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Home My WebLink AboutCAG2022-095 - Amendment - #1 - Keller Associates of Idaho, Inc. - Lindental Generator Replacement - 11/02/2022Dani Hodgins for Bryan Bond Public Works 11/02/2022 11/07/2022 N/A S20113 N/A Keller Associates, Inc.Contract Amendment Lindental Generator Replacement Provide additional design and materials to meet the services from the original scope of work. N/A 12/31/2022 $5,100.00 CAG2022-095 11/04/2022 AMENDMENT - 1 OF 2 AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: Keller Associates, Inc. DBA Keller Associates of Idaho, Inc. CONTRACT NAME & PROJECT NUMBER: Lindental Generator Replacement ORIGINAL AGREEMENT DATE: March 17, 2022 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor’s work is modified as follows: 1.Section I of the Agreement, entitled “Description of Work,” is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: Provide additional design and materials in order to meet the services from the original Scope of Work. For a description, see the Consultant's Scope of Work attached as Exhibit A and incorporated by this reference. 2.The contract amount and time for performance provisions of Section II “Time of Completion,” and Section III, “Compensation,” are modified as follows: Original Contract Sum, including applicable WSST $22,082.50 Net Change by Previous Amendments including applicable WSST $0 Current Contract Amount including all previous amendments $22,082.50 Current Amendment Sum $5,100.00 Applicable WSST Tax on this Amendment $0 Revised Contract Sum $27,182.50 Original Time for Completion 12/31/2022 (insert date) Revised Time for Completion under N/A prior Amendments (insert date) Add'1 Days Required (f) for this 0 calendar days Amendment Revised Time for Completion 12/31/2022 (insert date) The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTANT/VENDOR: CITY OF KENT: Digitally signed by David A Brock David A. Brock Works Opercn=Davatons, enaii-dtyot Kent,oa=Public Works Operations, email=dbrock@kenlwagar, �}/ By: ! V c=US Qy Date: 2022110205:56:12-07'00' LJ (signature) (signature) Print Name: Stillman Norton Print Name: David A. Brock, P.F. Its Principal Its Deputy Director Operations (title) DATE: 10/27/2022 (title) DATE: ATTEST: APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent City Clerk Kent Law Department P:\Ac1nnin\Contracts\Dani AMENDMENT - 2 OF 2 KA# 222035 AMENDMENT NO 1 Page 1 of 2 AMENDMENT TO OWNER-CONSULTANT AGREEMENT Amendment No. 1 Background Data: Effective Date of Owner-Consultant Agreement: March 17, 2022 Owner: City of Kent Consultant: Keller Associates, Inc. Project: Lindental Generator Replacement KA # 222035 Nature of Amendment: Additional time and materials budget was required to complete services under the original scope of work. Additional budget was required for the following reasons: The design phase required prior to having plans and specifications ready for bid. In excess of what was identified in the original contract due to sizing change of the replacement generator. Additional coordination on the generator was needed in July and August 2022 (submitted information to Owner on 7/29/22, 8/03/2022, 8/04/2022, and 8/05/2022) to determine suitability of new generator for existing generator pad. Consultant coordinated with the generator supplier to provide additional The scope and budget developed with the original agreement assumed one round of review comments per submittal (30%, 60%, 90%) and that 30% comments would be addressed on the 60% design, 60% comments would be addressed on the 90% design, and 90% comments would be incorporated into a final bid set with no additional revisions thereafter. The 60% set was revised and resubmitted one additional time (6/10/22 original submission, 6/13/22 resubmittal), the 100% final set was revised and resubmitted four additional times (9/01/2022 original submission, then resubmittals on 9/09/2022, 9/12/2022, 9/30/2022, and 10/05/2022). Description of Modifications: Modify Exhibit A, Scope of Work as follows: ADD Subtask 2.7 as follows: 2.7 Revise Final Issue of Design. Make up to four additional revisions to the drawings and specifications and reissue a stamped copy to the Owner. ADD the following sentence to Subtask 3.3: Coordinate installation requirements with Owner and address Owner comments up to three times. KA# 222035 AMENDMENT NO 1 Page 2 of 2 Compensation Summary: Update the compensation schedule using the following table: Task Billing Basis Original Agreement Prior Amendments This Amendment Total Task 1 Project Management T&M $7,832.50 $0.00 $0.00 $7,832.50 Task 2 Design Development and Final Issue T&M $12,045.00 $0.00 $2,000.00 $14,045.00 Task 3 Specifications for Equipment Purchases T&M $1,150.00 $0.00 $3,100.00 $4,250.00 Task 4 Bidding Services T&M $1,055.00 $0.00 $0.00 $1,055.00 Total $22,082.50 $0.00 $5,100.00 $27,182.50 LS = Lump Sum; T&M = Time and Materials Schedule: No change to contract days. 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 2/16/2022 25674 Keller Associates, Inc. 131 SW 5th Ave, Ste A Meridian, ID 83642 25615 28188 31194 32603 A 1,000,000 X X 6804H953952 12/1/2021 12/1/2022 1,000,000 CGD361 CG2037 10,000 CGD379 wos 1,000,000 2,000,000 2,000,000 1,000,000B X X BA2R090770 12/1/2021 12/1/2022 5,000,000C X X CUP8961X179 12/1/2021 12/1/2022 5,000,000 10,000 5,000,000 D X UB8J144072 12/1/2021 12/1/2022 1,000,000 1,000,000 1,000,000 E Professional Liabili AEC-9049533-02 12/1/2021 Each Claim 5,000,000 E Retro date 12/1/1993 AEC-9049533-02 12/1/2021 12/1/2022 Aggregate 5,000,000 City of Kent - Lindental Generator Replacement (21-3020) The City of Kent, Washington, its officers, agents and employees are additional insureds with respect to auto and general liability, as provided by policy forms (specimens attached) Umbrella follows form. City of Kent 220 Fourth Ave. S. Kent Kent, WA 98032 KELLASS-01 WRAMOS The Hartwell Corporation PO Box 400 Caldwell, ID 83606 Wendy Ramos wendy@thehartwellcorp.com Travelers Property Casualty Company of America Charter Oak Fire Insurance Co Travelers Ins Co Travelers Casualty and Surety Berkley Insurance Company Products/C-O X 12/1/2022 X X X X X X X X X X X X Policy Number-4H953952 COMMERCIAL GENERAL LIABILITY 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 Names of Additional Insured Person(s) or Organization(s): Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part, provided that such written contract was signed by you before,and is in effect when, the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising injury" offense is Location of Covered Operations: Any project to which a written contract with the Additional Insured Person(s) or Organization(s) in the Schedule applies. (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) A. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: CG D3 61 03 05 This insurance does not apply to "bodily injury" or "property damage" occurring, or "personal injury" or "advertising injury" arising out of an offense committed, after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, mainte- nance or repairs) to be performed by or on behalf of the additional insured(s) at the loca- tion of the covered operations has been com- pleted; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project. Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. CG T8 03 12 21ncludes copyrighted material of Insurance Services Office, Inc. with its permission. DATE OF ISSUE: 11/18/2021 Page 1 of 1 Policy Number-41-1953952 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part for "bodily injury" or "property damage" included in the products -completed operations hazard, provided that such contract was signed by you before, and is in effect when, the "bodily injury or "property damage" occurs. Location And Description Of Completed Operations Any project to which a written contract with the Additional Insured Person(s) or Organization(s) in the Schedule applies. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or or- ganization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the CG 20 37 07 04 CG T8 04 12 21 DATE OF ISSUE: 11/12/2021 location designated and described in the schedule of this endorsement performed for that additional in- sured and included in the "products -completed opera- tions hazard". © ISO Properties, Inc., 2004 Page 1 of 1 Q J w Z W U' Q O U c�ou—. w:C mi6 a"oOu o9 aco cSw v@` � mm`° L`a Ocoj °t`my �ac@ .@ O..aw « O am 0)=0 - w Z- To`O 0- U— uc 3N-wmoma3 :a.cCOmocw f .• Lg6°gc Locyao o E°v o. aa oO(tmuw}n) -tLs$u�i m«OE o 6 E0 mo CO i'm3G�oTJ �dNoT 0.2 Tv v -pw 0Oca c °im upN°eO ` -.F!12 0u C wva m O>Lw° mO`wU -W .0 E R�O u° m m EEU°_v5u �o Ea0ai�ccm`0d�n�T @wLy OcvE c t4@EYE.�Eonwo9E'o oTocc O>� oL -o Ew>m9 ° n1 E nm n-�m o mE `a�t 0 u o.c oiv°vowMa>oni 0a 05s mu'c `'oT 6 E ° o:m m Vwa>w?6.2nLl m0 L� o p W ?° vvEoao °0m arnuvo �woaimw J^ dw>�7 30°r'°3 °u 'nEo O '^aau£u`mc'EE c E:E 0'uT co E u@m m 0w`w=y w u`oc w O w T°� orZ,sQN d m Vi $ wwo'oY'vm aya w c`w a-o_=_u@i `"° N W W ej na�nO��.wmT FW wcym �- E-on uatO 'o$ wETE°aEowm1m ouN o ° E O wu E d wOv voon�r E ° E OnnE-O TO `U ? uov Om O E W aw .°E�vE-- LLICNA=LO �ajo�aoN v� w _ ._£E�i m�m o @u m WQ SZ vdwou'^ �cd v�4E o0 c ai m@ of a m a E in L J'- a w v ° a Z wy- mOcyow mOw u@wOc@ -NC emuW O1 °E m >c u u�'E NNO@F oT v fomO 'o7ws"°�oEE O awN o u0co oEo m2 °^E>canaor 0 3Oo>y w.ctO �mco OOZyj CT T0 omNWNN �=°uVw2H Fw5 O � o wnSomu0 e¢ Ucon Q E¢¢A noC° iuumi O N w > x w W C w Tye 3 a z ? o ni a li '-^ a ai a ti ra of 3 i r (n ¢ -a ° m o `o a `. 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BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES —INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. BA2R090770 COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (i) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set- tle any such claim or "suit" and keep The following is added to Paragraph A.1., Who Is us advised of all proceedings and ac- An Insured, of SECTION II — COVERED AUTOS tions. LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- (ii) Neither you nor any other involved ing a covered "auto" you don't own, hire or borrow "insured" will make any settlement in your business or your personal affairs. without our consent. E. SUPPLEMENTARY PAYMENTS — INCREASED (iii) We may, at our discretion, participate LIMITS in defending the "insured" against, or in the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION II — COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in - we cover. We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to make such payments ends when we (5) Anywhere in the world, except any country or have used up the applicable limit of jurisdiction while any trade sanction, em- insurance in payments for damages, bargo, or similar regulation imposed by the settlements or defense expenses. United States of America applies to and pro- hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. BA2R090770 You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES —INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph AA., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex - We will a u to $400 for "loss" to wearing a - tent required of you by a written contract pay p 9 p signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. BA2R090770 COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non -renewal. Page 4 of 4 © 2015 The Travelers Indemnity Compa ny. All rights reserved . CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. BA2R090770 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 1. The following is added to Paragraph A.1.c., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: This includes any person or organization who you are required under a written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to name as an additional insured for Covered Autos Liability Coverage, but only for damages to which this insurance applies and only to the extent of that person's or organization's liability for the conduct of another "insured". 2. The following is added to Paragraph B.5., Other Insurance of SECTION IV — BUSINESS AUTO CONDITIONS: Regardless of the provisions of paragraph a. and paragraph d. of this part 5. Other Insurance, this insurance is primary to and non-contributory with applicable other insurance under which an additional insured person or organization is the first named insured when the written contract or agreement between you and that person or organization, that is signed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, requires this insurance to be primary and non-contributory. CA T4 74 02 16 © 2016 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. N N v Q Z'O C w L C 0 0 Y Ol w. Q N m r L L w L Ol m GILL ywj LL. al 0 w= u Cw �_ m N.r m, m VI J U T� m C m N J 'E m v -Z Tw dEw wm�2`w �T m E vaCNtOmvol at_EcoE3.. wmNc VI mw m�0 vv' F EvovcE mo 9L, vm u`JI�`rna�2ma«E—Nav«?> oc m�� m= .. v vJ�LLJm Fy`-' JcvTa-o wv vc`m��'wcwvr �rmwwvc wca w�rnJ rn>a. mO213w �. 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N .m. O 0 01 O -to O_ N ;° �E"v mao,0Y >>uvi E om wL_ '"nnc �° �o� vN 'v ° cLm. 2 � ooc � °= >vo o� aoc v E� °u m .c�c o m3"- J= m E om3 �� e v � 03 � o v vSmm c c y Esc my Z5 �E� mv' m 12 iao N3Jo m aci vo u�,a ;3 n o vY « u £� x�,m No o>;v v a�'9 v-cy �v�a o c.ci 'o =co 3Oo3 c -omu� 3ou5umiw Tu'S Y O Qom cvu-J° 'vi �E >, aE uo .. yT wuf6 Li o mawEv du °v£o°uo y cQao ?ate UE�a�?imJao H3 aooc3`o ��01 o v Tv E�.j u v c o o O E J v j- m v m a v .-, u .-, vL v 3 ami .. u c Rai c N J Y as c 0 o.- m i .r_. .N^.- _ ... .N^.. o j i 0 V ~wvm ~3 ri N N 0 o jOuo: �O3vu ao ri a N N } vi N a u } ' �e N a 0 s 0 LU W r �o UB8J144072 TRAVELERSJW ONE TOWER SQUARE HARTFORD CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 03 13 (00) - 001 POLICY NUMBER: UB-8J144072-21-47-E WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. DATE OF ISSUE: 11-12-21 ST ASSIGN: PAGE 1 OF 1 POLICY NUMBER: 680-4H953952-21-47 ISSUE DATE: 02/09/2022 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY CANCELLATION: SCHEDULE Number of Days Notice: WHEN WE DO NOT RENEW (Nonrenewal): Number of Days Notice: PERSON OR ORGANIZATION: CITY OF KENT ADDRESS: 220 FOURTH AVE. S KENT VA 98032 PROVISIONS A. If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. 30 30 B. If we do not renew this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for When We Do Not Renew (Nonrenewal) in the Schedule above, we will mail notice of nonrenewal to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for When We Do Not Renew (Nonrenewal) in such Schedule before the effective date of nonrenewal. IL T4 00 05 19 © 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 POLICY NUMBER: 13A-2R090770-21-47-G ISSUE DATE: 02-09-22 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY CANCELLATION: SCHEDULE Number of Days Notice: WHEN WE DO NOT RENEW (Nonrenewal): Number of Days Notice: PERSON OR ORGANIZATION: CITY OF KENT ADDRESS: 220 FOURTH AVE. S. KENT WA 98032 PROVISIONS A. If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. 30 30 B. If we do not renew this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for When We Do Not Renew (Nonrenewal) in the Schedule above, we will mail notice of nonrenewal to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for When We Do Not Renew (Nonrenewal) in such Schedule before the effective date of nonrenewal. IL T4 00 05 19 © 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 POLICY NUMBER: CUP-8961x179-21-47 ISSUE DATE: 02/09/2022 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY CANCELLATION: SCHEDULE Number of Days Notice: WHEN WE DO NOT RENEW (Nonrenewal): Number of Days Notice: PERSON OR ORGANIZATION: CITY OF KENT ADDRESS: 220 FOURTH AVE. S. KENT WA 98032 PROVISIONS A. If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. 30 30 B. If we do not renew this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for When We Do Not Renew (Nonrenewal) in the Schedule above, we will mail notice of nonrenewal to the person or organization shown in such Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for When We Do Not Renew (Nonrenewal) in such Schedule before the effective date of nonrenewal. IL T4 00 05 19 © 2019 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 TRAVELERS, WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 06 R3 (00) - 004 POLICY NUMBER: Us-8J144072-21-47-E NOTICE OF CANCELLATION TO DESIGNATED PERSONS OR ORGANIZATIONS The following is added to PART SIX — CONDITIONS : Notice Of Cancellation To Designated Persons Or Organizations If we cancel this policy for any reason other than non-payment of premium by you, we will provide notice of such cancellation to each person or organization designated in the Schedule below. We will mail or deliver such notice to each person or organization at its listed address at least the number of days shown for that person or organiza- tion before the cancellation is to take effect. You are responsible for providing us with the information necessary to accurately complete the Schedule below. If we cannot mail or deliver a notice of cancellation to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete, we have no responsibility to mail, deliver or otherwise notify such designated person or organization of the cancellation. SCHEDULE Name and Address of Designated Persons or Organizations: Number of Days Notice CITY OF KENT 220 FOURTH AVE. S. 30 KENT WA 98032 All other terms and conditions of this policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Insured Insurance Company Policy No. Countersigned by Endorsement No. Premium $ DATE OF ISSUE: 02-09-22 STASSIGN: Page 1 of 1 © 2013 The Travelers Indemnity Company. All rights reserved.