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HomeMy WebLinkAboutCAG2020-383 - Original - Evergreen Asphalt & Concrete, Inc. - Briscoe Park Asphalt Patching - 11/23/2020ApprovalOriginator:Department: Date Sent:Date Required: Authorized to Sign: Director or Designee Mayor Date of Council Approval: 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: Budget? Yes No Dir Asst: Sup/Mgr: Dir/Dep: rev. 200804 N/A FOR CITY OF KENT OFFICIAL USE ONLY 11/16/2020 4 Other213355 Parks, Recreation & Community ServicesJan Applegate 4 4 11/18/2020 11/20/2020 n/a Other 10006600.64190.5225 ContractEvergreen Asphalt & Concrete 4 12/31/2020 4 14,025.00 BL BL 11/23/2020 PUBLIC WORKS AGREEMENT - 1 ($20K or Less and No Performance Bond) PUBLIC WORKS AGREEMENT between City of Kent and Evergreen Asphalt & Concrete Construction, Inc. dba Evergreen Asphalt & Concrete, Inc. THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Evergreen Asphalt & Concrete Construction, Inc. dba Evergreen Asphalt & Concrete, Inc. organized under the laws of the State of Washington, located and doing business at 27204 SE Kent Kangley Road, Ravensdale WA 98051-9851; Mailing Address: P.O. Box 867, Ravensdale WA 98051 (hereinafter the "Contractor"). AGREEMENT The parties agree as follows: I. DESCRIPTION OF WORK. The Contractor shall perform the following services for the City in accordance with the following described plans and/or specifications: Asphalt patching at Briscoe Park, located at South 190th Street near 64th Avenue South, Kent WA 98032. Includes 2500 square feet of asphalt removal and replacement in four areas per attached Proposal #8343, dated 11/16/2020 attached as Exhibit A. The Contractor further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices within the Puget Sound region in effect at the time such services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon execution of this Agreement. Upon the effective date of this Agreement, the Contractor shall complete the work described in Section I by December 31, 2020 . III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed FOURTEEN THOUSAND TWENTY FIVE DOLLARS AND NO CENTS ($14,025.00), including any applicable Washington State Sales Tax, for the work and services contemplated in this Agreement. The City shall pay the Contractor eighty-five percent (85%) of the Contract amount upon completion and acceptance of the work by the City, or at such earlier time as the City may determine is appropriate. The City will pay the remaining Contract amount upon fulfillment of the conditions listed below and throughout this Agreement. Card Payment Program. The Contractor may elect to participate in automated credit card payments provided for by the City and its financial institution. This Program is provided as an alternative to payment by check and is available for the convenience of the Contractor. If the Contractor voluntarily participates in this Program, the Contractor will be solely responsible for any fees imposed by financial institutions or credit card companies. The Contractor shall not charge those fees back to the City. PUBLIC WORKS AGREEMENT - 2 ($20K or Less and No Performance Bond) A. No Payment and Performance Bond. Because this contract, including applicable sales tax, is $150,000 or less, and pursuant to Chapter 39.08 RCW, the Contractor, in lieu of providing the City a payment and performance bond, has elected to have the City retain the final ten percent (10%) of the Contract amount for a period of thirty (30) days after the date of final acceptance, or until receipt of all necessary releases from the State Department of Revenue, the State Department of Labor & Industries, and the State Employment Security Department, and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. B. Retainage. The City shall also hold back a retainage in the amount of five percent (5%) of any and all payments made to the Contractor for a period of sixty (60) days after the date of final acceptance, or until receipt of all necessary releases from the State Department of Revenue, the State Department of Labor & Industries, and the State Employment Security Department, and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. The amount retained shall be placed in a fund by the City pursuant to RCW 60.28.011(4)(a), unless otherwise instructed by the Contractor within fourteen (14) calendar days of the Contractor’s signature on the Agreement. C. Defective or Unauthorized Work. The City reserves its right to withhold payment from the Contractor for any defective or unauthorized work. Defective or unauthorized work includes, without limitation: work and materials that do not conform to the requirements of this Agreement; and extra work and materials furnished without the City’s written approval. If the Contractor is unable, for any reason, to satisfactorily complete any portion of the work, the City may complete the work by contract or otherwise, and the Contractor shall be liable to the City for any additional costs incurred by the City. “Additional costs” shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Contract price specified above. The City further reserves its right to deduct the cost to complete the Contract work, including any Additional Costs, from any and all amounts due or to become due the Contractor. D. Final Payment: Waiver of Claims. THE CONTRACTOR’S ACCEPTANCE OF FINAL PAYMENT (EXCLUDING WITHHELD RETAINAGE) SHALL CONSTITUTE A WAIVER OF CONTRACTOR’S CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY CONTRACTOR AS UNSETTLED AT THE TIME FINAL PAYMENT IS MADE AND ACCEPTED. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor- Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: 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 the Contractor’s services under this Agreement will be performed. C. The Contractor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained the Contractor’s services and is a service other than that furnished by the City, or the Contractor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. 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. PUBLIC WORKS AGREEMENT - 3 ($20K or Less and No Performance Bond) E. 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 the Contractor’s business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Contractor has a valid contractor registration pursuant to Ch. 18.27 RCW or an electrical contractor license pursuant to Ch. 19.28 RCW. G. The Contractor maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. The City may terminate this Agreement for good cause. “Good cause” shall include, without limitation, any one or more of the following events: A. The Contractor’s refusal or failure to supply a sufficient number of properly skilled workers or proper materials for completion of the Contract work. B. The Contractor’s failure to complete the work within the time specified in this Agreement. C. The Contractor’s failure to make full and prompt payment to subcontractors or for material or labor. D. The Contractor’s persistent disregard of federal, state or local laws, rules or regulations. E. The Contractor’s filing for bankruptcy or becoming adjudged bankrupt. F. The Contractor’s breach of any portion of this Agreement. If the City terminates this Agreement for good cause, the Contractor shall not receive any further money due under this Agreement until the Contract work is completed. After termination, the City may take possession of all records and data within the Contractor’s possession pertaining to this project which may be used by the City without restriction. VI. PREVAILING WAGES. The Contractor shall file a “Statement of Intent to Pay Prevailing Wages,” with the State of Washington Department of Labor & Industries prior to commencing the Contract work. The Contractor shall pay prevailing wages in effect on the date the bid is accepted or executed by the Contractor, and comply with Chapter 39.12 of the Revised Code of Washington, as well as any other applicable prevailing wage rate provisions. The latest prevailing wage rate revision issued by the Department of Labor and Industries is attached. VII. CHANGES. The City may issue a written change order for any change in the Contract work during the performance of this Agreement. If the Contractor determines, for any reason, that a change order is necessary, the Contractor must submit a written change order request to the person listed in the notice provision section of this Agreement, Section XVI(D), within fourteen (14) calendar days of the date the Contractor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Contractor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Contractor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Contractor shall proceed with the change order work upon receiving either a written change order from the City or an oral order from the City before actually receiving the written change order. If the Contractor fails to require a change order within the time specified in this paragraph, the Contractor waives its right to make any claim or submit subsequent change order requests for that portion of the contract work. If the Contractor disagrees with the equitable adjustment, the Contractor must complete the change order work; however, the Contractor may elect to protest the adjustment as provided in subsections A through E of Section IX, Claims, below. PUBLIC WORKS AGREEMENT - 4 ($20K or Less and No Performance Bond) The Contractor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by the Contractor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. VIII. FORCE MAJEURE. Neither party shall be liable to the other for breach due to delay or failure in performance resulting from acts of God, acts of war or of the public enemy, riots, pandemic, fire, flood, or other natural disaster or acts of government (“force majeure event”). Performance that is prevented or delayed due to a force majeure event shall not result in liability to the delayed party. Both parties represent to the other that at the time of signing this Agreement, they are able to perform as required and their performance will not be prevented, hindered, or delayed by the current COVID-19 pandemic, any existing state or national declarations of emergency, or any current social distancing restrictions or personal protective equipment requirements that may be required under federal, state, or local law in response to the current pandemic. If any future performance is prevented or delayed by a force majeure event, the party whose performance is prevented or delayed shall promptly notify the other party of the existence and nature of the force majeure event causing the prevention or delay in performance. Any excuse from liability shall be effective only to the extent and duration of the force majeure event causing the prevention or delay in performance and, provided, that the party prevented or delayed has not caused such event to occur and continues to use diligent, good faith efforts to avoid the effects of such event and to perform the obligation. Notwithstanding other provisions of this section, the Contractor shall not be entitled to, and the City shall not be liable for, the payment of any part of the contract price during a force majeure event, or any costs, losses, expenses, damages, or delay costs incurred by the Contractor due to a force majeure event. Performance that is more costly due to a force majeure event is not included within the scope of this Force Majeure provision. If a force majeure event occurs, the City may direct the Contractor to restart any work or performance that may have ceased, to change the work, or to take other action to secure the work or the project site during the force majeure event. The cost to restart, change, or secure the work or project site arising from a direction by the City under this clause will be dealt with as a change order, except to the extent that the loss or damage has been caused or exacerbated by the failure of the Contractor to fulfill its obligations under this Agreement. Except as expressly contemplated by this section, all other costs will be borne by the Contractor. IX. CLAIMS. If the Contractor disagrees with anything required by a change order, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Contractor may file a claim as provided in this section. The Contractor shall give written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14) calendar days of the date the Contractor knew or should have known of the facts or events giving rise to the claim, whichever occurs first . Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been waived by the Contractor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Contractor's written claim shall include the information set forth in subsections A, items 1 through 5 below. FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY. A. Notice of Claim. Provide a signed written notice of claim that provides the following information: PUBLIC WORKS AGREEMENT - 5 ($20K or Less and No Performance Bond) 1. The date of the Contractor's claim; 2. The nature and circumstances that caused the claim; 3. The provisions in this Agreement that support the claim; 4. The estimated dollar cost, if any, of the claimed work and how that estimate was determined; and 5. An analysis of the progress schedule showing the schedule change or disruption if the Contractor is asserting a schedule change or disruption. B. Records. The Contractor shall keep complete records of extra costs and time incurred as a result of the asserted events giving rise to the claim. The City shall have access to any of the Contractor's records needed for evaluating the protest. The City will evaluate all claims, provided the procedures in this section are followed. If the City determines that a claim is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. C. Contractor's Duty to Complete Protested Work. In spite of any claim, the Contractor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Contractor also waives any additional entitlement and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Contractor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). X. LIMITATION OF ACTIONS. CONTRACTOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK IS COMPLETE OR CONTRACTOR’S ABILITY TO FILE THAT CLAIM OR SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. XI. WARRANTY. The Contractor warrants that it will faithfully and satisfactorily perform all work provided under this Agreement in accordance with the provisions of this Agreement. The Contractor shall promptly correct all defects in workmanship and materials: (1) when the Contractor knows or should have known of the defect, or (2) upon the Contractor’s receipt of notification from the City of the existence or discovery of the defect. In the event any parts are repaired or replaced, only original replacement parts shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for an additional year beyond the original warranty period applicable to the overall work. The Contractor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Contractor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Contractor shall pay all costs incurred by the City in order to accomplish the correction. XII. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Contractor, its sub-contractors, or any person acting on behalf of the Contractor or sub-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 who is qualified and available to perform the work to which the employment relates. The Contractor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. XIII. INDEMNIFICATION. The 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 PUBLIC WORKS AGREEMENT - 6 ($20K or Less and No Performance Bond) suits, including all legal costs and attorney fees, arising out of or in connection with the Contractor's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of the Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, its officers, officials, employees, agents and volunteers, the Contractor's duty to defend, indemnify, and hold the City harmless, and the Contractor’s liability accruing from that obligation shall be only to the extent of the Contractor's negligence. 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 NEGOTIATED THIS WAIVER. In the event the 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 part, then the 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 part. The provisions of this section shall survive the expiration or termination of this Agreement. XIV. INSURANCE. The Contractor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. XV. WORK PERFORMED AT CONTRACTOR'S RISK. The 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 the Contractor's own risk, and the 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. XVI. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties’ performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section XIII of this Agreement. PUBLIC WORKS AGREEMENT - 7 ($20K or Less and No Performance Bond) D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and the Contractor. G. 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. H. 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 the Contractor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. I. Public Records Act. The 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. As such, the Contractor agrees to cooperate fully with the City in satisfying the City’s duties and obligations under the Public Records Act. J. City Business License Required. Prior to commencing the tasks described in Section I, the Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. / / / / / / / / / / K. 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. 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 PUBLIC WORKS AGREEMENT - 8 ($20K or Less and No Performance Bond) 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: Its (title) DATE: CITY OF KENT: By: (signature) Print Name: Brian Levenhagen Its: Parks Deputy Director DATE: NOTICES TO BE SENT TO: CONTRACTOR: Shane M. Gilbertson Evergreen Asphalt & Concrete, Inc. P.O. Box 867 Ravensdale, WA 98051 (425) 584-7890 (telephone) (253) 639-3779 (facsimile) NOTICES TO BE SENT TO: CITY OF KENT: Ben Levenhagen, Support Services Field Supervisor City of Kent 220 Fourth Avenue South Kent, WA 98032 (253) 856-5033 or (253) 508-9548 (cell) (telephone) (253) 856-6120 (facsimile) ATTEST: Kent City Clerk Shane Gilbertson (Nov 18, 2020 07:13 PST) Shane Gilbertson President Nov 18, 2020 Shane Gilbertson Brian Levenhagen (Nov 23, 2020 10:07 PST) 11/23/2020 Kim Komoto (Nov 23, 2020 10:18 PST) Kim Komoto EEO COMPLIANCE DOCUMENTS - 1 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 opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City’s sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. 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. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. By: __________________________________________ For: _________________________________________ Title: ________________________________________ Date: ________________________________________ Shane Gilbertson (Nov 18, 2020 07:13 PST) Shane Gilbertson President Evergreen Asphalt and Concrete Inc. 11/18/2020 EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City’s nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City’s equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 3 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT 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 represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. By: __________________________________________ For: _________________________________________ Title: ________________________________________ Date: ________________________________________ BIDDER RESPONSIBILITY CRITERIA - 1 BIDDER RESPONSIBILITY CRITERIA Certification of Compliance with Wage Payment Statutes This certification is required by state law (RCW 39.04.350(2)) to be submitted to the City before the contract can be awarded. The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date (11/16/2020), the bidder is not a “willful” violator, as defined in RCW 49.48.082, of any provision of chapters 49.46, 49.48, or 49.52 RCW, as determined by a final and binding citation and notice of assessment issued by the Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Evergreen Asphalt & Concrete, Inc. By: __________________________________________ Signature of Authorized Official* Printed Name: _________________________________ Title: ________________________________________ Date: ________________________________________ City and State: _________________________________ *If a corporation, proposal must be executed in the corporate name by the president or vice- president (or any other corporate officer accompanied by evidence of authority to sign). If a co- partnership, proposal must be executed by a partner. Shane Gilbertson (Nov 18, 2020 07:13 PST) Shane Gilbertson Kent Wa President Shane Gilbertson 11/18/2020 PROPOSAL Date 11/16/2020 Proposal# 8343 PROPOSAL SUBMITTED TO: City of Kent 220 Fourth Avenue Kent, WA 98032 Attn Nate Harper Evergreen Asphalt & Concrete, Inc. P.O. Box 867 Ravensdale, WA 98051 Ph: 425 584-7890 Fax: 253 639-3779 TERMS Due on receipt SUBMITTE... SG JOB ADDRESS Signature E-mail: evergreen.shane@comcast.net Web Site: Evergreenasphalt.com Total Sales Tax (10.0%) DescriptionQty Rate Total Brisco Park Patching SQ FT Asphalt Remove and Replace in 4 areas2,500 5.10 12,750.00T _____________________________________ The above prices, specifications and conditions are satisfactory and are herby accepted. You are authorized to do the work as specified. 100% Payment is due within 30 days. 1.5% PER MONTH SERVICE CHARGE ON ALL PAST DUE ACCOUNTS. IN THE EVENT LEGAL ACTION IS TAKEN TO COLLECT ANY AMOUNTS DUE, YOU AGREE TO PAY ALL LEGAL FEES & EXPENSES. THIS QUOTATION IS ONLY VALID FOR THIRTY (30) DAYS. $14,025.00 $1,275.00 EXHIBIT A 11/16/2020 about:blank about:blank 1/4 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Washington State Prevailing Wage The PREVAILING WAGES listed here include both the hourly wage rate and the hourly rate of fringe benefits. On public works projects, worker's wage and benefit rates must add to not less than this total. A brief description of overtime calculation requirements are provided on the Benefit Code Key. Journey Level Prevailing Wage Rates for the Effective Date: 11/16/2020 County Trade Job Classification Wage Holiday Overtime Note *Risk Class King Laborers Air, Gas Or Electric Vibrating Screed $52.39 7A 4V 8Y View King Laborers Airtrac Drill Operator $54.01 7A 4V 8Y View King Laborers Ballast Regular Machine $52.39 7A 4V 8Y View King Laborers Batch Weighman $44.40 7A 4V 8Y View King Laborers Brick Pavers $52.39 7A 4V 8Y View King Laborers Brush Cutter $52.39 7A 4V 8Y View King Laborers Brush Hog Feeder $52.39 7A 4V 8Y View King Laborers Burner $52.39 7A 4V 8Y View King Laborers Caisson Worker $54.01 7A 4V 8Y View King Laborers Carpenter Tender $52.39 7A 4V 8Y View King Laborers Cement Dumper-paving $53.35 7A 4V 8Y View King Laborers Cement Finisher Tender $52.39 7A 4V 8Y View King Laborers Change House Or Dry Shack $52.39 7A 4V 8Y View King Laborers Chipping Gun (30 Lbs. And Over) $53.35 7A 4V 8Y View King Laborers Chipping Gun (Under 30 Lbs.)$52.39 7A 4V 8Y View King Laborers Choker Setter $52.39 7A 4V 8Y View King Laborers Chuck Tender $52.39 7A 4V 8Y View King Laborers Clary Power Spreader $53.35 7A 4V 8Y View King Laborers Clean-up Laborer $52.39 7A 4V 8Y View King Laborers Concrete Dumper/Chute Operator $53.35 7A 4V 8Y View King Laborers Concrete Form Stripper $52.39 7A 4V 8Y View King Laborers Concrete Placement Crew $53.35 7A 4V 8Y View King Laborers Concrete Saw Operator/Core Driller $53.35 7A 4V 8Y View King Laborers Crusher Feeder $44.40 7A 4V 8Y View King Laborers Curing Laborer $52.39 7A 4V 8Y View King Laborers Demolition: Wrecking & Moving (Incl. Charred Material) $52.39 7A 4V 8Y View 11/16/2020 about:blank about:blank 2/4 King Laborers Ditch Digger $52.39 7A 4V 8Y View King Laborers Diver $54.01 7A 4V 8Y View King Laborers Drill Operator (Hydraulic, Diamond) $53.35 7A 4V 8Y View King Laborers Dry Stack Walls $52.39 7A 4V 8Y View King Laborers Dump Person $52.39 7A 4V 8Y View King Laborers Epoxy Technician $52.39 7A 4V 8Y View King Laborers Erosion Control Worker $52.39 7A 4V 8Y View King Laborers Faller & Bucker Chain Saw $53.35 7A 4V 8Y View King Laborers Fine Graders $52.39 7A 4V 8Y View King Laborers Firewatch $44.40 7A 4V 8Y View King Laborers Form Setter $52.39 7A 4V 8Y View King Laborers Gabian Basket Builders $52.39 7A 4V 8Y View King Laborers General Laborer $52.39 7A 4V 8Y View King Laborers Grade Checker & Transit Person $54.01 7A 4V 8Y View King Laborers Grinders $52.39 7A 4V 8Y View King Laborers Grout Machine Tender $52.39 7A 4V 8Y View King Laborers Groutmen (Pressure) Including Post Tension Beams $53.35 7A 4V 8Y View King Laborers Guardrail Erector $52.39 7A 4V 8Y View King Laborers Hazardous Waste Worker (Level A) $54.01 7A 4V 8Y View King Laborers Hazardous Waste Worker (Level B) $53.35 7A 4V 8Y View King Laborers Hazardous Waste Worker (Level C) $52.39 7A 4V 8Y View King Laborers High Scaler $54.01 7A 4V 8Y View King Laborers Jackhammer $53.35 7A 4V 8Y View King Laborers Laserbeam Operator $53.35 7A 4V 8Y View King Laborers Maintenance Person $52.39 7A 4V 8Y View King Laborers Manhole Builder-Mudman $53.35 7A 4V 8Y View King Laborers Material Yard Person $52.39 7A 4V 8Y View King Laborers Motorman-Dinky Locomotive $53.35 7A 4V 8Y View King Laborers Nozzleman (Concrete Pump, Green Cutter When Using Combination Of High Pressure Air & Water On Concrete & Rock, Sandblast, Gunite, Shotcrete, Water Blaster, Vacuum Blaster) $53.35 7A 4V 8Y View King Laborers Pavement Breaker $53.35 7A 4V 8Y View King Laborers Pilot Car $44.40 7A 4V 8Y View King Laborers Pipe Layer Lead $54.01 7A 4V 8Y View King Laborers Pipe Layer/Tailor $53.35 7A 4V 8Y View King Laborers Pipe Pot Tender $53.35 7A 4V 8Y View King Laborers Pipe Reliner $53.35 7A 4V 8Y View King Laborers Pipe Wrapper $53.35 7A 4V 8Y View King Laborers Pot Tender $52.39 7A 4V 8Y View King Laborers Powderman $54.01 7A 4V 8Y View 11/16/2020 about:blank about:blank 3/4 King Laborers Powderman's Helper $52.39 7A 4V 8Y View King Laborers Power Jacks $53.35 7A 4V 8Y View King Laborers Railroad Spike Puller - Power $53.35 7A 4V 8Y View King Laborers Raker - Asphalt $54.01 7A 4V 8Y View King Laborers Re-timberman $54.01 7A 4V 8Y View King Laborers Remote Equipment Operator $53.35 7A 4V 8Y View King Laborers Rigger/Signal Person $53.35 7A 4V 8Y View King Laborers Rip Rap Person $52.39 7A 4V 8Y View King Laborers Rivet Buster $53.35 7A 4V 8Y View King Laborers Rodder $53.35 7A 4V 8Y View King Laborers Scaffold Erector $52.39 7A 4V 8Y View King Laborers Scale Person $52.39 7A 4V 8Y View King Laborers Sloper (Over 20")$53.35 7A 4V 8Y View King Laborers Sloper Sprayer $52.39 7A 4V 8Y View King Laborers Spreader (Concrete)$53.35 7A 4V 8Y View King Laborers Stake Hopper $52.39 7A 4V 8Y View King Laborers Stock Piler $52.39 7A 4V 8Y View King Laborers Swinging Stage/Boatswain Chair $44.40 7A 4V 8Y View King Laborers Tamper & Similar Electric, Air & Gas Operated Tools $53.35 7A 4V 8Y View King Laborers Tamper (Multiple & Self- propelled) $53.35 7A 4V 8Y View King Laborers Timber Person - Sewer (Lagger, Shorer & Cribber) $53.35 7A 4V 8Y View King Laborers Toolroom Person (at Jobsite)$52.39 7A 4V 8Y View King Laborers Topper $52.39 7A 4V 8Y View King Laborers Track Laborer $52.39 7A 4V 8Y View King Laborers Track Liner (Power)$53.35 7A 4V 8Y View King Laborers Traffic Control Laborer $47.48 7A 4V 9C View King Laborers Traffic Control Supervisor $50.31 7A 4V 9C View King Laborers Truck Spotter $52.39 7A 4V 8Y View King Laborers Tugger Operator $53.35 7A 4V 8Y View King Laborers Tunnel Work-Compressed Air Worker 0-30 psi $129.67 7A 4V 9B View King Laborers Tunnel Work-Compressed Air Worker 30.01-44.00 psi $134.70 7A 4V 9B View King Laborers Tunnel Work-Compressed Air Worker 44.01-54.00 psi $138.38 7A 4V 9B View King Laborers Tunnel Work-Compressed Air Worker 54.01-60.00 psi $144.08 7A 4V 9B View King Laborers Tunnel Work-Compressed Air Worker 60.01-64.00 psi $146.20 7A 4V 9B View King Laborers Tunnel Work-Compressed Air Worker 64.01-68.00 psi $151.30 7A 4V 9B View King Laborers Tunnel Work-Compressed Air Worker 68.01-70.00 psi $153.20 7A 4V 9B View King Laborers Tunnel Work-Compressed Air Worker 70.01-72.00 psi $155.20 7A 4V 9B View 11/16/2020 about:blank about:blank 4/4 King Laborers Tunnel Work-Compressed Air Worker 72.01-74.00 psi $157.20 7A 4V 9B View King Laborers Tunnel Work-Guage and Lock Tender $54.11 7A 4V 8Y View King Laborers Tunnel Work-Miner $54.11 7A 4V 8Y View King Laborers Vibrator $53.35 7A 4V 8Y View King Laborers Vinyl Seamer $52.39 7A 4V 8Y View King Laborers Watchman $40.36 7A 4V 8Y View King Laborers Welder $53.35 7A 4V 8Y View King Laborers Well Point Laborer $53.35 7A 4V 8Y View King Laborers Window Washer/Cleaner $40.36 7A 4V 8Y View 11/16/2020 about:blank about:blank 1/2 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Washington State Prevailing Wage The PREVAILING WAGES listed here include both the hourly wage rate and the hourly rate of fringe benefits. On public works projects, worker's wage and benefit rates must add to not less than this total. A brief description of overtime calculation requirements are provided on the Benefit Code Key. Apprentice Level Prevailing Wage Rates for King County and Laborers Trade for the Effective Date: 11/16/2020 Step Occupation Begin Hours End Hours Apprentice Wage Holiday Overtime Note Step 1 Window Washer,Cleaner registered prior to 6/1/2012 1 1000 $36.47 7A 4V 8Y Step 2 Window Washer,Cleaner registered prior to 6/1/2012 1001 2000 $40.36 7A 4V 8Y Step 3 Window Washer,Cleaner registered prior to 6/1/2012 2001 3000 $40.36 7A 4V 8Y Step 4 Window Washer,Cleaner registered prior to 6/1/2012 3001 4000 $40.36 7A 4V 8Y Step 1 Window Washer, Cleaner registered on or after 6/1/2012 1 1000 $36.47 7A 4V 8Y Step 2 Window Washer, Cleaner registered on or after 6/1/2012 1001 2000 $40.36 7A 4V 8Y Step 3 Window Washer, Cleaner registered on or after 6/1/2012 2001 3000 $40.36 7A 4V 8Y Step 4 Window Washer, Cleaner registered on or after 6/1/2012 3001 4000 $40.36 7A 4V 8Y Step 5 Window Washer, Cleaner registered on or after 6/1/2012 4001 5000 $40.36 7A 4V 8Y Step 6 Window Washer, Cleaner registered on or after 6/1/2012 5001 6000 $40.36 7A 4V 8Y Step 1 Laborer registered prior to 6/1/2012 1 1000 $36.47 7A 4V 8Y Step 2 Laborer registered prior to 6/1/2012 1001 2000 $40.45 7A 4V 8Y Step 3 Laborer registered prior to 6/1/2012 2001 3000 $44.43 7A 4V 8Y Step 4 Laborer registered prior to 6/1/2012 3001 4000 $48.41 7A 4V 8Y Step 1 Laborer registered on or after 6/1/2012 1 1000 $36.47 7A 4V 8Y Step 2 Laborer registered on or after 6/1/2012 1001 2000 $40.45 7A 4V 8Y Step 3 Laborer registered on or after 6/1/2012 2001 3000 $44.43 7A 4V 8Y Step 4 Laborer registered on or after 6/1/2012 3001 4000 $46.42 7A 4V 8Y 11/16/2020 about:blank about:blank 2/2 Step 5 Laborer registered on or after 6/1/2012 4001 5000 $48.41 7A 4V 8Y Step 6 Laborer registered on or after 6/1/2012 5001 6000 $50.40 7A 4V 8Y EXHIBIT B INSURANCE REQUIREMENTS FOR CONSTRUCTION PROJECTS Insurance The Contractor 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 Contractor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Contractor shall obtain insurance of the types described below: Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 or its equivalent, with minimum limits of $3,000,000 per occurrence and in the aggregate for each 1 year policy period. This coverage may be any combination of primary, umbrella or excess liability coverage affording total liability limits of not less than $3,000,000 per occurrence and in the aggregate. Products and Completed Operations coverage shall be provided for a period of 3 years following Substantial Completion of the work. The Commercial General Liability insurance shall be endorsed to provide the Aggregate per Project Endorsement ISO form CG 25 03 11 85. The City shall be named as an Additional Insured under the Contactor's Commercial General Liability insurance policy with respect to the work performed for the City. All endorsements adding Additional Insureds shall be issued on form CG 20 10 11 85 or a form deemed equivalent, providing the Additional Insureds with all policies and endorsements set forth in this section. 2. 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. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: Commercial General Liability insurance shall be written with minimum limits of $,3,000,000 per occurrence and in the aggregate for each 1 year policy period. This coverage may be any EXHIBIT B (Continued) combination of primary, umbrella or excess liability coverage affording total liability limits of not less than $3,000,000 per occurrence and in the aggregate. Products and Completed Operations coverage shall be provided for a period of 3 years following Substantial Completion of the work. 2. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 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: 1. The Contractor'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 Contractor's insurance and shall not contribute with it. 2. The Contractor'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 contractor 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 Contractor'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. Contractor's Insurance for Other Losses The Contractor shall assume full responsibility for all loss or damage from any cause whatsoever to any tools, Contractor's employee owned tools, machinery, equipment, or motor vehicles owned or rented by the Contractor, or the Contractor's agents, suppliers or contractors as well as to any temporary structures, scaffolding and protective fences. EXHIBIT B (Continued) E. Waiver of Subrogation The Contractor and the City waive all rights against each other any of their Subcontractors, Sub -subcontractors, agents and employees, each of the other, for damages caused by fire or other perils to the extend covered by Builders Risk insurance or other property insurance obtained pursuant to the Insurance Requirements Section of this Contract or other property insurance applicable to the work. The policies shall provide such waivers by endorsement or otherwise. F. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. G. Verification of Coverage Contractor 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 Automobile Liability and Commercial General Liability insurance of the Contractor before commencement of the work. H. Subcontractors Contractor 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 Contractor. ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTRINSDWVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 9/10/2020 (206) 838-1015 24465 Evergreen Asphalt & Concrete, Inc. PO Box 867 Ravensdale, WA 98051 15377 A 1,000,000 X X CPP 1213195 9/15/2020 9/15/2021 100,000 5,000 1,000,000 2,000,000 2,000,000 WA Stop Gap 1,000,000 1,000,000B X X CPP1212799 9/15/2020 9/15/2021 Comp ded $1000 Coll ded $1000 2,000,000A UMB1035977 9/15/2020 9/15/2021 2,000,000 10,000 A CPP 1213195 9/15/2020 9/15/2021 1,000,000 1,000,000 1,000,000 Re: Kiwanis #3 project The City of Kent, its officials, employees and volunteers and Owner are additional insured as required by written contract or written agreement and insurance is primary and non-contributory per the attached. Waiver of subrogation and Per Project Aggregate applies per the attached. City of Kent 400 West Gowe Kent, WA 98032 EVERASP-02 LBUSCIO Hub International Northwest LLC PO Box 3018Bothell, WA 98041 Laura Buscio laura.buscio@hubinternational.com Western National Assurance Company Western National Mutual Insurance Company X X X X X X X X X X COMMERCIAL GENERAL LIABILITY WN GL 139 06 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WN GL 139 06 18 Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ADDITIONAL INSURED ±CONTRACTORS ± OPERATIONS AND COMPLETED OPERATIONS ± WITH ADDITIONAL INSURED REQUIREMENT IN CONSTRUCTION CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILIT Y COVERAGE PART 1.Additional Insured ±Operations A.Section II ±Who Is An Insured is amended to include as an additional insured: (1)Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and (2)Any other person or organization you are required to add as an additional insured under the contract or agreement de- scribed in Paragraph 1. above. Such person(s) or organization(s) is an add- tional insured only with respect to liability for "bodily injury", "property damage" or "per- sonal and advertising injury" caused, in whole or in part, by: a.Your acts or omissions; or b.The acts or omissions of those acting on your behalf; in the performance of yo ur ongoing opera- tions for the additional insured. B.With respect to Additional Insured -Opera- tions,coverage is limited as follows: This insuranFHGRHVQRWDSSO\WR³bodily in- jXU\´RU³SURSHUW\GDPDJH´RFFXUULQJDIWHU (1)All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2)7KDWSRUWLRQRI³\RXUZRUN´RXWRIZKLFK the injury or damage arises has been put to its intended use by any person or or- ganization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 2.Additional Insured ±Completed Operations A.Section II ±Who Is An Insured is amended to include as an additional insured: (1)Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and (2)Any other person or organization you are required to add as an additional insured under the contract or agreement de- scribed in Paragraph 1.above. Such person(s)or organization(s)is an addi- tional insured only with respect to liability for "bodily injury", "property damage" or "per- sonal and advertising injury" caused, in whole or in part, by: a.Your acts or omissions; or b.The acts or omissions of those acting on your behalf; and included LQWKH³SURGXFWV-completed op- HUDWLRQVKD]DUG´ WN GL 139 06 18 Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. B.With respect to Additional Insured ±Com- pleted Operations,coverage is limited as fol- lows: (1)$SHUVRQRURUJDQL]DWLRQ¶VVWDWXVDVDQLQ sured under Additional Insured ±Com- pleted Operations continues only for the period of time required by a ny w ritten con- tract or agreement. (2)The insurance provided to the additional LQVXUHGGRHVQRWDSSO\WR³ERGLO\LQMXU\´ ³SURSHUW\GDPDJH´RU³SHUVRQDODQGDG YHUWLVLQJLQMXU\´DULVLQJRXWRI³\RXUZRUN´ for which a consolidated (wrap -up) insur- ance program has been provided by the prime contractor-project manager or owner of the construction project in which you are involved. 3.Primary and Noncontributory The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek con- tribution from any other insurance available to an additional insured under your policy provided that: (1)The additional insured is a Named Insured un- der such other insurance; and (2)You have agreed in writing in a contract or agreement that this insurance would be pri- mary and would not seek contribution from any other insurance available to the additional insured. 4.Other Provisions Applicable to Additional In- sured ±Operations and Additional Insured ± Completed Operations A.The Amendment of Insured Contract Defini- tion (Endorsement CG 24 26)does not apply to an additional insured. B.The coverage provided under Paragraph f.of WKHGHILQLWLRQRI³LQVXUHGFRQWUDFW´XQGHUSec- tion V ±Definitions does not apply to an ad- ditional insured under this endorsement un- less required by a written contract or agreement. C.The insurance afforded to such additional in- sured only applies to the extent permitted by law; and If coverage provided to the additional insured is required by a contract or agreement, the in- surance afforded to such additional insured will not be broader than that which you are re- quired by t he contract or agreement to provide for such additional insured. D.With respect to the insurance afforded to these additional insureds, the following is added to Section III ±Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: (1)The minimum amount required by the contract or agreement; or (2)The Limits of Insurance shown in the Dec- larations; whichever is less. This endorsement shall not increase the ap- plicable Limits of Insurance shown in the Dec- larations. E.With respect to the insurance afforded to these additional insureds, the following addi- tional exclusion applies: This insurance does not apply to: "Bodily injury", "property damage" or "per- sonal and advertising injury" arising out of the rendering of, or the failure to render, any pro- fessional architectural, engineering or survey- ing services, including: (1)The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders, change orders or drawings and specifications; or (2)Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against an additional insured allege negli- gence or other wrongdoing in the supervision, hiring, employm ent, training or monitoring of RWKHUVE\WKDWLQVXUHGLIWKH³RFFXUUHQFH´ ZKLFKFDXVHGWKH³ERGLO\LQMXU\´RU³SURSHUW\ GDPDJH´RUWKHRIIHQVHZKLFKFDXVHGWKH ³SHUVRQDODQGDGYHUWLVLQJLQMXU\´LQYROYHGWKH rendering of or failure to render any profes- sional services by you with respect to yo ur providing engineering, architectural or survey- ing services in your capacity as an engineer, architect or surveyor. COMMERI CAL GENERAL LIABI LITY WN GL 39 08 18 WN GL 39 08 18 In cludes c opyrighted material of the In suranc e Service Off ic e, In c., w ith its permi ssion.Page 1 of 10 COM MERCIAL G ENERAL L IABILITY E NHANC EM ENT ENDORSEMENT Th e Commerc ial General Liability Enhanc ement Endors ement is an optional endors ement that provides cove rage en - hanc ements. Th e fo llowing is a summary of broadened cove rages provided by t hi s endors ement. No cove rage is p ro - vi ded by t his summary , refer to following endorsement for changes in your polic y. SUMMAR Y OF COVERAGE S PAGE Bodily Injury And Propert y Damage Liability x Non Ow ned Waterc ra ft Up To 50 Feet ...............................................................................2 Propert y Dam age Liability x Eleva tors ..........................................................................................................................3 x Fire, Lig ht ni ng, Explosion Or Sprink ler Le akag e Exception ..................................................3 x Borrowed Equipment ($25,000 Per Oc currenc e, $50,000 Aggregat e, $2,50 0 Deduc tible Per Oc currence .................................................................................3 Supplem entary Payments ±Amended x Bail Bonds Up To $5,000 ...................................................................................................4 x Loss of Earnings Up To $50 0/Day .....................................................................................4 Who Is An Insured Amendment s x Employee Bodily Inj ury To A Co -Empl oy ee .........................................................................4 x Ne wly Form ed Or Acquire d Or ga nizations Fo r Up To 18 0 Day s ...........................................4 x Blank et Addit ional Insured ±Vendo rs ±As Req ui re d By Cont ract ........................................4 x Blank et Addit ional Insured ±Lessor Of Leased Eq ui pme nt ..................................................6 x Blank et Addit ional Insured ±Managers O r Les sors O f Premis es ..........................................6 x Blank et Addit ional Ins ured ±State Or Gove rnment al Agenc y Or Subdivi sion Or Political Subdi vi sion ±Permits Or Authoriz at ions .........................................................7 x Blank et Addit ional Ins ured ±State Or Gove rnment al Agenc y Or Subdivi sion Or Political Subdi vi sion ±Permits Or Autho rizations Relat ing To Premis es ........................8 Dam age To Premises Rent ed To You ±$300,000 .........................................................................9 Medic al Payment s Inc re as ed Li mit ±$1 0,00 0 Or Amount Shown on Dec larations ...........................9 Conditions x Knowl ed ge of Oc currenc e, Offe ns e, Claim Or Suit Amend ed ...............................................9 x Unint ent ion al Failu re To Disclose Haz ards .........................................................................9 x Waiver of Su br ogation .....................................................................................................10 Ins ured Co nt rac t Amen ded ..........................................................................................................10 Pers onal And Adve rt ising Injury Redefined x Tele vi sed, Videot ap ed Or Electronic Public atio n ...............................................................10 COMMERCI AL GENERAL LIABI LITY WN GL 39 08 18 WN GL 39 08 18 In cludes c opyrighted material of the In suranc e Service Off ic e, In c., w ith its permi ssion.Page 2 of 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY COM MERCIAL G ENERAL L IABILITY E NHANC EM ENT ENDORSEMENT Th is endors ement modifi es the ins uranc e provided under the fol lowing: COMMERCIA L GENERAL LIABILITY COVERAGE FORM With r es pec t to t he cove rage provided by this endors ement, the provisions of the Coverage Form apply unles s modified by this endors ement. The SECTIONS of the Commercial General Liability Coverage Form identified in this endors ement wi ll be amended as shown below. SECTION I ±COVERAGES AM ENDM ENT S COV ERAGE A ±BODI LY INJURY AND PROPERT Y DAMAGE LIABI LITY A.Non Ow ned Ai rcra ft Or Watercraft It em 2.Ex clusions,Paragraph g.is replac ed by the following: g.Ai rcra ft, Auto Or Watercra ft ³%RGLO\LQMXU\´RU³SURSHUW \GDP DJH´DULVLQJRXWRI the owners hip, maintenanc e, us e or entrus t ment WRRW KHUVRIDQ\DL UF UDIW³DXW R´RUZDW HUcraf t owned or operated by or rent ed or loaned to any LQVXUHG8V HLQFOXGHV RSHUDW LRQDQG³O RDGLQJRU  XQORDGLQJ´ This ex clus ion applies even if the claims against any insured allege negligenc e or other wron g - doing in the supervis ion, hiring, employ ment , training or moni toring of others by that insured, if WKH³RFFXUUHQF H´ZKLFKFDXV HGWKH³ERGLO\LQMXU\´ RU³SURSHUW \GDPDJH´LQYR OYHGLQWKHRZQHUV KLS maintenanc e, use or ent rus tment to ot hers of any DLUF UDIW³DXW R´RUZDW HUFUDIWWKDW LV RZQHGRU  operated by or rented or loaned to any ins ured. This ex clusion does not apply to: (1)A wat erc raft while as hore on premises you own or rent ; (2)A wat erc raft you do not own that is: (a )Les s than 50 feet long; and (b)Not bei ng us ed to carry pers ons or prop - ert y for a charge; This Subparagraph (2)applies to any person, who with your ex pres sed or implied cons ent, either us es or is r es pons ible fo r the us e of the wat erc raft; (3)3DUN LQJDQ³DXWR´RQRURQWKHZD\VQH[WWR SUHP LVHV\RXRZQRUUHQW SURYLGHGWKH³DXWR´ is not owned by or rent ed or loaned to you or the ins ured; (4)/LDELOLW\DV VXPHGXQGHUDQ\³LQV XUHGFRQ- WUDF W´IRUWKHRZQHUV KLSPDLQWHQDQF HRUXVH of aircraft or wat erc raft; or (5)³%RGLO\LQMXU\´RU³SURSHUW \GDPDJH´DULVLQJ  out of: (a )Th e operat ion of mac hinery or equipment that is attached to, or part of, a land ve hicle that would qualify under the GHIL QLWLRQRI³P RELOHHTXLSP HQW´LILWZHU H not subject to a compulsory or fi nanc ial res ponsibility law or ot her motor ve hic le insuranc e law where it is licens ed or principally garaged; or (b)Th e operat ion of any of the machinery or equipment lis ted in Paragraph f. (2)or f. (3)RIWKHGHILQLWLRQRI³P RELOHHTXLS - PHQW ´ B.Da mage To Prope rty Co ve ra ge Extensi ons It em 2. Exclusions, Paragraph j.is replac ed by the following: j.Da mage To Prope rty ³3 URSHUW \GDPDJH´WR (1)Propert y you own, rent , or oc cupy, includi ng any costs or ex pens es incurred by you, or any ot her pers on, organiz at ion or ent ity, for repair, replacement , enhancement , res tora - tion or maintenanc e of suc h propert y for any reas on, including prevent ion of injury to a SHUV RQRUGDPDJHWRDQRW KHU¶VSURSHUW \ (2)Prem ises you sell, give away or abandon, if WKH³SURSHUW \GDPDJH´DULVHVRXW RIDQ\SDUW  of thos e prem ises; WN GL 39 08 18 In cludes c opyrighted material of the In suranc e Service Off ic e, In c., w ith its permi ssion.Page 3 of 10 (3)Propert y loaned to you; (4)Pers onal propert y in the care, custody o r con- trol of the insured; (5)That particular part of real propert y on whic h you or any cont rac tors or subc ont rac tors work ing direc tly or indirec tly on your behal f DUHSHUIRUPLQJRSHUDW LRQV LIWKH³SURSHUW \ daPDJH´DULV HV RXW RIWKRV HRSHUDW LRQV RU (6)That particular part of any propert y that must be res tored, repaired or replac ed bec aus e ³\RXUZRUN ´ZDV LQFRUUHF WO\SHUIRUPHGRQLW Paragraphs (1), (3)and (4)of this ex clus ion do not DSSO\WR³SURSHUW \GDPDJH´ RW KHUWKDQGDPDJHE\ fi re, light ning, ex plosion or sprink ler leakage) to premises , including the content s of such premis es , rented to you for a period of seve n or fewe r cons ecut ive day s. A separat e limit of insuranc e applies to Dam age To Premises Rent ed To You as des cribed in SECTION III ±LIMITS OF INSURAN CE. However, the provisions of this paragraph do not apply if c overage for Dam age To Premis es Rent ed To You is excluded by endorsement . Paragraph (2)of this exclusion does not apply if the SUHPLVHVDUH³\RXUZRUN ´DQGZHUHQHYHURF FXSLHG rented or held for rental by you. Paragraphs (3)and (4) of this exclus ion do not apply to the us e of eleva tors . Paragraphs (3), (4), (5)and (6)of this ex clus ion do not apply to liability as sumed under a side trac k agreement . Paragraph (4)of this ex clusion does not apply to ³SURSHUW \GDPDJH´WRERUURZHGHTXLSPHQW ZKLOHQRW  being us ed to perform operat ions at the jobs ite. Subjec t to Paragraph 2. of SECTION III ±LIMITS OF INSURANCE, the rul es below fi x the most we wi ll pay IR U³SURSHUW \GDPDJH´XQGHUWKLVSURYLVLRQ (1)DQ\RQH³RF FXUUHQF H´UHJDUGOHV VRIWKH num ber of pers ons or organiz ations who sustain GDP DJHV EHF DXV HRIWKDW³RF FXUUHQF H´ (2)$50,000 annual aggregat e; and (3)We wi ll pay only for dam ages in excess of $2,50 0 DVDUHV XOW RIDQ\RQH³RFFXUUHQF H´UHgardless of the number of pers ons or organizations who VXVWDLQGDP DJHV EHF DXV HRIWKDW ³RF FXUUHQFH´ We may, or if required by law, pay al l or any part of any deduc tible am ount , if applicable, to effect VHWWOHPHQWRIDQ\FODLPRU³V XLW´8SRQQRW LF HRI  our payment of a deductible amount, you shall promptly reimburs e us fo r the part of the deduc tible am ount we paid. Paragraph (6)of this ex clusion does not apply to ³SURSHUW \GDPDJH´LQFOXGHGLQWKH³SURGXF WV -com - SO HWHGRSHUDW LRQV KD]DUG´ 7K HLQVXUDQF HSURYLGHGIRU³SURSHUW \GDPDJH´IUR P WKHXV HRIHOHYDW RUV DQGIRU³SURSHUW \GDPDJH´WR borrowed equipment is excess over any other va li d and collectible propert y insuranc e (inc luding any de- ductible portion thereof) available to the insure d whet her primary, excess, cont ingent or on any other basis. C.Da mage To Pre mises Rente d To You It em 2. Exclusions,the las t paragraph is replac ed by the fo llowing: Exclusions c.through n. do not apply to damage by fi re, light ni ng, ex plos ion or sprink ler leak age to premises while rent ed to you or temporarily oc cupi ed by y ou with perm ission of the owner. A separat e limit of ins uranc e applies to this cove rage as described in Paragraph 6.of SECTION III ±LIMITS OF INSURANCE. COVERAGE B ±PERS ONAL AND ADV ERT ISI NG INJURY LIABI LITY D.Pe rsona l And Ad ve rti si ng Injury It em 2. Ex cl usions is amended by replac ing Sub- paragraphs b. and c.wi th the following: b.Mate ri al P ublishe d With Kn ow ledge Of Fa lsity ³3 HUV RQDODQGDGYHUW LV LQJLQMXU\´DUL VLQJRXW RI  oral, wri tten, televi sed, vi deotaped or elec tronic publicat ion, in any manner,of material, if done by or at the direc tion of the insured wi th knowled ge of its fal sity. c.Mate ri al P ublishe d Prior T o Policy Period ³3 HUV RQDODQGDGYHUW LV LQJLQMXU\´DUL VLQJRXW RI  oral, wri tten, televi sed, vi deotaped or elec tronic publicat ion, in any m anner, of mat erial whos e fi rs t publicat ion took place before the beginning of the policy period. SUP PLEMENTARY PAYM ENTS ±COV ERAGES A AND B E.Supplementary P ayments ±Co ve ra ge s A and B It em 1.is amended by replac ing Subparagraphs b. and d.wi th the following: b.Up to $5,000 for cost of bail bonds required be - cause of accident s or t raffi c law vi olat ions ari s ing out of the us e of any vehicle to which the Bodily Injury Liability Coverage applies . We do not have to furnish thes e bonds . d.All reas onable expens es incurred by the insure d at our request to assist us in the inve stigation or GHIHQV HRIWKHFODLPRU³V XLW´L QF OXGLQJDF WXDOORV V of earnings up to $500 a day bec ause of time off from work . WN GL 39 08 18 In cludes c opyrighted material of the In suranc e Service Off ic e, In c., w ith its permi ssion.Page 4 of 10 SECTION II ±WHO IS AN INSURED AM ENDMENTS A.Em ployee Bodily Injury To A Co-Em ployee Paragraph 2. a. (1)is repl ac ed by the following: However, none of thes e ³HPSOR\HHV ´RU³YROXQW HHU ZRUN HUV ´DUHLQVXUHGV IRU³ERGLO\LQMXU\´RU³SHUVRQD O DQGDGYHUW LVLQJLQMXU\´ (a )To you, to y our part ners or members (if you are a part nership or joint vent ure), to your members (if you are a limited liability company ), to a co- ³HPSOR\HH´ZKLOHLQWKHFRXUVHRIKLVRUKHU  employ ment or perform ing dut ies relat ed to the conduc t of your bus ines s, or to your other ³YROXQW HHUZRUN HUV ´ZKLOHSHUIRUPLQJGXW LHV relat ed to the conduc t of your bus ines s; (b)To the spous e, child, parent , brot her or sister of the co-³HPSOR\HH´RU³YROXQW HHUZRUN HU´DVD cons equenc e of Paragraph (1)(a )above; (c)For which there is any obligation to share dam ages with or repay someone else who must pay damages bec aus e of the injury described in Paragraph (1)(a )or (b)above; or (d)Arising out of his or her providing or failing to provide profes sional health care services. +RZHYHULIDVXLWVHHN LQJGDPDJHV IRU³ERGLO\LQMXU\´ RU³SHUV RQDODQGDGYHUW LV LQJLQMXU\´WRDQ\FR- ³HPSOR\HH´RURW KHU´YROXQWHHUZRUN HU´DULV LQJRXW RI  and in the cours e of the co-³HPSOR\HH¶V´RU³YROXQW HHU ZRUN HU¶V ´HPSOR\PHQW RUZKLOHSHUIRUP LQJGXW LHV relat ed to the conduc t of your bus ines s, or a suit seek ing damages brought by t he spous e, child, parent , brot her or sister of the co-³HPSO R\HH´RURW KHU  ³YROXQWHHUZRUN HU´LVEURXJKWDJDLQV W\RXRUDFR- ³HPSOR\HH´RUD³YROXQW HHUZRUN HU´ZHZLOOUHLPEXUV H the reas onable costs that you incur in providing a defens e to the co-³HPSOR\HH´RU³YROXQWHHUZRUN HU ´ agains t such matters . Any reimburs ement made purs uant to this sub-section will be in addition to the limits of liability set fort h in the Dec larat ions . B.Ne wly Acquired Orga nizations Paragraph 3.a . is replac ed by the following: a.Coverage under this provis ion is afforded only unt il the 180th day aft er you ac quire or form the organization or the end of the polic y period , whichever is earlier; Th e fol lowing are added: C.Bl anke t Additional Insure d ±Ve ndors ±As Re - quire d By Co ntra ct 1.Secti on II ±Who Is An Insure d is amended to include as an additional insured any pers on(s ) or organization(s ) (referred to throughout this endors ement as ve ndor) with whom you ha ve agreed in a writ ten contrac t, ex ecut ed pri or to loss, to name as an additional insured, but only wit h res pec t to "bodily injury " or "propert y damage" arising out of "your products" which are distribut ed or sold in the regular cours e of the ve ndor's bus ines s . However, a.Th e insuranc e afforded to suc h ve ndor only applies to the ex tent perm itted by law; and b.If cove rage provided to t he ve ndor is required by a contrac t or agreement, the ins uranc e afforded to such vendor wi ll not be broad er than that which you are required by the contrac t or agreement to provide for s uc h ve ndor. 2.With res pec t to the insuranc e afforded to thes e ve ndors, the following additional ex clusions apply : a .Th e insuranc e afforded the ve ndor does not apply to: (1)"Bodi ly injury" or "propert y damage" for which the ve ndor is o bligated to pay dam- ages by reas on of the as sumption of liabi lity in a cont rac t or agreem ent. This ex clusion does not apply to liability for damages that the ve ndor would have in the abs enc e of the contrac t or agreement ; (2)Any ex pres s warrant y unauthoriz ed by you; (3)Any phy sical or chemical change in the produc t made intentionally by the ve ndo r; (4)Repackaging, ex cept when unpacked solely for the purpose of inspec tion, demons trat ion, testing, or the substitution of parts under instruc tions from the manufacturer, and then repac kaged in the original cont ainer; WN GL 39 08 18 In cludes c opyrighted material of the In suranc e Service Off ic e, In c., w ith its permi ssion.Page 5 of 10 (5)Any failure to make such inspec tions , adjustments, tests or servic ing as the ve ndor has agreed to mak e or normally undertak es to mak e in the us ual cours e of bus ines s, in connec tion with the di stribution or sale of the products; (6)Demonstrat ion, installation, servicing or repair operat ions , ex cept such operations perform ed at the ve ndo r's premises in connec tion wi th the sale of the produc t; (7)Produc ts whic h, aft er distribut ion or sale by y ou, have been labeled or relabeled or us ed as a container, part or ingredient of any other thing or subs tanc e by or for the ve ndor; or (8)"Bodily injury or "propert y damage " arising out of the sole negligenc e of the ve ndor for its own acts or omissions or thos e of its em ploy ees or any one el se ac ting on its behalf. However, this ex clus ion does not apply to: (i )Th e ex cept ions contained in Subparagraphs (4)or (6);or (ii)Such inspections , adj ustment s, tests or servic ing as the ve ndor has agreed to make or normally undertak es to make in the us ual cours e of bus iness, in connec tion with the dis tribution or sale of the products. 3.This Provision C.does not apply : a.To any insured person or organization fro m whom you have ac quired suc h produc ts, or any ingredient , part or cont ai ner, ent ering into, ac company ing or containi ng such products; b.To any vendor for whic h cove rage as an addi - tional insured spec ific ally is scheduled by endorsement ; or c.When liability included within the "products- completed operations haz ard" has been ex - cluded for such product ei ther by the provi - sions of the cove rage part or by endors e - ment. 4.With res pec t to the insuranc e afforded to thes e ve ndors, the following is added to Secti on III ± Limits Of Insura nce : If cove rage provided to the ve ndor is required by a contrac t or agreement , the mos t we wi ll pay on behalf of the ve ndor is : a .Th e minimum amount required by the contrac t or agreement ; or b.Th e Li mits of Ins uranc e s hown in the Dec larat ions ; whichever is less. Th is endorsement shall not inc reas e the applicable Limits of Insuranc e shown in the Dec larat ions . 5.With res pec t to the insuranc e afforded to thes e additional insureds , the following additiona l ex clusion applies : Th is insurance does not apply to: a ."Bodi ly injury ", "propert y damage" or "pers onal and advert ising injury " aris ing out of the rendering of, or the failure to render , any profes sional arc hit ec tural, engineering or surveying services, including: (1)Th e preparing, approving,or failing to prepare or approve, maps , shop drawings , opinions , report s, surveys , fi eld orders , change orders or drawing s and specifications; or (2)Supervis ory , inspec tion, arc hit ec tural or engineering ac tivities. Th is ex clusion applies even if the claims against an additional insured allege negligenc e or ot her wrongdoing in the supervis ion, hiring, employ ment , trai ning or monitoring of others by that ins ured, if WKH³RF FXUUHQFH´ZKLFKFDXV HGWKH ³ERGLO\LQMXU\´RU³SURSHUW \GDPDJH´RU  the offens e whic KFDXV HGWKH³SHUV RQD O DQGDGYHUW LVLQJLQMXU\´LQYR OYHGWKH rendering of or failure to render any profes sional services by you with res pect to your providing engineering, arc hit ectural or survey ing servic es in your capac ity as an engineer, arc hit ec t or survey or. WN GL 39 08 18 In cludes c opyrighted material of the In suranc e Service Off ic e, In c., w ith its permi ssion.Page 6 of 10 D.Blanke t Additi ona l Insure d ±Lesso r Of Le ased Eq uipment 1.Se cti on II ±Who Is An Insure d is amended to include as an addit ional insured any pers on(s )or organization(s )from whom you leas e equipm en t when you and such pers on(s )or organization(s ) have agreed in wri ting in a cont rac t or agreement , exec uted pri or to loss, that such pers on (s )or organization(s )be added as an additional ins ure d on your policy. Such pers on(s )or organiz at ion(s ) is an insured only wi th res pec t to liability for "bodily injury ", "propert y damage" or "pers ona l and advert ising injury" caus ed, in whole or in part , by your maintenance, operat ion or us e of equipm ent leas ed to you by such person (s )or organization(s ). However, the insuranc e afforded to such additional ins ured: a .Only applies to the ex tent permitted by law; and b.Will not be broader than that whic h you are required by the contrac t or agreement to provide for such additional ins ured. A pers on's or organization's status as an addi - tional insured under this endors ement ends whe n their contrac t or agreement wi th you for such leased equipment ends . 2.With res pec t to the insuranc e afforded to these additional ins ureds , this i ns uranc e does not ap ply to any "occurrenc e" which takes plac e after the equipm ent lease ex pires . 3.With res pec t to the insuranc e afforded t o these additional insureds, the fol lowing is added to Se cti on III ±Limits Of Insura nce : If cove rage provided to the additional insured is required by a c ont rac t or agreement , the mos t we will pay on behalf of the additional insured is: a .The minimum amount required by the cont rac t or agreement; or b.The Limits of Insuranc e shown in the Dec larat ions; whichever is les s. This endors ement shal l not increas e the applic able Limits of Ins uranc e shown in the Dec larations. 4.With res pec t to the insuranc e afforded to these additional insureds , the following additiona l ex clusion appl ies : Th is insurance does not apply to: a ."Bodi ly injury ", "propert y damage" or "pers onal and advert ising injury " aris ing out of the rendering of, or the failure to render , any profes sional arc hitec tural, engineering or surveying services, including: (1)Th e preparing, approving, or failing to prepare or approve, maps , shop drawings , opinions , report s, surveys , fi eld orders , change orders or drawing s and specifications; or (2)Supervisory , inspection, arc hitectural or engineering ac tivities. Th is ex clusion applies even if the claims agains t an additional insured allege negligenc e or ot her wrongdoing in the supervis ion, hiring, em ploy ment, traini ng or monit oring of ot hers by that ins ured, if the ³RFFXUUHQF H´ZKLFKFDXV HGWKH³ERGLO\LQMXU\´ RU³SURSHUW \GDP DJH´RUWKHRIIHQVHZKLF K FDXVHGWKH³SHUV RQDODQGDGYHUW LVLQJLQMXU\´ invo lved the rendering of or failure to rende r any profes sional services by y ou wi th res pec t to y our providing engineering, arc hitectural or surveying servic es in your capac ity as an engineer, arc hit ec t or survey or. E.Bl anke t Additi ona l Insure d ±Mana ge rs Or Le s- so rs Of Premises 1.Secti on II ±Who Is An Insure d is amended to include as an addit ional insured any pers on(s )or organization(s )wit h whom you have agreed in a written cont rac t, ex ec ut ed prior to los s, to name as an addit ional insured, but onl y with res pec t to liabi lity aris ing out of the owners hip, maintenanc e or us e of that part of the premises leas ed to you, subjec t to the following additional exclusions : Th is insurance does not apply to: a .Any "occurrenc e" which takes place aft er you cease to be a tenant in that premises . b.Struc tural alterations , new cons truc tion or demolition operat ions performed by or on behalf of suc h addit ional insured. WN GL 39 08 18 In cludes c opyrighted material of the In suranc e Service Off ic e, In c., w ith its permi ssion.Page 7 of 10 However: a .The insuranc e afforded to such additiona l insured only applies to the ex tent permitted by law; and b.If cove rage provided to t he additional ins ure d is required by a contrac t or agreement , the insuranc e afforded to s uc h additional ins ure d will not be broader than that which you are required by the contrac t or agreement to provide for such additional ins ured. 2.With res pec t to the insuranc e afforded to these additional insureds, the fol lowing is added to Se cti on III ±Limits Of Insura nce : If cove rage provided to the additional insured is required by a c ont rac t or agreement , the mos t we will pay on behalf of the additional insured is : a .The minimum amount required by the cont rac t or agreement; or b.The Limits of Insuranc e shown in the Dec larat ions; whichever is les s. This endors ement shal l not increas e the applic able Limits of Ins uranc e shown in the Dec larations. 3.With res pec t to the insuranc e afforded to these additional ins ureds , the following additiona l exclus ion applies : This ins uranc e does not apply to: a ."Bodily injury", "property damage" or "pers onal and advert is ing injury" arising out of the rendering of, or the failure to render , any profes sional arc hitec tural, engineering or survey ing services, including: (1)Th e preparing, approving, or fa iling to prepare or approve, maps, shop drawings , opinions , reports, survey s , fi eld orders , change orders or drawing s and spec ifications ; or (2)Supervisory , inspec tion, arc hitec tural or engineering ac tivi ties. This ex clusion applies even if the claims agains t an additional insured allege negligenc e or other wrongdoing in the supervision, hiring, employ ment , training or monitoring of others by that ins ured, if the ³RF FXUUHQF H´ZKLFKFDXV HGWKH³ERGLO\LQMXU\´ RU³SURSHUW \GDPDJH´RUWKHRIIHQV HZKLFK FDXV HGWKH³SHUV RQDODQGDGYHUW LVLQJLQMXU\´ invo lved the rendering of or failure to rende r any profes sional services by you with res pec t to y our providing engineering, arc hit ec tural or survey ing services in your capacity as an engineer, arc hitect or survey or. F.Bl anke t Additional Insure d ±State Or Governmenta l Agency Or Subdivision Or Politi cal Subdivision ±Permits Or Authorizations Se cti on II ±Who Is An Insure d is amended to in- clude as an additional insured any state or governm ent al agency or subdivis ion or political subdivision with whom you have agreed in a wri tten cont rac t, ex ecut ed prior to loss, to name as an additional ins ured, subjec t to t he following provis ion s : 1.Th is insuranc e applies only with res pec t to op - erat ions perform ed by you or on your behalf for which the state or government al agency or sub- divi sion or political subdivis i on has issued a permit or aut horiz at ion. However: a.Th e insuranc e afforded to such additiona l insured only applies to the ex tent permitted by law; and b.If cove rage provided to t he additional ins ure d is required by a cont rac t or agreement , the insuranc e afforded to s uc h additional ins ure d will not be broader than that which you are required by the cont rac t or agreement to provide fo r such additional ins ured. 2.Th is insurance does not apply to: a."Bodi ly injury ", "propert y dam age" or "per- sonal and advertising injury" arising out of op- erat ions performed for the federal govern- ment, state or municipal ity; or b."Bodi ly injury " or "propert y damage" include d wit hin the "produc ts-completed operat ions haz ard". 3.With res pec t to the insuranc e afforded to thes e additional insureds , the fo llowing is added to Secti on III ±Limits Of Insura nce : If cove rage provided to the additional insured is required by a c ont rac t or agreement , the most we will pay on behalf of the addit ional insured is: a .Th e minimum amount required by the contrac t or agreement ; or b.Th e Li mits of Ins uranc e shown in the Dec larat ions ; whichever is less. Th is endorsement shall not inc reas e the applicable Limits of Insuranc e shown in the Dec larat ions . WN GL 39 08 18 In cludes c opyrighted material of the In suranc e Service Off ic e, In c., w ith its permi ssion.Page 8 of 10 4.With res pec t to the insuranc e afforded to these additional ins ureds , the following additiona l exclus ion applies : This ins uranc e does not apply to: a ."Bodily injury", "property damage" or "pers onal and advert is ing injury" arising out of the rendering of, or the failure to render , any profes sional arc hitec tural, engineering or survey ing services, including: (1)Th e preparing, approving, or fa iling to prepare or approve, maps, shop drawings , opinions , reports, survey s , fi eld orders , change orders or drawing s and spec ifications ; or (2)Supervisory , inspec tion, arc hitec tural or engineering ac tivi ties. This ex clusion applies even if the claims agains t an additional insured allege negligenc e or other wrongdoing in the supervision, hiring, em ploy ment, training or monitoring of others by that ins ured, if the ³RF FXUUHQF H´ZKLFKFDXV HGWKH³ERGLO\LQMXU\´ RU³SURSHUW \GDPDJH´RUWKHRIIHQV HZKLFK FDXV HGWKH³SHUV RQDODQGDGYHUW LVLQJLQMXU\´ invo lved the rendering of or failure to rende r any profes sional servic es by you wit h res pec t to y our providing engineering, arc hit ec tural or survey ing services in your capacity as an engineer, arc hitect or survey or. G.Blanke t Ad ditional Insure d ±State Or Gove rnmenta l Ag ency Or Subdivision Or Politi cal Subdivision ±Permits Or Au thorizations Re lati ng To Premises Secti on II ±Who Is An Insure d is amended to in- clude as an additional ins ured any state or governmental agenc y or subdivi sion or political subdivi sion wi th whom you have agreed in a wri tten contrac t, exec uted prior to loss, to name as an addit ional insured, subjec t to the following provis ion: 1.This insuranc e applies onl y wit h res pec t to t he fol - lowing haz ards for which the state or governm ent al agency or subdivi sion or political subdivi sion has is sued a permit or aut horiz at ion in connec tion wi th premis es you own, rent or cont rol and to which this insuranc e applies : a .The ex istenc e, maintenanc e, repair , cons truc tion, erec tion or rem oval of advert ising signs , awnings , canopies , cell ar ent ranc es , coal holes , drive way s, manholes , marquees , hois t away openings , sidewalk va ults, street banners or dec orat ions and similar expos ures ; or b.Th e construc tion, erec tion or removal of elevators ; or c.Th e owners hip, maintenanc e or us e of any eleva tors cove red by this i nsuranc e. However, a .Th e insuranc e afforded to such additiona l insured only applies to the ex tent permitted by law; and b.If cove rage provided to t he additional ins ure d is required by a cont rac t or agreement , the insuranc e affo rded to s uc h additional insure d will not be broader than that which you are required by the cont rac t or agreement to provide fo r such additional ins ure d. 2.With res pec t to the insuranc e afforded to thes e additional insureds , the fo llowing is added to Secti on III ±Limits Of Insura nce : If cove rage provided to the additional insured is required by a c ont rac t or agreement , the most we will pay on behalf of the additional insured is: a .Th e minimum amount required by the contrac t or agreement ; or b.Th e Li mits of Ins uranc e shown in the Dec larat ions ; whichever is less. Th is endorsement shall not inc reas e the applicable Limits of Insuranc e shown in the Dec larat ions . 3.With res pec t to the insuranc e afforded to thes e additional insureds , the following additiona l ex clusion appl ies : Th is insurance does not apply to: a ."Bodi ly injury ", "propert y damage" or "pers onal and advert ising injury " aris ing out of the rendering of, or the fai lure to render , any profes sional arc hit ec tural, engineering or surveying services, including: (1)Th e preparing, approving, or failing to prepare or approve, maps , shop drawings , opinions , report s, surveys , fi eld orders , change orders or drawing s and specifications; or (2)Supervis ory , inspec tion, arc hit ec tural or engineering ac tivities. WN GL 39 08 18 In cludes c opyrighted material of the In suranc e Service Off ic e, In c., w ith its permi ssion.Page 9 of 10 This ex clusion applies even if the claims agains t an additional insured allege negligenc e or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that ins ured, if the ³RF FXUUHQF H´ZKLFKFDXV HGWKH³ERGLO\LQMXU\´ RU³SURSHUW \GDPDJH´RUWKHRIIHQV HZKLFK FDXV HGWKH³SHUV RQDODQGDGYHUW LVLQJLQMXU\´ invo lved the rendering of or failure to rende r any profes sional servic es by you wit h res pec t to y our providing engineering, arc hit ec tural or survey ing services in your capacity as an engineer, arc hitect or survey or. SECTION III ±LIMITS OF INSURANCE AM ENDMENT S A.Da ma ge To Premises Rente d To Yo u Paragraph 6.is replac ed by the following: 6.Subject to Paragraph 5. above, the most we wi ll pay under Coverage A for damages bec aus e of ³SURSHUW \GDPDJH´WRDQ\RQHSUHP LVHVZKLOH rent ed to you, or in the case of damage by fire, lightning, ex plos ion or sprinkler leak age, while rent ed to you or temporarily oc cupied by you with permission of the owner is the great er of: a.$300,000; or b.The amount shown nex t to the Damage To Premis es Rented To You Limit in the Dec la- rat ions. However, the provisions of this paragraph do not apply if Damage To Prem ises Rent ed To You Coverage is excluded by endors ement . B.Me dical Ex pe nse Limit Paragraph 7.is replac ed wi th the fol lowing: 7.Subject to Paragraph 5.above, the most we wi ll pay under Coverage C for all medic al expens es EHF DXV HRI³ERGLO\LQMXU\´VXVWDLQHGE\DQ\RQH  pers on is the great er of: a.$10,000; or b.The amount shown nex t to the Medical Ex - pens e Limit in the Dec larat ions . This insuranc e does not apply if cove rage for Medic al Expens es is excluded either by the pro - vi sions of the cove rage part or by endors ement . SECTION IV ±COMMERCI AL GENERAL LIABI LIT Y CONDI TIONS AMENDMENTS A.Kn ow ledge Of Occurre nce It em 2. Duti es In The Event Of Occurre nce , Of- fe nse, Cl aim or Suit is amended by adding the fol - lowi ng: e.You must give us or our aut horized repres ent a - WLYHSURPSWQRW LFHRIDQ³RF FXUUHQF H´FODLPRU  ORVVRQO\ZKHQWKH³RF FXUUHQFH´FODLPRUORVVLV  known to: (1)You, if you are an individual; (2)A partner, if you are a part ners hip; (3)An executive offi cer or insurance manager, if you are a corporat ion; or (4)A member or manager, if you are a limited liabi lity company . B.Othe r Insura nce It em 4. Othe r Insura nce , b. Ex ce ss Insura nce (1) (a ) (i i) is replac ed by the following: (i i)Th at is fire, light ning, explosion or sprink ler leak - age insurance fo r premises rent ed to you or temporarily occupied by you wi th permis sion of the owner; C.Un intenti ona l Failure To Disc lose Ha zards It em 6. Re pre se ntations is replac ed by t he following: 6.Re pre se ntations And Unintenti ona l Fa ilure To Di sc lose Ha zards a.By ac cept ing this polic y, you agree: (1)Th e statement s in the Dec larat ions are ac curate and complete; (2)Th ose statement s are based upon repre - sentations you made to us; and (3)We have issued this policy in relianc e upon your repres ent at ions. b.If you unint ent ionally fail to disclose any haz - ards ex is ting at the incept ion dat e of your policy, we will not deny cove rage under this Coverage Part bec aus e of such failure . However, this provision does not affe ct our right to c ollect additional premium or exer cise our right of cancellation or non-renewal. WN GL 39 08 18 In cludes c opyrighted material of the In suranc e Service Off ic e, In c., w ith its permi ssion.Page 10 of 10 D.Waive r of Subroga ti on It em 8. Transfe r of Ri ghts of Re cove ry Ag ainst Othe rs to Us is hereby amended by the addit ion of the fol lowing: We waive any right of rec overy we may have be cause of pay ments we make for injury or dam age aris ing out of your ongoing operations or "your work " done unde r a written contrac t, ex ec uted prior to loss, requiri ng such waive r with that pers on or organization and included in the "produc ts-completed operations haz ard". However, our right s may only be waive d prior to the "occurrenc e" giving ris e to the injury or damage fo r which we make pay ment under this Coverage Part . Th e insured must do nothing after a loss to impair our right s. At our reques t, the ins ure d will bring "suit" or trans fer those right s to us and help us enforc e those right s. SECTION V ±DEF INITIONS AM ENDM ENT S A.Insure d Contra ct Am ende d Paragraph 9. a.is replac ed by the fol lowi ng: a.A cont rac t for a leas e of prem ises. However, that port ion of the cont rac t for a l eas e of prem ises that indemnifies any pers on or or ganization for damage by fi re, lightning, ex plos ion or sprinkler leak age to premises while rent ed to you or temporarily occupied by you wi th permission of WKHRZQHULVQRW DQ³LQV XUHGFRQWUDF W´ B.Pe rsona l And Ad ve rti si ng Injury Re de fi ne d Paragraph 14. d.and e . are replac ed by t he following: d.Oral, written, televi sed,vi deot aped or elec tronic publicat ion of material that slanders or libel s a SHUV RQRURUJDQL]DWLRQRUGLVSDUDJHV DSHUV RQ¶V  RURUJDQL]DWLRQ¶VJRRGV SURGXF WVRUVHUYLFH e.Oral, written, televi sed, vi deotaped or elec tronic publicat ion of material that YL RODW HVDSHUV RQ¶V  right of priva cy; WN CA 27 06 16 WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, with its permission Page 1 of 5BUSINESS AUTO ENHANCEMENT ENDORSEMENT The Business Auto Enhancement Endorsement is an optional endorsement that provides coverage enhancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is provided by this summary, refer to following endorsement for changes in your policy. SUMMARY OF COVERAGES PAGE Accidental Airbag Deployment Coverage 4 Auto Loan/Lease Gap Coverage 4 Blanket Additional Insured 2 Blanket Waiver of Subrogation 5 Broadened Definition of Insured includes: xNewly Acquired Organizations for up to 180 Days 2 xEmployees as Insureds 2 xSubsidiaries in Which You Own 50% or More 2 Deductible Waiver for Glass Repair 3 Employee Hired Auto 2, 5 Fellow Employee Coverage 3 Hired Auto Physical Damage Coverage 4 Knowledge of Accident, Claim, Suit or Loss 5 Loss Of Use Expenses - Amended 3 Personal Effects 3 Rental Reimbursement Coverage 4 Supplementary Payments - Amended: xBail Bonds up to $5,000 2 xLoss of Earnings up to $500/Day 2 Transportation Expense Limits Amended 3 Unintentional Failure to Disclose Hazards 5 WN CA 27 06 16 WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, with its permission Page 2 of 5THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BUSINESS AUTO ENHANCEMENT ENDORSEMENTThis endorsement modifies the insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The SECTIONS of the Business Auto Coverage Form identified in this endorsement will be amended as shown below. SECTION II COVERED AUTOS LIABILITY COVERAGE AMENDMENTS A.Who Is An Insured SECTION II COVERED AUTOS LIABILITYCOVERAGE, A. Coverage, 1. Who Is An Insuredis amended to add: d.Any legally incorporated subsidiary of yours inwhich you own more than 50% of the votingstock on the effective date of this coverage form. However, insured does not include anysubsidiary of yours that is an insured underany other automobile liability policy, or would bean insured under such policy but fortermination of such policy or the exhaustion onsuch policys limits of insurance.e.Any organization which is newly acquired orformed by you and over which you maintainmajority ownership. However, coverage underthis provision:(1)is afforded only for the first 180 days afteryou acquire or form the organization or untilthe end of the policy period, whichevercomes first; (2)does not apply to bodily injury or propertydamage that results from an accident thatoccurred before you formed or acquired theorganization; (3)does not apply to any newly acquired orformed organization that is a joint venture orpartnership; and (4)does not apply to an insured under anyother automobile liability policy, or would bean insured under such a policy but for ter-mination of such policy or the exhaustion ofsuch policys limits of insurance.f.Any employee of yours is an insured whileusing a covered auto you dont own, hire orborrow in your business or your personal affairs.g.Any employee of yours is an insured whileoperating a covered auto hired or rented under a contract or agreement in the employeesname, with your permission, while performingduties related to the conduct of your business.B.Blanket Additional InsuredSECTION ll COVERED AUTOS LIABILITYCOVERAGE, A. Coverage, 1. Who Is An Insured,paragraph c. is amended to add the following:Any person or organization who is required under awritten contract or agreement between you and thatperson or organization, that is signed and executedby you before the bodily injury or propertydamage occurs and that is in effect during the policy period, to be named as an additional insured is aninsured for Liability Coverage, but only fordamages to which this insurance applies and only to the extent that persons or organization qualifies asan insured under the Who Is An Insured provisioncontained in Section ll. C.Liability Coverage Extensions SupplementaryPaymentsSECTION II COVERED AUTOS LIABILITYCOVERAGE, A. Coverage, 2. CoverageExtensions, a. Supplementary Payments isamended by replacing subparagraphs (2) and (4)with the following: (2)Up to $5,000 for cost of bail bonds (includingbonds for related traffic law violations) requiredbecause of an accident we cover. We do nothave to furnish these bonds. (4)All reasonable expenses incurred by theinsured at our request, including actual loss ofearnings up to $500 a day because of time offfrom work. WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, with its permission Page 3 of 5D. Fellow Employee Coverage SECTION II COVERED AUTOS LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee, the following is added: Co-Employee Lawsuit Defense Cost Reimbursement If a suit seeking damages for bodily injury to any fellow employee of the insured arising out of and in the course of the fellow employees employment or while performing duties related to the conduct of your business, or a suit seeking damages brought by the spouse, child, parent, brother or sister of that fellow employee, is brought against you, we will reimburse reasonable costs that you incur in the defense of such matters. Any reimbursement made pursuant to this sub-section will be in addition to the limits of liability set forth in the Declarations. SECTION III PHYSICAL DAMAGE COVERAGE AMENDMENTS A. Transportation Expense Limits Amended SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Trans-portation Expenses is amended by replacing $20 per day/$600 maximum limit with $50 per day/$1000 maximum. B. Hired Auto Physical Damage Loss Of Use Expenses Limits Amended SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, b. Loss of Use Expenses is amended by replacing the $20 per day/$600 maximum limit with $50 per day/$750 maximum limit. C. Personal Effects Coverage SECTION lll PHYSICAL DAMAGE COVERAGE, A. Coverage, 4.Coverage Extensions is amended by adding the following: c. Personal EffectsWe will pay up to $500 for loss to personal effects, which are: (1) Owned by an insured; and(2) In or on your covered auto.This coverage applies only in the event of the total theft of your covered auto. No deductible applies to this coverage D. Glass Repair Deductible Waiver SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 3. Glass Breakage Hitting A Bird Or Animal Falling Objects Or Missiles, is amended by adding the following: No deductible will apply to glass breakage if such glass is repaired, in a manner acceptable to us, rather than replaced. E. Hired Auto Physical DamageSECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage is amended by adding the following: 5.Hired Auto Physical Damage If hired autos are covered autos for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are pro-vided under this coverage form for any auto you own, then the Physical Damage Coverages provided are extended to autos you hire of like kind and use, subject to the following: a.The most we will pay for any one loss is $50,000 or the actual cash value or cost to repair or replace, whichever is less, minus a deductible; b.The deductible will be equal to the largest deductible applicable to any owned auto for that coverage. Any Comprehensive deductible does not apply to loss caused by fire or lightening; c.Hired Auto Physical Damage coverage is excess over any other collectible insurance; and d.Subject to the above limit, deductible and excess provisions we will provide coverage equal to the broadest coverage applicable to any covered auto you own. If a limit for Hired Auto Physical Damage is indicated in the Declarations, then that limit replaces, and is not added to, the $50,000 limit indicated above. WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, with its permission Page 4 of 5F. Rental Reimbursement SECTION III PHYSICAL DAMAGE COVERAGE A. Coverage, is amended by adding the following: 6.Rental Reimbursement This coverage applies only to a covered auto of the private passenger or light truck type as follows: a. We will pay for rental reimbursement expenses incurred by you for the rental of a private passenger or light truck type auto because of loss to a covered private pas-senger or light truck type auto. Payment applies in addition to the otherwise applica-ble amount of each coverage you have on a covered private passenger or light truck type auto. No deductibles apply to this coverage. b.We will pay only for those expenses incurred during the policy period beginning 24 hours after the loss and ending, regardless of the policys expiration, with the lesser of the fol-lowing number of days: (1) The number of days reasonably re-quired to repair or replace the covered private passenger or light truck type auto. If loss is caused by theft, this number of days is added to the number of days it takes to locate the covered private passenger or light truck type auto and return it to you; or(2) 30 days. c.Our payment is limited to the lesser of the following amounts: (1) Necessary and actual expenses incurred, or (2) $50 per day, up to a maximum of $1,000. d.This coverage does not apply while there are spare or reserve private passenger or light truck type autos available to you for your operations. e.If loss results from the total theft of a covered auto of the private passenger or light truck type, we will pay under this cover-age only that amount of your rental reim-bursement expenses which is not already provided for under SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions.For the purposes of this Rental Reimbursement coverage, light truck is defined as a truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as the maximum loaded weight the auto is designed to carry. G. Accidental Airbag Deployment Coverage SECTION III PHYSICAL DAMAGE COVERAGE, A. Coverage is amended by adding the following: 7.Accidental Airbag Deployment Coverage We will pay to reset or replace factory installed airbag(s) in any covered auto for accidental discharge, other than discharge due to a collision loss. This coverage is applicable only if comprehen-sive coverage applies to the covered auto.This coverage is excess over any other collecti-ble insurance or reimbursement by manufac-turers warranty.H. Auto Loan/Lease Gap Coverage SECTION III PHYSICAL DAMAGE COVERAGE, Item A., Coverage, is amended by adding the following: 8.Auto Loan/Lease Gap CoverageThis coverage applies only to a covered auto described or designated in the Schedule or in the Declarations as including physical damage coverage. In the event of a covered total loss to a covered auto described or designated in the Schedule or in the Declarations, we will pay any unpaid amount due on the lease or loan for a covered auto less:a. The amount paid under the Physical Damage Coverage Section on the policy; and b. Any: (1) Overdue lease/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 loans or leases. WN CA 27 06 16 Includes copyrighted material of Insurance Services Office, with its permission Page 5 of 5SECTION IV BUSINESS AUTO CONDITIONS AMENDMENTS A. Duties In The Event Of Accident, Claim, Suit Or Loss Amended SECTION IV BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit Or Loss, a. is amended by adding the following: This condition applies only when the accident or loss is known to:(1)You, if you are an individual; (2)A partner, if you are a partnership; (3) An executive officer or insurance manager, if you are a corporation; or (4) A member or manager, if you are a limited liability company. But, this section does not amend the provisions relating to notification of police, protection or exami-nation of the property which was subject to the loss.B. Blanket Waiver of Subrogation Section IV BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer of Rights of Recovery Against Others to Us, is amended by adding the following exception: However, we waive any right of recovery we may have against any person or organization to the extent required of you by a written contract signed and executed prior to any accident or loss, provided that the accident or loss arises out ofoperations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. C. Unintentional Failure to Disclose Hazards SECTION IV BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment, Misrepre-sentation Or Fraud, is amended by adding the following paragraph: If you unintentionally fail to disclose any hazards existing at the inception date of the policy, or during the policy period in connection with any additional hazards, we will not deny coverage under this Cov-erage Part because of such failure. D. Employee Hired Auto SECTION IV BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, paragraph b. is deleted and replace by the following: b.For Hired Auto Physical Damage Coverage, the following are deemed to be a covered autos you own: (1)Any covered auto you lease, hire, rent or borrow. (2)Any covered auto hired or rented by your employee under a contract in that individual employees name, with your permission, while performing duties related to the conduct of your business. However, any auto that is leased, hired, rented or borrowed with a driver is not a covered auto. EVERGREEN ASPHALT & CONCRETE INC PO BOX 867 RAVENSDALE, WA 98051-0867 City of Kent Business License Per RCW 82.14 local sales and use tax must be coded No. 1715 for all qualified sales within the city of Kent. BUSINESS LICENSE LICENSE MUST BE PAID ANNUALLY BY JANUARY 1st TO AVOID PENALTY Issuance of License Does Not Imply Licensee's Compliance with State and Local Laws THIS LICENSE MUST BE POSTED IN A CONSPICUOUS PLACE. NOT TRANSFERABLE OR ASSIGNABLE NAME AND ADDRESS OF BUSINESS MAYOR The City of Kent At 220 4TH AVE SO KENT, WASHINGTON 98032 BLOC-2140738 2020 EVERGREEN ASPHALT & CONCRETE INC Please tear at perforation 18744 SE 282ND ST KENT, WA 98042 Tax Registration Endorsement Signature: Email: Signature: Email: Signature: Email: Signature: Email: Janice Applegate (Nov 16, 2020 14:55 PST) Janice Applegate japplegate@kentwa.gov Ben Levenhagen (Nov 17, 2020 16:35 PST) blevenhagen@kentwa.gov rlashley@kentwa.gov Melissa McCormick (Nov 30, 2020 13:51 PST) Melissa McCormick cityclerk@kentwa.gov EvergreenAsphalt_BriscoePk_2020 Final Audit Report 2020-11-30 Created:2020-11-16 By:Janice Applegate (japplegate@kentwa.gov) Status:Signed Transaction ID:CBJCHBCAABAA2Z3fkTg_QrEWwfZeNAh2RdrT0AxekvGl "EvergreenAsphalt_BriscoePk_2020" History Document created by Janice Applegate (japplegate@kentwa.gov) 2020-11-16 - 10:40:10 PM GMT- IP address: 146.129.252.126 Document e-signed by Janice Applegate (japplegate@kentwa.gov) Signature Date: 2020-11-16 - 10:55:19 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to Ben Levenhagen (blevenhagen@kentwa.gov) for signature 2020-11-16 - 10:55:22 PM GMT Email viewed by Ben Levenhagen (blevenhagen@kentwa.gov) 2020-11-18 - 0:34:04 AM GMT- IP address: 172.56.42.70 Document e-signed by Ben Levenhagen (blevenhagen@kentwa.gov) Signature Date: 2020-11-18 - 0:35:38 AM GMT - Time Source: server- IP address: 172.56.42.70 Document emailed to Shane Gilbertson (evergreen.shane@comcast.net) for signature 2020-11-18 - 0:35:43 AM GMT Email viewed by Shane Gilbertson (evergreen.shane@comcast.net) 2020-11-18 - 3:10:33 PM GMT- IP address: 73.225.166.223 Document e-signed by Shane Gilbertson (evergreen.shane@comcast.net) Signature Date: 2020-11-18 - 3:13:10 PM GMT - Time Source: server- IP address: 73.225.166.223 Document emailed to Ronald Lashley (rlashley@kentwa.gov) for signature 2020-11-18 - 3:13:16 PM GMT Email viewed by Ronald Lashley (rlashley@kentwa.gov) 2020-11-18 - 7:38:17 PM GMT- IP address: 146.129.252.126 Document e-signed by Ronald Lashley (rlashley@kentwa.gov) Signature Date: 2020-11-18 - 7:41:06 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to Brian Levenhagen (bjlevenhagen@kentwa.gov) for signature 2020-11-18 - 7:41:11 PM GMT Email viewed by Brian Levenhagen (bjlevenhagen@kentwa.gov) 2020-11-23 - 6:06:06 PM GMT- IP address: 146.129.252.126 Document e-signed by Brian Levenhagen (bjlevenhagen@kentwa.gov) Signature Date: 2020-11-23 - 6:07:29 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to Kim Komoto (kkomoto@kentwa.gov) for signature 2020-11-23 - 6:07:34 PM GMT Email viewed by Kim Komoto (kkomoto@kentwa.gov) 2020-11-23 - 6:17:42 PM GMT- IP address: 146.129.252.126 Document e-signed by Kim Komoto (kkomoto@kentwa.gov) Signature Date: 2020-11-23 - 6:18:59 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to Melissa McCormick (cityclerk@kentwa.gov) for signature 2020-11-23 - 6:19:02 PM GMT Email viewed by Melissa McCormick (cityclerk@kentwa.gov) 2020-11-30 - 9:47:54 PM GMT- IP address: 146.129.252.126 Document e-signed by Melissa McCormick (cityclerk@kentwa.gov) Signature Date: 2020-11-30 - 9:51:32 PM GMT - Time Source: server- IP address: 146.129.252.126 Agreement completed. 2020-11-30 - 9:51:32 PM GMT