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CAG2021-473 - Original - LUSIO - Kherson Park Renocation Lighting Design Concepts - 11/01/2021
ApprovalOriginator:Department: Date Sent:Date Required: Authorized to Sign: Director or Designee Date of Council Approval: Grant? Yes No Type:Review/Signatures/RoutingComments: Date Routed to the City Clerk’s Office:Agreement InformationVendor Name:Category: Vendor Number:Sub-Category: Project Name: Project Details: Agreement Amount: Start Date: Basis for Selection of Contractor: Termination Date: Local Business? Yes No* Business License Verification: Yes In-Process Exempt (KCC 5.01.045) If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace. Notice required prior to disclosure? Yes No Contract Number: Agreement Routing Form For Approvals, Signatures and Records Management This form combines & replaces the Request for Mayor’s Signature and Contract Cover Sheet forms. Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20 Budget Account Number: Budget? Yes No Sup/Mgr: rev. 20210513 FOR CITY OF KENT OFFICIAL USE ONLY * Memo to Mayor must be attached Dir. Assist: 4 10/22/2021 Original2460965 Parks, Recreation & Community ServicesLynn Osborn for Kerry O'Connor 12/31/2021 4 Earliest possible please 11/01/2021 N/A 4 Other P21035 Contract $2,250.00 N/A 4 4 4 KRO KRO 11/01/2021 CONSULTANT SERVICES AGREEMENT - 1 ($20,000 or Less) CONSULTANT SERVICES AGREEMENT between the City of Kent and Mollie Bryan dba LUSIO THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Mollie Bryan dba LUSIO organized under the laws of the State of Washington, located and doing business at 6406 South 120th Street, Seattle, WA 98178 (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. The Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: As described in attached Exhibit A, incorporated herein, consultant shall assess site and provide lighting design recommendations for Kherson Park Renovation. The Consultant 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 those services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon the effective date of this Agreement. The Consultant shall complete the work described in Section I by 12/31/2021. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed $2,250.00, for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit A. B. The Consultant shall submit a single payment invoices to the City for work performed, and a final bill upon completion of all services described in this Agreement. The City shall provide payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any portion of an invoice, it shall notify the Consultant and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. C. Card Payment Program. The Consultant 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 Consultant. If the Consultant voluntarily participates in this Program, the Consultant will be solely responsible CONSULTANT SERVICES AGREEMENT - 2 ($20,000 or Less) for any fees imposed by financial institutions or credit card companies. The Consultant shall not charge those fees back to the City. 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 Consultant 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 Consultant maintains and pays for its own place of business from which the Consultant’s services under this Agreement will be performed. C. The Consultant 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 Consultant’s services, or the Consultant is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Consultant 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 Consultant has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by the Consultant’s business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Consultant maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. After termination, the City may take possession of all records and data within the Consultant’s possession pertaining to this project, which may be used by the City without restriction. If the City’s use of the Consultant’s records or data is not related to this project, it shall be without liability or legal exposure to the Consultant. VI. FORCE MAJEURE. Neither party shall be liable to the other for breach due to delay or failure in performance resulting from acts of God, acts of war or of the public enemy, riots, pandemic, fire, flood, or other natural disaster or acts of government (“force majeure event”). Performance that is prevented or delayed due to a force majeure event shall not result in liability to the delayed party. Both parties represent to the other that at the time of signing this Agreement, they are able to perform as required and their performance will not be prevented, hindered, or delayed by the current COVID-19 pandemic, any existing state or national declarations of emergency, or any current social distancing restrictions or personal protective equipment requirements that may be required under federal, state, or local law in response to the current pandemic. If any future performance is prevented or delayed by a force majeure event, the party whose performance is prevented or delayed shall promptly notify the other party of the existence and nature of the force majeure event causing the prevention or delay in performance. Any excuse from liability shall be effective only to the extent and duration of the force majeure event causing the prevention or delay in performance and, provided, that the party prevented or delayed has not caused such event to occur and continues to use diligent, good faith efforts to avoid the effects of such event and to perform the obligation. Notwithstanding other provisions of this section, the Consultant 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 Consultant due to a force majeure event. CONSULTANT SERVICES AGREEMENT - 3 ($20,000 or Less) 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 Consultant 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 Consultant to fulfill its obligations under this Agreement. Except as expressly contemplated by this section, all other costs will be borne by the Consultant. VII. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. The Consultant 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. VIII. INDEMNIFICATION. The Consultant 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 Consultant'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 Consultant'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 Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's duty to defend, indemnify, and hold the City harmless, and the Consultant’s liability accruing from that obligation shall be only to the extent of the Consultant's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'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 Consultant refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant’s part, then the Consultant shall pay all the City’s costs for defense, including all reasonable expert witness fees and reasonable attorneys’ fees, plus the City’s legal costs and fees incurred because there was a wrongful refusal on the Consultant’s part. The provisions of this section shall survive the expiration or termination of this Agreement. IX. INSURANCE. The Consultant 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. X. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to the Consultant for the purpose of completion of the work under this Agreement. XI. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and CONSULTANT SERVICES AGREEMENT - 4 ($20,000 or Less) become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the Consultant. The Consultant shall make such data, documents, and files available to the City upon the City’s request. The Consultant 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. As such, the Consultant agrees to cooperate fully with the City in satisfying the City’s duties and obligations under the Public Records Act. The City’s use or reuse of any of the documents, data, and files created by the Consultant for this project by anyone other than the Consultant on any other project shall be without liability or legal exposure to the Consultant. XII. CITY'S RIGHT OF INSPECTION. Even though the Consultant is an independent contractor with the authority to control and direct the performance and details of the work authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. XIII. WORK PERFORMED AT CONSULTANT'S RISK. The Consultant 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 Consultant's own risk, and the Consultant 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. XIV. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties’ performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section VIII 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 Consultant. CONSULTANT SERVICES AGREEMENT - 5 ($20,000 or Less) 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 Consultant 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 Consultant'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 Consultant 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 Consultant 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 Consultant agrees to cooperate fully with the City in satisfying the City’s duties and obligations under the Public Records Act. J. City Business License Required. Prior to commencing the tasks described in Section I, 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 CONSULTANT SERVICES AGREEMENT - 6 ($20,000 or Less) to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. CONSULTANT: By: Print Name: Its: DATE: CITY OF KENT: By: Print Name: Terry Jungman Its: Parks Planning & Development Manager DATE: NOTICES TO BE SENT TO: CONSULTANT: Mollie Bryan LUSIO 6406 S. 120th St. Seattle, WA 98178 206-383-6951 (telephone) lusiolight@gmail.com (email) NOTICES TO BE SENT TO: CITY OF KENT: Kerry O'Connor City of Kent 220 Fourth Avenue South Kent, WA 98032 (253) 856-5115 (telephone) koconnor@kentwa.gov (email) ATTEST: Kent City Clerk \\PKUPFPP1V\PKPublic\Planning\Kherson Park\Redevelopment 2019-20\Design Terry Jungman (Nov 1, 2021 09:57 PDT) Terry Jungman Nov 1, 2021 Mollie Bryan (Nov 1, 2021 12:56 PDT) Mollie Bryan Creative Director Mollie Bryan Nov 1, 2021 EEO COMPLIANCE DOCUMENTS - 1 DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City’s equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City’s sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. By: __________________________________________ For: _________________________________________ Title: ________________________________________ Date: ________________________________________ Mollie Bryan (Nov 1, 2021 12:56 PDT) Mollie Bryan Creative Director Lusio Nov 1, 2021 EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City’s nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City’s equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 3 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (date) between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. By: __________________________________________ For: _________________________________________ Title: ________________________________________ Date: ________________________________________ Contract Agreement This agreement rendered on 9/6/2021 is between City of Kent and Mollie Bryan; the Curator and Event Producer of LUSIO events; hereby known at LUSIO. SCOPE OF SERVICES LUSIO’s services will include ●Consultation on the location of Kherson Park for a long term projection project for the City of Kent. ●Site visits to the location; during the day and night to check for ambient lighting issues. ●Recommendations for equipment including projects,screen or screen options, ambient lighting issues, and other recommendations relevant to the project. FEE / DEPOSIT / SCHEDULE OF PAYMENT ●The fee for the LUSIO consultation is $90/hr. Estimated time range for feasibility study is between 10-25 hrs. ●Fee to paid in full within 30 days of completion and receiving the LUSIO invoice ●Payment can be made in the form of a check or digitally via paypal. Please make check out to Mollie Bryan 6406 South 120th St. Seattle, WA 98178 Paypal account email is mokedophoto@gmail.com CANCELATION This agreement cannot be canceled except by mutual written consent of both City of Kent and LUSIO. If cancellation is initiated by the City of Kent, the cancelation must be done so in writing prior to work beginning, and agreed to by LUSIO. If cancellation is initiated by the City of Kent after work has begun, all fees to LUSIO for work completed must be paid up to the date of cancelation. This agreement cannot be canceled after work has begun on the consultation project. MODIFICATIONS All modifications of this Agreement must be in writing and signed by both parties. This Agreement constitutes the entire understanding between parties hereto. Governing Law. The Agreement shall be construed in accordance with the laws of the State of Washington. Any action pursued regarding enforcement of the terms of this Agreement shall occur in Seattle, Washington. ATTORNEY’S FEES The prevailing party in any action to enforce this Agreement shall be entitled to recover from the other party its reasonable attorney’s fees and expenses in connection with such action, including appeal. WAIVER OF BREACH The waiver of any breach of any provision of this Agreement or failure to enforce any provision hereof shall not operate or be construed as a waiver of any subsequent breach by any party. AMENDMENTS This Agreement may not be amended or modified except by written instrument executed by the parties hereto. SEVERABILITY. In the event any provision of this Agreement is deemed to be invalid or unenforceable, to the extent practical the same shall be construed in a manner which would render it valid and enforceable and said determination shall in no event affect the enforceability or validity of any other provision hereof. LUSIO will begin work on the event as soon as the deposit or payment has been made. AGREED TO AND ACCEPTED: Signature: Printed Name: Date: AGREED TO AND ACCEPTED: Signature: _________________________ Printed Name: Mollie Bryan Date 9/6/2021 EXHIBIT B INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS Insurance The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non-owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01. The City shall be named as an Additional Insured under the Consultant’s Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. 2. Workers’ Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. EXHIBIT B (Continued) C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Consultant’s insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Consultant’s insurance and shall not contribute with it. 2. The Consultant’s insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the Consultant and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Consultant’s Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer’s liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. E. Verification of Coverage Consultant shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Consultant before commencement of the work. F. Subcontractors Consultant shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Consultant. Form_SCTNID_CTGRY.XX0713VOI_OTHER <docindex><index>VOI</index></docindex> PROGRESSIVE P.O. BOX 31260 TAMPA, FL 33631 NAIC Company Code: 16322 Policy Number: 908771884 Underwritten by: Progressive Direct Insurance Co Policyholder : Mollie Bryan Page of 1 1 October 20, 2021 Customer Service 24 hours a day, 7 days a week 1-800-776-4737 Verification of Insurance for Mollie Bryan This verification of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this verification of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of the policies. Please accept this letter as verification of insurance for this policy. Policy and driver information …………………………………………………………………………………………………………………………………… Policy number: 908771884 …………………………………………………………………………………………………………………………………… Policy state: Washington …………………………………………………………………………………………………………………………………… Policy period: Aug 4, 2021 - Feb 4, 2022 …………………………………………………………………………………………………………………………………… There was no lapse in coverage during this policy period. …………………………………………………………………………………………………………………………………… Effective date: Aug 4, 2021 ……………………………………………………………………………………………………………………………………Drivers: Mollie Bryan Insured Driver Address: …………………………………………………………………………………………………………………………………… 10123 66th ave S Seattle, WA 98178 Vehicle information……………………………………………………………………………………………………………………………………Vehicle: ……………………………………………………………………………………………………………………………………Vehicle identification number: 2004 HONDA CR-V JHLRD78844C029930 Coverage information…………………………………………………………………………………………………………………………………… Liability To Others Bodily Injury Liability $25,000 each person/$50,000 each accident Property Damage Liability $10,000 each accident Deductible: …………………………………………………………………………………………………………………………………… Personal Injury Protection $10,000 $0 Deductible: …………………………………………………………………………………………………………………………………… Comprehensive Actual Cash Value $1,000 Deductible: …………………………………………………………………………………………………………………………………… Collision Actual Cash Value $1,000 Form VOI (07/13) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 10/20/2021 Hiscox Inc. 5 Concourse Parkway Suite 2150 Atlanta GA, 30328 (888) 202-3007 contact@hiscox.com Hiscox Insurance Company Inc 10200 LUSIO 6406 S 120th St Seattle, WA 98178 X X A X Y Y UDC-4642087-CGL-21 10/26/2021 10/26/2022 1,000,000 100,000 5,000 1,000,000 2,000,000 S/T Gen. Agg City of Kent 220 4th Ave. S Kent, WA 98032 Hiscox Insurance Company Inc. Your Insurance documents Enclosed you will find the policy documents that make up your insurance contract with us. Please read through all of these documents. If you have any questions or need to update any of your information please call us at 888-202-3007 (Mon-Fri, 7am-10pm EST). Si tiene alguna pregunta o necesita actualizar su información, por favor llámenos al 1-855-744-2300 (Horario de Lunes – Viernes, 9am – 10pm ET). Your insurance documents Declarations Page This contains specific policy information, such as the limits and deductibles you have selected. Policy Wording This details the terms and conditions of your coverage, subject to policy endorsements. Endorsements These documents modify the Policy Wording or Declarations Page. These include relevant terms and conditions as required by your state and are part of your policy. Notices These documents provide information that may affect your coverage such as optional terrorism coverage (if purchased) and other important items required by your state. Application Summary This is a summary of the information that you provided to us as part of your application. Please review this document and let us know if any of the information is incorrect. Reporting a claim Please inform us immediately if you have a claim or loss to report. Please have your policy number available so we can handle your call quickly. Email: reportaclaim@hiscox.com Phone: 866-424-8508 Mail:Attn: Direct Claims Hiscox 5 Concourse Parkway - Suite 2150 Atlanta GA, 30328 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5421 CW (02/14) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 ADDITIONAL INSURED – AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II – Who Is An Insured is amended to include as an additional insured any per- son(s) or organization(s) for whom you are performing operations or leasing a premises when you and such person(s) or organiza- tion(s) have agreed in writing in a contract or agreement that such person(s) or organiza- tion(s) be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to lia- bility for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1.In the performance of your ongoing opera- tions; or 2.In connection with your premises owned by or rented to you. A person's or organization's status as an addi- tional insured under this endorsement ends when your operations or lease agreement for that additional insured are completed. UDC-4642087-CGL-20 LUSIO 1 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5409 CW (03/10) Page 1 of 1 RIGHT AND DUTY TO SELECT DEFENSE COUNSEL This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART In regard to any covered “suit” seeking damages under Section I – COVERAGE A – BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY or COVERAGE B – PERSONAL AND ADVERTISING INJURY LIABILITY, our right and duty to defend shall include the right to select defense counsel. UDC-4642087-CGL-20 LUSIO 2 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5404 CW (03/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. EXCLUSION – PERSONAL INFORMATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Paragraph 2. Exclusions under Section I – COV- ERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY , COVERAGE B – PERSONAL AND ADVERTISING INJURY LIABILITY, and COVERAGE C – MEDICAL PAYMENTS is amended to include the following exclusion: Personal Information “Bodily injury”, “property damage” or “personal and advertising injury” caused by the insured’s failure to protect any non-public, personally identifiable infor- mation in the insured’s care, custody or control. UDC-4642087-CGL-20 LUSIO 3 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5408 CW (03/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. CANCELLATION PROVISION (14 DAY FULL REFUND) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART All Coverage Parts included in this policy are subject to the following condition: Notwithstanding anything in the “COMMON POLICY CONDITIONS” or any other cancellation provision to the contrary, if the first Named Insured cancels within 14 days of the inception of the policy period shown in the Declarations without there having been: (i) an “occurrence” that caused “bodily in- jury” or “property damage”; (ii) an offense arising out of your business that caused a “personal and advertising injury”; or (iii) an accident that caused “bodily injury”; then we shall return in full any pre- mium amount actually paid to us. In such event, the effective date of cancellation shall be deemed to be the inception date of the policy period shown in the Declarations. UDC-4642087-CGL-20 LUSIO 4 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5403 CW (03/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. NOTICE INFORMATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Where To Send Notice Phone: 866-424-8508 Email: reportaclaim@hiscox.com Mail: Hiscox 5 Concourse Parkway-Suite 2150 Attn: Direct Claims Atlanta GA, 30328 Subparagraph 2. Duties In The Event Of Occur- rence, Offense, Claim Or Suit in Section IV – COMMERCIAL GENERAL LIABILITY CONDI- TIONS is amended to include the following: Any notification required by this policy shall be pro- vided to us at the address listed in the above SCHEDULE. UDC-4642087-CGL-20 LUSIO 5 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5401 CW (03/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. DEFINITION OF EMPLOYEE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART In Section V – DEFINITIONS, Definition 5. “Employee” is deleted and replaced with the following: 5. “Employee” includes a “leased worker” and a “temporary worker”. UDC-4642087-CGL-20 LUSIO 6 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5407 CW (03/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. EXCLUSION – PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Paragraph 2. Exclusions under Section I – COVERAGE A – BODILY INJURY AND PROPER- TY DAMAGE LIABILITY , and COVERAGE B – PERSONAL AND ADVERTISING INJURY LIABILITY, is amended to include the following exclusion: Professional Services “Bodily injury”, “property damage” or “personal and advertising injury” caused by the rendering or failure to render any professional service. This exclusion applies even if the claims allege neg- ligence or other wrongdoing in the supervision, hir- ing, employment, training or monitoring of others by an 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 or failure to render any pro- fessional service. UDC-4642087-CGL-20 LUSIO 7 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. IL 01 98 09 08 ISO Properties, Inc., 2007 Page 1 of 2 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (Broad Form) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The insurance does not apply: A. Under any Liability Coverage, to "bodily injury" or "property damage": (1) With respect to which an "insured" under the policy is also an insured under a nuc- lear energy liability policy issued by Nuclear Energy Liability Insurance Association, Mu- tual Atomic Energy Liability Underwriters, Nuclear Insurance Association of Canada or any of their successors, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or (2) Resulting from the "hazardous properties" of "nuclear material" and with respect to which (a) any person or organization is re- quired to maintain financial protection pur- suant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the "in- sured" is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by the United States of America, or any agency thereof, with any person or organi- zation. B. Under any Medical Payments Coverage, to expenses incurred with respect to "bodily in- jury" resulting from the "hazardous properties" of "nuclear material" and arising out of the op- eration of a "nuclear facility" by any person or organization. C. Under any Liability Coverage, to "bodily injury" or "property damage" resulting from "hazard- ous properties" of "nuclear material", if: (1) The "nuclear material" (a) is at any "nuclear facility" owned by, or operated by or on be- half of, an "insured" or (b) has been dis- charged or dispersed therefrom; (2) The "nuclear material" is contained in "spent fuel" or "waste" at any time pos- sessed, handled, used, processed, stored, transported or disposed of, by or on behalf of an "insured"; or (3) The "bodily injury" or "property damage" arises out of the furnishing by an "insured" of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any "nuc- lear facility", but if such facility is located within the United States of America, its terri- tories or possessions or Canada, this Ex- clusion (3) applies only to "property dam- age" to such "nuclear facility" and any property thereat. UDC-4642087-CGL-20 LUSIO 8 October 26, 2020 Page 2 of 2 ISO Properties, Inc., 2007 IL 01 98 09 08 2. As used in this endorsement: "Hazardous properties" includes radioactive, toxic or explosive properties; "Nuclear material" means "source material", "Spe- cial nuclear material" or "by-product material"; "Source material", "special nuclear material", and "by-product material" have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof; "Spent fuel" means any fuel element or fuel com- ponent, solid or liquid, which has been used or ex- posed to radiation in a "nuclear reactor"; "Waste" means any waste material (a) containing "by- product material" other than the tailings or wastes produced by the extraction or concentration of ura- nium or thorium from any ore processed primarily for its "source material" content, and (b) resulting from the operation by any person or organization of any "nuclear facility" included under the first two para- graphs of the definition of "nuclear facility". "Nuclear facility" means: (a) Any "nuclear reactor"; (b) Any equipment or device designed or used for (1) separating the isotopes of uranium or plu- tonium, (2) processing or utilizing "spent fuel", or (3) handling, processing or packaging "waste"; (c) Any equipment or device used for the processing, fabricating or alloying of "special nuclear material" if at any time the total amount of such material in the custody of the "insured" at the premises where such equipment or de- vice is located consists of or contains more than 25 grams of plutonium or uranium 233 or any combination thereof, or more than 250 grams of uranium 235; (d) Any structure, basin, excavation, premises or place prepared or used for the storage or dis- posal of "waste"; and includes the site on which any of the foregoing is located, all operations conducted on such site and all premises used for such operations; "Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a self-supporting chain reaction or to contain a critical mass of fissiona- ble material; "Property damage" includes all forms of radioactive contamination of property. Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 21 41 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 EXCLUSION – INTERCOMPANY PRODUCTS SUITS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART This insurance does not apply to any claim for dam- ages by any Named Insured against another Named Insured because of "bodily injury" or "property dam- age" arising out of "your products" and included within the "products-completed operations hazard." UDC-4642087-CGL-20 LUSIO 9 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: CG 00 68 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 RECORDING AND DISTRIBUTION OF MATERIAL OR INFORMATION IN VIOLATION OF LAW EXCLUSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion q. of Paragraph 2. Exclusions of Sec- tion I – Coverage A – Bodily Injury And Proper- ty Damage Liability is replaced by the following: 2. Exclusions This insurance does not apply to: q. Recording And Distribution Of Material Or Information In Violation Of Law "Bodily injury" or "property damage" arising directly or indirectly out of any action or omission that violates or is alleged to vi- olate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN-SPAM Act of 2003, including any amendment of or addition to such law; (3) The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accu- rate Credit Transaction Act (FACTA); or (4) Any federal, state or local statute, ordin- ance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the print- ing, dissemination, disposal, collecting, recording, sending, transmitting, com- municating or distribution of material or information. B. Exclusion p. of Paragraph 2. Exclusions of Sec- tion I – Coverage B – Personal And Advertising Injury Liability is replaced by the following: 2. Exclusions This insurance does not apply to: p. Recording And Distribution Of Material Or Information In Violation Of Law "Personal and advertising injury" arising di- rectly or indirectly out of any action or omis- sion that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN-SPAM Act of 2003, including any amendment of or addition to such law; (3) The Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accu- rate Credit Transaction Act (FACTA); or (4) An y federal, state or local statute, ordin- ance or regulation, other than the TCPA, CAN-SPAM Act of 2003 or FCRA and their amendments and additions, that addresses, prohibits, or limits the print- ing, dissemination, disposal, collecting, recording, sending, transmitting, com- municating or distribution of material or information. UDC-4642087-CGL-20 LUSIO 10 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ I T CAREFULLY. IL 01 46 08 10 © Insurance Services Office, Inc., 2010 Page 1 of 4 WASHINGTON COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. The conditions in this endorsement replace any similar conditions in the policy that are less favorable to the insured. A. Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by notifying us or the insurance producer in one of the following ways: a. Written notice by mail, fax or e-mail; b. Surrender of the policy or binder; or c. Verbal notice. Upon receipt of such notice, we will cancel this policy or any binder issued as evidence of coverage, effective on the later of the following: a. The date on which notice is received or the policy or binder is surrendered; or b. The date of cancellation requested by the first Named Insured. 2. We may cancel this policy by mailing or delivering to the first Named Insured and the first Named Insured's agent or broker written notice of cancellation, including the actual reason for the cancellation, to the last mailing address known to us, at least: a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or b. 45 days before the effective date of cancellation if we cancel for any other reason; except as provided in Paragraphs 3. and 4. below. 3. We may cancel the Commercial Property Coverage Part and the Capital Assets Program (Output Policy) Coverage Part, if made a part of this policy, by mailing or delivering to the first Named Insured and the first Named Insured's agent or broker written notice of cancellation at least five days before the effective date of cancellation for any structure where two or more of the following conditions exist: a. Without reasonable explanation, the structure is unoccupied for more than 60 consecutive days, or at least 65% of the rental units are unoccupied for more than 120 consecutive days, unless the structure is maintained for seasonal occupancy or is under construction or repair; b. Without reasonable explanation, progress toward completion of permanent repairs to the structure has not occurred within 60 days after receipt of funds following satisfactory adjustment or adjudication of loss resulting from a fire; c. Because of its physical condition, the structure is in danger of collapse; d. Because of its physical condition, a vacation or demolition order has been issued for the structure, or it has been declared unsafe in accordance with applicable law; e. Fixed and salvageable items have been removed from the structure, indicating an intent to vacate the structure; f. Without reasonable explanation, heat, water, sewer and electricity are not furnished for the structure for 60 consecutive days; or UDC-4642087-CGL-20 LUSIO 11 October 26, 2020 Page 2 of 4 © Insurance Services Office, Inc., 2010 IL 01 46 08 10 g. The structure is not maintained in substantial compliance with fire, safety and building codes. 4. If: a. You are an individual; b. A covered auto you own is of the "private passenger type"; and c. The policy does not cover garage, automobile sales agency, repair shop, service station or public parking place operations hazards; we may cancel the Commercial Automobile Coverage Part by mailing or delivering to the first Named Insured and the first Named Insured's agent or broker written notice of cancellation, including the actual reason for cancellation, to the last mailing address known to us: a. At least 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or b. At least 10 days before the effective date of cancellation for any other reason if the policy is in effect less than 30 days; or c. At least 20 days before the effective date of cancellation for other than nonpayment if the policy is in effect 30 days or more; or d. At least 20 days before the effective date of cancellation if the policy is in effect for 60 days or more or is a renewal or continuation policy, and the reason for cancellation is that your driver's license or that of any driver who customarily uses a covered "auto" has been suspended or revoked during policy period. 5. We will also mail or deliver to any mortgage holder, pledgee or other person shown in this policy to have an interest in any loss which may occur under this policy, at their last mailing address known to us, written notice of cancellation, prior to the effective date of cancellation. If cancellation is for reasons other than those contained in Paragraph A.3. above, this notice will be the same as that mailed or delivered to the first Named Insured. If cancellation is for a reason contained in Paragraph A.3. above, we will mail or deliver this notice at least 20 days prior to the effective date of cancellation. 6. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 7. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund will be at least 90% of the pro rata refund unless the following applies: a. For Division Two – Equipment Breakdown, if the first Named Insured cancels, the refund will be at least 75% of the pro rata refund. b. If: (1) You are an individual; (2) A covered auto you own is of the "private passenger type"; (3) The policy does not cover garage, automobile sales agency, repair shop, service station or public parking place operations hazards; and (4) The first Named Insured cancels; the refund will be not less than 90% of any unearned portion not exceeding $100, plus 95% of any unearned portion over $100 but not exceeding $500, and not less than 97% of any unearned portion in excess of $500. The cancellation will be effective even if we have not made or offered a refund. 8. If notice is mailed, proof of mailing will be sufficient proof of notice. B. Changes The policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspection And Surveys 1. We have the right to: a. Make inspections and surveys at any time; b. Give you reports on the conditions we find; and c. Recommend changes. IL 01 46 08 10 © Insurance Services Office, Inc., 2010 Page 3 of 4 2. We are not obligated to make any inspections, surveys, reports or recommendations, and any such actions we do undertake relate only to insurability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspections, surveys, reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recommendations we may make relative to certification, under state or municipal statutes, ordinances or regulations, of boilers, pressure vessels or elevators. E. Premiums The first Named Insured shown in the Declarations: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual Named Insured. If you die, your rights and duties will be transferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. G. Nonrenewal 1. We may elect not to renew this policy by mailing or delivering written notice of nonrenewal, stating the reasons for nonrenewal, to the first Named Insured and the first Named Insured's agent or broker, at their last mailing addresses known to us. We will also mail to any mortgage holder, pledgee or other person shown in this policy to have an interest in any loss which may occur under this policy, at their last mailing address known to us, written notice of nonrenewal. We will mail or deliver these notices at least 45 days before the: a. Expiration of the policy; or b. Anniversary date of this policy if this policy has been written for a term of more than one year. Otherwise, we will renew this policy unless: a. The first Named Insured fails to pay the renewal premium after we have expressed our willingness to renew, including a statement of the renewal premium, to the first Named Insured and the first Named Insured's insurance agent or broker, at least 20 days before the expiration date; b. Other coverage acceptable to the insured has been procured prior to the expiration date of the policy; or c. The policy clearly states that it is not renewable and is for a specific line, subclassification, or type of coverage that is not offered on a renewable basis. 2. If: a. You are an individual; b. A covered auto you own is of the "private passenger type"; and c. The policy does not cover garage, automobile sales agency, repair shop, service station or public parking place operations hazards; Page 4 of 4 © Insurance Services Office, Inc., 2010 IL 01 46 08 10 the following applies to nonrenewal of the Commercial Automobile Coverage Part in place of G.1.: a. We may elect not to renew or continue this policy by mailing or delivering to you and your agent or broker written notice at least 20 days before the end of the policy period, including the actual reason for nonrenewal. If the policy period is more than one year, we will have the right not to renew or continue it only at an anniversary of its original effective date. If we offer to renew or continue and you do not accept, this policy will terminate at the end of the current policy period. Failure to pay the required renewal or continuation premium when due shall mean that you have not accepted our offer. b. We will not refuse to renew Liability Coverage or Collision Coverage solely because an "insured" has submitted claims under Comprehensive Coverage or Towing And Labor Coverage. c. If we fail to mail or deliver proper notice of nonrenewal and you obtain other insurance, this policy will end on the effective date of that insurance. Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5405 CW (03/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. EXCLUSION – DAMAGE TO PRIMARY RESIDENCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to a premises that is an insured’s primary residence: A. The last paragraph ("Exclusions c. through n. do not apply . . . ") of Paragraph 2., Exclusions un- der Section I – Coverage A – Bodily Injury And Property Damage Liability is deleted. B. The first exception ("Paragraphs (1), (3) and (4) of this exclusion do not apply . . . ") to Exclusion j., Damage To Property of Paragraph 2., Exclu- sions of Section I – Coverage A – Bodily Injury And Property Damage Liability is deleted. C. Paragraph 6. of Section III – Limits Of Insur- ance is deleted. D. Any reference in the Declarations to "Damage To Premises Rented To You" is deleted. UDC-4642087-CGL-20 LUSIO 12 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5402 CW (03/10) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. MODIFIED WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions: You may waive your rights against another party so long as you do so in writing prior to: (i) an offense arising out of your business that caused a “personal and advertising injury”; or (ii) an “occurrence” that caused “bodily injury” or “property damage”. UDC-4642087-CGL-20 LUSIO 13 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 01 81 05 08 © ISO Properties, Inc., 2007 Page 1 of 1 WASHINGTON CHANGES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Exclusion e. of Coverage A – Bodily Injury And Property Damage Liability (Section I – Coverages) applies only to "bodily injury" to any "employee" of the insured whose employment is not subject to the Industrial Insurance Act of Washington (Wash- ington Revised Code Title 51). With respect to "bodily injury" to "employees" of the insured whose employment is subject to the Industrial Insurance Act of Washington, Exclusion e. is replaced with the following: This insurance does not apply to: 1. "Bodily injury" to an "employee" of the insured arising out of and in the course of: a. Employment by the insured; or b. Performing duties related to the conduct of the insured's business; or 2. Any obligation to share damages with or repay someone else who must pay damages be- cause of the injury. This exclusion does not apply to liability assumed by the insured under an "insured contract". B. Paragraphs 2.a.(1)(a), (b) and (c) of Section II – Who Is An Insured apply only to "employees" of the insured whose employment is not subject to the Industrial Insurance Act of Washington (Wash- ington Revised Code Title 51). With respect to "employees" of the insured whose employment is subject to the Industrial Insurance Act of Washington, the reference to "volunteer workers" is removed from Paragraph 2.(a) of Sec- tion II – Who Is An Insured and Paragraph 2.a.(1) of Section II is replaced with the following: 2. Each of the following is also an insured: a. Your "employees", other than either your "executive officers" (if you are an organiza- tion other than a partnership, joint venture or limited liability company) or your manag- ers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing du- ties related to the conduct of your business. However, none of these "employees" is an insured for: (1) "Bodily injury" or "personal and advertis- ing injury": (a) To you, to your partners or members (if you are a partnership or joint ven- ture), to your members (if you are a limited liability company), or to a co- "employee" while that co-"employee" is either in the course of his or her employment or performing duties re- lated to the conduct of your busi- ness; (b) For which there is any obligation to share damages with or repay some- one else who must pay damages because of the injury described in Paragraph (1)(a) above; or (c) Arising out of his or her providing or failing to provide professional health care services. UDC-4642087-CGL-20 LUSIO 14 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 21 70 01 15 © Insurance Services Office, Inc., 2015 Page 1 of 1 CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk In- surance Act exceed $100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act, we shall not be lia- ble for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with proc e- dures established by the Secretary of the Trea- sury. "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in ac- cordance with the provisions of the federal Terror- ism Risk Insurance Act, to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a "certified act of terrorism" include the following: 1.The act resulted in insured losses in excess of $5 million in the aggregate, attributable to all types of insurance subject to the Terrorism Risk Insurance Act; and 2.The act is a violent act or an act that is dan- gerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian pop u- lation of the United States or to influence the policy or affect the conduct of the United States Government by coercion. B. The terms and limitations of any terrorism exclu- sion, or the inapplicability or omission of a terror- ism exclusion, do not serve to create coverage for injury or damage that is otherwise excluded under this Coverage Part. UDC-4642087-CGL-20 LUSIO 15 October 26, 2020 Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS ENDORSEMENT DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. IL 09 85 01 15 © Insurance Services Office, Inc., 2015 Page 1 of 2 DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT SCHEDULE SCHEDULE – PART I Terrorism Premium (Certified Acts) $ This premium is the total Certified Acts premium attributable to the following Coverage Part(s), Cover- age Form(s) and/or Policy(ies): Additional information, if any, concerning the terrorism premium: SCHEDULE – PART II Federal share of terrorism losses 85% year 2015; 84% year 2016; 83% year 2017; 82% year 2018; 81% year 2019 and 80% year 2020. Information required to complete this Schedule, if not shown above, will be shown in the De clarations. A. Disclosure Of Premium In accordance with the federal Terrorism Risk In- surance Act, we are required to provide you with a notice disclosing the portion of your premium, if any, attributable to coverage for terrorist acts certi- fied under the Terrorism Risk Insurance Act. The portion of your premium attributable to such cov- erage is shown in the Schedule of this endorse- ment or in the policy Declarations. UDC-4642087-CGL-20 LUSIO 16 October 26, 2020 6.00 Page 2 of 2 © Insurance Services Office, Inc., 2015 IL 09 85 01 15 B. Disclosure Of Federal Participation In Payment Of Terrorism Losses The United States Government, Department of the Treasury, will pay a share of terrorism losses in- sured under the federal program. The federal share equals a percentage (as shown in Part II of the Schedule of this endorsement or in the policy Declarations) of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However, if aggregate insured losses at- tributable to terrorist acts certified under the Ter- rorism Risk Insurance Act exceed $100 billion in a calendar year, the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. C. Cap On Insurer Participation In Payment Of Terrorism Losses If aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed $100 billion in a calendar year and we have met our insurer deductible under the Terror- ism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures es- tablished by the Secretary of the Treasury. Hiscox Insurance Company Inc. Policy Number: Named Insured: Endorsement Number: Endorsement Effective: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGL E5426 WA (04/15) Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. SUPPLEMENTAL BUSINESS PERSONAL PROPERTY FLOATER COVERAGE - WASHINGTON This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The terms and conditions of the Commercial General Liability Form and the following terms and conditions all apply to this Coverage. Words and phrases that appear in quotes are defined in the Commercial General Liability Form or this form and are given their defined meaning. SCHEDULE Limit of Insurance (per “occurrence”) Deductible (per “occurrence”) COVERAGE D – SUPPLEMENTAL BUSINESS PERSONAL PROPERTY COVERAGE FLOATER 1.Insuring Agreement – WHAT WE COVER We will pay for direct physical loss or damage to “computer equipment” or “contents” caused by an “occurrence”. 2.What We Will Pay If you have first paid the deductible stated in the Schedule, we will pay the following amounts up to the Limit of Insurance stated in the Schedule. Loss or damage to “contents” and “computer equipment” away from the premises shall be subject to a sublimit of $ , which shall be part of, and not in addition to the Limit of Insurance shown in the Schedule. a.For loss or damage to ”computer equipment” or “contents” you own, we will pay the lesser of: (1) the cost to repair the “computer equipment” and “contents”; or (2) the “replacement cost” of the “computer equipment” and “contents”. b.For loss or damage to “computer equipment” or “contents” you do not own that are in your care, custody or control, we will pay the least of: (1) the cost to repair the “computer equipment” and “contents”; (2) the “replacement cost” of the “computer equipment” and “contents”; or $$ UDC-4642087-CGL-20 LUSIO 17 October 26, 2020 10,000 500 2,500.00 CGL E5426 WA (04/15) Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. (3) the amount for which you are legally liable for the “computer equipment” and “contents”. If the lowest amount is “replacement cost”, we will pay the “actual cash value” as of the date of loss and then pay the difference between “actual cash value” and “replacement cost” if you replace the “computer equipment” or “contents” within one year from the date of the “occurrence”. 3. Exclusions – What We Do Not Cover a. We will pay only for loss or damage to the “computer equipment” or “contents” themselves. We will not pay for any loss or damage caused by or ensuing from loss or damage to “computer equipment” or “contents”, including without limitation: (1) personal injury; (2) property damage to property other than “computer equipment” or “contents”; (3) loss of or damage to electronic data, applications or systems; or (4) economic loss or damage, including loss of use, loss of market or business interruption. b. We will not pay for loss or damage to “computer equipment” attributable solely to wear and tear, deterioration or inherent fault. DEFINITIONS 1. “Actual cash value” means the fair market value of the lost or damaged property as of the date of the “occurrence” taking into account deterioration, depreciation and obsolescence. 2. “Computer equipment” means the following equipment used primarily in your business: a. hardware capable of accepting information, processing it according to a plan, and producing the desired results (including without limitation desktop and laptop computers, electronic tablets and mobile phones), as well as related peripheral equipment, including without limitation printers, video display monitors, modems, surge protectors, keyboards, routers and servers; b. air conditioning and fire protection equipment used exclusively in computer operations; and c. telephone systems and their component parts that you own. 3. “Contents” means all business personal property used primarily in your business. 4. “Replacement cost” means the cost to replace lost or damaged property with new material of like, kind and quality and utility. Replacement cost will be valued as of the date of the “occurrence. Signature: Email: Signature: Email: Signature: Email: rlashley@kentwa.gov Kerry O'Connor (Nov 1, 2021 09:44 PDT) Kerry O'Connor koconnor@kentwa.gov Melissa McCormick (Nov 1, 2021 14:15 PDT) Melissa McCormick cityclerk@kentwa.gov E-TRANSMITTAL: Agmt. for Kherson Park Creative Lighting Concepts Final Audit Report 2021-11-01 Created:2021-10-26 By:Lynn Osborn (losborn@kentwa.gov) Status:Signed Transaction ID:CBJCHBCAABAAjdzm5OgeyBycXf49k_4bX5rI0sefywiS "E-TRANSMITTAL: Agmt. for Kherson Park Creative Lighting C oncepts" History Document created by Lynn Osborn (losborn@kentwa.gov) 2021-10-26 - 11:54:46 PM GMT- IP address: 146.129.252.126 Document emailed to Ronald Lashley (rlashley@kentwa.gov) for signature 2021-10-26 - 11:59:35 PM GMT Email viewed by Ronald Lashley (rlashley@kentwa.gov) 2021-10-28 - 11:09:32 PM GMT- IP address: 146.129.252.126 Document e-signed by Ronald Lashley (rlashley@kentwa.gov) Signature Date: 2021-10-28 - 11:11:28 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to bjlevenhagen@kentwa.gov for signature 2021-10-28 - 11:11:30 PM GMT Lynn Osborn (losborn@kentwa.gov) replaced signer bjlevenhagen@kentwa.gov with Kerry O'Connor (koconnor@kentwa.gov) 2021-11-01 - 4:42:01 PM GMT- IP address: 146.129.252.126 Document emailed to Kerry O'Connor (koconnor@kentwa.gov) for signature 2021-11-01 - 4:42:01 PM GMT Email viewed by Kerry O'Connor (koconnor@kentwa.gov) 2021-11-01 - 4:43:06 PM GMT- IP address: 146.129.252.126 Document e-signed by Kerry O'Connor (koconnor@kentwa.gov) Signature Date: 2021-11-01 - 4:45:00 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to Terry Jungman (tjungman@kentwa.gov) for signature 2021-11-01 - 4:45:01 PM GMT Email viewed by Terry Jungman (tjungman@kentwa.gov) 2021-11-01 - 4:56:58 PM GMT- IP address: 73.118.200.115 Document e-signed by Terry Jungman (tjungman@kentwa.gov) Signature Date: 2021-11-01 - 4:57:21 PM GMT - Time Source: server- IP address: 73.118.200.115 Document emailed to Mollie Bryan (lusiolight@gmail.com) for signature 2021-11-01 - 4:57:23 PM GMT Email viewed by Mollie Bryan (lusiolight@gmail.com) 2021-11-01 - 5:39:06 PM GMT- IP address: 66.249.84.201 Document e-signed by Mollie Bryan (lusiolight@gmail.com) Signature Date: 2021-11-01 - 7:56:59 PM GMT - Time Source: server- IP address: 67.183.113.182 Document emailed to Kim Komoto (kkomoto@kentwa.gov) for signature 2021-11-01 - 7:57:02 PM GMT Email viewed by Kim Komoto (kkomoto@kentwa.gov) 2021-11-01 - 9:03:52 PM GMT- IP address: 146.129.252.126 Document e-signed by Kim Komoto (kkomoto@kentwa.gov) Signature Date: 2021-11-01 - 9:04:38 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to Melissa McCormick (cityclerk@kentwa.gov) for signature 2021-11-01 - 9:04:41 PM GMT Email viewed by Melissa McCormick (cityclerk@kentwa.gov) 2021-11-01 - 9:12:37 PM GMT- IP address: 146.129.252.126 Document e-signed by Melissa McCormick (cityclerk@kentwa.gov) Signature Date: 2021-11-01 - 9:15:34 PM GMT - Time Source: server- IP address: 146.129.252.126 Agreement completed. 2021-11-01 - 9:15:34 PM GMT