HomeMy WebLinkAboutCAG2022-446 - Original - A & M Consulting - 2023 Utility Consulting and Coordination - 11/30/2022Ap
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Originator:Department:
Date Sent:Date Required:
Director or Designee to Sign.
Interlocal Agreement Uploaded to Website
Date of Council Approval:
Grant? Yes No
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Vendor Name:Category:
Vendor Number:Sub-Category:
Project Name:
Project Details:
Agreement Amount:
Start Date:
Basis for Selection of Contractor:
Termination Date:
Local Business? Yes No*
Business License Verification: Yes In-Process Exempt (KCC 5.01.045)
If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace.
Notice required prior to disclosure?
Yes No
Contract Number:
Agreement Routing Form
For Approvals, Signatures and Records Management
This form combines & replaces the Request for Mayor’s Signature and Contract Cover
Sheet forms.
Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20
Budget Account Number:
Budget? Yes No
Dir Asst:
Sup/Mgr:
Dir/Dep:
rev. 20210513
FOR CITY OF KENT OFFICIAL USE ONLY
(Optional)
* Memo to Mayor must be attached
CONSULTANT SERVICES AGREEMENT - 1
($20,000 or Less)
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
A & M Consulting
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and A & M Consulting organized under the laws of the State of Washington,
located and doing business at 18119 NE 30th Street, Redmond, WA 98052, Phone: (206) 276-3635,
Contact: Arnie Tomac (hereinafter the "Consultant").
I. DESCRIPTION OF WORK.
The Consultant shall perform the following services for the City in accordance with the following
described plans and/or specifications:
The Consultant shall provide public and private utility coordination for multiple 2023
projects. For a description, see the Consultant's Scope of Work which is attached as Exhibit
A and incorporated by this reference.
The Consultant further represents that the services furnished under this Agreement will be
performed in accordance with generally accepted professional practices within the Puget Sound region in
effect at the time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in
Section I above immediately upon the effective date of this Agreement. The Consultant shall complete the
work described in Section I by December 31, 2023.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to exceed
Nine Thousand, Two Hundred Forty Dollars ($9,240), for the services described in this
Agreement. This is the maximum amount to be paid under this Agreement for the work
described in Section I above, and shall not be exceeded without the prior written
authorization of the City in the form of a negotiated and executed amendment to this
agreement. The Consultant agrees that the hourly or flat rate charged by it for its services
contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1)
year from the effective date of this Agreement. The Consultant's billing rates shall be as
delineated in Exhibit A.
B. The Consultant shall submit monthly payment invoices to the City for work performed, and
a final bill upon completion of all services described in this Agreement. The City shall
provide payment within forty-five (45) days of receipt of an invoice. If the City objects to
all or any portion of an invoice, it shall notify the Consultant and reserves the option to only
pay that portion of the invoice not in dispute. In that event, the parties will immediately
make every effort to settle the disputed portion.
C. Card Payment Program. The Consultant may elect to participate in automated credit card
payments provided for by the City and its financial institution. This Program is provided as
an alternative to payment by check and is available for the convenience of the Consultant. If
CONSULTANT SERVICES AGREEMENT - 2
($20,000 or Less)
the Consultant voluntarily participates in this Program, the Consultant will be solely
responsible for any fees imposed by financial institutions or credit card companies. The
Consultant shall not charge those fees back to the City.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in
accordance with Ch. 51.08 RCW, the parties make the following representations:
A. The Consultant has the ability to control and direct the performance and details of its
work, the City being interested only in the results obtained under this Agreement.
B. The Consultant maintains and pays for its own place of business from which the
Consultant’s services under this Agreement will be performed.
C. The Consultant has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed before the City
retained the Consultant’s services, or the Consultant is engaged in an independently
established trade, occupation, profession, or business of the same nature as that
involved under this Agreement.
D. The Consultant is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, including the Internal
Revenue Service and the state Department of Revenue.
E. The Consultant has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by the
Consultant’s business, and has obtained a Unified Business Identifier (UBI) number
from the State of Washington.
F. The Consultant maintains a set of books dedicated to the expenses and earnings of
its business.
V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party thirty (30) days written notice at its address set forth on the signature block of
this Agreement. After termination, the City may take possession of all records and data within the
Consultant’s possession pertaining to this project, which may be used by the City without restriction. If
the City’s use of the Consultant’s records or data is not related to this project, it shall be without liability
or legal exposure to the Consultant.
VI. FORCE MAJEURE. Neither party shall be liable to the other for breach due to delay or
failure in performance resulting from acts of God, acts of war or of the public enemy, riots, pandemic, fire,
flood, or other natural disaster or acts of government (“force majeure event”). Performance that is
prevented or delayed due to a force majeure event shall not result in liability to the delayed party. Both
parties represent to the other that at the time of signing this Agreement, they are able to perform as
required and their performance will not be prevented, hindered, or delayed by the current COVID-19
pandemic, any existing state or national declarations of emergency, or any current social distancing
restrictions or personal protective equipment requirements that may be required under federal, state, or
local law in response to the current pandemic.
If any future performance is prevented or delayed by a force majeure event, the party whose
performance is prevented or delayed shall promptly notify the other party of the existence and nature of
the force majeure event causing the prevention or delay in performance. Any excuse from liability shall be
effective only to the extent and duration of the force majeure event causing the prevention or delay in
performance and, provided, that the party prevented or delayed has not caused such event to occur and
continues to use diligent, good faith efforts to avoid the effects of such event and to perform the
obligation.
CONSULTANT SERVICES AGREEMENT - 3
($20,000 or Less)
Notwithstanding other provisions of this section, the Consultant shall not be entitled to, and the
City shall not be liable for, the payment of any part of the contract price during a force majeure event, or
any costs, losses, expenses, damages, or delay costs incurred by the Consultant due to a force majeure
event. Performance that is more costly due to a force majeure event is not included within the scope of
this Force Majeure provision.
If a force majeure event occurs, the City may direct the Consultant to restart any work or
performance that may have ceased, to change the work, or to take other action to secure the work or the
project site during the force majeure event. The cost to restart, change, or secure the work or project site
arising from a direction by the City under this clause will be dealt with as a change order, except to the
extent that the loss or damage has been caused or exacerbated by the failure of the Consultant to fulfill its
obligations under this Agreement. Except as expressly contemplated by this section, all other costs will be
borne by the Consultant.
VII. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the
Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation,
national origin, or the presence of any sensory, mental, or physical disability, discriminate against any
person who is qualified and available to perform the work to which the employment relates. The
Consultant shall execute the attached City of Kent Non-Discrimination Policy Declaration and comply with
City Administrative Policy 1.2.
VIII. INDEMNIFICATION. The Consultant shall defend, indemnify and hold the City, its
officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages,
losses or suits, including all legal costs and attorney fees, arising out of or in connection with the
Consultant's performance of this Agreement, except for that portion of the injuries and damages caused
by the City's negligence.
The City's inspection or acceptance of any of the Consultant's work when completed shall not be
grounds to avoid any of these covenants of indemnification.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW
4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to
property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers,
officials, employees, agents and volunteers, the Consultant's duty to defend, indemnify, and hold the City
harmless, and the Consultant’s liability accruing from that obligation shall be only to the extent of the
Consultant's negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL
INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES
FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER.
In the event the Consultant refuses tender of defense in any suit or any claim, if that tender was
made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court
having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant’s part,
then the Consultant shall pay all the City’s costs for defense, including all reasonable expert witness fees
and reasonable attorneys’ fees, plus the City’s legal costs and fees incurred because there was a wrongful
refusal on the Consultant’s part.
The provisions of this section shall survive the expiration or termination of this Agreement.
IX. INSURANCE. The Consultant shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by
this reference.
CONSULTANT SERVICES AGREEMENT - 4
($20,000 or Less)
X. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide
reasonable accuracy of any information supplied by it to the Consultant for the purpose of completion of
the work under this Agreement.
XI. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings,
designs, reports, or any other records developed or created under this Agreement shall belong to and
become the property of the City. All records submitted by the City to the Consultant will be safeguarded
by the Consultant. The Consultant shall make such data, documents, and files available to the City upon
the City’s request. The Consultant acknowledges that the City is a public agency subject to the Public
Records Act codified in Chapter 42.56 of the Revised Code of Washington. As such, the Consultant agrees
to cooperate fully with the City in satisfying the City’s duties and obligations under the Public Records Act.
The City’s use or reuse of any of the documents, data, and files created by the Consultant for this project
by anyone other than the Consultant on any other project shall be without liability or legal exposure to the
Consultant.
XII. CITY'S RIGHT OF INSPECTION. Even though the Consultant is an independent
contractor with the authority to control and direct the performance and details of the work authorized
under this Agreement, the work must meet the approval of the City and shall be subject to the City's
general right of inspection to secure satisfactory completion.
XIII. WORK PERFORMED AT CONSULTANT'S RISK. The Consultant shall take all necessary
precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the
performance of the contract work and shall utilize all protection necessary for that purpose. All work shall
be done at the Consultant's own risk, and the Consultant shall be responsible for any loss of or damage to
materials, tools, or other articles used or held for use in connection with the work.
XIV. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price
preference may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this
Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those
covenants, agreements or options, and the same shall be and remain in full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any
dispute, difference or claim arising from the parties’ performance of this Agreement, the exclusive means
of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules
and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred
in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or
award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section VIII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at
the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written
notice hereunder shall become effective three (3) business days after the date of mailing by registered or
certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this
Agreement or such other address as may be hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written consent
of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment,
the terms of this Agreement shall continue in full force and effect and no further assignment shall be
made without additional written consent.
CONSULTANT SERVICES AGREEMENT - 5
($20,000 or Less)
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of the City
and the Consultant.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative
of the City, and such statements shall not be effective or be construed as entering into or forming a part
of or altering in any manner this Agreement. All of the above documents are hereby made a part of this
Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any
language contained in this Agreement, the terms of this Agreement shall prevail.
H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable to the
Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or
accruing out of the performance of those operations.
I. Public Records Act. The Consultant acknowledges that the City is a public agency subject to
the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents,
notes, emails, and other records prepared or gathered by the Consultant in its performance of this
Agreement may be subject to public review and disclosure, even if those records are not produced to or
possessed by the City of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying
the City’s duties and obligations under the Public Records Act.
J. City Business License Required. Prior to commencing the tasks described in Section I,
Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of
the Kent City Code.
K. Counterparts and Signatures by Fax or Email. This Agreement may be executed in any
number of counterparts, each of which shall constitute an original, and all of which will together constitute
this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page
to the other by fax or email and that signature shall have the same force and effect as if the Agreement
bearing the original signature was received in person.
IN WITNESS, the parties below execute this Agreement, which shall become effective on
the last date entered below. All acts consistent with the authority of this Agreement and prior
to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed
to have applied,
CONSULTANT:
By:_
Print Name:
Its:
DATE: J1 12 f 12 -1,
CITY OF KENT:
E%ftmly signed by Chad IN —
':Chad B i e re n °.-h d are; -Pe°� w°
BY: D.W.2022.,,-30,7,4,:3U '
Print Name: Chad Bleren, P.E.
Its: Public Works Director
DATE:
NOTICES TO BE SENT TO:
NOTICES TO BE SENT TO:
CONSULTANT:
CITY OF [CENT:
Arnie Tomac
Chad Bieren, P.E.
A & M Consulting
City of Kent
18119 NE 30"' Street
220 Fourth Avenue South
Redmond, WA 98052
Kent, WA 98032
(206) 276-3635 (telephone)
(253) 856-5500 (telephone)
253) 209-4886 facsimile
253 856-6500 facsimile
ATTEST:
L;L' e0VIA,
Kent City Clerk
A d M Consulting • Utility Consulting 9 Coordination 31Leyrer
CONSULTANT SERVICES AGREEMENT - 6
($20,000 or Less)
EEO COMPLIANCE DOCUMENTS - 1
DECLARATION
CITY OF KENT NON-DISCRIMINATION POLICY
The City of Kent (City) is committed to conform to Federal and State laws regarding equal
opportunity. As such all contractors, subcontractors, consultants, vendors, and suppliers who
perform work with relation to this Agreement shall comply with the regulations of the City’s
equal employment opportunity policies.
The City of Kent and its contractors are subject to and will comply with the following:
• Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat.
252), (prohibits discrimination on the basis of race, color, national origin);
• 49 C.F.R. Part 21 (entitled Non-discrimination In Federally-Assisted Programs
Of The Department Of Transportation-Effectuation Of Title VI Of The Civil
Rights Act Of 1964);
• 28 C.F.R. section 50.3 (U.S. Department of Justice Guidelines for
Enforcement of Title VI of the Civil Rights Act of 1964).
Ch. 49.60 RCW (Washington Law Against Discrimination)
The preceding statutory and regulatory cites hereinafter are referred to as “the Acts and
Regulations”.
The following statements specifically identify the requirements the City deems necessary for any
contractor, subcontractor, or supplier on this specific Agreement to adhere to. An affirmation of
all of the following is required for this Agreement to be valid and binding. If any contractor,
subcontractor, or supplier willfully misrepresents themselves with regard to the directives
outlined below, 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 statements 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 I, 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. During the performance of this contract, the contractor, for itself, its assignees, and
successors in interest (hereinafter referred to as the "contractor") agrees as follows:
EEO COMPLIANCE DOCUMENTS - 2
A. Compliance with Regulations: The contractor, subcontractor, consultant,
vendor, and supplier (hereinafter “Contractor”) will comply with all Acts and the
Regulations relative to non-discrimination, including those applicable to Federally-
assisted programs of the U.S. Department of Transportation, State-assisted
programs through the Washington State Department of Transportation, and
generally under Washington’s Law Against Discrimination, Ch. 49.60 RCW, as they
may be amended from time to time, which are herein incorporated by reference
and made a part of this contract.
B. Non-discrimination: The contractor, with regard to the work performed by it
during the contract, will not discriminate on the grounds of race, color, or national
origin in the selection and retention of subcontractors, including procurements of
materials and leases of equipment. The contractor will not participate directly or
indirectly in the discrimination prohibited by the Acts and the Regulations, including
employment practices when the contract covers any activity, project, or program
set forth in Appendix B of 49 CFR Part 21.
C. Solicitations for Subcontracts, Including Procurements of Materials and
Equipment: In all solicitations, either by competitive bidding, or negotiation made
by the contractor for work to be performed under a subcontract, including
procurements of materials, or leases of equipment, each potential subcontractor or
supplier will be notified by the contractor of the contractor's obligations under this
contract and the Acts and the Regulations relative to non-discrimination on the
grounds of race, color, or national origin.
D. Information and Reports: The contractor will provide all information and reports
required by the Acts and Regulations and directives issued pursuant thereto and will
permit access to its books, records, accounts, other sources of information, and its
facilities as may be determined applicable to contractor’s contract by the City or the
Washington State Department of Transportation to be pertinent to ascertain
compliance with such Acts and Regulations and instructions. Where any information
required of a contractor is in the exclusive possession of another who fails or
refuses to furnish the information, the contractor will so certify to the City or the
Washington State Department of Transportation, as appropriate, and will set forth
what efforts it has made to obtain the information.
E. Sanctions for Noncompliance: In the event of a contractor's noncompliance with
the non-discrimination provisions of this contract, the City will impose such contract
sanctions as it or the Washington State Department of Transportation may
determine to be appropriate, including, but not limited to:
a. withholding payments to the contractor under the contract until the
contractor complies; and/or
b. cancelling, terminating, or suspending a contract, in whole or in part.
F. Incorporation of Provisions: The contractor will include the provisions of
paragraphs (A) through (F) above in every subcontract, including procurements of
materials and leases of equipment, unless exempt by the Acts and Regulations and
directives issued pursuant thereto. The contractor will take action with respect to
any subcontract or procurement as the City or the Washington State Department of
Transportation may direct as a means of enforcing such provisions including
sanctions for noncompliance. Provided, that if the contractor becomes involved in,
EEO COMPLIANCE DOCUMENTS - 3
or is threatened with litigation by a subcontractor, or supplier because of such
direction, the contractor may request the City to enter into any litigation to protect
the interests of the City. In addition, the contractor may request the United States
to enter into the litigation to protect the interests of the United States.
6. During the performance of this contract, the contractor, for itself, its assignees, and
successors in interest agrees to comply with the following non-discrimination statutes and
authorities; including but not limited to:
Pertinent Non-Discrimination Authorities:
i. Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252),
(prohibits discrimination on the basis of race, color, national origin); and 49 CFR
Part 21.
ii. The Uniform Relocation Assistance and Real Property Acquisition Policies Act of
1970, (42 U.S.C. § 4601), (prohibits unfair treatment of persons displaced or
whose property has been acquired because of Federal or Federal-aid programs and
projects);
iii. Federal-Aid Highway Act of 1973, (23 U.S.C. § 324 et seq.), (prohibits
discrimination on the basis of sex);
iv. Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as
amended, (prohibits discrimination on the basis of disability); and 49 CFR Part 27;
v. The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq.),
(prohibits discrimination on the basis of age);
vi. Airport and Airway Improvement Act of 1982, (49 USC § 471, Section 47123), as
amended, (prohibits discrimination based on race, creed, color, national origin, or
sex);
vii. The Civil Rights Restoration Act of 1987, (PL 100-209), (Broadened the scope,
coverage and applicability of Title VI of the Civil Rights Act of 1964, The Age
Discrimination Act of 1975 and Section 504 of the Rehabilitation Act of 1973, by
expanding the definition of the terms "programs or activities" to include all of the
programs or activities of the Federal-aid recipients, sub-recipients and contractors,
whether such programs or activities are Federally funded or not);
viii. Titles II and III of the Americans with Disabilities Act, which prohibit discrimination
on the basis of disability in the operation of public entities, public and private
transportation systems, places of public accommodation, and certain testing entities
(42 U.S.C. §§ 12131-12189) as implemented by Department of Transportation
regulations at 49 C.F.R. parts 37 and 38;
ix. The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. §
47123) (prohibits discrimination on the basis of race, color, national origin, and
sex);
x. Executive Order 12898, Federal Actions to Address Environmental Justice in
Minority Populations and Low-Income Populations, which ensures Non-
discrimination against minority populations by discouraging programs, policies, and
activities with disproportionately high and adverse human health or environmental
effects on minority and low-income populations;
xi. Executive Order 13166, Improving Access to Services for Persons with Limited
English Proficiency, and resulting agency guidance, national origin discrimination
includes discrimination because of Limited English proficiency (LEP). To ensure
compliance with Title VI, you must take reasonable steps to ensure that LEP
persons have meaningful access to your programs (70 Fed. Reg. at 74O87 to
7aL00);
xii. Title IX of the Education Amendments of L972, as amended, which prohibits you
from discriminating because of sex in education programs or activities (20 U.S.C.
1681 et seq).
xiii. Washington Law Against Discrimination (Ch. 49.60 RCW)
7. The submission of the final invoice for this contract will constitute a reaffirmation that the
preceding statements were complied with during the course of the contract's performance.
By signing below, I agree to fulfill the five requirements referenced above.
By
For:LM ttn 'r/ft,
Title:,0 ,"r+ L
Date ttl+tlzu
EEO COMPLIANCE DOCUMENTS - 4
EEO COMPLIANCE DOCUMENTS - 5
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: October 20, 2022
SUBJECT: INCLUSIVE CONTRACTING SUPERSEDES: January 1, 1998
APPROVED BY Dana Ralph, Mayor
POLICY:
Equal employment opportunity and non-discrimination in contracting 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.
Further, all contractors, subcontractors, consultants, suppliers, grantees, or subgrantees of the
City, regardless of the value of the Agreement, are required to sign the City’s Non-Discrimination
Policy Declaration, prior to commencing performance.
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 coordinate with the City’s Title VI coordinator, and perform 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.
EXHIBIT A
EXHIBIT B INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS
Insurance
The Consultant shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Consultant, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Consultant shall obtain insurance of the types described below:
1. Automobile Liability insurance covering all owned, non-owned,
hired and leased vehicles. Coverage shall be written on Insurance
Services Office (ISO) form CA 00 01 or a substitute form providing
equivalent liability coverage. If necessary, the policy shall be
endorsed to provide contractual liability coverage.
2. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01. The City shall be named as an
Additional Insured under the Consultant’s Commercial General
Liability insurance policy with respect to the work performed for the
City using ISO additional insured endorsement CG 20 10 11 85 or a
substitute endorsement providing equivalent coverage.
3. Workers’ Compensation coverage as required by the Industrial
Insurance laws of the State of Washington.
B. Minimum Amounts of Insurance
Consultant shall maintain the following insurance limits:
1. Automobile Liability insurance with a minimum combined single
limit for bodily injury and property damage of $1,000,000 per
accident.
2. Commercial General Liability insurance shall be written with limits
no less than $1,000,000 each occurrence, $2,000,000 general
aggregate.
EXHIBIT B (Continued)
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
insurance:
1. The Consultant’s insurance coverage shall be primary insurance as
respect the City. Any Insurance, self-insurance, or insurance pool
coverage maintained by the City shall be excess of the Consultant’s
insurance and shall not contribute with it.
2. The Consultant’s insurance shall be endorsed to state that coverage
shall not be cancelled by either party, except after thirty (30) days
prior written notice by certified mail, return receipt requested, has
been given to the City.
3. The City of Kent shall be named as an additional insured on all
policies (except Professional Liability) as respects work performed
by or on behalf of the Consultant and a copy of the endorsement
naming the City as additional insured shall be attached to the
Certificate of Insurance. The City reserves the right to receive a
certified copy of all required insurance policies. The Consultant’s
Commercial General Liability insurance shall also contain a clause
stating that coverage shall apply separately to each insured against
whom claim is made or suit is brought, except with respects to the
limits of the insurer’s liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than A:VII.
E. Verification of Coverage
Consultant shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Consultant before commencement of the work.
F. Subcontractors
Consultant shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Consultant.
25
50
UK
SBM
ThisSpectrumPolicyconsistsoltneLleclarallon$'L/ovsritgururrl
other Forms and Enclorsements issued to ou . prrt'of ttie Pilicy. This rnsurance is provided bythe stock
iniurance company of The Hartford lnsurance Group shown below'
INSURER: HARTFORD CASUAI,TY INSUNANCE COMPANY
ONE HARTFORD PLAZA, HARTFORD, CT 06].55
COMPANYCODH: 3
PolicyNumber: ?2 SBM UKs025 DX
SPECTRUM POLICY DECLARATIONS oRTGTNAL
,sx*# a
Narned lnsured and Mailing Address: ARNOLD TOMAC DBA A & M
(No,, Street, Town, State, Zip Code) CONSULTING
1.81.19 N.E, 3OTH STREET
REDMONP WA 98052
Policy Pericd: From LL / AL /22 To LL / AL / 23 1 YnAR
12:01 a.rn., $tandard time at your mailing address shown above' Exceptisn: 12 noon in New Hanrpsltire
Nameof Agent/Broker: AJ GALLAGHER & CO TNS BRKRS CA/pHS
Code: 255202
Previous Policy Number: 72 SBM UKs025
Named lnsured is: TNDIVIDUAL
Audit PETiOd: NON*AUDITABI,E
Type of ProPertY Coverage: N0NE
ln*urarrce Frovided: ln return for the payment of the premium and subject to all of the terms of this policy' we
agree with yor-r to provide insurance as stated in this poliey'
TOTAL ANNUAL PREMIUM l$r *425 MP
IN RECOGNI?ION OF TFIH MUT'TIPLE COVERAGES INSURED WITH THE HARTFORD' YOUR
POLTCY PA"EMIUM INCLUDES AN ACCOUNT CREDIT'
Countersigned bY
lfo-a-r, C" fftur /i{-"7.4aN/r.t*}
Authorized RePresentative
09 /L9 /22
Date
i{ri
Form SS 00 0? 12 06
Process Oate: 09 /L9 /22
TNSURHD COPY
Page 001 (CONTINUED CII\t t{aXT PAGE)
PolicY HxPiratinn Aate: 1I /AL / 23
SPECTRUM POLTCY DECLARATTONS {Continued)POLICYNUMBER: ?2 sBM UKS02S
:'1
Location(s), Building(s), Business of Named lnsured and $chedule of Coverages for premises as designated byNumber below.
Locaticn: 001 Building: 001_
18].19 N.E. 3OTH STRAETREDMONN WA 98052
Oescription of Business :
REATJ ESTA?E APFRAISER
Deductible: NO COirsRAcE
BUILDING AND BU$INE$$ PER$ONAL PROPERTY LIMITS OF INSURANCE
EUILDING
NO COVERAGE
BUSINE$S PERSCINAL PRCIPERTY
REPLACEMENT CO$T
PERSONAL PRCIPERTY OF OTHERS
REPLACEMENT COST
MONEY AND SECURITIES
INSIDE THE PREMISES
OUT$IDE THE PRSMTSES
Form $S 00 02 t2 06
Process Aar'e: Ag /L9 /22
PAgC OO2 (CONTINUED ON NEXT PAGE}
Pcticy Expiration Daft: j,I / AI /23
NO COVERAGE
NO CO\ISNAGE
NO CO\rERAGE
NO CO1rSRAGE
d
SPECTRUM POLICY DECLARATTONS {Continued}
POLICY NUMBER: 72 SBM UKs025
BUSINEE$ LIABILITY
LIABILITY AND MEDICAL EXPENSES
MEDICAL EXPENSI$ - ANY ONE PER$OftI
PERSONAL AND ADVERTI$ING INJURY
AGGREGATE LIMIT$
PRODUCTS.COMPLETED OPERATIONS
LIMITS OF INSURANCE
$2,000, oo0
$ l-0, 000
$2, 000, 000
q
DAMAGES TO PREMISES RENTED TO YOU
ANY CINE PREMISES
$ 300,000
$4,000,000
$4, 000, 000
GENERAL AGGREGATE
EMPLCIYMEFIT PRACTICES LIAEILITY
C0VERAGEI FORM $S 09 01
EACH CLAIM LIMIT
DEDI.,CTIBLE - EASH CLAIM LIMIT
NOT APPI,ICA3I,E
AGGREGATE LIMIT
RETROACTIVE DATE: 1"10120 05
This Employment practice$ Liability c*verage c*ntsins clairns fnade cov*mge' Except a$ mffy be otherwise
provided herein, $pecifi;;;;uerages of t'i* lnuui*nce ffre limitecl 0enerully to lialrility.for iniuries for which cl*ims are
first rnacle against the insureci wtrite tne inuiiiunc* iu in for**. piease read anri review the insurunee carefrrlly *nd
discu*s the coverage with your l'lartforrJ Agent or Brsk*r'
The Limits of lnsurance statecl in this Declarati$ns will be recluced, anrl may he etrnpletcly exl'lau*t*d, by the
paynxent of ,.deferrse expens€,' anrl. irr such eve*t, The company will not be *bligat*d t* pay any f[l*h*r
,,def$ilse expsnse,, or sums which the insurecl is or nray beccnte legally otrligated to pay a$ "damsge$"'
BUSINESS LlABlI,lTY OPTTONAL
COVERAGES
HIRED/NON_OWNED AUfO LIABII,TTY
FOF-l4r $S 0L 70
$2,000,000
$ 5,000
$ 5, ooo
rr.ti. r
Form $$ 00 02 1 2 06
Process Date: 09 /19 /22
(COT{TINUED ON NEXT TXAGE}
Policy Expiration Oale: LL/0L/23,l
Fage 003
SPECTRUM POLICY DECLARATTONS {Continued}POLICYNUMBER: 72 sBM UKS0AS
BUSINE$S LIABILITY OPTIONAL COVERAGES
{Continued}
d
ISdFITOYS&S f,XtBIIrIft tilD glsr0p Ct&B8ouxLt rHfl'ltY BY ICSTDENT!&cE lccxpp{l!IODIIY fK.yUltY Dt OIgltgE&rcE n|PIl*XA&
IODIIrY INdfirRt BE DIgSlgU
POI.XCry IJIilX'l!rFPLICllLtl |lO LOCAtrXO$g III ftrsF0LLOWIHC S$ruE(6) Iwl.gtrMflro!{
$rtrlrER Or $mnocasroN:roru{ ss 1} 15
IaoeA,fXO!(r 001 tSILDIt[Glr 001t{ltiEr Ir }!{y
Form $$ 00 02 1A 06
Process Date: 0 I /Lg /22
LIMITS OF INSURANCH
$1, 000, 000
$1, 000, 000
$l_, 000, 0oo
Page 004 (CONTINUED ON NEXT PAGE)
Policy Expiration Date: l'L/ 0L/23
t:
SPECTRUM POLICY DECLARATION$ {Continued}
POLICY NUMtsER: 72 SEM uK5025
ADDITIONAL IN$UREDS
&
a
THEFoLLotvINGAREADDITI0NALIN$uREpsFoRBU$lNEss
LIABILITYCOVERAGE IN THIS POLICY.
T"OCATXOB
lryPE
al![E
001. Bnr[DrMl 001
e[$3ISgAR LESSOB
gEe rox$ xs 13 00
a
Form$$ AA021206
Process Date: 09 lLg/22
PaEe 005 (CONTINUSD 0I$ NEXT PAGE)
PolicY gxpiration Aa|r: LL/AL/23
SPECTRUM FOLICY DECLARATTON$ {Continued}POLICYNUMBER: 72 s8ld UK5025
Form Numbers of Forms and Endorsements that apply:
OO 11 85 ADDTTTONAIJ INSURED * MAT{AGAR/LSSSOR
Form $$ 00 02 1? 06
Process Da&i Ag /Lg l22
ss 00 0l-ss 00 64ss 00 60ss 05 47ss 09 25ss 10 04ss 83 76rr{ 12
16
14
YU
20
03no
09
09
L2
09
T2
L4 ils
(:c
05
04
n1
09
03
05
2B
v4
l*0
67
1c,
00
n1
41
09
IZ
ss 00ss s95s s5ss 09s5 09rH 99
o?
03
0l_
7L
4L
05
09
11
!r. I
L4
09
04
a9
UO
vt1n
04
OB
70
63
07
?0
40
00
01-
4L
1')
no
99
45gs
ss
|iti
IH
1H
LZ ut)
L7
05
71
t4
00
1_2 0607 L6
03 00L2 L4
t2 L4
04 09
d
E
Fage 005
Policy Expiration Date: i_1 /0t/23
$PECTRUM POLICY DECLARATIONS (Continued)
POLICYNUMBER: 72 ssM UK5025
SUPPLEMENTAL OECLARATION$:
Form S$ 00 45 12 06
Process Date: 09 / L9 /22
r
,3
A service fee of g 6.00 is charged for eaclr instailment when your pfemiurn is paid in
installments. The service tee is $ -'
5 ' 00 p*r withdrawal when you select an electronic
fund transfer payment plan. The service fee wilt be added to the premium amount
shown on your premium billing staternent'
a
Policy Expiration gate: 1-Ll0Ll23
ft
coMMO${ pOLtcY coh$ DITIOruS
Form $$ 00 05 f2 S6
(O 2006, The Hartford
QUICK REFERENCE . SPECTRUM POLICY
DECLARATION$
and
COMMON POLICY CONDITICINS
I. DECLARATION$
Named lnsured and Mailing Address
Policy Period
Description and Business Location
Coverages and Limits of lnsurance
II. COMMON POLICY CONDITIONS
A. Cencellation
B. Changes
C. Concealment, Misrepresentation Or Fraud
D. Examination Of your Books And Records
E. lnspeciions And $urveys
F. lnsurance Under Two Or More Coverages
G. Liberalizaiion
H. Other lnsurance - property Coverage
l. Premiums
J. Transfer Of Rights Of Recovery Against Others To Us
K. Transfer Of your Rights And Duties Under This Folicy
L. Premium Audit
Eeginning on Page
I
1t
4
2
4t
2
rt&
2
2
4A
J
,d
d
Form $S 00 05 1t 06
#
coMeJION pCLICY CSrumnTr*rus
All coverages of this policy are subject to the following conditions'
A. Cancellation
1. The first Namecl lnsured shown in the
Declarations may cancel this policy by ntailing
or delivering to us advance written notice of
cancellation.
2. We may cancel this policy by mailing 0r
delivering to the firsl Named lnsured wtitten
notice of cancellation at least;
a. 5 days before the effective date of
cancellation if any one of the foltowing
condiiions exists at any building that is
Covered Property in this PolicY:
(1) The building has been vacant or
unoccuPied 60 or more consecutive
daYs. This does not aPPIY to:
{a) Seasonal unoccuPancY; or
(b) Birilclings in the course of
construction, renovation or
addition.
Buildings with 650/o or more of the rental
units or floor area vacanl or unoccupied ar<:
considerecl unoccupied under this
provision.
(2) After damage by a Covered Cause of
Los$, permanent repairs to the ltuilelittg:
(a) Have not staded; attd
(b) Have ttct been contracted for,
within 30 days of initial payment of
loss.
{3) The building has:
{ai An outstanding order to vacate;
(b) An outstanding dernolition order; or
tc) Been declared unsafe bY
governmental authoritY
(4) FixeeJ and salvageable ilems have
beett or are treirrg; removed frorn the
building and are not being replaced'
This does not aPPIY to such removal
that is necessary or incidental to any
renovation or remodeling'
{5} Faiture to:
(a) Furnish necessary heat, water,
sewer service or electricity fot 30
conseculive daYs or more, except
during a Period of seasonal
unoccupancy; or
(bl Pay property taxes that are owing
and have been outstanding for
more than one Year following the
clate due, except ihat this provision
will not aPPIY where You are in a
bona fide disPute with the taxing
authoritY regarding PaYment of
such taxes.
b. 10 clays before the effective date of
cancellation if we cancel for nonpayment
of premium.
c. 30 days before the effective date of
cancellation if we cancel for any oiher
reason'
3. We will mail or deliver our notice to the first
Named lnsured's last mailing address known to
us.
4. Notice of cancellation will stale the effeclive
date of cancellation. The policy period will end
on that date.
5. lf this policy is canceled, we will send the first
Named lnsured any premium refund due Such
refund will be pro rata. The cancellation will be
effective even if we have not made or offered
a refund.
6. lf notice is mailed, proof of nrailing will be
sufficient Proof of notice.
7. lf the first Named lnsured cancels this policy,
we will retain no less than $100 of the
premtum.
B. Changes
This policy contains all the agreements between
you and us concerning the insurance afforded'
fne first Named lnsured shown in the Declarations
is authorized to make changes in the terms of this
policy with our consent. This policy's terms can be
amended or waived only by endorsement issued by
us and made a Parl of this PoticY'
Form SS 00 05 12 06
@ 2006, The Hartford
FaEe 1 af 3
*
coMMoN POt_tCY CONDtTtOAtS
C. Concealment, Misrepresentation Or Fraud
This policy is voicl in any case of fraucl lry you as it
relates to this palicy at any tinre" lt is also void ifyou 0r any other insured, at any time, interrti*nally
conceal or rnisrepresenl a material fact concerning:
1. "Ihis policy;
2. The Covered proper"ty;
3. Your interest in the Covered Froperty; or
4, A claim under this policy.
D, Examination Of your Books And Records
We may examine and audii your books and records
as they relerte to the policy at any time during thepolicy peiiocl and up to three years afterward.
E. lnspections And $urveys
We have the right but are not obligated to:
1. Make inspections and surveys at any tirne;
2. Give you reports on the conditions we find; and
3" Recommend changes.
Any inspections, srJrveys, repoft$ ot
recornrnenclatiorrs relatr; only to insur.ability anc.i tlre
;:rerniurns to t:e t:ha,rgr:rl. Wel clo not rnake safetyin$pection$. \iVe clo noi unclert*ke to perfornr the
cluty of any Betsolj ar etrganizatir:n to piovicle fr.rr the
health nr safety of ilny flet$ort. /\rrcJ vue clo nol
represent or warrant that conditions:
1. Are safe or healthful; or
2. Comply vuith laws, regulations, codes or
slandards.
T'tris conclition applies nct only to us, i:ul alsu lo anyrating, aclvi*ory, raie *ervice or similar org;lnization
which makes insurance irrspections, survey$, re;lortsct r*commondations.
F. lnsurance Under Two Or More Ccverages
lf two or rnore of this policy,s oilverages apply to the
sitnre loss or damage, r,rr* will nr:rl pily more than ihe
actual arnount of the loss or damage.
G. Liberalization
lf we adopl any revision that would broaden thecoverage under this policy without additionalpremiurn within 4S clays prior to or during the poticy
periocl, the broadeleel coverage will immerjialely
apply to this poticy.
H. Other lnsurance - property Coverage
lf lhere is other insurance covering the sanre loss or
clarnag*, we will pny only for llte amourtt of covered
Ioss or damage in excess of the amount due from
that other insurance, whether you can collect on it ornot. Birt we rarill not pay more than the applicable
Limii of lrrsnrarnce.
Fremiums
1. The first Named lnsured shown in the
Declarations:
a. ls responsible for lhe payment of all
premiums; and
b. Will be the payee for any return premiums
vve p8y.
2. The premium shown in the Declarations was
computed based on rates in effect at the time
the poticy was issued. lf applicable, on eachrenewal, continuation or anniversary of the
effective date of this policy, we wilt compute thepremiurn in accordance with our rales and rules
then in effect,
3. With our consent, you may continue this policy
in force by paying a conlinuation premium for
each successive one-year period. The premium
must be:
a. Paid to us prior to the anniversary date; and
b. Determined in accordance with paragraph
2. abcve.
Our forms then in effect wiil apply. lf you donct pay the continuation premium, lhis policy
will expire on the first anniversary date that vue
have not received the premium.
4. Changes in exposures or changes in your
business operaticn, acquisition or use of
locations that are not shown in the Declaralions
may occur during ihe palicy period. lf so, wemay require an additional prernium. Thatpremium will be determined in accordance witlr
our rates and rules then in effect.
Transfer Of Rights Of Recovery Against Othens
To Us
Applicable to Property Coverage:
lf any person or organization to or for whom uremake payment under this policy has rights torecover damages from anolher, those rights are
transferred to us to the extent of our payrnent. ttratper$on or organization musl do everything
necessary to secure our rights and must do nothing
after loss t0 impait them. But you may waive your
rights against another party in writing:
1. Prior to a loss to your Covered properiy.
2. After a loss to your Covered property only if, at
time of loss, that party is one of the fottowing;
a. Someone insured by lhis insnrance;
b. A business firm:
{1} Owned or controlleeJ by you; or
(2) That owns or controls you; or
J.
ti'ii
Fag* I *f 3 Form SS 00 05 1A 06
c. Your tenant.
You may also accept the usual bills of lading or
shipping receipts limiting the liability of carriers'
This will not restrict your insutance.
K. Transfer Of Your Rights And Duties Under This
Policy
Your rights and duties under this policy may not be
transfeired without our written consent except in the
case of death of an individual Named lnsured'
lf you die, your rights and duties will be transferred
to your legal representative but ottly while acting
within the scope of duties 8s your legal
representative. Until your legal representative is
appointed, anyone having proper temporary custody
oi'yort prope*y will have your rights and duties but
only with respect to that ProPedY'
COMMON POLICY CCINDITICINS
Premium Audit
a. We will compute all premiums for ihis policy in
accordance with our rules and rates' I
b, The pronriuttt amcrint shcwn in the Declaratiorts :
is a ieposii plemi$ln only. Al th* close of each ;
auelit periocl we will conrprrte the earneel E.
i**luii iot ir'at periorl. Anv additicnal 8
prerniitrn founct to be due as i: result etf the
auclit are due ancl payable on fiotice to the fitst
Nsrnocl Insured. tf the deposit premiurn paid
for the policy term is greater than the earned
premium, we will reiurn the exce$s to the first
Named lnsured'
The first Named lnsured must maintain all
records related to the coverage provided by this
policy ancl necessary to finalize the premium
audit, ancl send us copies of the same upon our
request,
Douglas Elliot, President
L
t"
our President and secretary have signed this policy. where required by law' the Declarations page has also been
countersigned by our duly authorized representative'
r*j*'-tt Q^#^ tllteh
()
Kevin Barnett, SecretarY
$
Form SS 00 05 12 06 Page 3 of 3
ffiPOLICYNUIUIBEB: ?2 SBM UK5O25
THI$ ENDOR$EMENT CHANGES THE POLICY' PLEA$E HEAD IT CAREFULLY'
ADDITIONAI, INSURED' MANAGAR/I'ESSOR
fHE CITY OF KNWT
PUBLIC WORXS M{GI$EEITING
22? TOURTII AVE. so'
KENT WA 98032
h;
6
i' -i
l{l
LTt
Form lH 12 0011 05T SEA. NO' 002
procesa Dats: 09 lLg / 22
Printod in U.S.A. Page 00L
ExPlration Dato: 1"1/0L /23
INSURSD COPY
e
TI{IS ENDOR$EMENT CHANGES TI'IF POLICY. PLEA$E READ IT CAREFULLY'
GOODS AT\ND Sffi RVICES ENDORSHMESIT WASI{&NGTOru
This endorsement modifies insurance provided under all Covelage Parts of this Policy'
we nrny offer or make ,,goods or seruices" availai:le tr, you thrCIugh this ttnclerwriting company, a non-ittsurer
sr"rrrsidiary, or unaffitiatecitnirct pafiics r;; ;;;i ;i ilris pbticy, The "goocis or $ervices" may be providecl for a
charge, al a discount, 0n a subsiclized oi*iu, nr fr*e of inaloe ln some case$, we mffy rec*ive e fee from the
urraffiliated thir.i palties that pr0vide "gooiu oi sorvices".- we do not wartant ot guatuntee the "goods or
services,, providecl by thircl parlies, *n*iltcrr tnirrl pnrlies shall be sol*ly liable anel resFottsible for the "goods
or services,'u.,uv priruiJ*.'rn*,,good$ oi services" offerecJ or rrrarle availatrle by us may be rnoelifiecl ar
discontinued at anY time.
This endorseffient is slrbject to RCW 48.30.150(1Xe), which prOhibitS insurance companies from-providing
prizes, goocls, wales, gifl cards, gift ee{tiiicates, orinerctrandise of an aggregate value in excess of $100 per
petso,i in the aggregate in any c*tlsecr*ive twelve'rlonth period'
,,Goods or seruices,, means goods, products or services, including but not limited to risk mitigation, safety'
andlor loss prevention services or equipment
!,-.'
tH 12 A7 82 21
@ 2021, The Hartford
Page 1 of 1
,***#i1
Named lnsured:
Policy Number:
Effective Oate:
Gompany Name:
truilOIJD rOUeC DBr & & !l
72 SBM UK5025
tL / 0L l 22 Expiration Date: IL / AL / 23
HARTFORD CASUALTY INSURANCE COMPANY
THIS ENDORSEMENT CHANGE$ THE POLICY' PLEASE READ tT CAREFULLY
TRADEoREcoNoMIGSANCTI0NSEND0RSEMENT
This insurance does not apply to the oxteilt that tracle or economic sanctiotrs or other laws or regulations
piorriuii"* trom provioing i;,iui*n"*, includinq, but not limiterl to, the payment of claims'
All other terms and conditions remain unchanged'
Li',
lri r
,t Form lH 99 4{ 04 09 Page 1 of 1
FOLICY NUMBER: ?2 SBMUK5025
THI$rNn0R$EnfigruTls&TTACrlguT*AL:FMAffrrAffi'TorYOuRP*tleYlhl
RFSPON$tr TO THg MISELCISUKT RfiQUIfrrrdrNT$ *F TY4fr'Ta&ftGffi,86f1fi RI$K
l}i'&\:&&'r{*g &'cT.
mtsfrL0suffiffi/cAp #zu Ltgsffis - Yffiffiffi#ffis$$w
ffissK frru$uffiAfi\$Cffi $-#?
e
it
$e F{E*Ul-g
Terrorism Premium
$ $s ' oo
A. Disclosure Of Fremium
ln accofdatlr:e with the fecletill Terrorisrn Risk
ln$ur.qnce Act. as atnencleci (-fRlA)' \'vc fire required
to provicle yotl with a notice rlisclosirig the poriir:n of
yot,r pre'niittl, if alty, aitritrLrtable--tti covet'age fct'
icertifiecl ncts of terrorism" trncier TRIA' Tlre portion
of your premium attributable to terrorism coverage is
shown in the above Scheclule of this endorsernent'
B. The following definition is added with respect to the
provisiotts of this endorsement:
1. A "certifiecl act oF terrori$tn" illeatl$ iill act ihat is
certifiecl by the $ecreiary r:f the Treasttry' in
atccorclanee with lhe provisions of TRIA' to be an
act of tetrr:rism uttclsll Tttll\' -l-lre ctiteria
contained in TRIA for a "certified act of terrorism"
include the followittg :
a. The act results in insured losses in excess of
$5 million itt the aggregate, attributable to all
types of insurance subject to TRIA; and
b. The act results in damage within the United
$iates, or r:Lrlside the United Siates in the
case of cedain air carriers or vess*:ls or the
premises of an United $tates mission; and
c. The act is a violent act or an act that i$
dangerous io human life, pt'operty 0l
infrastructure and is commiitecl by an
indiviclual or individuals as part of an effort to
coerce the civilian population of the
United States or to influence the policy or
affect the conduot of the United States
Government bY coerciott
C. Disclosure Of Federal Share Of Terrsrism
Losses
The United States Departmeni of the Treasury will
reimbitlse insurers {or SToiq of insuted los*es
attribLrtable to "cer"tificcl aets of terrolisltl" unrjsr
l"RlA that exceerls tlre a1:plir:af-rle insurer rleciLtctible '
l"lowever, if agtlregate industry insured lo:;ses
allribtllable to "certified acts of terrorism" uttcl+:r
TRIA exceed $100 billion in a calendar year, the
Tr*a*irry shall not make any payrrerli fr:r any poilion
of the amount of such losses lhat exceeds S100
billion. The United States governmeni has ttot
charged any premium for their pa*icipation in
covering terrorism losses
D. Cap On lnsLlrer Liability for Terrorism l-osses
lf aggregatt: inclustry insurecl losses .attrilrtttable io
"certfiect atls oi terlori$tn" Lrncler l-RlA cxceed $100
billion in a calencJat' year altcl we have trtet, or' vrill
rfiost, ouf ittsttt'el rjecluctible Lrrtcler 'frllA' rve sltall
rrol l'le liable for the payrnertt of arty lLorlictt r':f thtr
$rnorrlt of sLtch l$nssli tht.rl excertr'l $'100 billion' ln
such case, your coverage for terrorism losses rnay
be reducecl on a pt-o'rata basis irr accordance v'/ith
procedures established by the Treasury, based on its
eslimates of aggregate industry losses and our
estimate lhat we will exceed our insurer deductible'
-ji ?age 1 of 2
Form $5 837612 2a ts 202a,The Hartford
(lncludes copyrighted material of lnsurance Services Office, lnc., with its permission)
ln accordance with the Treasury,s procedures,
amounls paid for losses may be subject to further
adjustments based on differences between actual
losses and estimates.
E. Application of Other Exclusions
The terms and limitations of any terrorism exclusion,the inapplicability or omission of a terrorism
exclusicn, or the inclusion of terorism coverage, do
not sorvs to create coverage for any loss which
would olhenrvise be excluded under this Coverage
Form, Coverage Part or policy, such as losses
excluded by any pollution, pathogenic, nilcloar
hazard or war exclusions vrrhich nay be includecl on
this Policy.
F. All other terms and conditions remain the same
*E
Page 2 of 2 Form S$ 8376i22A
#
r
tMpsffiTANT NOTIGE T0 pot-lsYl-lsLpER$
To help your lnsurance ksep pace with increasing costs, we have increased your amounl of insUrancs
Uslter irotection ln case of sitl'isr a partial, or total loss lo your propo6y'
lf you feel the nsvv amount is not the proper One, pl€ase contact your agent or broksr"
. giving you
I
Form PG-07r1-0 Prinled in u.s.A.