HomeMy WebLinkAboutCAG2021-465 - Original - Evergreen Asphalt and Concrete Construction, Inc. - PSE Trail Repair and Maintenance - 10/27/202110/21/21
OK to sign, 10/22/2021, TW.
CAG2021-465
PUBLIC WORKS AGREEMENT - 1
(Over $20K and No Performance Bond)
PUBLIC WORKS AGREEMENT
between City of Kent and
Evergreen Asphalt and Concrete Construction, Inc.
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and Evergreen Asphalt and Concrete Construction, 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:
Trail repair and maintenance on the PSE (Puget Sound Energy) Trail between 64 th Avenue
South and 68th Avenue South, Kent, WA 98032. Remove and replace the asphalt trail from the
trailhead parking lot on 68th Avenue South to the west, approximately 450 linear feet. Remove
tree roots that have caused path to fail and re-compact those areas before paving per Proposal
#8893 attached and incorporated as Exhibit A, with the exception of any terms and conditions
included in the Proposal, which are specifically excluded from and not incorporated into this
Agreement.
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 within 15 working days after the City issues its Notice to Proceed. Upon the effective date
of this Agreement, all physical work shall thereafter be completed by November 30, 2021. The term of this
Agreement shall continue until all work has been completed, final acceptance has occurred, and all
Contractor obligations have been fulfilled.
III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed THIRTY
THOUSAND NINE HUNDRED SIXTY FIVE DOLLARS AND SIXTY THREE CENTS ($30,965.63), 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
PUBLIC WORKS AGREEMENT - 2
(Over $20K and No Performance Bond)
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.
A. No Payment and Performance Bond. Because this contract, including applicable sales
tax, is less than $150,000, 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 e
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
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
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 CONTRA
PAYMENT (EXCLUDING WITHHELD RETAINAGE) SHALL CONSTITUTE A WAIVER OF
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
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 ervices 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.
PUBLIC WORKS AGREEMENT - 3
(Over $20K and No Performance Bond)
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.
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
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.
include, without limitation, any one or more of the following events:
A.
workers or proper materials for completion of the Contract work.
B.
Agreement.
C.
material or labor.
D. The Con
regulations.
E.
F.
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
this project which
may be used by the City without restriction.
VI. PREVAILING WAGES. The
ct
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
PUBLIC WORKS AGREEMENT - 4
(Over $20K and No Performance Bond)
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.
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 . 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
PUBLIC WORKS AGREEMENT - 5
(Over $20K and No Performance Bond)
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:
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
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
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.
PUBLIC WORKS AGREEMENT - 6
(Over $20K and No Performance Bond)
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
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
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
the
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
PUBLIC WORKS AGREEMENT - 7
(Over $20K and No Performance Bond)
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.
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
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
(Over $20K 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:
Print Name:
Its
DATE:
CITY OF KENT:
By:
Print Name: Dana Ralph
Its Mayor
DATE:
NOTICES TO BE SENT TO:
CONTRACTOR:
Shane M. Gilbertson
Evergreen Asphalt and Concrete Construction, 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)
APPROVED AS TO FORM:
Kent Law Department
ATTEST:
Kent City Clerk
10/27/2021
PUBLIC WORKS AGREEMENT - 9
(Over $20K and No Performance Bond)
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
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
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: ________________________________________
PUBLIC WORKS AGREEMENT - 10
(Over $20K and No Performance Bond)
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 su
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
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
PUBLIC WORKS AGREEMENT - 11
(Over $20K and No Performance Bond)
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: ________________________________________
PUBLIC WORKS AGREEMENT - 12
(Over $20K and No Performance Bond)
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 (10/06/2021
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 and Concrete Construction, 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.
Evergreen Asphalt &
Concrete, Inc.
P.O. Box 867
Ravensdale, WA 98051
Ph: 425 584-7890
Fax: 253 639-3779
EXHIBIT A
PROPOSAL
Date
Proposal#
10/6/2021
8893
PROPOSAL SUBMITTED TO:
City of Kent
220 Fourth Avenue
Kent, WA 98032
Attn Nate Harper
TERMS
SUBMITTE... JOB ADDRESS
Due on receipt SG
Qty
Description
Rate
Total
PSE Trail
4,500
SQ FT Asphalt Remove and Replace with tree roots
6.25
28,125.00T
From PSE trailhead parking on 68th Ave. S. to the West aprox. 450 ft
Sales Tax (10.1 %) $2,840.63
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
Total $30,965.63
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 Signature
THIRTY (30) DAYS.
E-mail: Web Site. -
evergreen. shane@comcast.net Evergreenasphalt.com
10/13/21, 3:33 PM about:blank
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: 10/13/2021
*Risk
County_
Trade
Job Classification
Wage
Holiday Overtime Note
Class
King
Laborers
Air, Gas Or Electric Vibrating
$54.62
7A
4V
8Y
View
Screed
King
Laborers
Airtrac Drill Operator
$56.31
7A
4V
8Y
View
King
Laborers
Ballast Regular Machine
$54.62
7A
4V
8Y
View
King
Laborers
Batch Weighman
$46.29
7A
4V
8Y
View
King
Laborers
Brick Pavers
$54.62
7A
4V
8Y
View
King
Laborers
Brush Cutter
$54.62
7A
4V
8Y
View
King
Laborers
Brush Hog Feeder
$54.62
7A
4V
8Y
View
King
Laborers
Burner
$54.62
7A
4V
8Y
View
King
Laborers
Caisson Worker
$56.31
7A
4V
8Y
View
King
Laborers
Carpenter Tender
$54.62
7A
4V
8Y
View
King
Laborers
Cement Dumper -paving
$55.62
7A
4V
8Y
View
King
Laborers
Cement Finisher Tender
$54.62
7A
4V
8Y
View
King
Laborers
Change House Or Dry Shack
$54.62
7A
4V
8Y
View
King
Laborers
Chipping Gun (30 Lbs. And
$55.62
7A
4V
8Y
View
Over)
King
Laborers
Chipping Gun (Under 30 Lbs.)
$54.62
7A
4V
8Y
View
King
Laborers
Choker Setter
$54.62
7A
4V
8Y
View
King
Laborers
Chuck Tender
$54.62
7A
4V
8Y
View
King
Laborers
Clary Power Spreader
$55.62
7A
4V
8Y
View
King
Laborers
Clean-up Laborer
$54.62
7A
4V
8Y
View
King
Laborers
Concrete Dumper/Chute
$55.62
7A
4V
8Y
View
Operator
King
Laborers
Concrete Form Stripper
$54.62
7A
4V
8Y
View
King
Laborers
Concrete Placement Crew
$55.62
7A
4V
8Y
View
King
Laborers
Concrete Saw Operator/Core
$55.62
7A
4V
8Y
View
Driller
King
Laborers
Crusher Feeder
$46.29
7A
4V
8Y
View
King
Laborers
Curing Laborer
$54.62
7A
4V
8Y
View
King
Laborers
Demolition: Wrecking Et Moving
$54.62
7A
4V
8Y
View
(Incl. Charred Material)
about:blank 1/4
10/13/21, 3:33 PM
about:blank
King
Laborers
Ditch Digger
$54.62
7A
4V
8Y
View
King
Laborers
Diver
$56.31
7A
4V
8Y
View
King
Laborers
Drill Operator (Hydraulic,
$55.62
7A
4V
8Y
View
Diamond)
King
Laborers
Dry Stack Walls
$54.62
7A
4V
8Y
View
King
Laborers
Dump Person
$54.62
7A
4V
8Y
View
King
Laborers
Epoxy Technician
$54.62
7A
4V
8Y
View
King
Laborers
Erosion Control Worker
$54.62
7A
4V
8Y
View
King
Laborers
Faller Ft Bucker Chain Saw
$55.62
7A
4V
8Y
View
King
Laborers
Fine Graders
$54.62
7A
4V
8Y
View
King
Laborers
Firewatch
$46.29
7A
4V
8Y
View
King
Laborers
Form Setter
$54.62
7A
4V
8Y
View
King
Laborers
Gabian Basket Builders
$54.62
7A
4V
8Y
View
King
Laborers
General Laborer
$54.62
7A
4V
8Y
View
King
Laborers
Grade Checker Et Transit Person
$46.42
7A
4V
8Y
View
King
Laborers
Grinders
$54.62
7A
4V
8Y
View
King
Laborers
Grout Machine Tender
$54.62
7A
4V
8Y
View
King
Laborers
Groutmen (Pressure) Including
$55.62
7A
4V
8Y
View
Post Tension Beams
King
Laborers
Guardrail Erector
$54.62
7A
4V
8Y
View
King
Laborers
Hazardous Waste Worker (Level
$56.31
7A
4V
8Y
View
A)
King
Laborers
Hazardous Waste Worker (Level
$55.62
7A
4V
8Y
View
B)
King
Laborers
Hazardous Waste Worker (Level
$54.62
7A
4V
8Y
View
C)
King
Laborers
High Scaler
$56.31
7A
4V
8Y
View
King
Laborers
Jackhammer
$55.62
7A
4V
8Y
View
King
Laborers
Laserbeam Operator
$55.62
7A
4V
8Y
View
King
Laborers
Maintenance Person
$54.62
7A
4V
8Y
View
King
Laborers
Manhole Builder-Mudman
$55.62
7A
4V
8Y
View
King
Laborers
Material Yard Person
$54.62
7A
4V
8Y
View
King
Laborers
Motorman -Dinky Locomotive
$55.62
7A
4V
8Y
View
King
Laborers
nozzleman (concrete pump,
$46.42
7A
4V
8Y
View
green cutter when using
combination of high pressure
air Ft water on concrete Et
rock, sandblast, gunite,
shotcrete, water blaster,
vacuum blaster)
King
Laborers
Pavement Breaker
$55.62
7A
4V
8Y
View
King
Laborers
Pilot Car
$46.29
7A
4V
8Y
View
King
Laborers
Pipe Layer (Lead)
$46.42
7A
4V
8Y
View
King
Laborers
Pipe Layer/Tailor
$55.62
7A
4V
8Y
View '
King
Laborers
Pipe Pot Tender
$55.62
7A
4V
8Y
View
King
Laborers
Pipe Reliner
$55.62
7A
4V
8Y
View
King
Laborers
Pipe Wrapper
$55.62
7A
4V
8Y
View
King
Laborers
Pot Tender
$54.62
7A
4V
8Y
View
King
Laborers
Powderman
$56.31
7A
4V
8Y
View
about:blank 2/4
10/13/21, 3:33 PM
about:blank
King
Laborers
Powderman's Helper
$54.62
7A
4V
8Y
View
King
Laborers
Power Jacks
$55.62
7A
4V
8Y
View
King
Laborers
Railroad Spike Puller - Power
$55.62
7A
4V
8Y
View
King
Laborers
Raker - Asphalt
$46.42
7A
4V
8Y
View
King
Laborers
Re-timberman
$56.31
7A
4V
8Y
View
King
Laborers
Remote Equipment Operator
$55.62
7A
4V
8Y
View
King
Laborers
Rigger/Signal Person
$55.62
7A
4V
8Y
View
King
Laborers
Rip Rap Person
$54.62
7A
4V
8Y
View
King
Laborers
Rivet Buster
$55.62
7A
4V
8Y
View
King
Laborers
Rodder
$55.62
7A
4V
8Y
View
King
Laborers
Scaffold Erector
$54.62
7A
4V
8Y
View
King
Laborers
Scale Person
$54.62
7A
4V
8Y
View
King
Laborers
Sloper (Over 20")
$55.62
7A
4V
8Y
View
King
Laborers
Sloper Sprayer
$54.62
7A
4V
8Y
View
King
Laborers
Spreader (Concrete)
$55.62
7A
4V
8Y
View
King
Laborers
Stake Hopper
$54.62
7A
4V
8Y
View
King
Laborers
Stock Piler
$54.62
7A
4V
8Y
View
King
Laborers
Swinging Stage/Boatswain
$46.29
7A
4V
8Y
View
Chair
King
Laborers
Tamper Et Similar Electric, Air
$55.62
7A
4V
8Y
View
Et Gas Operated Tools
King
Laborers
Tamper (Multiple Et Self-
$55.62
7A
4V
8Y
View
propelled)
King
Laborers
Timber Person - Sewer (Lagger,
$55.62
7A
4V
8Y
View
Shorer Et Cribber)
King
Laborers
Toolroom Person (at Jobsite)
$54.62
7A
4V
8Y
View
King
Laborers
Topper
$54.62
7A
4V
8Y
View
King
Laborers
Track Laborer
$54.62
7A
4V
8Y
View
King
Laborers
Track Liner (Power)
$55.62
7A
4V
8Y
View
King
Laborers
Traffic Control Laborer
$49.50
7A
4V
9C
View
King
Laborers
Traffic Control Supervisor
$52.45
7A
4V
9C
View
King
Laborers
Truck Spotter
$54.62
7A
4V
8Y
View
King
Laborers
Tugger Operator
$55.62
7A
4V
8Y
View
King
Laborers
Tunnel Work -Compressed Air
$142.82
7A
4V
9B
View
Worker 0-30 psi
King
Laborers
Tunnel Work -Compressed Air
$147.85
7A
4V
9B
View
Worker 30.01-44.00 psi
King
Laborers
Tunnel Work -Compressed Air
$151.53
7A
4V
9B
View
Worker 44.01-54.00 psi
King
Laborers
Tunnel Work -Compressed Air
$157.23
7A
4V
9B
View
Worker 54.01-60.00 psi
King
Laborers
Tunnel Work -Compressed Air
$159.35
7A
4V
9B
View
Worker 60.01-64.00 psi
King
Laborers
Tunnel Work -Compressed Air
$164.45
7A
4V
9B
View
Worker 64.01-68.00 psi
King
Laborers
Tunnel Work -Compressed Air
$166.35
7A
4V
9B
View
Worker 68.01-70.00 psi
King
Laborers
Tunnel Work -Compressed Air
$168.35
7A
4V
9B
View
Worker 70.01-72.00 psi
about:blank
3/4
10113121, 3:33 PM
about:blank
King
Laborers
Tunnel Work -Compressed Air
$170.35
7A
4V
9B
View
Worker 72.01-74.00 psi
King
Laborers
Tunnel Work-Guage and Lock
$57.41
7A
4V
8Y
View
Tender
King
Laborers
Tunnel Work -Miner
$57.41
7A
4V
8Y
View
King
Laborers
Vibrator
$55.62
7A
4V
8Y
View
King
Laborers
Vinyl Seamer
$54.62
7A
4V
8Y
View
King
Laborers
Watchman
$42.08
7A
4V
8Y
View
King
Laborers
Welder
$55.62
7A
4V
8Y
View
King
Laborers
Well Point Laborer
$55.62
7A
4V
8Y
View
King
Laborers
Window Washer/Cleaner
$42.08
7A
4V
8Y
View
about:blank 4/4
10/13/21, 3:35 PM about:blank
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: 10/13/2021
County Trade Job Classification Wage Holiday Overtime Note *Risk
Class
King Traffic Control Stripers Journey Level $50.51 7A 1 K View
about:blank 1/1
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 Liabilit insurance shall be written with
minimum limits of $2,000,000 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 $2,000,000 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.
EVERASP-02
LBUSCIO
1
ACORO CERTIFICATE OF LIABILITY INSURANCE
FDA�TE(MM/DDNYYY)
9/20/2021
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).
PRODUCER
CONTACT Laura BUSCIO
NAME:
PHONE FAX
(A/C, No, Ext): (206) 838-1015 (A/C, No):
Hub International Northwest LLC
PO Box 3018
Bothell, WA 98041
E-MAILlaura.buscio@hubinternational.com
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: Western National Assurance Company
24465
INSURED
INSURER B : Western National Mutual Insurance Company
15377
INSURER C :
Evergreen Asphalt & Concrete Construction, Inc.
INSURER D :
PO BOX 867
Ravensdale, WA 98051
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. 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.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE X OCCUR
X
X
CPP 1213195
9/15/2021
9/15/2022
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
100,000
$
MED EXP (Any oneperson)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GENT AGGREGATE LIMIT APPLIES PER:
RPOLICY 1 JECT LOC
X OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
WA Stop Gap
$ 1,000,000
B
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Comp ded $10" X Collision ded $1000
X
X
CPP1212799
9/15/2021
9/15/2022
COMBINED SINGLE LIMIT
Ea accident
1,000,000
$
X
BODILY INJURY Perperson)
$
BODILY INJURY Per accident
$
PROPERTY DAMAGE
Per accident
$
X
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
UMB1035977
9/15/2021
9/15/2022
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
$ 2,000,000
DED I X I RETENTION $ 10,000
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
CPP 1213195
9/15/2021
9/15/2022
PER X OTH-
STATUTE ER
E.L. EACH ACCIDENT
1,000,000
$
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
1,000,000
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: Clark Lake Park, Glenn Nelson Park and West Fenwick Park projects
The City of Kent, its officials, employees and volunteers are additional insured for general liability, but only if required by written contract or written
agreement and insurance is primary and non-contributory per the attached. Waiver of subrogation applies per the attached.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Kent
Y
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
220 Fourth Ave S
Kent, WA 98032
AUTHORIZED
pREPRESENTATIVE
(�(�eLavC
ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
COMMERICAL GENERAL LIABILITY
WNGL390818
COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT
The Commercial General Liability Enhancement Endorsement is an optional endorsement that provides coverage en-
hancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is pro-
vided by this summary, refer to following endorsement for changes in your policy.
SUMMARY OF COVERAGES
PAGE
Bodily Injury And Property Damage Liability
• Non Owned Watercraft Up To 50 Feet...............................................................................2
Property Damage Liability
• Elevators..........................................................................................................................3
• Fire, Lightning, Explosion Or Sprinkler Leakage Exception..................................................3
• Borrowed Equipment ($25,000 Per Occurrence, $50,000 Aggregate,
$2,500 Deductible Per Occurrence.................................................................................3
Supplementary Payments — Amended
• Bail Bonds Up To$5,000...................................................................................................4
• Loss of Earnings Up To $500/Day.....................................................................................4
Who Is An Insured Amendments
• Employee Bodily Injury To A Co-Employee.........................................................................4
• Newly Formed Or Acquired Organizations For Up To 180 Days...........................................4
• Blanket Additional Insured —Vendors —As Required By Contract........................................4
• Blanket Additional Insured — Lessor Of Leased Equipment..................................................6
• Blanket Additional Insured — Managers Or Lessors Of Premises..........................................6
• Blanket Additional Insured — State Or Governmental Agency Or Subdivision
Or Political Subdivision —Permits Or Authorizations.........................................................7
• Blanket Additional Insured — State Or Governmental Agency Or Subdivision
Or Political Subdivision — Permits Or Authorizations Relating To Premises ........................8
Damage To Premises Rented To You —$300,000.........................................................................9
Medical Payments Increased Limit — $10,000 Or Amount Shown on Declarations ...........................
9
Conditions
• Knowledge of Occurrence, Offense, Claim Or Suit Amended...............................................9
• Unintentional Failure To Disclose Hazards.........................................................................9
• Waiver of Subrogation.....................................................................................................
10
InsuredContract Amended..........................................................................................................
10
Personal And Ad\ertising Injury Redefined
• Televised, Videotaped Or Electronic Publication...............................................................
10
W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission. Page 1 of 10
COMMERCIAL GENERAL LIABILITY
WNGL390818
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT
This endorsement modifies the insurance provided under the following:
COMMERCIAL GENERAL LIABILITY 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 Commercial General Liability Coverage Form identified in this endorsement will
be amended as shown below.
SECTION I — COVERAGES AMENDMENTS
COVERAGE A — BODILY INJURY AND PROPERTY
DAMAGE LIABILITY
A. Non Owned Aircraft Or Watercraft
Item 2. Exclusions, Paragraph g. is replaced by the
following:
g. Aircraft, Auto Or Watercraft
"Bodily injury" or "property damage" arising out of
the ownership, maintenance, use or entrustment
to others of any aircraft, "auto" or watercraft
owned or operated by or rented or loaned to any
insured. Use includes operation and "loading or
unloading".
This exclusion applies even if the claims against
any insured allege negligence or other wrong-
doing in the supervision, hiring, employment,
training or monitoring of others by that insured, if
the "occurrence" which caused the "bodily injury"
or "property damage" involved in the ownership,
maintenance, use or entrustment to others of any
aircraft, "auto" or watercraft that is owned or
operated by or rented or loaned to any insured.
This exclusion does not apply to:
(1) A watercraft while ashore on premises you
own or rent;
(2) A watercraft you do not own that is:
(a) Less than 50 feet long; and
(b) Not being used to carry persons or prop-
erty for a charge;
This Subparagraph (2) applies to any person,
who with your expressed or implied consent,
either uses or is responsible for the use of the
watercraft;
(3) Parking an "auto" on, or on the ways next to,
premises you own or rent, provided the "auto"
is not owned by or rented or loaned to you or
the insured;
(4) Liability assumed under any "insured con-
tract" for the ownership, maintenance or use
of aircraft or watercraft; or
(5) "Bodily injury" or "property damage" arising
out of -
(a) The operation of machinery or equipment
that is attached to, or part of, a land
vehicle that would qualify under the
definition of "mobile equipment" if it were
not subject to a compulsory or financial
responsibility law or other motor vehicle
insurance law where it is licensed or
principally garaged; or
(b) The operation of any of the machinery or
equipment listed in Paragraph f. (2) or f.
(3) of the definition of "mobile equip-
ment".
B. Damage To Property Coverage Extensions
Item 2. Exclusions, Paragraph j. is replaced by the
following:
j. Damage To Property
"Property damage" to:
(1) Property you own, rent, or occupy, including
any costs or expenses incurred by you, or
any other person, organization or entity, for
repair, replacement, enhancement, restora-
tion or maintenance of such property for any
reason, including prevention of injury to a
person or damage to another's property;
(2) Premises you sell, give away or abandon, if
the "property damage" arises out of any part
of those premises;
W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 2 of 10
(3) Property loaned to you;
(4) Personal property in the care, custody or con-
trol of the insured;
(5) That particular part of real property on which
you or any contractors or subcontractors
working directly or indirectly on your behalf
are performing operations, if the "property
damage" arises out of those operations; or
(6) That particular part of any property that must
be restored, repaired or replaced because
"your work" was incorrectly performed on it.
Paragraphs (1), (3) and (4) of this exclusion do not
apply to "property damage" (other than damage by
fire, lightning, explosion or sprinkler leakage) to
premises, including the contents of such premises,
rented to you for a period of seven or fewer
consecutive days. A separate limit of insurance
applies to Damage To Premises Rented To You as
described in SECTION III —LIMITS OF INSURANCE.
However, the provisions of this paragraph do not
apply if coverage for Damage To Premises Rented To
You is excluded by endorsement.
Paragraph (2) of this exclusion does not apply if the
premises are "your work" and were never occupied,
rented or held for rental by you.
Paragraphs (3) and (4) of this exclusion do not apply
to the use of elevators.
Paragraphs (3), (4), (5) and (6) of this exclusion do
not apply to liability assumed under a sidetrack
agreement.
Paragraph (4) of this exclusion does not apply to
"property damage" to borrowed equipment while not
being used to perform operations at the jobsite.
Subject to Paragraph 2. of SECTION III —LIMITS OF
INSURANCE, the rules below fix the most we will pay
for "property damage" under this provision:
(1) $25,000 any one "occurrence", regardless of the
number of persons or organizations who sustain
damages because of that "occurrence";
(2) $50,000 annual aggregate; and
(3) We will pay only for damages in excess of $2,500
as a result of any one "occurrence", regardless of
the number of persons or organizations who
sustain damages because of that 'occurrence".
We may, or if required by law, pay all or any part
of any deductible amount, if applicable, to effect
settlement of any claim or "suit". Upon notice of
our payment of a deductible amount, you shall
promptly reimburse us for the part of the
deductible amount we paid.
Paragraph (6) of this exclusion does not apply to
"property damage" included in the "products -com-
pleted operations hazard".
The insurance provided for "property damage" from
the use of elevators and for "property damage" to
borrowed equipment is excess over any other valid
and collectible property insurance (including any de-
ductible portion thereof) available to the insured
whether primary, excess, contingent or on any other
basis.
C. Damage To Premises Rented To You
Item 2. Exclusions, the last paragraph is replaced by
the following:
Exclusions c. through n. do not apply to damage by
fire, lightning, explosion or sprinkler leakage to
premises while rented to you or temporarily occupied
by you with permission of the owner. A separate limit
of insurance applies to this coverage as described in
Paragraph 6. of SECTION III — LIMITS OF
INSURANCE.
COVERAGE B — PERSONAL AND ADVERTISING
INJURY LIABILITY
D. Personal And Advertising Injury
Item 2. Exclusions is amended by replacing Sub-
paragraphs b. and c. with the following:
b. Material Published With Knowledge Of Falsity
"Personal and advertising injury" arising out of
oral, written, televised, videotaped or electronic
publication, in any manner, of material, if done by
or at the direction of the insured with knowledge
of its falsity.
c. Material Published Prior To Policy Period
"Personal and advertising injury" arising out of
oral, written, televised, videotaped or electronic
publication, in any manner, of material whose first
publication took place before the beginning of the
policy period.
SUPPLEMENTARY PAYMENTS — COVERAGES A
AND B
E. Supplementary Payments — Coverages A and B
Item 1. is amended by replacing Subparagraphs b.
and d. with the following:
b. Up to $5,000 for cost of bail bonds required be-
cause of accidents or traffic law violations arising
out of the use of any vehicle to which the Bodily
Injury Liability Coverage applies. We do not have
to furnish these bonds.
d. All reasonable expenses incurred by the insured
at our request to assist us in the investigation or
defense of the claim or "suit", including actual loss
of earnings up to $500 a day because of time off
from work.
W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 3 of 10
SECTION II —WHO IS AN INSURED AMENDMENTS
A. Employee Bodily Injury To A Co -Employee
Paragraph 2. a. (1) is replaced by the following:
However, none of these "employees" or "volunteer
workers" are insureds for "bodily injury" or "personal
and advertising injury":
(a) To you, to your partners or members (if you are a
partnership or joint venture), to your members (if
you are a limited liability company), to a co -
"employee" while in the course of his or her
employment or performing duties related to the
conduct of your business, or to your other
"volunteer workers" while performing duties
related to the conduct of your business;
(b) To the spouse, child, parent, brother or sister of
the co -"employee" or "volunteer worker" as a
consequence of Paragraph (1)(a) above;
(c) For which there is any obligation to share
damages with or repay someone else who must
pay damages because of the injury described in
Paragraph (1)(a) or (b) above; or
(d) Arising out of his or her providing or failing to
provide professional health care services.
However, if a suit seeking damages for "bodily injury"
or "personal and advertising injury" to any co -
"employee" or other "volunteer worker" arising out of
and in the course of the co -"employee's" or "volunteer
worker's" 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 the co -"employee" or other
"volunteer worker', is brought against you or a co -
"employee" or a "volunteer worker", we will reimburse
the reasonable costs that you incur in providing a
defense to the co -"employee" or "volunteer worker"
against such matters. Any reimbursement made
pursuant to this sub -section will be in addition to the
limits of liability set forth in the Declarations.
B. Newly Acquired Organizations
Paragraph 3. a. is replaced by the following:
a. Coverage under this provision is afforded only
until the 180th day after you acquire or form the
organization or the end of the policy period,
whichever is earlier;
The following are added:
C. Blanket Additional Insured — Vendors — As Re-
quired By Contract
1. Section II — Who Is An Insured is amended to
include as an additional insured any person(s) or
organization(s) (referred to throughout this
endorsement as vendor) with whom you have
agreed in a written contract, executed prior to
loss, to name as an additional insured, but only
with respect to "bodily injury" or "property
damage" arising out of "your products" which are
distributed or sold in the regular course of the
vendors business.
However,
a. The insurance afforded to such vendor only
applies to the extent permitted by law; and
b. If coverage provided to the vendor is required
by a contract or agreement, the insurance
afforded to such vendor will not be broader
than that which you are required by the
contract or agreement to provide for such
vendor.
With respect to the insurance afforded to these
vendors, the following additional exclusions
apply:
a. The insurance afforded the vendor does not
apply to:
(1) "Bodily injury" or "property damage" for
which the vendor is obligated to pay dam-
ages by reason of the assumption of
liability in a contract or agreement. This
exclusion does not apply to liability for
damages that the vendor would have in
the absence of the contract or
agreement;
(2) Any express warranty unauthorized by
you;
(3) Any physical or chemical change in the
product made intentionally by the vendor;
(4) Repackaging, except when unpacked
solely for the purpose of inspection,
demonstration, testing, or the
substitution of parts under instructions
from the manufacturer, and then
repackaged in the original container;
W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 4 of 10
(5) Any failure to make such inspections,
adjustments, tests or servicing as the
vendor has agreed to make or normally
undertakes to make in the usual course
of business, in connection with the
distribution or sale of the products;
(6) Demonstration, installation, servicing or
repair operations, except such
operations performed at the vendor's
premises in connection with the sale of
the product;
(7) Products which, after distribution or sale
by you, have been labeled or relabeled or
used as a container, part or ingredient of
any other thing or substance by or for the
vendor; or
(8) "Bodily injury or "property damage"
arising out of the sole negligence of the
vendor for its own acts or omissions or
those of its employees or anyone else
acting on its behalf. However, this
exclusion does not apply to:
(i) The exceptions contained in
Subparagraphs (4) or (6); or
(ii) Such inspections, adjustments, tests
or servicing as the vendor has
agreed to make or normally
undertakes to make in the usual
course of business, in connection
with the distribution or sale of the
products.
3. This Provision C. does not apply:
a. To any insured person or organization from
whom you have acquired such products, or
any ingredient, part or container, entering
into, accompanying or containing such
products;
b. To any vendor for which coverage as an addi-
tional insured specifically is scheduled by
endorsement; or
c. When liability included within the "products -
completed operations hazard" has been ex-
cluded for such product either by the provi-
sions of the coverage part or by endorse-
ment.
4. With respect to the insurance afforded to these
vendors, the following is added to Section III —
Limits Of Insurance:
If coverage provided to the vendor is required by
a contract or agreement, the most we will pay on
behalf of the vendor is:
a. The minimum amount required by the
contract or agreement; or
b. The Limits of Insurance shown in the
Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
5. With respect to the insurance afforded to these
additional insureds, the following additional
exclusion applies:
This insurance does not apply to:
a. "Bodily injury", "property damage" or
"personal and advertising injury" arising out
of the rendering of, or the failure to render,
any professional architectural, engineering or
surveying services, including:
(1) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or drawings
and specifications; or
(2) Supervisory, inspection, architectural or
engineering activities.
This exclusion applies even if the claims
against an additional insured allege
negligence or other wrongdoing in the
supervision, hiring, employment, training
or monitoring of others by that insured, if
the "occurrence" which caused the
"bodily injury" or "property damage", or
the offense which caused the "personal
and advertising injury", involved the
rendering of or failure to render any
professional services by you with respect
to your providing engineering,
architectural or surveying services in
your capacity as an engineer, architect or
surveyor.
W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 5 of 10
D. Blanket Additional Insured — Lessor Of Leased
Equipment
1. Section II —Who Is An Insured is amended to
include as an additional insured any person(s) or
organization(s) from whom you lease equipment
when you and such person(s) or organization(s)
have agreed in writing in a contract or agreement,
executed prior to loss, that such person(s) or
organization(s) be added as an additional insured
on your policy. Such person(s) or organization(s)
is an insured only with respect to liability for
"bodily injury", "property damage" or "personal
and advertising injury" caused, in whole or in part,
by your maintenance, operation or use of
equipment leased to you by such person(s) or
organization(s).
However, the insurance afforded to such
additional insured:
a. Only applies to the extent permitted by law;
and
b. Will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
A person's or organization's status as an addi-
tional insured under this endorsement ends when
their contract or agreement with you for such
leased equipment ends.
2. With respect to the insurance afforded to these
additional insureds, this insurance does not apply
to any "occurrence" which takes place after the
equipment lease expires.
3. With respect to the insurance afforded to these
additional insureds, the following is added to
Section 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:
a. The minimum amount required by the
contract or agreement; or
b. The Limits of Insurance shown in the
Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
4. With respect to the insurance afforded to these
additional insureds, the following additional
exclusion applies:
This insurance does not apply to:
a. "Bodily injury", "property damage" or
"personal and advertising injury" arising out
of the rendering of, or the failure to render,
any professional architectural, engineering or
surveying services, including:
(1) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or drawings
and specifications; or
(2) Supervisory, inspection, architectural or
engineering activities.
This exclusion applies even if the claims
against an additional insured allege
negligence or other wrongdoing in the
supervision, hiring, employment, training or
monitoring of others by that insured, if the
"occurrence" which caused the "bodily injury"
or "property damage", or the offense which
caused the "personal and advertising injury",
involved the rendering of or failure to render
any professional services by you with respect
to your providing engineering, architectural or
surveying services in your capacity as an
engineer, architect or surveyor.
E. Blanket Additional Insured — Managers Or Les-
sors Of Premises
1. Section II — Who Is An Insured is amended to
include as an additional insured any person(s) or
organization(s) with whom you have agreed in a
written contract, executed prior to loss, to name
as an additional insured, but only with respect to
liability arising out of the ownership, maintenance
or use of that part of the premises leased to you,
subject to the following additional exclusions:
This insurance does not apply to:
a. Any "occurrence" which takes place after you
cease to be a tenant in that premises.
b. Structural alterations, new construction or
demolition operations performed by or on
behalf of such additional insured.
W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 6 of 10
However:
a. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and
b. If coverage provided to the additional insured
is required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
2. 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:
a. The minimum amount required by the
contract or agreement; or
b. The Limits of Insurance shown in the
Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
3. With respect to the insurance afforded to these
additional insureds, the following additional
exclusion applies:
This insurance does not apply to:
a. "Bodily injury", "property damage" or
"personal and advertising injury" arising out
of the rendering of, or the failure to render,
any professional architectural, engineering or
surveying services, including:
(1) The preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or drawings
and specifications; or
(2) Supervisory, inspection, architectural or
engineering activities.
This exclusion applies even if the claims
against an additional insured allege
negligence or other wrongdoing in the
supervision, hiring, employment, training or
monitoring of others by that insured, if the
"occurrence" which caused the "bodily injury"
or "property damage", or the offense which
caused the "personal and advertising injury",
involved the rendering of or failure to render
any professional services by you with respect
to your providing engineering, architectural or
surveying services in your capacity as an
engineer, architect or surveyor.
F. Blanket Additional Insured — State Or
Governmental Agency Or Subdivision Or Political
Subdivision — Permits Or Authorizations
Section II — Who Is An Insured is amended to in-
clude as an additional insured any state or
governmental agency or subdivision or political
subdivision with whom you have agreed in a written
contract, executed prior to loss, to name as an
additional insured, subject to the following provisions:
1. This insurance applies only with respect to op-
erations performed by you or on your behalf for
which the state or governmental agency or sub-
division or political subdivision has issued a
permit or authorization.
However:
a. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and
b. If coverage provided to the additional insured
is required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to
provide for such additional insured.
2. This insurance does not apply to:
a. "Bodily injury", "property damage" or "per-
sonal and advertising injury" arising out of op-
erations performed for the federal govern-
ment, state or municipality; or
b. "Bodily injury" or "property damage" included
within the "products -completed operations
hazard".
3. 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:
a. The minimum amount required by the
contract or agreement; or
b. The Limits of Insurance shown in the
Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 7 of 10
4. With respect to the insurance afforded to these
b. The construction, erection or removal of
additional insureds, the following additional
elevators; or
exclusion applies:
c. The ownership, maintenance or use of any
This insurance does not apply to:
elevators covered by this insurance.
a. "Bodily injury", "property damage" or
However,
"personal and advertising injury" arising out
a. The insurance afforded to such additional
of the rendering of, or the failure to render,
insured only applies to the extent permitted
any professional architectural, engineering or
by law; and
surveying services, including:
b. If coverage provided to the additional insured
(1) The preparing, approving, or failing to
is required by a contract or agreement, the
prepare or approve, maps, shop
insurance afforded to such additional insured
drawings, opinions, reports, surveys,
will not be broader than that which you are
field orders, change orders or drawings
required by the contract or agreement to
and specifications; or
provide for such additional insured.
(2) Supervisory, inspection, architectural or
2. With respect to the insurance afforded to these
engineering activities.
additional insureds, the following is added to
This exclusion applies even if the claims
Section III —Limits Of Insurance:
against an additional insured allege
If coverage provided to the additional insured is
negligence or other wrongdoing in the
required by a contract or agreement, the most we
supervision, hiring, employment, training or
will pay on behalf of the additional insured is:
monitoring of others by that insured, if the
"occurrence" which caused the "bodily injury"
a. The minimum amount required by the
or "property damage", or the offense which
contract or agreement; or
caused the "personal and advertising injury",
b. The Limits of Insurance shown in the
involved the rendering of or failure to render
Declarations;
any professional services by you with respect
to your providing engineering, architectural or
whichever is less.
surveying services in your capacity as an
This endorsement shall not increase the
engineer, architect or surveyor.
applicable Limits of Insurance shown in the
G. Blanket Additional Insured — State Or
Declarations.
Governmental Agency Or Subdivision Or Political
3. With respect to the insurance afforded to these
Subdivision —Permits Or Authorizations Relating
additional insureds, the following additional
To Premises
exclusion applies:
Section II — Who Is An Insured is amended to in-
This insurance does not apply to:
clude as an additional insured any state or
a. "Bodily injury", "property damage" or
governmental agency or subdivision or political
"personal and advertising injury" arising out
subdivision with whom you have agreed in a written
of the rendering of, or the failure to render,
contract, executed prior to loss, to name as an
any professional architectural, engineering or
additional insured, subject to the following provision:
surveying services, including:
1. This insurance applies only with respect to the fol-
(1) The preparing, approving, or failing to
lowing hazards for which the state or
prepare or approve, maps, shop
governmental agency or subdivision or political
drawings, opinions, reports, surveys,
subdivision has issued a permit or authorization
field orders, change orders or drawings
in connection with premises you own, rent or
and specifications; or
control and to which this insurance applies:
(2) Supervisory, inspection, architectural or
a. The existence, maintenance, repair,
engineering activities.
construction, erection or removal of
advertising signs, awnings, canopies, cellar
entrances, coal holes, driveways, manholes,
marquees, hoist away openings, sidewalk
vaults, street banners or decorations and
similar exposures; or
W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 8 of 10
This exclusion applies even if the claims
SECTION IV — COMMERCIAL GENERAL LIABILITY
against an additional insured allege
CONDITIONS AMENDMENTS
negligence or other wrongdoing in the
supervision, hiring, employment, training or
A. Knowledge Of Occurrence
monitoring of others by that insured, if the
Item 2. Duties In The Event Of Occurrence, Of -
"occurrence" which caused the "bodily injury"
fense, Claim or Suit is amended by adding the fol-
or "property damage", or the offense which
lowing:
caused the "personal and advertising injury",
e. You must give us or our authorized representa-
involved the rendering of or failure to render
tive prompt notice of an "occurrence", claim or
any professional services by you with respect
loss only when the "occurrence", claim or loss is
to your providing engineering, architectural or
known to:
surveying services in your capacity as an
engineer, architect or surveyor.
(1) You, if You are an individual;
(2) A partner, if you are a partnership;
SECTION III —LIMITS OF INSURANCE AMENDMENTS
(3) An executive officer or insurance manager, if
you are a corporation; or
A. Damage To Premises Rented To You
(4) A member or manager, if you are a limited
Paragraph 6. is replaced by the following:
liability company.
6. Subject to Paragraph 5. above, the most we will
B. Other Insurance
pay under Coverage A for damages because of
Item 4. Other Insurance, b. Excess Insurance (1)
"property damage" to any one premises, while
(a) (ii) is replaced by the following:
rented to you, or in the case of damage by fire,
lightning, explosion or sprinkler leakage, while
(ii) That is fire, lightning, explosion or sprinkler leak -
rented to you or temporarily occupied by you with
age insurance for premises rented to you or
permission of the owner is the greater of:
temporarily occupied by you with permission of
the owner;
a. $300,000; or
C. Unintentional Failure To Disclose Hazards
b. The amount shown next to the Damage To
Item 6. Representations is replaced by the following:
Premises Rented To You Limit in the Decla-
rations.
6. Representations And Unintentional Failure To
However, the provisions of this paragraph do not
Disclose Hazards
apply if Damage To Premises Rented To You
a. By accepting this policy, you agree:
Coverage is excluded by endorsement.
(1) The statements in the Declarations are
accurate and complete;
B. Medical Expense Limit
(2) Those statements are based upon repre-
Paragraph 7. is replaced with the following:
sentations you made to us; and
7. Subject to Paragraph 5. above, the most we will
(3) We have issued this policy in reliance
pay under Coverage C for all medical expenses
"bodily
upon your representations.
because of injury" sustained by any one
person is the greater of:
b. If you unintentionally fail to disclose any haz-
ards existing at the inception date of your
a. $10,000; or
policy, we will not deny coverage under this
b. The amount shown next to the Medical Ex-
Coverage Part because of such failure.
pense Limit in the Declarations.
However, this provision does not affect our
This insurance does not apply if coverage for
right to collect additional premium or exercise
Medical Expenses is excluded either by the pro-
our right of cancellation or non -renewal.
visions of the coverage part or by endorsement.
W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,w ith its permission. Page 9 of 10
D. Waiver of Subrogation
Item 8. Transfer of Rights of Recovery Against
Others to Us is hereby amended by the addition of
the following:
We waive any right of recovery we may have because
of payments we make for injury or damage arising out
of your ongoing operations or "your work" done under
a written contract, executed prior to loss, requiring
such waiver with that person or organization and
included in the "products -completed operations
hazard". However, our rights may only be waived
prior to the "occurrence" giving rise to the injury or
damage for which we make payment under this
Coverage Part. The insured must do nothing after a
loss to impair our rights. At our request, the insured
will bring "suit" or transfer those rights to us and help
us enforce those rights.
SECTION V —DEFINITIONS AMENDMENTS
A. Insured Contract Amended
Paragraph 9. a. is replaced by the following:
a. A contract for a lease of premises. However, that
portion of the contract for a lease of premises that
indemnifies any person or organization for
damage by fire, lightning, explosion or sprinkler
leakage to premises while rented to you or
temporarily occupied by you with permission of
the owner is not an "insured contract';
B. Personal And Advertising Injury Redefined
Paragraph 14. d. and e. are replaced by the following:
d. Oral, written, televised,
videotaped or electronic
publication of material
that slanders or libels a
person or organization
or disparages a person's
or organization's goods,
products or service;
e. Oral, written, televised,
videotaped or electronic
publication of material
that violates a person's
right of privacy;
W N GL 39 08 18 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 10 of 10
COMMERCIAL GENERAL LIABILITY
WN GL 139 06 18
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - CONTRACTORS -
OPERATIONS AND COMPLETED OPERATIONS -
WITH ADDITIONAL INSURED REQUIREMENT
IN CONSTRUCTION CONTRACT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY 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 your ongoing opera-
tions for the additional insured.
B. With respect to Additional Insured - Opera-
tions, coverage is limited as follows:
This insurance does not apply to "bodily in-
jury" or "property damage" occurring after:
(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) That portion of "your work" out of which
the injury or damage arises has been put
to its intended use by any person or or-
ganization other than another contractor
or subcontractor engaged in performing
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 in the "products -completed op-
erations hazard".
WN GL 139 06 18
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Page 1 of 2
B. With respect to Additional Insured — Com-
pleted Operations, coverage is limited as fol-
lows:
(1) A person or organization's status as an in-
sured under Additional Insured — Com-
pleted Operations continues only for the
period of time required by any written con-
tract or agreement.
(2) The insurance provided to the additional
insured does not apply to "bodily injury",
"property damage" or "personal and ad-
vertising injury" arising out of "your work"
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
the definition of "insured contract" under Sec-
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 the 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, employment, training or monitoring of
others by that insured, if the "occurrence"
which caused the "bodily injury" or "property
damage", or the offense which caused the
"personal and advertising injury", involved the
rendering of or failure to render any profes-
sional services by you with respect to your
providing engineering, architectural orsurvey-
ing services in your capacity as an engineer,
architect or surveyor.
WN GL 139 06 18
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
Page 2 of 2
J
J
LL
LL
W
Q
U
F
0
a
W
W
a
W
J
a
}
U
J
O
a
W
2
F
LU
W
Z
Q
U
H
Z
w
LU
W
U)
w
O
0
Z
W
2
F
O
O
A
t"
N
N
0
N
a
a
U
O
914
0
w
Q
w
0
U
0
H
Q
U)
U)
w
z
m
d d
N rL.
.L. w
O
m U
Z
a0
0w
nU
m d
>
0 w a
c
o0
O y
api C W
N d a
N N �
m
W "'W ad >. C O N C
N L U W� "' W O
= E
arc Wd�-��oama J Q 0 p c C O N C N
myo cc s_n 20
L L N C 3 TJ O d a N
Na
• a L S y d a `y C m N
�.c W > O
dWOf aiO ccc0� t
7 W w d' a N L' = fO N C y
C> ..-T.
tOjOd mm to m-y c
C U W & 0.-
W E J U a d O
C I a N C N
° U W
La
O W Of O C 3 W O U)
a OL c�oa oa°o"cz
=p5
y Wn N 8 O Q N C iV a
d C O O) d Old N C
W O a T N T E ` N E d C C
m in0 n d` � nna nCa.L.. W U
a r 0"_ two
d m d c p-.p T O E
E Qoac 0 cad a-'-
n J V T.N.. y Cc a O
C y N
3 to d y C O 5 N W O
fn N fl. L U
W O
7 t�
C Q m 12
N W d E s O o C O C `5 a
C > d 3 y jF d m dW
x WU o'N Am y yco
> n 0
Lu d N u'i
d U N� °aai 10w d us
t0 _
C - W yj s 0 w G {Np =p Ol g
UY z0Qoa° $N3 �iuc5
ZE OL>u �aat acdo
a>.d.,dL
Mad w0 x E"S a^
J a fn U W W S
m
U
H
`_7
c cd9wo o-d
E W W a
a00
d'CN
C >
L L
`o `o cao
J
m
J
m C
iCa C
O>
N G U
O C d
`O" �5 0 0 'y :EF
J
J Q
o '-' d V j 0 T L f00 O U1
O t0
o U N
3 O p
W?
O
\
Tx
T O dO
V° d N C 'CQ
L
n
_
C
Q
d
y�3
w o
E
03
Wain
aLm o.-sy��
aym
.Ld.�=
aN�
IIp
a?�a oc ox°
O 3C
oEa
= j°
d
oco_ of0 ng° o'�vyi
TN
W ~
Z
d
1E+• N �aLLI CL �-
W
AwL
..
d
C
>.Na Z= c O.£
Z.
i
LL,
02 a
0>
UV
N O O° 0 0 `= C L
°U wTE NE o°�
0 0
n
mZao
n C W G
Woo W E'ao'T dma
U
CZ
a�o�
C.
C
W
°y
C
CNCc
y O CIWC
U
-
a
Za dW
N C C O
o.doO
o >L•
00°0mW
U
a O E '
O
°LLJ
0
>E
aEL
E=
¢OEM
m
c
O3) a<UmQ
Q
O
O0>
W
NU y
v ai
w
WO
in U Q
W
Q7 7 N N N N N M u M V u M m V N N M LL
a N
0)
W
0
LLI
O
v LL
0
Ca
CC
G
y
N
d J C a
f00 O a � d N
n
d d
d E d N ¢ O O N
O W a p N- O J N
m E U p N o
0 o > o m y d E a d d
3 U (Tp N N n
a d H U a N N a C W wt0
a W
o. a ° d E m
d d E ° o> _> w m m m o 4
a T W Q N C N a C
U >i O o N .d.
d O N C n•• C C
N W
U W i 2 Y J a K U H D
W m— m
d r�
C i t
d U
N
W d
L
Q~
C y
O)
0
m d I m
L_ C
O T D
a
N,
m
fOp
C
w3 c'�m
pno corm
w�
N
-ohm
inmc-m
Ol O O > O a
M. U r- m c o m
U L T
_m c a
O
U T
y
>y
8�t
of
> w.Ld. U Z, m
2 `d cc
w�
d
16'w 5 m
U Qc a`l m
ocoi mE
m am
O:s
.oaoa_ml
pm o �ma
at wa
�p
O O
Q E
m Q
U oa
>m
y m
T J a N O N m
m Q O w
yl E
Q N X N
o
U a N
C
y Q
a U y
d a 01 y y
m a d
a V
O y
m a--m
m d
m m O N
} m 9 y C L_
y m N o
O OI
A m m C
O a r a d
Ol
S o m a o
N
(L d
J N N
m e= C 0 3
T C N
o
O
o y
a2_
I>
dU
0
_O
my
cay OL.
dC>m2C 2
y zi y
Q y
N>
m
O a
LHU
d LO
a OL
u)U d y
y
auwi¢�
Eo
a'ai�wco
U U
r m m w
a O r J
d O_
an
z
f0 cm n
a
d3 a
as
t c
a
y y a E
LD
a m o
o
m
`
a m
am d
a E m
m a w
o
y> N
2 d U
N
'W
O y
y
N
d m
o"2
N c Ol O
U j N
ym
>
07- a`xxL d
d y
cy m
O
wol
C y O
cm� my
y L O y
`mm
m
>E owhm
a
0Z ii2m Ud
C
U�O3 U3
L m
soma_
a
=
a
a
w O c m O m c f0 m alE N 3 w i y a= d y a w N O
<`0 5n aEimtOmi.fl-oYY�y 3L�y >ZIr_Ea c E
W p W 2 'y- c y m a 0 >>O ` 0 C N N r- N V V L ` V V `y X E
�` ELYo-oo�a2 m y m
J
W r o r• d ... = 2 W L y— m 0- C N N ±V U Ol m a f0 O r J m
a O w c o g (o? C. L C.L.. d O MO O 0 0 O A O
Q m 2` O T 10 � o U O Fe
m U y O C rg y O OM N a a
y O y y S N O �- E y C
Q a m y y O a J C U m d w am C 10 y H Y y OE y m T
C V 'y0 E d 01 N O� r O y y a Z U m O O Ly d N a N m C
ay CC d% 16 5o OGN`L Eoa-=0 mn` `o ma y
d0.mMw yO`0CC T 0.2xEC yayTy.m>ym0das
aa N c 3 y N E N c• N a O) L y O) L 3 C 3 J 'm6 > O N C d C`Ol N O
E- o S>> y O> U C O m> j> d C U C - O- a f0 C O O, M O O z E fH A
� Zi .m+ mn� ��anwma os,0 a`m no `. �O°
O > C w 0.O
m H 0
0`i W U
x u1 Q o0
LL
0Ow mOm E-O IQ mL_m>
r 00o orncoi`�=W aEi�a_mlx
yy0 L-:EcoZOc ayoEw `
c o 0
a y
omN Z t0 O.L.. C N >C
lO VO mOly$
m O 9.= W U W
"m' ae
> > y > I20wa0 m
'm o3 4)t
`anyac Wy m r
d ryi yOa
3 aQ y a wj o 1
m N
y 0 3 {Ey O Q O Y L C O
r
m O a X� Q V O U 01 m m
>a`.Lm. N. 0 J� N 2 3
? y V N V 2`y as Ol G. O)d.L-L
8y.2.o O—HdL.'.oyvW`Mm o=
o > >
2 >OOS O
mON N a�C O
sa3m
a N ll U 5m C
LLF -E
J aO "N N y
ny
m-�NO
KK�Qd 00 >
wNN
Cy
W WJu)�
E Lr.O NO
20 c Q
CEnyo O
mOO aam Q.oE
`2
ul— Y Q . 6 O - o m 0y
WS NV WL Om>'3 C>y TUO m� -0001 V�L
(� I O L U 0 r'� 3 c> E E i/l O m j` m y _- `a m 'y ...
gaol vie �v mwed �oaa 'E°coi E—>0 ao°
wpm E dE'volc�o� mm� ad t0 �a`l yyVo ohm
.y"o
y d`aO Om m T'° >O= nO a G VL.. o3N.T O m
am m 0cE.TT mcmS Qdm
yUV >O
. J U y Ol y a Q a O d ;r o U C 0 y U d M o y m L C d O 0 o m 0 0
m mUm N CL U
3 ul q C« O- c y c N m d d a Y f0 a a> o r. a m y w L` = C
d }�WOI m'-a Vey T-041L'L-'Xy 'V mVaLOl odm 2L!�U1
o`y
Q a O LL C .Q 'y a m a O` O .-� C y o O N d— ?> O L '-' .O >
Nj -ao 3`1t0 T T— MO
000� m10zO a
y O om0y5 Mo y V m0> 0
Imlmdm�a I.d7myom moEo`3a�w�may yy�Oco�a a
�e o Ol_
n ` m L `1 C a0+ — OI Q a t`0 m O d C L Yi Q" m E r 0
jyY 7 Z� d �dNaOam �fA;va Hawan 2 ym V)NNm V mJ
S �md
> c-o a. Q 0> c o m'yo 3 2.9 m'a
=
4ys
wUU'>°.a- m a l; v w���
c~ic°�a`m 2
d c~ic°�
w E O m w
(7 U) z w'� 'x Ina ui
o Li
W"Wg:y:NmaLd W Omyag W
mcc . i
O yU OA
FQJQ
cToOmLcto0—mL0md
C`sm
T ` VO QN :y
V
Do oc FCT
dn
w � �
mmy00
-sC3cC
O E
O p
E a O y yj3y 2 > m> > > 0
r„Na
G
W
�
QNOUyOME O.L. ON mNT`OU C U
3 d (2 a O U o OU N
Oc>y
wN'aCm
c a
C(n
OD Eo
my0£T w
O
mN O'0 CN
7Q D- 0
LL OL'
-0
a
ad Wiy
N AYa 'L-'T'cc0 Q EaWc' ma Qk>, L. Qx w
m �a
i0m
d °y ddd-mroc SL Q Jody Ed QWa'§ O
CO
ya.z
dQW
LUc
ty�0 Lu O N y cc
C 3 y y d O 0 a O C J d Q I`0 m. Q C Q Old = A Q Ol
2
y y c 0
> >> mLy. naya`l °o'r U c Ud`-'E mE UdmMm E > V`m of o
c 0 ym
a�oi3y
O Ou-o J E wa yam .'o N a�oNO oa >E o>`y-O
U Uxd mo dmm-o '- maw_ >- dE Yo E YO'- a�
w a c 2 U S U S O
m
m a d
W.- x T U m O U d O
d a c L C L E y y = W
A I M m C m N w o y y N L y a a a OCf m L E a v E a T
T T
U Q m>
N c v O�LLJ
—a=W OI dE N�d'C y m C om N"'r I Oid xO aJ!dym !ddma
Td y m =Zw� 0 1 -imC E_ W �O):E c
mo Ou
o mom
U, c 0ainy03a� oa
E Z y E O n C O E y 0 '"' f0 —_ ~ Y Z C fA O y Z d Z Ol O
O N d a
0 O> O>
y c N O
O T
y y L y J N m 0 W a > x 5 3 C
w= E a '9 N 3 C a d d
d pp>
oo>
O V> 0 W E y Q y L O L y` ,•y-• Z c U U Lm" a X d 0. U U m� x � U U m a 3
U� `o >.nw Ea aE H yQ a'a SW a u
N •�• N• W w U
0.0
li fwAU« =w5 UW uwjQnmE u) m
f`Zw
W
O M Q Q m U
m L
C c 0
m U 6 L
O
O O L p 2 22
C
o
2 p & m
N `1 d A
Z y
INO
Z
T
O N
L C U 3 L>
N Z C 9
S O -p
m C
O y
Z U o
O
d N N O
CC, C y m
o
W C
.+L_• N
N .L... C m
Or O m E w
C
N U j N C
O HO
U C y
3
-6 O O j
N O L
O
T L
VI Q O E
U m
p rm-� V O-
" U L
Q O
-6 F
y d
T n p <0 N
E W N
�p N
w C C c N
W m T m
N C O. -o'J -6
Zcd LaEi
.W
- 3E�3ii �`°
o rnc�t
o
• ��a
mncoapi
c$-cy
yo n-mp
Q 7ao
t
L
d d= m
y c-p
IL m= LL
O C O- m-
•O m •O -O J N
y 0
j > C .0
I
N I C t�0
C OO
m N N 3
nNQ
1 0 N
2 Zf..) a
C
U U 2
5 E L U1
o ZUca'E75
•gip@.2
C.L..
m
d
a0 Z a23o
To TE O
Qao Q° Win° `o
op,_yd
TO m Oo_
Hm mliw20
n
N 2
E W N W
C W
� fA aNw
x
= N.L..L N
W V1 Ua d
U
0
Z O
Q O a O
N
C o.E L Q 0 9 N L N N p L O
p
y.
d E
yx� uiw� E�ooS~m
O N O 'N O
OWE
Z L 'UO C
n�m OBE
Z
V•m
U
Z 0f m
E o
o�oHmo�
3 C m
V
O
Z 0 T U'C V N= U O
O , w
0
U C m C
N N T
C E � y6 U N' N CVl Q U O
.O
Q V
0 N y
d O
_ C C ._
J 'C w
E O. S O FO a O O_
m U U m` o o n
L 0 3
U
U) Q
Q �.J
Ina 2
n `o `o m
C T T
oot cm w �cmmc m
c n3
,y
yp0 o
v m c m
o m man To w m
O`
yO
Z N7 N
m tC N E
O O N n
N U
y
> >
m
W N ai 'Q
7 N C p-
T
3 o o c
`1 0 n O m
O N? N -N O. >,
v ._ n w p-
(p 0 O N o m C T w 'C E C L
m o q'o moE
? w> E
o n `m m oe o ccn� c of
1
om5
y �m a�
y
yew .� laQe dc�d�p cpi�c
VJ He
r N
Z
>`oUo
C N a
Z o
C w C x N
o w = o N 3 'm Q U L-' y On. N
Z'
Z c E
W Q
C
OV w °U
Y m m m .._T.
�' 3 n Ea
N .. p U
m d C d �m xmo m
N
N
Y Q Q T Q
O O
H Z Q J
U U p N
y J Q tD0
y
_ f0 'rp--. N m. fN/i V a > N
m �' C m w J w N 2 L N m G o 3 'UO
UW
W 22
w Q a
an
City of Kent
440 Business License
KENT
WASHINGTON
EVERGREEN ASPHALT & CONCRETE CONSTRUCTIO
PO BOX 867
RAVENSDALE, WA 98051-0867
Please tear al per, or t on
BUSINESS LICENSE
40 LICENSE MUST BE PAID ANNUALLY BY
NS
• JANUARY 1st TO AVOID PENALTY
F- N T Issuance of License Does Not Imply. Licensee's
WASHINGTDN Compliance with State and Local Laws
'1111S LICENSE MUST BE POSTED IN A CONSPICUOUS
['LACE;. NOT I'kANSFF".RABLE OR ASSIGNABLE
NAME AND ADDRESS OF BUSINESS
BLOC-2140738
EVERGREEN ASPHALT CONCRETE CONSTRUCTION
27204 SE KENT KANGLEY RD
RAVENSDALE; WA 98051
Tax Registration
Endorsement
Per RCW 82,14 local sales
and use tax must be coded
No. 1715 for all qualified
sales within the city of Kent.
2021
MAYOR
The City of Kent
At 220 4T11 AV E SO
HIiN'r, WASHINGPON 98032
Signature:
Email: japplegate@kentwa.gov
Signature: Id
Garin Lee (Oct 19, 202108:01 PDT)
Email: glee@kentwa.gov
Signature: 10,a"L �-
Email: rlashley@kentwa.gov
Signature: J--'�—
Brian Levenhagen (Oct21, 202108:19 PDT)
Email: bj[evenhagen@kentwa.gov
EvergreenAsphalt.2021.PSE Trail
Final Audit Report 2021-10-21
Created: 2021-10-18
By: Janice Applegate Qapplegate@kentwa.gov)
Status: Signed
Transaction ID: CBJCHBCAABAAH_UYGsfxJgAylPt5v6oTV_RukwknmpP6
"EvergreenAsphalt.2021.PSE Trail" History
Document created by Janice Applegate (japplegate@kentwa.gov)
2021-10-18 - 3:22:05 PM GMT- IP address: 146.129.252.126
�>o Document e-signed by Janice Applegate (japplegate@kentwa.gov)
Signature Date: 2021-10-18 - 3:34:03 PM GMT - Time Source: server- IP address: 146.129.252.126
Document emailed to Garin Lee (glee@kentwa.gov) for signature
2021-10-18 - 3:34:05 PM GMT
s Email viewed by Garin Lee (glee@kentwa.gov)
2021-10-19 - 3:00:32 PM GMT- IP address: 146.129.252.126
�}o Document e-signed by Garin Lee (glee@kentwa.gov)
Signature Date: 2021-10-19 - 3:01:24 PM GMT - Time Source: server- IP address: 146.129.252.126
Document emailed to SMG (evergreen.shane@comcast.net) for signature
2021-10-19 - 3:01:28 PM GMT
13 Email viewed by SMG (evergreen.shane@comcast.net)
2021-10-19 - 3:01:38 PM GMT- IP address: 73.225.166.223
CI Document e-signed by SMG (evergreen.shane@comcast.net)
Signature Date: 2021-10-19 - 3:02:45 PM GMT - Time Source: server- IP address: 73.225.166.223
Document emailed to Ronald Lashley (rlashley@kentwa.gov) for signature
2021-10-19 - 3:02:48 PM GMT
s Email viewed by Ronald Lashley (rlashley@kentwa.gov)
2021-10-20 - 11:33:51 PM GMT- IP address: 146.129.252.126
�}o Document e-signed by Ronald Lashley (rlashley@kentwa.gov)
Signature Date: 2021-10-20 - 11:43:11 PM GMT - Time Source: server- IP address: 146.129.252.126
0 Adobe Sign
'. Document emailed to Brian Levenhagen (bjlevenhagen@kentwa.gov) for signature
2021-10-20 - 11:43:14 PM GMT
t Email viewed by Brian Levenhagen (bjlevenhagen@kentwa.gov)
2021-10-21 - 3:18:39 PM GMT- IP address: 146.129.252.126
Document e-signed by Brian Levenhagen (bjlevenhagen@kentwa.gov)
Signature Date: 2021-10-21 - 3:19:20 PM GMT - Time Source: server- IP address: 146.129.252.126
Q Agreement completed.
2021-10-21 - 3:19:20 PM GMT
a Adobe Sign