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CAG2022-259 - Original - GA Jorgensen Co Inc - Service Club Ballfields Parking lot Sealcoating & Striping - 06/13/2022
6/10/2022 Okay to sign CAG2022-259 6/13/22 PUBLIC WORKS AGREEMENT - 1 (Over $20K and No Performance Bond) PUBLIC WORKS AGREEMENT between City of Kent and G A Jorgensen Co Inc THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and G A Jorgensen Co Inc organized under the laws of the State of Washington, located and doing business at 1287 Thorton Ave SW, Pacific, WA 98047-2111; Contact: Curtis Riess, Phone: 253-863-0600 (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: Contractor to furnish all materials and necessary equipment and perform all labor necessary to sealcoat, crack fill and stripe the parking lots at Service Club Ballfields, located at 14608 SE 288th Street, Kent, WA 98042, per the Proposal & Contract dated May 18, 2022 attached and incorporated as Exhibit A, except for those additional terms outlined within the Proposal and Contract, 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 30 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 September 12, 2022. 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 THREE THOUSAND FOUR HUNDRED NINETY TWO DOLLARS AND NINETY SEVEN CENTS ($33,492.97), including any applicable Washington State Sales Tax, for the work and services contemplated in this Agreement. The City shall pay the Contractor eighty-five percent (85%) of the Contract amount upon completion and acceptance of the work by the City, or at such earlier time as the City may determine is appropriate. The City will pay the remaining Contract amount upon fulfillment of the conditions listed below and throughout this Agreement. Card Payment Program. The Contractor may elect to participate in automated credit card payments provided for by the City and its financial institution. This Program is provided as an alternative to payment by check and is available for the convenience of the Contractor. If the Contractor voluntarily participates in this Program, the Contractor will be solely responsible for any fees imposed by financial institutions or credit card companies. The Contractor shall not charge those fees back to the City. PUBLIC WORKS AGREEMENT - 2 (Over $20K and No Performance Bond) 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 Contractor’s signature on the Agreement. C. Defective or Unauthorized Work. The City reserves its right to withhold payment from the Contractor for any defective or unauthorized work. Defective or unauthorized work includes, without limitation: work and materials that do not conform to the requirements of this Agreement; and extra work and materials furnished without the City’s written approval. If the Contractor is unable, for any reason, to satisfactorily complete any portion of the work, the City may complete the work by contract or otherwise, and the Contractor shall be liable to the City for any additional costs incurred by the City. “Additional costs” shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Contract price specified above. The City further reserves its right to deduct the cost to complete the Contract work, including any Additional Costs, from any and all amounts due or to become due the Contractor. D. Final Payment: Waiver of Claims. THE CONTRACTOR’S ACCEPTANCE OF FINAL PAYMENT (EXCLUDING WITHHELD RETAINAGE) SHALL CONSTITUTE A WAIVER OF CONTRACTOR’S CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY CONTRACTOR AS UNSETTLED AT THE TIME FINAL PAYMENT IS MADE AND ACCEPTED. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor- Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: A. The Contractor has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Contractor maintains and pays for its own place of business from which the Contractor’s services under this Agreement will be performed. C. The Contractor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained the Contractor’s services and is a service other than that furnished by the City, or the Contractor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. 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 Contractor’s business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Contractor has a valid contractor registration pursuant to Ch. 18.27 RCW or an electrical contractor license pursuant to Ch. 19.28 RCW. G. The Contractor maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. The City may terminate this Agreement for good cause. “Good cause” shall include, without limitation, any one or more of the following events: A. The Contractor’s refusal or failure to supply a sufficient number of properly skilled workers or proper materials for completion of the Contract work. B. The Contractor’s failure to complete the work within the time specified in this Agreement. C. The Contractor’s failure to make full and prompt payment to subcontractors or for material or labor. D. The Contractor’s persistent disregard of federal, state or local laws, rules or regulations. E. The Contractor’s filing for bankruptcy or becoming adjudged bankrupt. F. The Contractor’s breach of any portion of this Agreement. If the City terminates this Agreement for good cause, the Contractor shall not receive any further money due under this Agreement until the Contract work is completed. After termination, the City may take possession of all records and data within the Contractor’s possession pertaining to this project which may be used by the City without restriction. VI. PREVAILING WAGES. The Contractor shall file a “Statement of Intent to Pay Prevailing Wages,” with the State of Washington Department of Labor & Industries prior to commencing the Contract work. The Contractor shall pay prevailing wages in effect on the date the bid is accepted or executed by the Contractor, and comply with Chapter 39.12 of the Revised Code of Washington, as well as any other applicable prevailing wage rate provisions. The latest prevailing wage rate revision issued by the Department of Labor and Industries is attached. VII. CHANGES.The City may issue a written change order for any change in the Contract work during the performance of this Agreement. If the Contractor determines, for any reason, that a change order is necessary, the Contractor must submit a written change order request to the person listed in the notice provision section of this Agreement, Section XVI(D), within fourteen (14) calendar days of the date the Contractor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Contractor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Contractor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Contractor shall proceed with the change order work upon receiving either a written change order from the City or an oral order from the City before actually receiving the written change order. If the Contractor fails to require a change order within the time PUBLIC WORKS AGREEMENT - 4 (Over $20K and No Performance Bond) 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 (“force majeure event”). Performance that is prevented or delayed due to a force majeure event shall not result in liability to the delayed party. Both parties represent to the other that at the time of signing this Agreement, they are able to perform as required and their performance will not be prevented, hindered, or delayed by the current COVID-19 pandemic, any existing state or national declarations of emergency, or any current social distancing restrictions or personal protective equipment requirements that may be required under federal, state, or local law in response to the current pandemic. If any future performance is prevented or delayed by a force majeure event, the party whose performance is prevented or delayed shall promptly notify the other party of the existence and nature of the force majeure event causing the prevention or delay in performance. Any excuse from liability shall be effective only to the extent and duration of the force majeure event causing the prevention or delay in performance and, provided, that the party prevented or delayed has not caused such event to occur and continues to use diligent, good faith efforts to avoid the effects of such event and to perform the obligation. Notwithstanding other provisions of this section, the Contractor shall not be entitled to, and the City shall not be liable for, the payment of any part of the contract price during a force majeure event, or any costs, losses, expenses, damages, or delay costs incurred by the Contractor due to a force majeure event. Performance that is more costly due to a force majeure event is not included within the scope of this Force Majeure provision. If a force majeure event occurs, the City may direct the Contractor to restart any work or performance that may have ceased, to change the work, or to take other action to secure the work or the project site during the force majeure event. The cost to restart, change, or secure the work or project site arising from a direction by the City under this clause will be dealt with as a change order, except to the extent that the loss or damage has been caused or exacerbated by the failure of the Contractor to fulfill its obligations under this Agreement. Except as expressly contemplated by this section, all other costs will be borne by the Contractor. IX. CLAIMS. If the Contractor disagrees with anything required by a change order, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Contractor may file a claim as provided in this section. The Contractor shall give written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14) calendar days of the date the Contractor knew or should have known of the facts or events giving rise to the claim, whichever occurs first . Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been waived by the Contractor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Contractor's written claim shall include the information set forth in subsections A, items 1 through 5 below. FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY PUBLIC WORKS AGREEMENT - 5 (Over $20K and No Performance Bond) 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 THE CONTRACT WORK IS COMPLETE OR CONTRACTOR’S ABILITY TO FILE THAT CLAIM OR SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. XI. WARRANTY. The Contractor warrants that it will faithfully and satisfactorily perform all work provided under this Agreement in accordance with the provisions of this Agreement. The Contractor shall promptly correct all defects in workmanship and materials: (1) when the Contractor knows or should have known of the defect, or (2) upon the Contractor’s receipt of notification from the City of the existence or discovery of the defect. In the event any parts are repaired or replaced, only original replacement parts shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for an additional year beyond the original warranty period applicable to the overall work. The Contractor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Contractor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Contractor shall pay all costs incurred by the City in order to accomplish the correction. XII. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Contractor, its sub-contractors, or any person acting on behalf of the Contractor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. 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 Contractor’s liability accruing from that obligation shall be only to the extent of the Contractor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event the Contractor refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Contractor’s part, then the Contractor shall pay all the City’s costs for defense, including all reasonable expert witness fees and reasonable attorneys’ fees, plus the City’s legal costs and fees incurred because there was a wrongful refusal on the Contractor’s part. The provisions of this section shall survive the expiration or termination of this Agreement. XIV. INSURANCE. The Contractor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. XV. WORK PERFORMED AT CONTRACTOR'S RISK. The Contractor shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at the Contractor's own risk, and the Contractor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XVI. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties’ performance of this Agreement, the exclusive means 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 agrees to cooperate fully with the City in satisfying the City’s duties and obligations under the Public Records Act. J. City Business License Required. Prior to commencing the tasks described in Section I, the Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. K. Counterparts and Signatures by Fax or Email. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that signature shall have the same force and effect as if the Agreement bearing the original signature was received in person. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. All acts consistent with the authority of this Agreement and prior PUBLIC WORKS AGREEMENT - 8 (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: Curtis Reiss, Estimator G A Jorgensen Co Inc 1287 Thorton Ave S.W. Pacific, WA 98047-2111 (253) 863-0600 (telephone) (253) 863-0692 (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) 508-9548 (cell) or (253) 856-5133 (telephone) (253) 856-6120 (facsimile) APPROVED AS TO FORM: Kent Law Department ATTEST: Kent City Clerk 06/13/2022 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 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: ________________________________________ 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 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. 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 (May 18, 2022), the bidder is not a “willful” violator, as defined in RCW 49.48.082, of any provision of chapters 49.46, 49.48, or 49.52 RCW, as determined by a final and binding citation and notice of assessment issued by the Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. G A Jorgensen Co 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. EXHIBIT A PROPOSAL & CONTRACT G.A. JORGENSEN CO., INC. a'or ensenco ,comcast.net General Contractor — GAJORCI132RN Paving Patching Sealing Striping Curbing Concrete 1287 Thornton Ave. SW Pacific, WA. 98047 Kent Parks and Recreation Department 525 4"' Avenue North Sumner: (253) 863-0600 Fax: (253) 863-0692 Kent, WA 98032 Phone: (253) 569-6940 Attn: Andy Martin AMartin(t-b.Kentwa. ov Fax No: We hereby agree to furnish any labor, materials, and equipment for the completion, in a good and workmanship manner, of the work described below. Service Club Community Park and Ballfields 14608 SE 288t' Street Kent, WA 98042 Our Recommendations: 3,000 L/F Crack Fill Asphalt with Dura Fill $ 1,000.00 134,900 S/F Sealcoat Asphalt with Armorseal A-100 HD High Solids $ 23,607.50 (Includes: Shop Area) 7,259 L/F Paint Parking Areas —190 L/F Paint Fire Lane Curbing Red $ 4,558.00 Paint (11) ADAs, (3) FLNP 18" White, and Paint (18) Abby Bar Crosswalks Paint (2) BUS Parking and (2) STAFF Parking Stencils Mobilization Charges $ 1,255.00 Subtotal: $ 30,420.50 Tax (10%) $ 3.072.47 Grand Total: $ 33,492.97 WASHINGTON STATE SALES TAX NOT INCLUDED Acceptance of this proposal includes work in its entirety, not in part. We reserve the right to adjust our pricing during executed contract if work is not completed in its entirety. Excessive thickness of asphalt, concrete and cleaning due to excessive dirt, a change order will be issued, signed and approved before work is performed. Any changes in this Proposal/Contract must be submitted in writing. This bid does not include payment and performance bonds, permits, engineering, traffic control, drawings, layouts, and testing. A field measurement and/or unit prices at completion of job, if applicable. All vehicles are to be removed by Owner/Contractor before arrival. Prices include mobilizations, additional mobilization charges will be accessed if required to complete job ($485/ea). Bid based on current price of labor and material, if not accepted within 30 days we reserve the right to submit a new bid. Progress billing due upon invoicing of completed phases of work within 10 days of date of invoice. A finance charge of 1 %2% per month, will be added to all past due accounts not paid within terms. No deposit required if payment terms (Net10) are agreed upon. May 18, 2022 ACCEPTANCE: G.A. JO E SEN O., INC. ti BY: Curtis less, -stimator I/We accept the within proposal. You are authorized to perform the work as stated above and I/We agree to pay the above amount in accordance with the terms set forth. In the event this contract shall be in default and placed for collection, the undersigned agrees to pay all reasonable attorney fees and cost of collection. Date: Company or Individual: Agent: By: DO Clil n t r ( •. 1 fir. - rT _� -- - ' `♦ y lift 26 r► 6/6/22, 1:30 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, workers 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: 6/6/2022 ounty. Trade Job Classification Wage Holiday Overtime Note 'Risk Class King Laborers Air, Gas Or Electric Vibrating Screed $54.62 Tu AY BY View King Laborers Airtrac Drill Operator $56.31 15_J AY 8Y Yew King Laborers Ballast Regular Machine $54.62 15J 4Y 8Y View King Labore Batch Weighman S46.29 ju 4V BY View King Lagers Brick Pavers $54.62 1u AM BY YiC2( King alders Brush Cutter $54.62 15_J 4v 8Y View King Lahore 6 Brush Hog Feeder $54.62 15J AY By MW King Laborers Burner $54.62 >5 1 4Y AY View King Lahore Caisson Worker $56.31 7 AY 8Y View King Laborers Carpenter Tender S54.62 15J 4V BY View King Laborers Cement Dumper -paving $55.62 15-J Ay Ey View King Laborers Cement Finisher Tender $54.62 15J 4V 8Y View King Laborers Change House Or Dry Shack $54.62 15J 4V BY View King Lahore Chipping Gun (30 Lbs. And Over) $55.62 15-J 4V MY view King Laborers Chipping Gun (Under 30 Lbs.) $54.62 15 4V 8Y View King Laborers Choker Setter S54.62 151 4V BY View King Laborer Chuck Tender $54.62 1LJ AY 8Y View King Laborers Clary Power Spreader $55.62 15 4V AY_ View King Laborers Clean-up Laborer $54.62 15J 4V BY View King Laborers Concrete Dumper/Chute Operator $55.62 15J 4V BY View King Labore. Concrete Form Stripper $54.62 15J 4V SY View King Laborers Concrete Placement Crew $55.62 15J 4V SY View King LattQre Concrete Saw Operator/Core Driller $55.62 15J 4Y AY_ View King Latlore13 Crusher Feeder S46.29 15J 4Y BY View King Laborers Curing Laborer $54.62 i5-j 4v BY View King Laborers Demolition: Wrecking a Moving (Incl. Charred Material) $54.62 111 4V 8Y View King Laborers Ditch Digger $54.62 15_J AY AY_ View King Laborers Diver $56.31 >5_J AY BY Yiew King Lahore Drill Operator (Hydraulic, Diamond) $55.62 J_U AY $Y View King Laborers Dry Stack Walls $54.62 13-1 4V 8Y View King Lahore 6 Dump Person $54.62 J-U AY i;Y View King Laborers Epoxy Technician $54.62 1U AY 8Y View King Lahore Erosion Control Worker $54.62 111 AY 8Y View King Lahore Faller Ft Bucker Chain Saw $55.62 15-J 4V 8Y View King Laborers Fine Graders $54.62 >-Li AV BY MW King Laborers Firewatch $46.29 1-Li 9Y AY_ Yiw King Laborers Form Setter $54.62 15_J AY $_ Y1W King laborers Gabian Basket Builders $54.62 15J AY $_Y Y King Lao General Laborer $54.62 111 AY BY View King Laborers Grade Checker Ft Transit Person $57.31 15 4V BY View King Laborers Grinders $54.62 151 4V 8Y View King Laborers Grout Machine Tender $54.62 1J 4V 8Y View King taborers Groutmen (Pressure) Including Post Tension Beams $55.62 L51 4Y AY_ View King Laborers Guardrail Erector $54.62 15J 4V BY View King Laborers Hazardous Waste Worker (Level A) $56.31 7 4Y 8Y View King Laborers Hazardous Waste Worker (Level B) $55.62 151 4V 8Y View King Laborers Hazardous Waste Worker (Level C) $54.62 15J 4V BY View King Laborers High Scaler $56.31 151 4V BY View King Laborers Jackhammer $55.62 15J 4Y 8Y View King LaboLer Laserbeam Operator $55.62 151 4V SY View King Laborers Maintenance Person $54.62 15_J 4V SY View King Laborers Manhole Builder-Mudman $55.62 15J 4V BY ie King Laborers Material Yard Person $54.62 1u 4V 8Y View King Lab4ISg Motorman -Dinky Locomotive $55.62 15J 4V ff View King I ahnrerc nozzleman (concrete pump, green cutter when using $57.31 1 i AY BY View combination of high pressure air rt water on concrete & rock, sandblast, gunite, shotcrete, water blaster, vacuum blaster) King Laborers Pavement Breaker $55.62 15J AY MY View King Laborers Pilot Car $46.29 15J AY BY View King Laborers Pipe Layer (Lead) $57.31 1_U AY BY View King Lahore rs Pipe Layer/Tailor $55.62 Lu 4V 1fY View King Laborers Pipe Pot Tender $55.62 151 AY BY View King Laborers Pipe Refiner $55.62 1_`J AY >iY View King Iaborea Pipe Wrapper S55.62 15J 4V AY View about:blank 112 6/6/22, 1:30 PM about:blank King Laborers Pot Tender $54.62 >5_J 4Y AY_ King Laborers Powderman $56.31 5 AY By King Laborers Powderman's Helper $54.62 1u1 9Y f King Laborers Power Jacks $55.62 iu AY King Laborers Railroad Spike Puller - Power $55.62 1U R SY King Laborers Raker - Asphalt $57.31 15J 0 9Y King Laborers Re-timberman $56.31 15_J R IY King Laborers Remote Equipment Operator $55.62 15J AY $y King Laborers Rigger/Signal Person $55.62 15J 4y >L King Laborers Rip Rap Person $54.62 iu AY 9Y King Laborers Rivet Buster $55.62 15,1 4V M King Laborers Rodder $55.62 15 AY EY King Laborers Scaffold Erector $54.62 1.5j AY EY King Laborers Scale Person $54.62 5 AY 8Y King Laborers SLoper (Over 20") S55.62 5 4Y 9Y King Laborers SLoper Sprayer S54.62 5 AY 0-Y King Laborers Spreader (Concrete) $55.62 15J 4Y BY King La Stake Hopper $54.62 15_J 9Y BY King Laborers Stock Piler $54.62 151 9.Y BY King Laborers Swinging Stage/Boatswain Chair $46.29 5 AY &_Y King Laborers Tamper li Similar Electric, Air fc Gas Operated Tools $55.62 5 gy EY King taborer Tamper (Multiple & Self-propelled) S55.62 5 AY 9Y King Laborers Timber Person - Sewer (Lagger, Shorer fr Cribber) $55.62 15J 4Y SY King Lai. Toolroom Person (at Jobsite) $54.62 15J -V ,ZSY King Topper $54.62 15J 4V 9Y King Track Laborer $54.62 15J 4V 8Y King Laborer Track Liner (Power) $55.62 15J 4V 6Y King 3_u Traffic Control Laborer $49.50 1i 4V 9C King (A1 r Traffic Control Supervisor $52.45 1 U 4V K King Labs Truck Spatter $54.62 15J 4V 8Y King Laboreu Tugger Operator S55.62 15J 4V $Y King Lahore sr Tunnel Work -Compressed Air Worker 0-30 psi $142.82 15J 4V 9B King Laborer Tunnel Work -Compressed Air Worker 30.01-44.00 psi $147.85 151 4V 9B King UF Tunnel Work -Compressed Air Worker 44.01-54.00 psi $151.53 15J 4V 9B King La sr Tunnel Work -Compressed Air Worker 54.01-60.00 psi $157.23 15J 4V QB King L [f Tunnel Work -Compressed Air Worker 60.01-64.00 psi $159.35 5 AY 9B King Tunnel Work -Compressed Air Worker 64.01-68.00 psi $164.45 111 4V 9B King labrgr Tunnel Work -Compressed Air Worker 68.01-70.00 psi $166.35 15-1 4V 9B King laborers Tunnel Work -Compressed Air Worker 70.01-72.00 psi $168.35 151 AV 9B King Tunnel Work -Compressed Air Worker 72.01-74.00 psi $170.35 1U 3y 9B King Litbarers Tunnel Work-Guage and Lock Tender $57.41 151 9y AY_ King L Tunnel Work -Miner $57.41 jg 4V 8Y King Laborers Work -Miner $57.41 15J AY M King Laboicg Vibrator $55.62 1U 4V BY King Wbor Vinyl Seamer $54.62 15J 4V AY King Watchman $42.08 15J 4Y King Labor Welder $55.62 1_ 1 4V Ay King Labore Well Point Laborer $55.62 15J 4V By King Lltbarers Window Washer/Cleaner $42.08 15J AY U about:blank 2/2 6/6/22, 1:31 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, workers 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: 6/6/2022 o n - Trade Job Classification Wow Holiday Overtime Note 'Risk Class King Power Equipmens Operators Asphalt Plant Operators $76.77 15J 11-G 8X View King Power E ujqEMtQperators Assistant Engineer $72.20 15J it 8X View King Power Equipment Opera ors Barrier Machine (zipper) $76.09 151 11 8X View King Power EA MWneftt QPerators Batch Plant Operator: concrete $76.09 151 11C 1 View King Power quinmenc Qgc a= Boat Operator $76.87 7A 11H 8�t View King Power Eouwmaat Operators Bobcat $72.20 t iJ 11G U View King Paver Eaui�nent b,tl01M Brokk - Remote Demolition Equipment $72.20 15J ]L $lS View King P 1�ipffi9LOperators Brooms $72.20 15J 11 BX View King _WQMMLQW== Bump Cutter $76.09 115-J 11f, B_X View King Po%,Mf uiumen_ LQD9Mtors Cableways $76.77 15J 11G 8X View King Power FAWRMMftLQ20Z= Chipper $76.09 151 11G 8X View King rMor & dpAa=LQ2CtM Compressor $72.20 151 11G 8X View King power equipment opera Concrete Finish Machine - Laser Screed $72.20 151 11G SX View King Power Equftwngm Opeaktars Concrete Pump - Mounted Or Trailer High Pressure Line $75.50 15J 11 C, BX View Pump, Pump High Pressure King Power EouiQ=t Operators Concrete Pump: Truck Mount With Boom Attachment Over $76.T7 151 11G 8X View 42 M King ftwOr �uPmeni > _ ar = Concrete Pump: Truck Mount With Boom Attachment Up To $76.09 15J 11G BX View 42m King Paver EuyEfiitrlent�i{rerat2s Conveyors $75.50 15J 11G BX View King Power EcuirdriM Operators Cranes Friction: 200 tons and over $79.20 7A 11H isK View King Cranes, A -frame: 10 tons and under $72.30 7A 11H BX View King Power. E064RmmLQDMta[s Cranes: 100 tons through 199 tons, or 150' of boom $77.63 7A 11H 8X View (including jib with attachments) King Power E0WRM0rrt flpr•ra= Cranes: 20 tons through 44 tons with attachments $76.19 7A 11H 8X View King Power Egglpinen_Qiler = Cranes: 200 tons- 299 tons, or 250' of boom including jib $78.44 7A 11H 8X View with attachments King Power £oulpme�_ Derra Cranes: 300 tons and over or 300' of boom including jib $79.20 7A 11H 1)X View with attachments King Iktwer ER A2 rfnt Operators Cranes: 45 tons through 99 tons, under 150' of $76.87 7A ]yj 8X View boom(including jib with attachments) King Power €guirm 0 Oaer = Cranes: Friction cranes through 199 tons S78.44 ]A 11H 8X 'View King Power ji,rnAn IM Oxratar i Cranes: through 19 tons with attachments, a -frame over 10 S75.60 7A i J Vie tons King Po m E meat tars Crusher $76.09 J5,! 11G Jix View King Deck Engineer/Deck Winches (power) $76.09 ] 1(t AX View King Power EaulpmentQQMt rs Derricks, On Building Work $76.T7 lu 11GG 8X view King Dozers D-9 & Under $75.50 15J J.1.G BX View King ft!eer Eguipa&nt Oner#As Drill Oilers: Auger Type, Truck Or Crane Mount $75.50 15J 11G 8X View King Power EgulnmenLomal 2rs Drilling Machine ST7.53 111 11 8X View King Power t _MMA Oper = Elevator and man -lift: permanent and shaft type $72.20 15-J Jly 8X View King Power EWp1pCSLQgCU= Finishing Machine, Bidwell And Gamaco 8 Similar S76.09 15J 11C SX View Equipment King Ewer Forklift: 3000 lbs and over with attachments $75.50 15J 11G SX View King Pow Grade Engineer: Using Blue Prints, Cut Sheets, Etc $76.09 15J 11G SX View King +ri°r ulnnrentOpera rs Gradechecker/Stakeman $72.20 15-J 11G Ax- View King Ppwe E❑r u_ipm nt�perators Guardrail Punch $76.09 15J 11G SX View King Hard Tail End Dump Articulating Off- Road Equipment 45 $76.T7 15J 11G 8X View Yards. @ Over King am rF4w0nWrSf7eraiors Hard Tail End Dump Articulating Off -road Equipment Under $76.09 15J 11G ! View 45 Yards King Horizontal/Directional Drill Locator $75.50 15J 11 ))K View King Power Eptr}pmen QgCM ors Horizontal/Directional Drill Operator $76.09 15J 11G MView King Power Equipment Operators Hydralifts/Boom Trucks Over 10 Tons $75.60 7A 11H 8X View King Power Eg ty J)i ment Operates Hydralifts/boom trucks: 10 tans and under $72.30 7A 11H BX view King w rEquipM0LQKraiors Levennan $78.33 15J 11ci BX yjW King Power Equi mp ent Operators Loader, Overhead, 6 Yards. But Not Including 8 Yards $76.77 11G 8X view King Power Equipment Operators Loaders, Overhead Under 6 Yards $76.09 J51 11 BX View King Power Equipme-A perators Loaders, Plant Feed $76.09 ] 111G M View King Power Equipment Operators Loaders: Elevating Type Belt $75.50 15.1 11G AN view King Power Equipment Operators Locomotives, All S76.09 Ju 11C AX vim King Power Equipment Operators Material Transfer Device $76.09 15J JJL SX View King Power Equipment Operators Mechanics: All (Leadmen - $0.50 per hour over mechanic) S77.53 15J JJf !)X View King Power Equipment Operators Motor Patrol Graders S76.77 15-1 11Q $X View King Power Equipment Operators Mucking Machine, Mole, Tunnel Drill, Boring, Road Header $76.77 J.SJ 11G 8X View And/or Shield King Power Equipment Operators Oil Distributors, Blower Distribution fc Mulch Seeding $72.20 15J 11fC 8X View about:blank 1/2 6/6/22, 1:31 PM about:blank Operator King Power Equipment Operators Outside Hoists (Elevators and Manlifts), Air Tuggers, Strato $75.50 IV 11G JIX View King Power Equipment Aerators Ovefiead, bridge type: 100 tons and over $77.63 7�i J LH View King Power Equi ment perators Overhead, bridge type: 45 tons through 99 tons $76.87 jp JI U 8X View King Power Equipment Operators Pavement Breaker $72.20 -1 11 a Yi= King Power Equipmen Operators Pile Driver (other Than Crane Mount) $76.09 iu 110 AX View King Power Equipment Operators Plant Oiler - Asphalt, Crusher $75.50 iLi 1� J)x View King Power Equipment Operators Posthole Digger, Mechanical $72.20 Js,i 11G Bps View King Power Equipment Operators Power Plant $72.20 15-J ii-Q 8X View King Power Equipment Operators Pumps - Water $72.20 15-1 li-Q E View King Power Equipment Operators Quad 9, Hd 41, D10 And Over $76.77 I_u 11G 1)X View King Power E uipment 0 rpe ators Remote Control Operator On Rubber Tired Earth Moving $76.77 J.5,) 11 B-X view Equipment King Power Equipment Operators Rigger and Bellman $72.30 7A jib 8X View King Power Equipment Operators Rigger/Signal Person, Bellman(Certified) $75.60 ZA 11H View King Power E uipment Operators Rollagon $76.77 1-u 11Si View King Power Equipment Operators Roller, Other Than Plant Mix $72.20 J 5.J 11 8� View King Power Equipment Operators Roller, Plant Mix Or Multi -lift Materials $75.50 15J IJL 8X View King Power Equipment 0 rpe ators Roto-mitt, Roto-grinder $76.09 15 iir. W View King Power Equipment Operators Saws - Concrete $75.50 11 J 11G AX View King Power Equipment Operators Scraper, Self Propelled Under 45 Yards $76.09 15J JIG 8X View King Power Equipment Operators Scrapers - Concrete ft Carry All $75.50 lu 11C BX view King Power Equipm n[ Operators Scrapers, Self-propelled: 45 Yards And Over $76.77 1�J 1LG Z View King Power Equipment Operators Service Engineers: Equipment $75.50 15J 11G 8X View King Power Equi mp ent Operators Shotcrete/Gunite Equipment $72.20 15J ii-Q 8X View King Power Equipment Operators Shovel, Excavator, Backhoe, Tractors Under 15 Metric Tons $75.50 15J li- 8X View King Power Equipment Operators Shovel, Excavator, Backhoe: Over 30 Metric Tons To 50 $76.77 15J 11G 8X View Metric Tons King Power Equipment Operators Shovel, Excavator, Backhoes, Tractors: 15 To 30 Metric Tons $76.09 15J 11 G 8X Wew King Power Equipment Operators Shovel, Excavator, Backhoes: Over 50 Metric Tons To 90 $77.53 15J 11G BX View Metric Tons King Eawer Equipment Ogerat9r� Shovel, Excavator, Backhoes: Over 90 Metric Tons $78.33 15J 11G 8X View King Power Eauipment Operators Slipform Pavers $76.77 15-j J I GG 8X yi- King Power E nt OOMdtgrs Spreader, Topsider & Screedman $76.77 i1i 11G 8X View King x rE�S Subgrader Trimmer $76.09 15J 11G SX View King P-- F& dyment 9perat2rs Tower Bucket Elevators $75.50 15J 11G View King Pawer Equipment Operators Tower Crane: over 175' through 250' in height, base to $78.44 7A 11 H 8X View boom King Power Equipment Operators Tower crane: up to 175' in height base to boom $77.63 7A 11 H SX View King Power Equipment Operators Tower Cranes: over 250' in height from base to boom $79.20 7A 11 H SX View King Power Equipment Operators Transporters, All Track Or Truck Type $76.77 15 11�C J)_X Am King Power Equipment Operators Trenching Machines $75.50 151 JIG 8X MW King Power Equipment Operators Truck crane oiler/driver: under 100 tons $75.60 ZA J 1 H B-X Yim King Power Equipment Operators Truck Mount Portable Conveyor $76.09 lu JS ON Yi- King Power Equipment Operators Welder $76.77 J5I 11G m View King Power Equipment roe ators Wheel Tractors, Farman Type $72.20 15J JIG $X Mm King Power Equipment Operators Yo Yo Pay Dozer $76.09 15J JJSQ BX Yi= about:blank 2/2 6/6/22, 1:32 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, workers 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: 6/6/2022 County. Trade Job Classification )M gg Holiday Overtime Note 'Risk Class King Truck Drivers Asphalt Mix over 16 Yards $69.95 151 ill 8L view King Truck Drivers Asphalt Mix To 16 Yards $69.11 1 U 111 SL view King Truck Drivers Dump Truck $69.11 VU 111 SL View King Truck Drivers Dump Truck ft Trailer $69.95 151 ill 8L yiew Kino Truck orivers other Trucks $69.95 TU 111 IiL View about:blank ill 6/6/22, 1:32 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, workers 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: 6/6/2022 Countv Trade Job Classification Mftge Holiday Overtime Note 'Risk Class King TM f S: Gran r !o Scrapers Journey Level $50.51 7A � K view about:blank 1/1 EXHIBIT B INSURANCE REQUIREMENTS FOR SERVICE CONTRACTS 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: 1. Commercial insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products -completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 1185 or a substitute endorsement providing equivalent coverage. 2. Automobile Lia illty 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' Com ensation 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: 1. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $1,000,000 general aggregate and a $1,000,000 products -completed operations aggregate limit. 2. Automobile I-iabilit insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 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 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 Contractors 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. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. E. 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 insurance requirements of the Contractor before commencement of the work. F. 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. INSR ADDL SUBRLTR INSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) The ACORD name and logo are registered marks of ACORD 5/26/2022 License # 0C36861 (425) 740-5216 13056 G A Jorgensen Company, Inc. 1287 Thornton Avenue Sw Pacific, WA 98047-2111 37206 A 1,000,000 X X RKA0400300 12/31/2021 12/31/2022 1,000,000 15,000 1,000,000 2,000,000 2,000,000 1,000,000B X X CKA0400421 12/31/2021 12/31/2022 4,000,000B X X CKA0400422 12/31/2021 12/31/2022 4,000,000 10,000 A RKA0400300 12/31/2021 12/31/2022 1,000,000 1,000,000 1,000,000 Re: Service Club Ballfields 14608 SE 2BBth Street, Kent, WA 98042 City of Kent Additional Insured with respect to the General Liability and Automobile Liability per forms attached. Waiver of Subrogation applies to the General Liability and Automobile Liability per forms attached. General Liability is Primary and Non-Contributory per forms attached. Umbrella Follows Form. City of Kent 220 4th Ave. S. Kent, WA 98032 GAJORGE-01 TNUBLE Alliant Insurance Services, Inc.3977 Harbour Pointe Blvd SW Mukilteo, WA 98275 Sarah Ogdon sarah.ogdon@alliant.com RLI Insurance Company Contractors Bonding and Insurance Company X X X X X X X X X X Policy Number: RKA0400300 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - WHERE REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE (Optional) Name of Additional Insured Persons or Organizations (as required by `written contract" per Paragraph A. below) Locations of Covered Operations (per "written contract', provided the location is within the coverage tern to " of this Coverage Part A. WHO IS AN INSURED (Section II) is amended to include as an insured: 1. Any person(s) or organization(s) whom you are required pursuant to a "written contract" to add as an additional insured on this policy; and 2. The particular person or organization, if any, scheduled above. B. When required in the "written contract", the coverage provided to the additional insured under this policy shall be primary and non- contributory to the additional insured subject to the limitations set forth below. C. The insurance provided to the additional insured is limited as follows: 1. The person or organization is an additional insured only with respect to liability for "bodily injury" or "property damage" 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 operations as specified in the "written contract". When required in the "written contract", the coverage provided to the additional insured by this endorsement will apply to "bodily injury" or "property damage" arising out of the "products -completed operations hazard". available limits in this policy, or those limits you agreed to provide in the "written contract". 3. With respect to the coverage provided under this endorsement, the following duties are added to Section IV — Commercial General Liability Conditions, paragraph 2. Duties In The Event of Occurrence, Offense, Claim or Suit: e. An additional insured under this endorsement will as soon as practicable: (1) Give written notice of an "occurrence" to us which may result in a claim or "suit" under this insurance; (2) Agree to trigger or activate any other insurance which the additional insured has for a loss we cover under this Coverage Part by tendering the defense to the insurers of all such other insurance. 4. If required by the "written contract", we waive the right of recovery we may have against the additional insured to which this endorsement applies for payments we make for "bodily injury" or "property damage" arising out of "your work" on the "written contract". 5. Unless otherwise agreed in the "written contract", this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis that is available to the additional insured. 2. The Limits of Insurance applicable to the D. SECTION V — DEFINITIONS is amended to additional insured are the lesser of the include the following definition: RLI INSURANCE COMPANY RGL 350 08 17 Includes copyrighted material of Page 1 of 2 Insurance Services Office, Inc., with its permission. Policy Number: RKA0400300 "Written contract" means a written contract or written agreement that requires you to make a person or organization an additional insured on this Coverage Part, provided the contract or agreement is: 1. Valid and legally enforceable; 2. Currently in effect or becoming effective during the term of this policy; and 3. Executed prior to an "occurrence" resulting in "bodily injury" or "property damage" for which the additional insured seeks coverage under this Coverage Part. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. RLI INSURANCE COMPANY RGL 350 08 17 Includes copyrighted material of Page 2 of 2 Insurance Services Office, Inc., with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CONTRACTORS GENERAL LIABILITY ENHANCEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE OF COVERAGES ADDRESSED BY THIS ENDORSEMENT This schedule is provided only as a convenience. It should not be assumed to provide a reference to every provision that can affect a question, claim or coverage. To determine the full scope of coverage and perti- nent restrictions and exclusions, the policy, including endorsements, must be read it its entirety. A. Reasonable Force — Bodily Injury Or Property Damage B. Aircraft, Auto or Watercraft C. Damage To Premises Rented To You D. Property damage care, custody or control E. Lost Key Coverage F. Supplementary Payments G. Newly Acquired Or Formed Organizations H. Additional Insured — Owner, Manager or Lessor Of Premises Or Leased Equipment I. Additional Insured — State or Political Subdivisions — Permits Related to Premises or Opera- tions J. Unnamed Partnership Or Joint Venture K. General Aggregate Limit — Per Project or Per Location L. Damage To Premises Rented To You Limit M. Knowledge And Notice Of Occurrence Or Offense N. Unintentional Omission O. Waiver Of Transfer Of Rights Of Recovery Against Others To Us P. Amended Bodily Injury Definition Q. Amended Insured Contract Definition RLI INSURANCE COMPANY RGL 365 01 19 Contains copyrighted material of Page 1 of 8 Insurance Services Office, Inc. with its permission SECTION I — COVERAGES COVERAGE A BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY A. Reasonable Force— Bodily Injury Or Prop- erty Damage Paragraph 2.a. Exclusions; Expected Or Intended Injury, is deleted and replaced by the following: a. Expected or Intended Injury "Bodily Injury" or "property damage" ex- pected or intended from the standpoint of the insured. This exclusion does not ap- ply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. B. Aircraft, Auto or Watercraft 1. Paragraph 2.g.(2) Exclusions; Aircraft, Auto Or Watercraft is deleted and re- placed by the following: (2) A watercraft you do not own that is: (a) Up to seventy-five (75) feet long; and (b) Not being used to carry persons or property for a charge; 2. The following is added to the exceptions to the exclusions: (6) Any non -owned aircraft chartered to you with a crew including a pilot. 3. The following is added to paragraph 2.g.: Only as respects to the insurance provided by this provision, Section II - Who Is An Insured is amended to include as an insured any person who, with your express consent uses a watercraft owned by you. The insurance provided by this provi- sion shall be excess over any valid and collectible other insurance avail- able to the insured, whether primary, excess, contingent or on any other basis, except for the insur- ance purchased specifically by you to apply in excess of the Limits of In- surance shown in the declarations for this Coverage Part. C. Damage To Premises Rented To You The last paragraph of 2. Exclusions is de- leted and replaced by the following: Exclusions c. through n. do not apply to damage by water, fire, explosion, light- ning, or smoke resulting from fire to premises while rented to you, or tempo- rarily occupied by you with permission by the owner. A separate limit of insurance applies to this coverage as described in Section III — Limits Of Insurance. This provision does not apply if coverage for Damage To Premises Rented To You is excluded by another endorsement to this policy. D. Property damage care, custody or control 1. The following is added to Exclusion 2 j. Paragraphs (4), (5) and (6) do not apply for the limited purpose of providing the sub -limits of liability set forth below. 2. We will pay those sums that the insured becomes legally obligated to pay as dam- ages arising out of "property damage" to: a. Personal property in the care, cus- tody or control of the insured; b. That particular part of real property on which you or any contractors or subcontractors working directly or in- directly on your behalf are perform- ing operations, if the "property dam- age" arises out of those operations; and c. That particular part of any property that must be restored repaired or re- placed because "your work" was in- correctly performed on it. The most we will pay under a, b, and c. above in any one "occurrence" is a sub - limit of $50,000. The most we will pay for all damages during any one policy period is $100,000. These limits are included in and not in ad- dition to The Limits of Insurance shown RLI INSURANCE COMPANY RGL 365 01 19 Contains copyrighted material of Page 2 of 8 Insurance Services Office, Inc. with its permission in the Declarations of the Commercial General Liability Policy. Our right and duty to defend the insured against any "suit" for damages under this coverage ends when we have used up the applicable sub -limit of liability in the payment of judgments or settlements un- der it. E. Lost Key Coverage 1. Coverage is extended to include the fol- lowing: If a customer's master or grand key, ex- cluding electronic key card, is lost while in your care, custody or control we will pay the cost of replacing the keys, includ- ing the master lock and all keys used in the same lock, the cost of adjusting locks to accept the new keys, or the cost to re- place the locks, whichever is less. 2. The most we will pay for "loss" arising out of any one "occurrence" is $10,000. 3. The following definition is added: "Loss" means unintentional physical damage or destruction to tangible prop- erty, including theft or disappearance. Tangible property does not include money or securities. SUPPLEMENTARY PAYMENTS - COVER- AGES A AND B. F. Supplementary Payments Paragraphs 1.b. and 1.d. are deleted and re- placed with the following: b. Up to $2,500 for the cost of bail bonds required because of accidents or traffic violations arising out of any vehicle to which Bodily Injury Liability Coverage ap- plies. 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 work. SECTION II — WHO IS AN INSURED G. Newly Acquired Or Formed Organizations The following replaces Paragraph 3.: 3. Any organization you newly acquire or form, other than a partnership, joint ven- ture or limited liability company, over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance avail- able to that organization. However: a. Coverage under this provision is af- forded only until the one hundred eightieth (180t") day after you ac- quire or form the organization or the end of the policy period, whichever is earlier; b. Coverage A does not apply to "bodily injury" or "property damage" that oc- curred before you acquired or formed the organization; and c. Coverage B does not apply to "per- sonal and advertising injury" arising out of an offense committed before you acquired or formed the organiza- tion. d. This provision does not apply to any organization for which coverage is excluded by another endorsement to this policy. H. Additional Insured — Owner, Manager Or Lessor Of Premises Or Leased Equipment The following paragraph is added: 4. Any person or organization that you have agreed in a contract or agreement to in- clude as an additional insured on this pol- icy, but: a. Only with respect to liability for "bod- ily injury" or "property damage" that occurs, or "personal and advertising injury" caused by an offense commit- ted, after you have entered into that contract or agreement; and (1) Only if the "bodily injury", "prop- erty damage" or "personal and advertising injury" is caused, in whole or in part, by you or any person or organization perform- ing operations on your behalf, RLI INSURANCE COMPANY RGL 365 01 19 Contains copyrighted material of Page 3 of 8 Insurance Services Office, Inc. with its permission and arises out of the ownership, (e) If the equipment is leased maintenance or use of that part with an operator. of any premises leased to you c. This provision does not apply on any under that contract or agree- basis to any person or organization ment; or for which coverage as an additional (2) The "bodily injury", "property insured specifically is added by an - damage" or "personal and adver- other endorsement to this policy. tising injury" is caused, in whole I. Additional Insured — State Or Political or in part, by you or any person Subdivisions — Permits Related To Prem- or organization performing oper- ises Or Operations ations on your behalf, and arises out of the maintenance, opera- The following paragraphs are added: tion or use of equipment leased 5. Any state or political subdivision that has to you by such additional in- sured. issued a permit in connection with prem- ises owned or occupied by, or rented or b. The insurance provided to such addi- loaned to, you, but only with respect to tional insured under this provision is "bodily injury", "property damage", "per - subject to the following: sonal and advertising injury" arising out (1) The limits of insurance afforded of the existence, ownership, use, mainte- to such additional insured shall nance, repair, construction, erection or be the limits which you agreed to removal of advertising signs, awnings, provide in the contract or agree- canopies, cellar entrances, coal holes, ment, or the limits shown in the driveways, manholes, marquees, hoist Declarations, whichever are away openings, sidewalk vaults, eleva- less; and tors, street banners or decorations for which that state or political subdivision (2) The insurance afforded to such has issued such permit. additional insured does not ap- 6. Any state or political subdivision that has ply: issued a permit, but only with respect to (a) To any "bodily injury" or "bodily injury", "property damage", "per - "property damage" that oc- sonal and advertising injury" arising out curs, or "personal and adver- of operations performed by you or on tising injury" caused by an your behalf for which that state or political offense committed, after you subdivision has issued such permit. How - cease to be a tenant in that ever, no such state or political subdivi- premises; sion is an insured for: (b) To any structural alterations, a. "Bodily injury", "property damage" construction or demolition "personal and advertising injury" aris- operations performed by or ing out of operations performed for on behalf of such additional that state or political subdivision; or insured; b. "Bodily injury" or "property damage" (c) To any premises for which included within the "products-com- coverage is excluded by an- pleted operations hazard". other endorsement to this J. Unnamed Partnership Or Joint Venture Coverage Part; (d) To any "bodily injury" or 1. The last paragraph of Section II — Who "property damage" that oc- Is An Insured is deleted and replaced by curs, or "personal and adver- the following: tising injury" caused by an No person or organization is an insured offense committed, after the with respect to the conduct of any current equipment lease expires; or RLI INSURANCE COMPANY RGL 365 01 19 Contains copyrighted material of Page 4 of 8 Insurance Services Office, Inc. with its permission or past partnership, joint venture or lim- (2) The Construction Project Gen- ited liability company that is not shown as eral Aggregate Limit is the most a Named Insured in the Declarations. we will pay for the sum of all However this limitation does not apply to damages under Coverage A, ex - your liability with respect to your conduct cept damages because of "bod- of the business of any current or past ily injury" or "property damage" partnership or joint venture: included in the "products -com- pleted operations hazard", and a. That is not shown as a Named In- for medical expenses under Cov- sured in the Declarations; and erage C regardless of the num- b. In which you are a member or partner ber of: but only if: a. Insureds; (1) Each and every member or part- b. Claims made or "suits" ner in that joint venture or part- brought; or nership is not a construction con- c. Persons or organizations tractor; and making claims or bringing "suits". (2) The joint venture or partnership (3) Any payments made under Cov- is not providing construction con- erage A for damages or under tracting services. Coverage C for medical ex- 2. This provision does not apply to any per- penses shall reduce the Con - son or organization for which coverage is struction Project General Aggre- excluded by another endorsement to this gate Limit for that construction policy. project. Such payments shall not reduce the General Aggregate 3. The insurance provided by this provision Limit shown in the Declarations shall be excess over any valid and col- nor shall they reduce any other lectible other insurance, whether pri- Construction Project General mary, excess, contingent or on any other Aggregate Limit for any other basis. single construction project SECTION III — LIMITS OF INSURANCE (4) The limits shown in the Declara- tions for Each Occurrence, Dam- K. General Aggregate Limit — Per Project Or age To Premises Rented To You Per Location and Medical Expense continue 1. General Aggregate Limits Of Insurance to apply. However, instead of be - Per Project ing subject to the General Aggre- gate Limit shown in the Declara- a. For all sums which the insured be- tions, such limits will be subject comes legally obligated to pay as to the applicable Construction damages caused by 'occurrences" Project General Aggregate Limit under Section I — Coverage A, and 2. For all sums which the insured be - for all medical expenses caused by comes legally obligated to pay as accidents under Section I — Cover- damages caused by 'occurrences" age C, which can be attributed only under Section I — Coverage A, and to ongoing operations at a single for all medical expenses caused by construction project : accidents under Section I — Cover- (1) A separate Construction Project age C, which cannot be attributed General Aggregate Limit applies only to ongoing operations at a sin - to each construction project, and gle construction project. that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. RLI INSURANCE COMPANY RGL 365 01 19 Contains copyrighted material of Page 5 of 8 Insurance Services Office, Inc. with its permission a. Any payments made under Cover- (2) The Location General Aggregate age A for damages or under Cover- Limit is the most we will pay for the age C for medical expenses shall re- sum of all damages under Coverage duce the amount available under the A, except damages because of "bod- General Aggregate Limit or the Prod- ily injury" or "property damage" in- ucts-completed Operations Aggre- cluded in the "products -completed gate Limit, whichever is applicable; operations hazard", and for medical and expenses under Coverage C regard- b. Such payments shall not reduce any less of the number of: Construction Project General Aggre- a. Insureds; gate Limit. b. Claims made or "suits" brought; 3. When coverage for liability arising out of or the "products -completed operations haz- c. Persons or organizations making ard" is provided, any payments for dam- claims or bringing "suits". ages because of "bodily injury" or "prop- (3) Any payments made under Cover- erty damage" included in the "products- age A for damages or under Cover - completed operations hazard" will reduce age C for medical expenses shall re - the Products -completed Operations Ag- duce the Location General Aggre- gregate Limit, and not reduce the Gen- gate Limit for that designated "loca- eral Aggregate Limit nor the Construction tion". Such payments shall not re - Project General Aggregate Limit. duce the General Aggregate Limit 4. If the applicable construction project has shown in the Declarations nor shall been abandoned, delayed, or aban- they reduce any other Location Gen- doned and then restarted, or if the au- eral Aggregate Limit for any other thorized contracting parties deviate from single designated 'location". plans, blueprints, designs, specifications (4) The limits shown in the Declarations or timetables, the project will still be for Each Occurrence, Damage To deemed to be the same construction pro- Premises Rented To You and Medi- ject. cal Expense continue to apply. How- 5. The provisions of Section III — Limits Of ever, instead of being subject to the Insurance not otherwise modified by this General Aggregate Limit shown in endorsement shall continue to apply as the Declarations, such limits will be stipulated subject to the applicable Location General Aggregate Limit. 2. General Aggregate Limits Of Insurance — 2. For all sums which the insured becomes Per Location legally obligated to pay as damages a. For all sums which the insured becomes caused by 'occurrences" under Section legally obligated to pay as damages — Coverage A, and for all medical ex - caused by "occurrences" under Section I penses caused by accidents under Sec- - Coverage A, and for all medical ex- tion I — Coverage C, which cannot be at- penses caused by accidents under Sec- tributed only to operations at a single "lo- tion I — Coverage C, which can be at- cation": tributed only to operations at a single " lo- a. Any payments made under Cover - cation". age A for damages or under Cover- (1) A separate Location General Aggre- age C for medical expenses shall re - gate Limit applies to each "location", duce the amount available under the and that limit is equal to the amount General Aggregate Limit or the Prod - of the General Aggregate Limit ucts-completed Operations Aggre- shown in the Declarations. gate Limit, whichever is applicable; and b. Such payments shall not reduce any Location General Aggregate Limit. RLI INSURANCE COMPANY RGL 365 01 19 Contains copyrighted material of Page 6 of 8 Insurance Services Office, Inc. with its permission 3. When coverage for liability arising out of the "products -completed operations haz- ard" is provided, any payments for dam- ages because of "bodily injury" or "prop- erty damage" included in the "products - completed operations hazard" will reduce the Products -completed Operations Ag- gregate Limit, and not reduce the Gen- eral Aggregate Limit nor the Location General Aggregate Limit. 4. For the purposes of this endorsement, the Definitions Section is amended by the addition of the following definition: "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of- way of a railroad. 5. The provisions of Section III — Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. L. Damage To Premises Rented To You Limit Paragraph 6. is deleted and replaced by the following: 6. Subject to paragraph 5. above, which- ever applies, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages be- cause of "property damage" to any one premises, while rented to you, or in the case of fire, explosion, lightning, smoke resulting from such fire; or water while rented to you or temporarily occupied by you with permission of the owner. SECTION IV — COMMERCIAL GENERAL LIA- BILITY CONDITIONS M. Knowledge And Notice Of Occurrence Or Offense Paragraph 2.a. Duties In The Event of Oc- currence, Offense, Claim Or Suit is deleted and replaced by the following: a. Notice of an "occurrence" or of an offense which may result in a claim must be given as soon as practicable after knowledge of the "occurrence" or offense has been re- ported to you, one of your "executive of- ficers" (if you are a corporation), one of your partners who is an individual (if you are a partnership), one of your managers (if you are a limited liability company), one of your trustees who is an individual (if you are a trust), or an "employee" (such as an insurance, loss control or risk manager or administrator) designated by you to give such notice. Knowledge by any other "employee" of an "occurrence" or offense does not im- ply that you also have such knowledge. Notice of an "occurrence" or of an offense which may result in a claim will be deemed to be given as soon as practica- ble to us if it is given in good faith as soon as practicable to your workers' compen- sation, accident, or health insurer. This applies only if you subsequently give no- tice of the "occurrence" or offense to us as soon as practicable after you, one of your "executive officers" (if you are a cor- poration), one of your partners who is an individual (if you are a partnership), one of your managers (if you are a limited lia- bility company), one of your trustees who is an individual (if you are a trust), or an "employee" (such as an insurance, loss control or risk manager or administrator) designated by you to give such notice discovers that the "occurrence" or of- fense may involve this policy. To the extent possible, notice should in- clude: (1) How, when and where the "occur- rence" or offense took place; (2) The names and addresses of any in- jured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occur- rence" or offense. N. Unintentional Omission The following is added to paragraph 6. Rep- resentations: However, the unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy shall not prejudice your rights under this insurance. This provi- sion does not affect our right to collect additional premium or to exercise our RLI INSURANCE COMPANY RGL 365 01 19 Contains copyrighted material of Page 7 of 8 Insurance Services Office, Inc. with its permission right of cancellation or nonrenewal in ac- cordance with applicable insurance laws or regulations. O. Waiver Of Transfer Of Rights Of Recovery Against Others To Us The following is added to paragraph 8. Transfer of Rights of Recovery Against Others to Us: However, we waive any rights of recov- ery we may have against any person or organization because of payments we make for "bodily injury", "property dam- age", "personal injury and advertising in- jury" arising out of: a. Premises owned by you, temporarily occupied by you with permission of the owner, or leased or rented to you; b. Ongoing and completed operations performed by you, or on your behalf, under a contract or agreement with that person or organization; c. Your "work"; or d. "Your products". We waive these rights only where you have agreed to do so as part of a contract or agreement entered into by you before the "bodily injury" or "property damage" occurs or the "personal and advertising injury" offense is committed. SECTION V - DEFINITIONS P. Amended Bodily Injury Definition Paragraph 3. is deleted and replaced by the following: 3. "Bodily injury" means injury to the body, sickness, disease, or death. "Bodily in- jury" also means mental injury, mental anguish, emotional distress, pain and suffering, or shock resulting from injury to the body, sickness, disease or death of any person. Q. Amended Insured Contract Definition 1. Paragraph 9.a. is deleted and replaced by the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemni- fies any person or organization for damage by water, fire, explosion, lightning, or smoke resulting from fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "in- sured contract'; 2. Paragraph 9.c. is deleted and replaced by the following: c. Any easement or license agreement 3. Subsection 9.f.(1) is deleted. 4. The fol- lowing is added to the end of para- graph 9.: The insurance provided by the above definitions of "Insured Contract' shall be excess over any valid and collectible Railroad Protec- tive Liability insurance available to an insured , whether primary, excess, contingent or on any other basis, ex- cept for the insurance purchased specifically by you to apply in excess of the Limits of Insurance shown in the declarations for this Coverage Part. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. RLI INSURANCE COMPANY RGL 365 01 19 Contains copyrighted material of Page 8 of 8 Insurance Services Office, Inc. with its permission Contractors Bonding and Insurance Company RAU 300WA 09 19 Contains copyrighted material of Page 1 of 6 Insurance Services Office, Inc., with its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO ENHANCEMENT SCHEDULE OF COVERAGES ADDRESSED BY THIS ENDORSEMENT A. Broad Form Named Insured B. Employees As Insureds C. Blanket Additional Insured D. Blanket Waiver Of Subrogation E. Employee Hired Autos F. Fellow Employee Coverage G. Auto Loan Lease Gap Coverage H. Glass Repair – Waiver Of Deductible I. Personal Effects Coverage J. Hired Auto Physical Damage Coverage K. Hired Auto Physical Damage – Loss Of Use L. Hired Car – Worldwide Coverage M. Temporary Transportation Expenses N. Amended Bodily Injury Definition – Mental Anguish O. Airbag Coverage P. Amended Insured Contract Definition – Railroad Easement Q. Coverage Extensions – Audio, Visual And Data Electronic Equipment Not Designed Solely For The Production Of Sound R. Notice Of And Knowledge Of Occurrence S. Unintentional Errors Or Omissions Contractors Bonding and Insurance Company RAU 300WA 09 19 Contains copyrighted material of Page 2 of 6 Insurance Services Office, Inc., with its permission This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Broad Form Named Insured The following is added to the SECTION II – COVERED AUTOS LIABILITY COVER- AGE, Paragraph A.1. Who Is An Insured Provision: Any business entity newly acquired or formed by you during the policy period, pro- vided you own fifty percent (50%) or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of one hundred eighty (180) days following the acquisition or formation of the business entity. This provision does not apply to any person or organization for which coverage is ex- cluded by endorsement. B. Employees as Insureds The following is added to the SECTION II – COVERED AUTOS LIABILITY COVER- AGE, Paragraph A.1. Who Is An Insured Provision: Any “employee” of yours is an “insured” while using a covered “auto” you don’t own, hire or borrow in your business or your per- sonal affairs. C. Blanket Additional Insured The following is added to the SECTION II – COVERED AUTOS LIABILITY COVER- AGE, Paragraph A.1. Who Is An Insured Provision: Any person or organization that you are re- quired to include as an additional insured on this coverage form in a contract or agree- ment that is executed by you before the “bodily injury” or “property damage” occurs is an “insured” for liability coverage, but only for damages to which this insurance applies and only to the extent that person or organi- zation qualifies as an “insured” under the Who Is An Insured provision contained in SECTION II – COVERED AUTOS LIABIL- ITY COVERAGE. The insurance provided to the additional insured will be on a primary and non- contributory basis to the additional insured’s own business auto coverage if you are re- quired to do so in a contract or agreement that is executed by you before the “bodily in- jury” or “property damage” occurs. D. Blanket Waiver Of Subrogation The following is added to the SECTION IV – BUSINESS AUTO CONDITIONS, A. Loss Condition, 5. Transfer of Rights Of Re- covery Against Others To Us: We waive any right of recovery we may have against any person or organization to the extent required of you by a contract exe- cuted prior to any “accident” or “loss”, pro- vided that the “accident” or “loss” arises out of the operations contemplated by such con- tract. The waiver applies only to the person or organization designated in such contract. E. Employee Hired Autos 1.The following is added to the SECTION II – COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured Provision: An “employee” of your is an “insured” while operating an “auto” hired or rented under a contract or agreement in that “employee’s” name, with your permis- sion, while performing duties related to the conduct of your business. 2.Changes In General Conditions: Paragraph 5.b. of the Other Insurance Condition in the BUSINESS AUTO CONDITIONS is deleted and replaced with the following: b.For Hired Auto Physical Damage Coverage, the following are deemed to be covered “autos” you own: (1)Any covered “auto” you lease, hire, rent or borrow; and (2)Any covered “auto” hired or rented by your “employee” un- der a contract in that individual “employee’s” name, with your permission, while performing duties related to the conduct of your business. However any “auto” that is leased, hired, rent- ed or borrowed with a driver is not a covered “auto”. Contractors Bonding and Insurance Company RAU 300WA 09 19 Contains copyrighted material of Page 3 of 6 Insurance Services Office, Inc., with its permission F. Fellow Employee Coverage SECTION II – COVERED AUTOS LIABIL- ITY COVERAGE, Exclusion B.5. does not apply if you have workers compensation in- surance in-force covering all of your em- ployees. G. Auto Loan Lease Gap Coverage SECTION III – PHYSICAL DAMAGE COV- ERAGE, C. Limit Of Insurance, is amend- ed by the addition of the following: In the event of a total “loss” to a covered “auto” shown in the Schedule of Declara- tions, we will pay any unpaid amount due on the lease or loan for a covered “auto” less: 1.The amount paid under the PHYSICAL DAMAGE COVERAGE section of the policy; and 2.Any: a.Overdue lease/loan payments at the time of the “loss”; b.Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage. c.Security deposits not returned by the lessor; d.Costs for extended warranties, Credit Life Insurance, Health, Acci- dent or Disability Insurance pur- chased with the loan or lease; and e.Carry-over balances from previous loans or leases. H. Glass Repair – Waiver Of Deductible SECTION III – PHYSICAL DAMAGE COV- ERAGE, D. Deductible is amended by add- ing the following: No deductible for a covered “auto” will apply to glass damage if the glass is repaired ra- ther than replaced. I. Personal Effects Coverage The following is added to SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions: c. Personal Effects Coverage In the event of a total theft loss of your covered “auto” we will pay up to $400 for “loss” to wearing apparel and other personal effects which are: (1)Owned by an “insured”; and (2)In or on your covered “auto”; No deductible applies to Personal Ef- fects Coverage. J. Hired Auto Physical Damage Coverage The following is added to SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions: d. Hired Auto Physical Damage Cover- age If hired “autos” are covered “autos” for Liability Coverage and this policy also provides Physical Damage Coverage for an owned “auto”, then the Physical Damage Coverage is extended to “au- tos” that you hire, rent or borrow subject to the following: (1)The most we will pay for “loss” in any one “accident” to a hired, rented or borrowed “auto” is the lesser of: (a)$60,000 (b)The actual cash value of the damaged or stolen property as of the time of the “loss”; or (c)The cost of repairing or replac- ing the damaged or stolen prop- erty with other property of like kind and quality. (2)An adjustment for depreciation and physical condition will be made in the event of a total “loss”. (3)We may deduct for betterment for parts normally subject to repair and replacement during the useful life of the “auto”. In this event, deductions shall be limited to the lesser of: (a)An amount equal to the propor- tion that the expired life of the part to be repaired or replaced bears to the normal useful life of the part; or (b)The amount which the resale value of the “auto” is increased from the repair or replacement. Contractors Bonding and Insurance Company RAU 300WA 09 19 Contains copyrighted material of Page 4 of 6 Insurance Services Office, Inc., with its permission (4)A deductible equal to the highest Physical Damage deductible appli- cable to any owned auto will apply. (5)This Coverage Extension will not apply to: (a)Any “auto” that is hired, rented or borrowed with a driver; or (b)Any “auto” that is hired, rented or borrowed from your “employ- ee”. K. Hired Auto Physical Damage – Loss Of Use The following is added to SECTION II - COVERED AUTOS LIABILITY COVER- AGE, A.2. Coverage Extensions: c.We will pay sums which you legally must pay to the lessor of a covered “au- to” which you have leased without a driver for thirty (30) days or less for the lessor’s loss of use of the covered “au- to”, provided: (1)This insurance provides compre- hensive, specified causes of loss or collision coverage on the covered “auto”; (2)The loss of use results from the covered “auto” being damaged in an “accident” while you are leasing it. We will pay up to a maximum limit of $1,500 for this coverage extension. L. Hired Car – Worldwide Coverage The following is added to SECTION II – COVERED AUTOS LIABILITY COVER- AGE, A.2. Coverage Extensions: d. Hired Car – Worldwide Coverage (1)We will pay all sums an “insured” legally must pay as damages be- cause of “bodily injury” or “property damage” to which this insurance applies, caused by an “accident” which occurs outside of the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada resulting from the mainte- nance, or use of any covered “auto” of the private passenger type you lease, hire, rent or borrow without a driver for thirty (30) days or less. (2)With respect to any claim made or “suit” instituted outside the United States of America, the territories and possessions of the United States of America, Puerto Rico, and Canada: (a)You shall undertake the investi- gation, settlement and defense of such claims and “suits” and keep us advised of all proceed- ings and actions. (b)You will not make any settle- ment without our consent. (c)We will reimburse you: (i)For the amount of damages because of liability imposed upon you by law on account of “bodily injury” or “property damage” to which this in- surance applies, and (ii)For all reasonable expenses incurred with our consent in connection with the investi- gation, settlement or de- fense of such claims or “suits”. Reimbursement for expenses will be part of the Limit of Insurance for liabil- ity coverage shown in the Business Auto Coverage Declarations, and not in ad- dition to such limits. (3)The limit of insurance for Liability Coverage shown in the Business Auto Coverage Declarations is the most we will reimburse you for the sum of all damages imposed on you, as set forth in paragraph (2)(c) above, and all expenses incurred by you arising out of any single “acci- dent” or “loss”. (4)You must maintain the greater of the following primary auto liability insur- ance limits: (a)Compulsory admitted insurance with limits required to be in force to satisfy the legal requirements of the jurisdiction where the ac- cident occurs; or (b)Insurance limits required by law and issued by a government en- Contractors Bonding and Insurance Company RAU 300WA 09 19 Contains copyrighted material of Page 5 of 6 Insurance Services Office, Inc., with its permission tity or by an insurer licensed or permitted by law to do business in the jurisdiction where the “ac- cident” occurs; or (c)Auto liability insurance limits of at least $300,000 combined sin- gle limit or $100,000 per person / $300,000 per accident Bodily Injury, $100,000 Property Dam- age. If you fail to comply with the above this insurance is not invalidated. However in the event of a “loss”, we will pay only to the extent that we would have been liable had you so complied. (5)The insurance provided by this cov- erage extension is excess over any other collectible insurance available to you whether on a primary, ex- cess, contingent or any other basis. M. Temporary Transportation Expenses SECTION III – PHYSICAL DAMAGE COV- ERAGE, A.4. Coverage Extensions, sub- paragraph a. Transportation Expense is deleted and replaced by the following: a. Transportation Expenses (1)We will pay up to a maximum of $1,500 for temporary transportation expense incurred by you because of Physical Damage to a covered “au- to”. (2)We will pay only for those covered “autos” for which you carry Compre- hensive, Collision or Specified Cause of Loss Coverage. (3)We will pay only for those expenses incurred by you during the period of time that begins twenty-four (24) hours after the covered “loss” and ends at the time when the covered “auto” can be reasonably repaired or replaced. (4)This coverage does not apply while there are spare or reserve “autos” available to you for your operations. N. Amended Bodily Injury Definition - Men- tal Anguish The following is added to SECTION V - DEFINITIONS, Definition C.: “Bodily injury” also includes mental anguish, but only when the mental anguish arises from other bodily injury, sickness or disease. O. Airbag Coverage The following is added to SECTION III - PHYSICAL DAMAGE COVERAGE B. Ex- clusions 3.a.: However, this exclusion will not apply to ac- cidental discharge of an airbag due to me- chanical or electrical breakdown. P. Amended Insured Contract Definition – Railroad Easement SECTION V – DEFINITION paragraph H. “Insured contract” is modified as follows: 1.Paragraph H.3. is replaced by the fol- lowing: 3.Any easement or license agree- ment. 2.Paragraph H.6.a. is deleted. Q. Coverage Extensions – Audio, Visual And Data Electronic Equipment Not De- signed Solely For The Production Of Sound SECTION III – PHYSICAL DAMAGE COV- ERAGE B. Exclusions, exception para- graph a. to exclusion 4.c. and 4.d. is deleted and replaced with the following: a.Equipment and accessories used with such equipment, except for tapes, rec- ords, discs or other electronic media de- vice, provided such equipment is per- manently installed in the covered “auto” at the time of the “loss” or is removable from the housing unit which is perma- nently installed in the covered “auto” at the time of the “loss”, and such equip- ment is designed to be solely operated by use of the power from the “autos” electrical system, in or upon the covered “autos”; or R. Notice Of And Knowledge Of Occurrence SECTION IV – BUSINESS AUTO CONDI- TIONS, A.2. Duties In The Event Of Acci- dent, Claim, Suit or Loss, subparagraph a. is deleted and replaced with the following: a.In the event of “accident”, claim, “suit” or “loss”, you must give us or our author- ized representative prompt notice of the “accident” or “loss” including: Contractors Bonding and Insurance Company RAU 300WA 09 19 Contains copyrighted material of Page 6 of 6 Insurance Services Office, Inc., with its permission (1)How, when and where the “acci- dent” or “loss” occurred; (2)The “insured’s” name and address; and (3)To the extent possible, the names and addresses of any injured person and witnesses. Your duty to give us or our authorized representative prompt notice of the “ac- cident” or “loss” applies only when the “accident” or “loss” is known to: (1)You, if you are an individual; (2)A partner if you are a partnership; or (3)An executive officer or insurance manager, if you are a corporation. S. Unintentional Errors Or Omissions SECTION IV – BUSINESS AUTO CONDI- TIONS, B. General Conditions; 2. Con- cealment, Misrepresentation or Fraud is amended by adding the following: The unintentional omission of, or uninten- tional error in, any information given by you shall not prejudice your rights under this in- surance. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non- renewal. CBX 101 05 18 Page 1 of 6 Policy Number:CKA0400422 Contractors Bonding and Insurance Company COMMERCIAL EXCESS LIABILITY COVERAGE FORM (Occurrence Form) Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the "Named Insured" shown in the Declarations. The words "we," "us" and "our" refer to the Company providing this insurance. The word "insured" means any person or organization qualifying as an insured person under the terms of the underlying insurance. Other words and phrases that appear in bold print have special meaning. Refer to SECTION II – DEFINITIONS. In consideration of the payment of premium, in reliance upon the statements in the Declarations and Schedule of Underlying Insurance which are made a part of this policy, and subject to the terms, conditions and exclusions of this policy we agree with you as follows: SECTION I – INSURING AGREEMENT A. Coverage Subject to the other provisions of this policy, we will pay on behalf of the insured the insured's ultimate net loss if such loss results from an occurrence insured by underlying insurance. However, the insurance afforded by this policy shall apply: (a) only in excess of the underlying insurance; (b) only after the under- lying insurance has been exhausted by payment of the limits of liability of such insurance; and (c) only if caused by an occurrence which takes place during the policy period and in the coverage territory as defined in the underlying insurance. If the underlying insur- ance does not pay a loss, for reasons other than exhaustion of an aggregate limit of liability, then we shall not pay such loss. This policy, except where provisions to the contrary appear herein, is subject to all of the conditions, agreements, exclusions, endorsements and limitations of and shall follow the underlying insurance in all respects. B. Defense And Expense Of Claims And Suits 1.We shall not be obligated to assume charge of or participate in the settlement or defense of any claim made, or suit brought, or proceedings instituted against the insured. However, we shall have the right and opportunity to be associated with the insured in the defense of any claim, suit or proceeding which, in our opinion, may create liability under the terms of this policy. If we assume such right and opportunity, we shall not continue to defend or participate in the defense of any claim or suit after the applicable limit of liability of this policy has been exhausted. 2.We shall not pay any expenses except as follows: a.If the insured is legally liable for interest which accrues on a judgment after the entry of the judgment and before we have paid, offered to pay, or deposited in court the amount of the judgment to which this policy applies, then we will pay the interest on the amount of the judgment to which this policy applies. b.If an expense is incurred directly by us and solely at our discretion, then we will pay such expense. c.If a payment for damages is made under this policy, then we will pay related prejudgment interest for which the insured is legally liable, provided: (1)The underlying insurance pays pre- judgment interest; and (2)Our share of prejudgment interest shall not exceed the proportion that payment for damages under this policy bears to the total damages determined by final judgment or settlement. 3.Subject to all of the foregoing: a.If the defense expense payments are included within the limit of liability of the underlying insurance by the terms of that policy, then any such expense payment we make shall reduce the limit of liability of this policy. b.If the underlying insurance does not include defense expense payments within its limit of liability by the terms of that policy, then any such expense payment we make shall not reduce the limit of liability of this policy. C. Limits Of Liability 1.The limit of liability stated in the Declarations as applicable to each occurrence shall be the total limit of our liability for all ultimate net loss sustained by any one person or as the result of any one occurrence as applied to the appropriate coverage. CBX 101 05 18 Page 2 of 6 2.Subject to the limit of liability for each occurrence: a.The limit of liability stated in the Declarations as general aggregate is the most we will pay during each policy period for all ultimate net loss, except ultimate net loss because of injury and damage included in the products- completed operations hazard or for covered claims involving automobile liability; and b.The limit of liability stated in the Declarations as products-completed operations aggregate is the most we will pay during each policy period for all ultimate net loss because of injury and damage included in the products- completed operations hazard. 3.This insurance shall apply only as excess of the underlying insurance limits of liability shown in the Declarations. However, if the limit of liability of the underlying insurance shown in the Declara- tions has been reduced or exhausted because of payments for an occurrence which took place during our policy period, then this policy shall apply as excess of such reduced limit of liability of the underlying insurance. SECTION II – DEFINITIONS A. Ultimate net loss means all sums actually paid, or which the insured is legally obligated to pay, as damages in settlement or satisfaction of claims or suits for which insurance is afforded under this policy, after proper deduction for all recoveries or salvage. Ultimate net loss shall include defense expense payments made by the insurer of the underlying insurance, provided that such expenses are included within the limit of insurance of the underlying insurance by the terms of that policy. B. Underlying insurance means the policy or policies of insurance in the Schedule of Underlying Insurance. SECTION III – EXCLUSIONS Regardless of whether or not such coverage is afforded by any underlying insurance, this policy does not apply: A. Pollution 1.Advertising injury, bodily injury, personal injury or property damage arising out of the actual, alleged or threatened discharge, dispersal, seepage, mi- gration, release or escape of pollutants: a.That are, or that are contained in any property that is: (1)Being moved from the place where such property or pollutants are accepted by an insured for movement into or onto an automobile; (2)Being transported or towed by an automobile; (3)Otherwise in the course of transit by or on behalf of an insured; (4)Being stored, disposed of, treated or processed in or upon an automobile; or (5)Being moved from an automobile to the place where such property or pollutants are finally delivered, disposed of or abandoned by an insured; b.At or from any premises, site or location which is or was at any time, owned or occupied by, or rented or loaned to, any insured; c.At or from any premises, site or location which is or was at any time used by or for any insured or others for the handling, storage, disposal, processing or treatment of waste; d.Which are or were at any time transported, handled, stored, treated, disposed of, or processed as waste by or for any insured or any person or organization for whom any insured may be legally responsible; or e.At or from any premises, site or location on which any insured or any contractors or sub- contractors working directly or indirectly on any insured's behalf are performing operations; (1)If the pollutants are brought on or to the premises, site or location in connection with such operations by such insured, contractor or subcontractor; or (2)If the operations are to test for, monitor, clean up, remove, contain, treat, detoxify or neutralize or in any way respond to, or assess the effects of pollutants. Paragraphs 1.a.(4) and 1.b. through 1.e. above do not apply to fuels, lubricants, fluids, exhaust gases or other similar pollutants that are needed for or result from the normal electrical, hydraulic or mechanical functioning of an automobile or its parts, if the pollutants escape, seep or migrate or are discharged, dispersed or released directly from an auto part designed by its manufacturer to hold, store, receive or dispose of such pollutants. Paragraphs 1.b. through 1.e. above do not apply to pollutants not in or upon an automobile if: a.The pollutants or any property in which the pollutants are contained are upset, overturned or damaged as a result of the maintenance or use of an automobile; CBX 101 05 18 Page 3 of 6 b.The discharge, dispersal, seepage, migration, release or escape of the pollutants is caused directly by such upset, overturn or damage; and c.The bodily injury or property damage is not otherwise excluded under Paragraph 1.a. of this exclusion. Paragraph 1.e.(1) above does not apply to bodily injury or property damage arising out of the escape of fuels, lubricants or other operating fluids which are needed to perform the normal electrical, hydraulic or mechanical functions necessary for the operation of mobile equipment or its parts, if such fuels, lubricants or other operating fluids escape from a vehicle part designed to hold, store or receive them. This exception does not apply if the fuels, lubricants or other operating fluids are intentionally discharged, dispersed or released, or if such fuels, lubricants or other operating fluids are brought on or to the premises, site or location with the intent to be discharged, dispersed or released as part of the operations being performed by such insured, contractor or subcontractor. Paragraphs 1.b. and 1.e.(1) above do not apply to bodily injury or property damage arising out of heat, smoke or fumes from a hostile fire. 2.Any loss, cost or expense arising out of any: a.Request, demand or order that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of pollutants; or b.Claim or suit by or on behalf of any gov- ernmental authority or others for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of pollutants. As used in this exclusion: 1.Hostile fire means one which becomes uncon- trollable or breaks out from where it was intended to be; and 2.Pollutants means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned, reclaimed or disposed of. B. Nuclear Energy Liability Exclusion (Broad Form) This policy does not apply: 1.Under any Liability Coverage, to ultimate net loss: a.With respect to which an insured under this policy is also an insured under a nuclear ener- gy liability policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters or Nuclear Insur- ance Association of Canada, or would be an insured under any such policy but for its termination upon exhaustion of its limit of liability; or b.Resulting from the hazardous properties of nuclear material and with respect to which (a) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law amendatory thereof, or (b) the insured 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 organization. 2.Under any Medical Payment Coverage, or under any Supplementary Payments provision relating to first aid, to expenses incurred with respect to ultimate net loss resulting from the hazardous properties of nuclear material and arising out of the operation of a nuclear facility by any person or organization; 3.Under any Liability Coverage, to ultimate net loss resulting from the hazardous properties of nuclear material, if: a.The nuclear material (a) is at any nuclear facility owned by, or operated by or on behalf of, an insured, or (b) has been discharged or dispersed therefrom; b.The nuclear material is contained in spent fuel or waste at any time possessed, handled, used, processed, stored, transported or dis- posed of by or on behalf of an insured; or c.The loss 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 nuclear facility. If such facility is located within the United States of America, its territories or possessions or Canada, this Exclusion 3. applies only to ultimate net loss to such nuclear facility and any property thereat. As used in this policy: Hazardous properties include radioactive, toxic or explosive properties; CBX 101 05 18 Page 4 of 6 Nuclear material means source material, special 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 component, solid or liquid, which has been used or exposed to radiation in a nuclear reactor; Waste means any waste material (1) containing by- product material other than the tailings or waste produced by the extraction or concentration of uranium or thorium from any ore processed primarily for its source material content, and (2) resulting from the operation by any person or organization of any nuclear facility included within the definition of nuclear facility under Paragraph (a) or (b) thereof; Nuclear facility means: (a)Any nuclear reactor; (b)Any equipment or device designed or used for: (1) separating the isotopes of uranium or plutonium, (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 device is located consists of or con- tains 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 disposal 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 fissionable material; Ultimate net loss includes all forms of radioactive contamination of property. C. Workers’ Compensation And Similar Laws This policy does not apply: To any obligation of the insured under a workers’ compensation, disability benefits or unemployment compensation law or any similar law. SECTION IV – CONDITIONS A. Appeal – In the event you or any underlying insurer elect not to appeal a judgment in excess of the amount of any underlying insurance, we may elect to appeal. Our limit of liability shall not be increased because of such appeal. Any appeal we elect to make will be at our cost and expense. B. Assignment – Your interest in this policy may not be transferred to another; except by an endorsement issued by us which gives our consent. If you die, this policy shall apply: (1) to your legal representative, but only while acting within the scope of their duties as such; and (2) with respect to your property, to the person having proper temporary custody as an insured, but only until the appointment and qualification of the legal representative. C. Changes – This policy may be changed only by an endorsement issued to form a part of the policy. Notice to you or to our agent or knowledge possessed by us, by our agent or by any other person shall not affect a waiver or a change in any part of this policy. Nor will such notice or knowledge prevent us from asserting any right under the terms of this policy. D. Cancellation 1.The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us or any of our authorized agents advance written notice of cancellation. 2.We may cancel this policy by mailing or delivering to the first Named Insured written notice of can- cellation at least: a.Ten (10) days before the effective date of can- cellation if we cancel for nonpayment of premium; or b.Thirty (30) days before the effective date of cancellation if we cancel for any other reason. 3.We will mail or deliver our notice to the first Named Insured's last mailing address known to us. 4.Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5.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 computed at ninety percent (90%) of pro rata. The cancellation will be effective even if we have not made or offered a refund. 6.If notice is mailed, proof of mailing will be sufficient proof of notice. CBX 101 05 18 Page 5 of 6 E. Duties In The Event Of Occurrence, Claim Or Suit You must see to it that we receive prompt written notice of an occurrence which may result in a claim under this policy. Notice should include how, when and where the occurrence took place. The names and addresses of any injured persons and witnesses must be included. If a claim is made or suit brought against any insured, you must see to it that we receive prompt written notice of the claim or suit. You and any other insured involved must: 1.Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or suit; 2.Authorize us to obtain records and other information; 3.Cooperate with us in the investigation, settlement, or defense of the claim or suit; and 4.Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of injury or damage to which this insurance may also apply. It is a requirement of this policy that you do not make any admission of liability. You shall not, unless we agree, incur any expense or make any payment. If you do, such liability, expense or payment will be at your own cost. F. Bankruptcy Of The Underlying Insurer – In the event of the bankruptcy or insolvency of the insurer of any underlying insurance, the insurance afforded by this policy shall not replace such underlying insurance. Rather, this policy shall apply in the same manner as though such underlying insurance were available and collectible. G. Maintenance Of Underlying Insurance – You agree to maintain all underlying insurance in full force and effect as scheduled in the Schedule of Underlying Insurance at the inception of this policy and during our policy period except for reduction of aggregate limits of liability by payment of losses. If any underlying insurance is not maintained in full effect by the insured, or if there is any material change in the terms, conditions or scope of coverage, by endorsement or otherwise, of any underlying insurance, the insur- ance afforded by this policy shall apply in the same manner as though such underlying insurance had been in full effect, so maintained and unchanged. You agree to notify us promptly if any underlying insur-ance is cancelled or terminated. H. Premium – Premiums for this policy shall be stated in the Declarations and computed in accordance with our rules, rates, rating plans, premiums, and minimum premiums applicable to this insurance. If this policy is issued for a period in excess of one year, the premium for this policy may be revised on each annual anni- versary. Any such revision will be in accordance with our manuals in effect at that time. If the policy is issued on a non-auditable basis, the Flat Rate Premium becomes the policy premium. If the policy is issued on an auditable basis, the premium designated on the Declarations page as Ad- vance Premium shall be credited to the amount of earned premium due at the end of the policy period. At the close of each audit period, the earned premium shall be computed for such period. Upon notice to you, it shall become due and payable. If the total earned premium exceeds the Advance Premium previously paid, the amount by which the earned premium ex- ceeds the Advance Premium shall be due and payable to us by you. In no case shall the earned premium be less than the Minimum Premium shown on the Declarations page. You shall maintain records of such information as is necessary for premium computation. You shall send copies of such records to us at the end of this policy period. You shall also send us copies of such records at such times during the policy period as we may direct. I. Legal Action Against Us – No legal action shall be brought against us unless the insured has fully com- plied with all terms of this policy. In addition, no legal action shall be brought against us until the amount of the insured's obligation to pay has been finally deter- mined. The insured’s obligation to pay must be finally determined either by judgment against the insured after actual trial or by written agreement between us, the insured and the claimant. J. Conformity – Terms of this policy which are in conflict with the laws of the state wherein this policy is issued are hereby amended to conform to such laws. K. Other Insurance – If other insurance, whether collec- tible or not, is available to the insured covering a loss also covered by this policy, other than insurance that is specifically excess of the insurance afforded by this policy, the insurance afforded by this policy shall be in excess of, and shall not contribute with, such other insurance. CBX 101 05 18 Page 6 of 6 L. Subrogation – In the event of any payment under this policy, the insured must notify us of any of the insured's rights of recovery against any person or organization. We shall be subrogated to all such rights. The insured shall execute and deliver instruments and papers and do whatever else is necessary to secure such rights. The insured shall do nothing after loss to prejudice such rights. Any amount recovered through subrogation or otherwise shall be apportioned in the inverse order of payment of the claim or claims involved to the extent of actual payment thereof by all interests. The expenses of all such recoveries and proceedings in connection therewith shall be apportioned in the ratio of respective recoveries. With respect to proceedings conducted solely by us, if there is no recovery, we will bear the expense thereof. If there is a recovery, we shall be reimbursed in full from such recovery for the amount of all expenses incurred by us before apportionment of such recovery as herein provided. M. Salvage – All salvage, recoveries, or payments recovered or received subsequent to a loss settlement under this policy shall be applied as if recovered or received prior to such settlement. All necessary adjustments shall then be made between the insured and us. Nothing in this clause shall be construed to mean that losses under this policy are not recoverable until the insured's ultimate net loss has been finally ascertained. N. Inspection And Audit – We shall be permitted but not obligated to inspect your property and operations at any time. Neither our rights to make inspections, nor the making thereof, nor any report thereon shall constitute an undertaking, on behalf of or for the benefit of you or others, to determine or warrant that such property or operations are safe. We may examine and audit your books and records at any time during the policy period and extensions thereof and within three (3) years after the final termination of this policy, as far as they relate to the subject matter of this insurance. O. Separation Of Insureds – Except with respect to the limits of liability this insurance applies as if each Named Insured were the only Named Insured and separately to each insured against whom claim is made or suit is brought. P. Payment Of Loss – It is a condition of this policy that the insurance afforded under this policy shall apply only after the underlying insurance has been exhausted by payment of its limits of liability. Upon final determination by settlement, award or verdict of the liability of the insured, we will promptly pay you as you shall pay, or be required to pay, the amounts of any losses falling within the terms or limits of this insurance. All losses covered under this policy shall be due and payable by us within thirty (30) days after they are respectively claimed and proof of loss filed with us in conformity with this policy. Bankruptcy or insolvency of the insured shall not relieve us of any of our obligations hereunder. Signature: 4. xe���� Email: japplegate@kentwa.gov Signature: Garin Lee (Jun 8, 202214:37 PDT) Email: glee@kentwa.gov Signature: 10,a"L �- Email: rlashley@kentwa.gov Signature: 8rcav Brian Levenhagen (Jun 10, 2208:23 PDT) Email: bjlevenhagen@kentwa.gov GAJorgensenCo.J u ne2022 Final Audit Report 2022-06-10 Created: 2022-06-08 By: Janice Applegate Qapplegate@kentwa.gov) Status: Signed Transaction ID: CBJCHBCAABAAuB_pG3eWbQVsFoOQ5eaJ_DweTUZ7e9AW "GAJorgensenCo.June2022" History Document created by Janice Applegate (japplegate@kentwa.gov) 2022-06-08 - 7:58:38 PM GMT- IP address: 146.129.252.126 Document e-signed by Janice Applegate (japplegate@kentwa.gov) Signature Date: 2022-06-08 - 8:07:11 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to Garin Lee (glee@kentwa.gov) for signature 2022-06-08 - 8:07:14 PM GMT Email viewed by Garin Lee (glee@kentwa.gov) 2022-06-08 - 9:37:06 PM GMT- IP address: 146.129.252.126 EY Document e-signed by Garin Lee (glee@kentwa.gov) Signature Date: 2022-06-08 - 9:37:54 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to Gary A Jorgensen Sr. (gajorgensenco@comcast.net) for signature 2022-06-08 - 9:37:55 PM GMT i Email viewed by Gary A Jorgensen Sr. (gajorgensenco@comcast.net) 2022-06-08 - 9:55:19 PM GMT- IP address: 67.170.26.154 Document e-signed by Gary A Jorgensen Sr. (gajorgensenco@comcast.net) Signature Date: 2022-06-08 - 9:56:40 PM GMT - Time Source: server- IP address: 67.170.26.154 Document emailed to Ronald Lashley (rlashley@kentwa.gov) for signature 2022-06-08 - 9:56:42 PM GMT Email viewed by Ronald Lashley (rlashley@kentwa.gov) 2022-06-09 - 9:06:48 PM GMT- IP address: 146.129.252.126 EY Document e-signed by Ronald Lashley (rlashley@kentwa.gov) Signature Date: 2022-06-09 - 9:29:09 PM GMT - Time Source: server- IP address: 146.129.252.126 0 Adobe Acrobat Sign Document emailed to Brian Levenhagen (bjlevenhagen@kentwa.gov) for signature 2022-06-09 - 9:29:11 PM GMT Email viewed by Brian Levenhagen (bjlevenhagen@kentwa.gov) 2022-06-10 - 3:22:37 PM GMT- IP address: 146.129.252.126 E= Document e-signed by Brian Levenhagen (bjlevenhagen@kentwa.gov) Signature Date: 2022-06-10 - 3:23:32 PM GMT - Time Source: server- IP address: 146.129.252.126 Agreement completed. 2022-06-10 - 3:23:32 PM GMT 0 Adobe Acrobat Sign