTI-2
INSURER(S} AFFORDING COVERAGE NAIC #
INSURED Multi-Service Center
PO Box 23599
Federal Way, WA 98093-0699
tNsURER A ; Philadelphia lndemnity lns.18058
INSURER B :
INSURER C
INSURER D:
INSURER E :
INSIIRFR F.
CERTIFICATE NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY NIIMBER POLIGY EFF
rMM/NN/YYYYI
POLICY EXP
IMM/ND/YYYYI LIMITSINSRITRryPE OF INSURANCE
EACH OCCURRENCE 1,000,000$
PRF[IISFS /Fe dn^r rrrehr.e\100,000$
MED EXP (Anv one person)5,000$
1,000,000$PERSONAL & ADV INJURY
GENERAL AGGREGATE $3,000,000
PRODUCTS - COMP/OP AGG $3,000,000
$
X PHPR2103284 03t0'U2020 03t0'U2021ACOMMERCIAL GENERAL LIABILITY
GEN'L AGGREGATE LIMIT APPLIES PER:
X
x
CLAIMS.MADE OCCUR
GENERAL LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)1,000,000$
BODILY INJURY (Per person)$
BODILY INJURY (Per accident)$
PROPERTY DAMAGE
(PER ACCIDENT)$
$50(Gomp
$50(
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON.OWNED AUTOS
X
X
x
x
AUTOMOBILE LIABILITY
PHPK2103284
$50,000
03101t2020 03t01t2021
Collision
A
EACH OCCURRENCE $
AGGREGATE $
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS-MADE
$
$
DEDUCTIBLE
RETENTION S
WUSIAIU-TNRY I II'ITS X o tH-
FR
1,000,00($E.L. EACH ACCIDENT
E.L, DISEASE - EA EMPLOYEE 1,000,00($
03t01t2020 03t01t2021
E-1. DISEASE - POLICY LIMIT ,t,000,00($
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
lf yes, describe under
DFSCRIPTION OF OPERATIONS below
Y/N
N/A PHPK2103284
WA STOP GAP
DESCRTPTTON OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional R€marks Schedule, if more space is required)
Certificate holder is additional insured if required bv written contract or
aqreement, subject to the General Liability iddition-al insured provision
efidorsemeint. '
CERTIFICATE
@ 1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN
ACCORDANCE WTH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
City of Kent
525 Fourth Avenue North
Kent, WA 98032
ACORD 25 (2009/09)
Tl-{tA trNnnps EMENT r+UANtatrq THtr DNI Il:V PL trA.qtr Ptr
Pr-GLD-HS (10/11)
an rr naptrtrl ll I v
GHNERAL LIABILITY DELUXE ENDOR$EMENT:
HUMAN SERVICES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE
It ls understood and agreed that the following extensions only apply in the event that no other specific coverage for
the indicated loss exposure is provided under this policy. lf such specific coverage applies, the terms, conditions and
limits of that coverage are the sole and exclusive coverage applicable under this policy, unless otherwise noted on
this endorsement. The following is a summary of the Limits of lnsurance and additional coverages provided by this
endorsement- For complete details on specific coverages, consult ihe policy contract wording.
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@ 2011 Philadelphia lndemnity lnsurance Company
Coverage Applicable Limit of lnsurance Page #
Extended Property Damage lncluded 2
Limited Rental Lease Contractual Liability $50,000limit 2
Non-Owned Watercraft Less than 58 feet 2
Damage to Property You Own, Rent, or Occupy $30,000 limit 2
Damage to Rented to You $1,000,000 2
HIPAA Clarification 4
Medical Payments $20,000 E.
Medical Payments * Hxtended Reporting Period 3 years tr
Athletic Activities Amended
Supplementary Paym - Bail Bonds $5,000
Supplementary Payment - Loss of Earnings $1,000 per day E
Employee lndemnification Defense Coverage $2s,000 5
Key and Lock Replacement - Janitorial Services Client Coverage $10,000limit o
ewly Acquired Tlrne Amended 6
Additional Directors and Admin lncluded 7
Additional nagers and Supervisors (with Fellow lnctuded 7
Additional Named lns lncluded 7
Additional lnsured - Funding Source lncluded 7
Additional lnsured - Home Care Providers lncluded 7
Additional lnsured - Managers, Landtords, or Lessors of Premises lncluded 7
- Lessor of Equipment lncluded 1
Additional lnsured - Grantor of Permits lncluded
Additional lnsured - Vendor lncluded t'
Additional lnsured - Franchisor lncluded I
nsu - When Required by Contract lncluded u
Additional lnsured - Owners, Lessees, or Contractors lncluded I
Additional lnsured - State or Political Subdivisions lncluded 10
Duties in the Event of Occurrence, Claim or Suit lncluded 10
Unintentional Failure to Disclose Hazards lncluded 10
Tansieiot Risihta of Recovery Against Others To Us Clarification 't0
Liberal izaiion lncluded 11
Bodily lnjury - includes Mental Anguish lncluded 11
peibonait and Advertising lnjury - includes Abuse of Process,
Discrimination
lncluded 11
P|-GLD-HS (10/11)
A. Extended Property Damage
SECTION I- COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Subsection 2. Exclusions, Paragraph a. is deleted in its entirety and replaced by the
following:
a. Expected or lntended 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'
B. Limited Rental Lease Agreement Contractual Liability
SECTION I- COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMiAGE
LIAB;LITY, Subseetion 2. Exclusions, Paragraph b. Contractual Liability is amended to include the
following:
(3) Based on the named insured's request at the time of claim, we agree to indemnify the
named insured for their liability assurned in a contract or agreement regarding the rental
or lease of a premises on behalf of their client, up to $50,000. This coverage extension
only applies to rental lease agreements. This coverage is excess over any renter's
liability insurance of the client.
C. Non-OwnedWatercraft
SECTTON I- COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Subsection 2. Exclusions, Paragraph g. (2) is deleted in its entirety and replaced by the
following:
(2) A watercraft you do not own that is:
(a) Less than 58 feet long; and
(b) Not being used to carry persons or property for a charge;
This provision applies to any person, who with your consent, either uses or is responsible for
the use of a watercraft. This insurance is excess over any other valid and collectible
insurance availabie to the insured whether primary, excess or contingent.
D. Damage to Property You Own, Rent or Occupy
sEcTIoN I. CoVERAGE$, CoVERAGE A BODILY INJURY AND PROPERTY DAMAGE
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@ 2011 Philadelphia lndemnity lnsurance Company
P|-GLD-HS (10/11)
tlABlLITY, Subsection 2. Exclusions, Paragraph j. Damage to Propedy, ltem (1) is deleted in its
entirety and replaced with the following:
(1) Property you own, rent, or occupy, including any costs or expenses incurred by you, or
any other person, organization or entity, for repair, replacement, enhancement,
restoration or maintenance of such property for any reason, including prevention of injury
to a person or damage to another's property, unless the damage to property is caused by
your client, up to a $30,000 fimit. A client is defined as a person under your direct care
and supervision.
E. Damage to Premises Rented to You
1, lf damage by fire to premises rented to you is not otherwise excluded from this Coverage Pad,
the word "fire" is changed to "fire, lightning, explosion, smoke, or leakage from automatic fire
prolective systems" where it appears in:
a. The lasi paragraph of SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND
PROPERTY DAMAGE LIABILITY, Subsection 2. Exclusions; is deleted in its entirety and
replaced by the following;
Exclusions c. through n, do not apply to damage by fire, lightning, explosion, smoke, or
leakage from automatic fire protective systems to premises while rented to you or
temporarily occupied by you with permission of the owner- A separate limit of insurance
applies to this coverage as described in SECTION lll- LIMITS OF lN$URANCE.
b. SECTION tll* LIMITS OF INSURANGE, Paragraph 6. is deleted in its entirety and replaced
by ihe following:
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 "propefty damage" to any
one premises, while rented to you, or in the case of damage by fire, lightning, explosion,
smoke, or leakage from automatic fire protective systems while rented to you or
temporarily occupied by you with permission of the owner.
c. SECTION V - DEFINITIONS, Paragraph La., is deleted in its entirety and replaced by the
ioilowing:
A contract for a lease of premises. However, that portion of the contract for a lease of
premises that indemnifies any person or organization for damage by fire, lightning,
explosion, smoke, or leakage from automatic fire protective systems to premises while
rented to you or temporarily occupied by you with permission of the owner is not an
"insured coniract";
2. $ECT|ON tV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Subsection 4. Other
lnsurance, Paragraph b. Excess lnsurance, (,t}(a) (ii) is deleted in its entirety and replaced by
the following:
That is insurance for fire, lightning, explosion, smoke, or leakage from automatic fire
protective systems for premises rented to you or temporarily occupied by you with permission
of the owner;
3. The Damage To Premises Rented To You Limit section of the Declarations is amended to the
greater of;
Page 3 of 12
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O 2011 Philadelphia lndemnity lnsurance Company
P|-GLD-HS (10/11)
a. $1,000,000; or
b. The amount shown in the Declarations as the Damage to Premises Renied to You Limit.
This is the mosi we will pay for all damage proximately caused by the same event, wheiher such
damage results from fire, lightning, explosion, smoke, or leaks from automatic fire protective
systems or any combination thereof,
F. HIPAA
SECTION I- COVERAGES, COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY,
is amended as follows:
1. Paragraph l. lnsuring Agreement is amended to include the following:
We will pay those sums that the insured becomes legally obligated io pay as damages because
of a "violation(s)" of the Health lnsurance Portability and Accountabitity Act (HIPAA), We have
the right and the duty to defend the insured against any "suit,'' "investigation," or "civil proceeding"
seekihg these damages. However, we will have no duty to defend the insured against any "suit"
seeking damages, "investigation," or "civil proceeding" to which this insurance does not apply.
2. Paragraph 2. Exclusions is amended to include the fotlowing additional exclusions:
This insurance does not apply to:
a. lntentional, Willful, or Deliberate Violations
Any willful, intentional, or deliberate "violation(s)" by any insured.
b. CriminalActs
Any "violation" which results in any criminal penalties under the HIPAA.
c. Other Remedies
nny remeciy other than monetary ciarnages for penalties assegsed.
d. Compliance Reviews or Audits
Any compliance reviews by the Deparlment of Healih and Human Services.
g. SECTION V * DEFINITIONS is amended to include the following additional definitions:
a. "Civil proceeding" means an action by the Department of Health and Human Services (HHS)
arising out of "violations."
b. "lnvestigation" rneans an examination of an actual or alleged "violation(s)" by HHS. However,
"investigation" does not include a Compliance Review,
c. "Violation" means the actual or alleged failure to comply with the regulations included in the
HIPAA.
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@ 2011 Philadelphia lndemnity lnsurance Company
Pr-GLD-HS (10t11)
G. Medical Payments - Limit lncreased to $20,000, Extended Reporting Period
tf COVERAGE G MEDICAL PAYMENTS is not oiherwise excluded from this Coverage Part;
1. The Medical Expense Limit is changed subject to all of the terms of SECTION lll . LIMITS OF
INSURANCE to the greater of:
a. $20,000; or
b. The Medical Expense Limit shown in the Declarations of this Coverage Paft,
2, SECTION t - COVERAGE, COVERAGE C MEDICAL PA,YMENTS, Subsection 1. lnsuring
Agreement, a. (3) (b) is deleted in its entirety and replaced by the following:
(b) The expenses are incurred and repofted to us within three years of the date of the
accident.
H. Athletic Activities
SECTION I * COVERAGES, COVERAGE C MEDICAL PAYMENT$, SUbSCCtiON 2. EXCIUS|ONS,
Paragraph e. Athletic Activities is deleted in its entirety and replaced with the following:
e. Athletic Activities
To a person injured while taking part in athletics-
L SupplementaryPayments
SECTION I - COVERAGE$, SUPPLEMENTARY PAYMENTS . COVERAGE A AND B ATC
amended as follows:
1. b. is deleied in its entirety and replaced by the following:
1. b. Up to $5000 for 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,
1.d. is deleted in its entirety and replaced by the following:
L d. All reasonable expenses incurred by the insured at our request to assist us in the
investigation or defense of the claim or "suit", including actual loss of earnings up to $1,000 a
day because of time off from work.
i. Employee lndemnification Defense Coverage
SECTION I * COVERAGES, $UPPLEMENTARY PAYMENTS - COVERAGE$ A AND B thc
following is added:
We will pay, on your behalf, defense costs incurred by an "employee" in a criminal proceeding
occurring in the course of employment,
The most we will pay for any "employee" who is alleged to be directly involved in a criminal
proceeding is $25,000 regardless of the numbers of "employees," claims or "suits" brought or
persons or organizations making claims or bringing "suits.
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@ 2011 Philadelphia lndemnity lnsurance Company
P|-GLD-HS (1oi 11)
K. Key and Lock Replacement - Janitorial Services Client Coverage
SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS _ GOVERAGES A AND B iS
amended to include the following;
We will pay for the cost to replace keys and locks at the "clients" premises due to theft or other
loss to keys entrusted io you by your "client," up to a $10,000 limit per occurrence and $10,000
policy aggregate.
We wilt not pay for loss or damage resulting from theft or any other dishonest or criminal act that
you of any of your paftnefs, members, offioers, "employees", "managers", directorS, trusteeS,
authorized representatives or any one to whom you entrust the keys of a "client" for any
purpose commit, whether acting alone or in collusion with other persons'
The following, when used on this coverage, are defined as follows:
a, "Client" means an individuat, company or organization with whom you have a written contraci
or work order for your services for a described premises and have billed for your services.
b. "Employee" means:
{{) Any naturalPerson;
(a) While in your service or for 30 days afier termination of service:
(b) Who you compensate directly by salary, wages or commissions; and
(c) Who you have the right to direct and control while pedorming services for you; or
(2) Any natural person who is furnished temporarily to you;
(a) To substitute for a permanent "employee" as defined in Paragraph ({) above, who is
on leave; or
(b) To meet seasonal or short-term workload conditions;
while that person is subject to your direction and control and performing services for you,
(3) "Employee" does not mean:
(a) Any agent, broker, person leased to you by a labor leasing firm, factor, commission
merchant, consignee, independent contractor or representative of the same general
character; or
(b) Any "manager," director or trustee except while performing acts coming within the
scope of the usual duties of an "employee'"
c. "Manager" means a person serving in a directorial capacity for a limited liability company.
L. Additional lnsureds
SECTION tl - WHO lS AN IN$URED is amended as follows:
1. lf coverage for newly acquired or formed organizations is not otherwise excluded from this
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lncludes copyrighted material of lnsurance Services Office, lnc., with its permission,
@ 2011 Philadelphia lndemnity lnsurance Company
P|-GLD-H$ (10/11)
Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the foltowing:
a. Coverage under this provision is afforded until the end of the policy period,
2. Each of the following is also an insured:
a. Medical Directors and Administrators - Your medical directors and administrators, but
only while acting within the scope of and during the course of their duties as such. $uch
duties do not include the furnishing or failure to furnish professional services of any physician
or psychiatrist in the treatment of a patient.
b. Managers and Supervisors - Your managers and supervisors are also insureds, but
only with respect to their duties as your managers and supervisors. Managers and
supervisors who are your "employees" are also insureds for "bodily injury" to a co-
"employee' while in the course of his or her employment by you or performing duties
related to the conduct of your business.
This provision does not change ltem 2.a.(1)(a) as it applies to managers of a limited
liability companY,
c. Broadened Named lnsured - Any organization and subsidiary thereof which you control and
actively manage on the effective date of this Coveiage Part. However, coverage does not
appty tb any oiganization or subsidiary not named in the Declarations as Named lnsured, if
they-are atio iniured under another similar policy, but for its termination or the exhaustion of
its limits of insurance.
d. Funding Source - Any person or organization with respect to their liability arising out of:
(1) Their financial control of you; or
(2) Premises they own, maintain or control while you lease or occupy these premises.
This insurance does not apply to structural alterations, new construction and demolition
operations performed by or for that person or organization.
e. llome Care Provldeis - Ai the first Named lngured's option, any perscn or organizetion
under your direct supervision and control while providing for you private home respite or
foster home care for the developmentally disabled-
f, Managers, Landlords, or Lessors of Premises * Any person or organization with respect
io their liability arising out of the ownership, maintenance or use of that part of the premises
leased or rented to you subject to the following additional exclusions:
This insurance does nCIt aPPIY to:
(1) Any "occurrence" which takes place afier you cease to be a tenant in that premises; or
(2) Structural alterations, new construction or demolition operations pedormed by or on
behalf of that person or organization,
g. Lessor of Leased Equipment - Automatic Status When Required in Lease Agreement
With You - Any person or organization from whom you lease equipment when you and such
person or organization have agreed in writing in a contract or agreement thai such person or
organization is io be added as an additional insured on your policy. Such person or
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P|-GLD-HS (10i11)
organization is an insured onty with respect to liability for "bodily injury," "properly damage" or
"personal and advertising injury" caused, in whole or in paft, by your maintenance, operation
or use of equipment leased to you by such person or organization.
A person's or organization's status as an additional insured under this endorsement ends
when their contract or agreernent with you for such leased equipment ends.
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.
h. Grantors of Permits - Any state or political subdivision granting you a permit in connection
with your premises subject to the following additional provision:
(1) This insurance applies only with respect to the following hazards for which the state or
political subdivision has issued a permit in connection with the premises you own, rent or
control and to which this insurance applies:
(a) The existence, maintenance, repair, construction, erection, or removal of advertising
signs, awnings, canopies, cellar entrances, coal holes, driveways, rnanholes,
marquees, hoist away openings, sidewalk vaults, street banners or decorations and
similar exposures;
(b) The construction, erection, or removal of elevators; or
(c) The ownership, rnaintenance, or use of any elevators covered by this insurance.
i. Vendors - Only with respect to "bodity injury" or "property damage" arising out of "your
produets" which are distributed or sold in the regular course of the vendor's business, subject
to the following additional exclusions:
{1} The insurance afforded the vendor does not apply to:
(a) "Bodily injury" or "property damage'' for which the vendor is obligated to pay
damages by reason of the assumption of liability in a contract or agreement, This
exclusion does not apply to liability for damages that the vendor would have in the
absence of the contract or agreement;
{b) Any express warranty unauthorized by you;
(c) Any physical or chemical change in the product made intentionally by the vendor;
(d) Repackaging, except when unpacked solely for the purpose of inspection,
demonstration, testing, or the substitution of parts under instructions from the
manufacturer, and then repackaged in the original container;
(e) Any failure to make such inspections, adjustments, tests or servicing as the vendor
has agreed to make or normally undertakes to make in the usual course of business,
in connection with the distribution or sale of the products;
(0 Demonstration, installation, servicihg or repair operations, except such operations
performed at the vendor's premises in connection with the sale of the product;
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(g) Products which, after distribution or sale by you, have been labeled or relabeled or'-
used a$ a container, part or ingredient of any other thing or subslance by or for the
vendor; or
(h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor
for its own acts or omissions or those of iis employees or anyone else acting on its
behatf. However, this exclusion does not apply to:
{i) The exceptions contained in Sub-paragraphs (d) or (f); or
(ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to
make or normally undertakes to make in the usual course of business, in
connection with the distribution or sale of the products'
(2) This insurance does not apply to any insured person or organization, from whom you
have acquired such products, or any ingredient, part or con{ainer, entering into,
accompanying or containing.
Franchisor - Any person or organization with respect to their liability as the grantor of a
franchise to you.
As Required by Gontract - Any person or organization where required by a written contract
executed prior tb the occurrence of a loss. Such person or organization is an additional
insured for "bodily injury," "property damage" or "personal and advertising injury" but only for
liability arising oui oftfr6 negligenc-e of the named insured, The limits of insurance applicable
to thele additional insureds are the lesser of the policy limits or those limits specified in a
contract or agreement. These limits are included within and not in addition to the limits of
insurance shown in the Declarations
Owners, Lessees or Gontractors - Any person or organization, but 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 acis or omissions of those actlng on your behalf;
in the performance of your ongoing operaiions for the additional insured when required by a
contract,
With respect to the insurance afforded to these additional insureds, the following additional
exclusions apply:
This inSurance does not apply to "bodily injury" or "property damage" ocCurring after:
(a) All work, including materials, parts or equipment furnished in connection with such
work, on the project (other than service, maintenance or repairs) to be performed by
or on behalf of the additional insured(s) at the location of the covered operations has
been comPleted; or
(b) That portion of "your work" oui of which the injury or damage arises has been put to
its intended use by any person or organizaiion other than another contractor or
subcontracior engaged in performing operations for a principal as a part of the same
projeet.
t.
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pI-GLD-HS (10/11)
m. State or Political Subdivisions - Any state or political subdivision as required, subject to
thefollowing provisions:
{t) This insurance applies only with respect to operations performed by you or on your behalf
for which the state or poliiical subdivision has issued a permit, and is required by
contract.
(2) This insurance does not apply to:
(a) "Bodily injury," "property damage" or "personal and advertising injury" arising out of
operations performed for the state or municipality; or
(b) "Bodily injury" or "property damage" included within the "products-completed
operations hazard."
M. Duties an ths Event of Occurence, Claim or $uit
sEcTloN tv - coMMERctAL GENERA.L LIABI!-ITY CONDITIONS, Paragraph 2. is amended as
follows:
a. is amended to include:
This condition applies only when the "occurrence" or o{fense is known to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership; or
(3) An executive officer or insurance manager, if you are a corporation,
b. is amended to include:
This condition will not be considered breached unless the breach occur$ after such claim or "suit"
is known to:
(1) You, if You are an individual;
{2} A pariner, if you are a partnership; or
{3) An executive officer or insurance manager, if you are a corporation.
N. Unintentional Failure To Disclose Hazards
sEcTtoN tv - coMMERctAL GFNERAL LIABILITY CONDITIONS, 6, Representations is
amended to include the following:
It is agreed that, based on our reliance on your representations as to existing hazards, if you
should unintentionally fail to disclose all such hazards prior to the beginning of the policy period of
this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure.
O. Transfer of Rights of Recovery Against Others To Us
SECTTON tV - COMMERCIAL GENFRAL LIABILITY cONDITIONS, 8. Transfer of Rights of
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Recovery Against Others To Us is deleted in its entirety and replaced by the fotlowing:
lf the insured has rights to recover all or part of any payment we have made under this Coverage
part, those rights aie tran$fened to us. The insured must do nothing after loss to impair them. At
our reguest, the insured will bring "suit" or transfer those rights to us and help us enforce them.
Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a
loss, provided ihe waiver is made in a written contract
P. Liberalization
SECTION IV * COMMERCIAL GENERAL LIABILITY CONDITIONS, iS AMCNdCd tO iNCIUdC thE
following:
lf we revise this endorsement to provide rnore coverage without additional premium charge, we
will automatieally provide the additional coverage to all endorsement holders as of the day the
revision is effective in your state.
Q. Bodily lnjury * Mental Anguish
sEcTloN v - DEFINIT|ONS, Paragraph 3. ls deleted in its entirety and replaced by the following:
"Bodily injury" means:
a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish
resulting from anY of these; and
b. Except for mental anguish, includes death resulting from the foregoang (ltem a' above) at any
time,
R- Personal and Advertising lnJury * Abuse of Proce$s, Discrimination
If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE iS NOt
otherwise excluded from this Coverage Part, ihe definition of "personal and advertising injury" is
amended as follows:
1. SECTION V - DEFINITIONS, Paragraph 14,b. is deleted in its entirety and reptaced by the
following;
b. Malicious proseculion or abuse of process;
2. $ECTION V - DEFINITIONS, Paragraph 14. is amended by adding the following:
Discrimination based on race, color, religion, sex, age or national origin, except when:
a. Done intentionally by or at the direction of, or with the knowledge or consent of:
(1) Any insured; or
(2i Any executive officer, director, stockholder, partner or rnember of the insured;
b. Directly or indirectly related to the employment, former or prospective employment,
termination of employment, or application for employment of any person or persons by an
insured,
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c. Directly or indirectly related to the sale, rental, Iease or sublease or prospective sales, rental,
lease or sub-lease of any room, dwelling or premises by or at the direction of any insured; or
d. lnsurance for such discrimination is prohibited by or held in violation of law, public policy,
legislaiion, court decision or administralive ruling.
The above does not apply to fines or penalties imposed because of discrimination.
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POLICY NUMBER: PHPK2103284 COMMERCIAL GENERAL LIABILITY
cG 20 260413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional lnsured Person(s) Or Organization(s):
City of Kent
Parks Dept. /Housing & Hunan Services
lnformation required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section ll - Who ls An lnsured 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", "property
damage" or "personal and advertising injury"
caused, in whole or in part, by your acts or
omissions or the acts or omissions of those acting
on your behalf:
1. ln the performance of your ongoing operations;
or
2. ln connection with your premises owned by or
rented to you.
However:
1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and
2. lf 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
provide for such additional insured.
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section lll- Limits Of lnsurance:
lf 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 the
amount of insurance:
1. Required by the contract or agreement; 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.
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