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CAG2022-119 - Amendment - #1 - Liberty Tire Recycling, LLC - 2022 Recycling Events - 09/06/2022
Nancy Yoshitake for Tony Donati Public Works 08/31/2022 09/07/2022 N/A 47005245.64110.7910/7940 N/A Liberty Tire Recycling, LLC formerly L&S Tire Company Contract Amendment 2022 Recycling Events L&S Tire Company was acquired by Liberty Tire Recycling, LLC on June 1, 2022. $0 Other 8/31/22 9/5/22 CAG2022-119 9/8/22 AMENDMENT NO. 1 Page 1 of 2 (between City of Kent and Liberty Tire Recycling, LLC) Amendment No. 1 to Goods & Services Agreement This Amendment No. 1 amends the Goods & Services Agreement originally entered into between the City of Kent and L&S Tire Company, and is effective on the date this document is signed by Liberty Tire Recycling, LLC, a Delaware corporation, and the City of Kent, a Washington municipal corporation ("the “City”). I. RECITALS 1.1 The City and L&S Tire Company, a Washington corporation, entered into a Goods & Services Agreement, dated March 31, 2022 (the "Agreement"). 1.2 On June 1, 2022, L&S Tire Company was acquired by Liberty Tire Recycling, LLC a Delaware corporation. Based on this acquisition, Liberty Tire Recycling, LLC desires to accept and assume all of the rights, duties, benefits, and obligations of L&S Tire Company under the Agreement. 1.3 The City desires to consent to such assumption under the terms of this Amendment No. 1. NOW, THEREFORE, the parties amend the Agreement as follows: II. AMENDMENT 2.1 Liberty Tire Recycling, LLC accepts and assumes all rights, duties, benefits, and obligations of the Agreement and all prior Amendments, including all existing and future obligations to perform under the Agreement and all legal and financial responsibility for the prior performance of L&S Tire Company. 2.2 All references to L&S Tire Company in the Agreement, shall hereinafter be referred to as Liberty Tire Recycling, LLC. 2.3 The notice address information in the Agreement for L&S Tire Company, is replaced with the following notice address information for Liberty Tire Recycling, LLC: Name: Steffeny Wallace-Jacobs Address: Liberty Tire Recycling, LLC 9215 39th Avenue SW Lakewood, WA 98499 Email: swallace-jacobs@libertytire.com Phone: (253) 582-5556 2.4 The City consents to the foregoing assignment to and assumption by Liberty Tire Recycling, LLC. 2.5 Liberty Tire Recycling, LLC agrees to obtain and maintain insurance of the types and in the amounts required by Exhibit B to the Agreement. Attached and incorporated as Attachment 1 to this Amendment No. 1 is a current Certificate of Insurance and endorsement evidencing coverage as required by the Agreement. 2.6 Except as amended by this Amendment No. 1, all other terms and conditions of the Agreement and prior Amendments shall remain in full force and effect. 2.7 In the event of any inconsistency between the provisions of this Amendment No. 1 and the documents comprising the Agreement and prior Amendments, the provisions of this Amendment No. 1 shall prevail. IN WITNESS WHEREOF, the parties have caused this Amendment No. 1 to be executed by their duly authorized representatives. By signing this document, the undersigned certifies they have authority to enter the agreement. The undersigned also understands the services and term. VENDOR LIBERTY TIRE RECYCLING, LLC ByjTk[kWj= watma- CITY CITY OF KENT 'By :-D_ _� Print Name: Dana Ralph ItsMayor Print Name: Its M C4, DATE: o On 22 DATE: 09/06/2022 ATTEST eu� r� Kent City Clerk APPROVED AS TO FORM Kent City Attorney AMENDMENT NO. 1 page 2 of 2 (between City of Kent and Liberty Tire Recycling, LLC) ACORN° CERTIFICATE OF LIABILITY INSURANCE 11/1/2022 DATE (MMIDDIYYYY) 1 8/31/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this Certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies 3280 Peachtree Road NE, Suite #250 Atlanta GA 30305 (404)460-3600 CONTACT NAME: PHONE F /C Ext : A/C No E MAILo ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Illinois Union Insurance Company 27960 INSURED L&S Tire Company 1383905 8119 N Regal Street INSURER B : National Union Fire Ins Co Pitts. PA 19445 INSURER C : National Fire and Marine Insurance Co 20079 INSURER D: AIU Insurance Company 19399 Spokane WA 99217-8120 INSURER E : Everest Indemnity Insurance Company 10851 INSURER F : COVERAGES CERTIFICATE NUMBER: 18813825 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX] OCCUR Y N G27920238007 11/1/2021 11/1/2022 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTE PREMISESEa occu ante $ 500,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY D JECOT- [�] LOC OTHER: GENERAL AGGREGATE $ 2,000,000 X PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY N N 4888747. 11/1/2021 11/1/2022 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 X BODILY INJURY (Per person) $ XXXYAXX BODILY INJURY (Per accident) $ XXX�G�XX PROPERTY DAMAGE Per accident $ XXX�G�XX $ XX=XX C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N 42 - UMO - 306767-04 11/l/2021 l l/l/2022 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I I RETENTION $ $ XX=XX D D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) yes, describe under DESCRIPTION OF OPERATIONS below N /A N WC 65885850 AOS + Mono ( * See Attached FUII Schedule 11/1/2021 11/1/2021 11/1/2022 11/1/2022 X STATUTE ERH E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 E Umbrella - $5M xs $5M N N XC5EX00855-211 11/l/2021 11/l/2022 Each OCC: $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. The City of Kent is included as an Additional Insured as respect General Liability as required by written contract subject to policy terms, conditions, and exclusions. 30 Day Notice of Cancellation/Non-renewal, except 10 days for nonpayment of premium, to the certificate holder when required by written agreement. CERTIFICATE HOLDER CANCELLATION See Attachments 18813825 City Of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PUUl1C Works Department P 400 West Gowe St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Kent WA 98032 AUTHORIZED REPRESENT T VE zl-_ Y f' ACORD 25 (2016/03) © 1988-201,9 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Attachment Code: D570915 Master ID: 1383905, Certificate ID: 18813825 11/1/2021— 11/1/2022 - Worker's Compensation Schedule of Policies Issuing Company States Policy Number AIU Insurance Company AL,AZ,DE,FL, WC 65885850 (AOS + Mono) GA,IA,IL,IN,KY, LA,MD,MN,MO, MS,NC,OH,OK, PA,SC,SD,TN, TX,UT,VA AIU Insurance Company CA WC 65885851 (Cali only) AIU Insurance Company WI WC 65885852 (WI only) Attachment Code: D601579 Master ID: 1383905, Certificate ID: 18813825 Named Insureds: LTR Intermediate Holdings, Inc. Liberty Tire Recycling Holdco, LLC Liberty Tire Recycling Finance, Inc. Liberty Tire Services, LLC Liberty Tire Recycling, LLC Liberty/Lakin National Tire Recycling, LLC Liberty Tire Services of Ohio, LLC Liberty Tire Services of North Carolina, LLC LTS Management, LLC Quality Tire Recycling, LLC LTR Products, LLC U.S. Tire Recycling Partners LP. U.S. Tire Holdings, LLC B.T. Sanitation Service, Inc. Central Carolina Holdings, LLC Auburndale Recycling Center, Inc. L&S Tire Company POLICY NUMBER: G27920238 007 COMMERCIAL GENERAL LIABILITY CG20101001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: As required by written agreement signed by both parties prior to loss. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II — Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily inju- ry" or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the addi- tional insured(s) at the site of the cov- ered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another con- tractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 10 01 © ISO Properties, Inc., 2000 Page 1 of 1 0