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CAG2023-221 - Original - Devgan Construction, LLC - Replace Synthetic Turf on Cricket Pitch at North Meridian Field - 04/08/2023
FOR CITY OF KENT OFFICIAL USE ONLY Sup/Mgr: Agreement Routing Form • For Approvals,Signatures and Records Management KE N T This form combines&replaces the Request for Mayor's Signature and Contract Cover WASHINGTON Sheet forms. Originator: Department: Shayla Ott Parks, Recreation & Community Services Date Sent: Date Required: 0 04/07/2023 As soon as possible CL Authorized to Sign: Date of Council Approval: QDirector or Designee N/A Budget Account Number: Grant? YesFI/iNo P21082.64190.5496 860 W Budget?w]Yes No Type: N/A Vendor Name: Category: Devgan Construction LLC Contract Vendor Number: Sub-Category: = 2514741 Original Project Name: Replacesynthetic turf on Cricket Pitch at North Meridian Field. 1.1. Project Details:Vendor to provide materials and surface prep to remove and replace 0 = synthetic turn on cricket pitch at North Meridian Field as outlined in Exhibit *, A. c a� Agreement Amount: $5 626.11 Basis for Selection of Contractor: Other `Memo to Mayor must be attached Start Date: As soon as possible Termination Date: 5/31/2023 Im Q Local Business? Yes1ZNo* If meets requirements per KCC3.70.100,please complete"Vendor Purchase-Local Exceptions'form on Cityspace. Business License Verification: YeswI ln-Process Exempt(KCC 5.01.045) Notice required prior to disclosure? Contract Number: YesQNo CAG2023-221 Comments: C a:+ 3 4) H •� i N 3 f0 C V1 Date Routed to the City Clerk's Office: 4/8/23 ,c«w»373__,0 Visit Documents.KentWA.gov to obtain copies of all agreements rev.20210513 • KENT WAs�, �ro GOODS & SERVICES AGREEMENT between the City of Kent and Devgan Construction, LLC THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Devgan Construction, LLC organized under the laws of the State of Washington, located and doing business at 30519 1281h PI SE Auburn, WA 98092; Contact: Sukhvinder Singh; Phone: (206) 349-7628 (hereinafter the "Vendor"). AGREEMENT I. DESCRIPTION OF WORK. The Vendor shall provide the following goods and materials and/or perform the following services for the City: Vendor to provide materials and surface prep to remove and replace synthetic turn on cricket pitch at North Meridian Field as outlined in Exhibit A. The Vendor acknowledges and understands that it is not the City's exclusive provider of these goods, materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and services through other sources. II. TIME OF COMPLETION. Upon the effective date of this Agreement, the Vendor shall complete the work and provide all goods, materials, and services by May 31St 2023 III. COMPENSATION. The City shall pay the Vendor an amount not to exceed FIVE THOUSAND SIX HUNDRED TWENTY SIX DOLLARS AND ELEVEN CENTS ($5,626.11), including applicable Washington State Sales Tax, for the goods, materials, and services contemplated in this Agreement. The City shall pay the Vendor the following amounts according to the following schedule: Vendor to submit invoice to APinvoices@kentwa.gov after completion and approval of work. Card Payment Program. The Vendor 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 GOODS & SERVICES AGREEMENT - 1 ($20,000 or Less, inci. WSST) by check and is available for the convenience of the Vendor. If the Vendor voluntarily participates in this Program, the Vendor will be solely responsible for any fees imposed by financial institutions or credit card companies. The Vendor shall not charge those fees back to the City. If the City objects to all or any portion of an invoice, it shall notify the Vendor 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. A. Defective or Unauthorized Work. The City reserves its right to withhold payment from the Vendor for any defective or unauthorized goods, materials or services. If the Vendor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services from other sources, and the Vendor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Agreement price specified above. The City further reserves its right to deduct these additional costs incurred to complete this Agreement with other sources, from any and all amounts due or to become due the Vendor. B. Final Payment: Waiver of Claims. VENDOR'S ACCEPTANCE OF FINAL PAYMENT SHALL CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR FINAL PAYMENT IS MADE. 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 Vendor 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 Vendor maintains and pays for its own place of business from which the Vendor's services under this Agreement will be performed. C. The Vendor 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 Vendor's services, or the Vendor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Vendor 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 Vendor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by the Vendor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Vendor 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. VI. CHANGES. The City may issue a written amendment for any change in the goods, materials or services to be provided during the performance of this Agreement. If the Vendor determines, for any reason, that an amendment is necessary, the Vendor must submit a written amendment request to the GOODS & SERVICES AGREEMENT - 2 ($20,000 or Less, including WSST) person listed in the notice provision section of this Agreement, Section XV(D), within fourteen (14) calendar days of the date the Vendor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Vendor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the amended work upon receiving either a written amendment from the City or an oral order from the City before actually receiving the written amendment. If the Vendor fails to require an amendment within the time allowed, the Vendor waives its right to make any claim or submit subsequent amendment requests for that portion of the contract work. If the Vendor disagrees with the equitable adjustment, the Vendor must complete the amended work; however, the Vendor may elect to protest the adjustment as provided in subsections A through E of Section VIII, Claims, below. The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. An amendment that is accepted by the Vendor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. VII. FORCE MA)EURE. Neither party shall be liable to the other for breach due to delay or failure in performance resulting from acts of God, acts of war or of the public enemy, riots, pandemic, fire, flood, or other natural disaster or acts of government ("force majeure event"). Performance that is prevented or delayed due to a force majeure event shall not result in liability to the delayed party. Both parties represent to the other that at the time of signing this Agreement, they are able to perform as required and their performance will not be prevented, hindered, or delayed by the current COVID-19 pandemic, any existing state or national declarations of emergency, or any current social distancing restrictions or personal protective equipment requirements that may be required under federal, state, or local law in response to the current pandemic. If any future performance is prevented or delayed by a force majeure event, the party whose performance is prevented or delayed shall promptly notify the other party of the existence and nature of the force majeure event causing the prevention or delay in performance. Any excuse from liability shall be effective only to the extent and duration of the force majeure event causing the prevention or delay in performance and, provided, that the party prevented or delayed has not caused such event to occur and continues to use diligent, good faith efforts to avoid the effects of such event and to perform the obligation. Notwithstanding other provisions of this section, the Vendor 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 Vendor 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 Vendor 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 Vendor to fulfill its obligations under this Agreement. Except as expressly contemplated by this section, all other costs will be borne by the Vendor. VIII. CLAIMS. If the Vendor disagrees with anything required by an amendment, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Vendor may file a claim as provided in this section. The Vendor shall give written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14) calendar days of the date the Vendor knew or should have known of the facts or events giving rise to the claim, whichever occurs first. Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed GOODS & SERVICES AGREEMENT - 3 ($20,000 or Less, including WSST) to have been waived by the Vendor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Vendor's written claim shall include the information set forth in subsections A, items 1 through 5 below. FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY. A. Notice of Claim. Provide a signed written notice of claim that provides the following information: 1. The date of the Vendor's claim; 2. The nature and circumstances that caused the claim; 3. The provisions in this Agreement that support the claim; 4. The estimated dollar cost, if any, of the claimed work and how that estimate was determined; and 5. An analysis of the progress schedule showing the schedule change or disruption if the Vendor is asserting a schedule change or disruption. B. Records. The Vendor shall keep complete records of extra costs and time incurred as a result of the asserted events giving rise to the claim. The City shall have access to any of the Vendor's records needed for evaluating the protest. The City will evaluate all claims, provided the procedures in this section are followed. If the City determines that a claim is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor also waives any additional entitlement and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Vendor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). IX. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. X. WARRANTY. The Vendor warrants that it will faithfully and satisfactorily perform all work provided under this Agreement in accordance with the provisions of this Agreement. In addition to any other warranty provided for at law or herein, this Agreement is additionally subject to all warranty provisions established under the Uniform Commercial Code, Title 62A, Revised Code of Washington. The Vendor warrants goods are merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance with their specifications and the Vendor's representations to City. The Vendor shall promptly correct all defects in workmanship and materials: (1) when the Vendor knows or should have known of the defect, or (2) upon the Vendor's receipt of notification from the City of the existence or discovery of the defect. In the event any part of the goods are repaired, only original replacement parts shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for GOODS & SERVICES AGREEMENT - 4 ($20,000 or Less, including WSST) that portion of the work shall extend for an additional year beyond the original warranty period applicable to the overall work. The Vendor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the correction. XI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. The Vendor shall execute the attached City of Kent Non-Discrimination Policy Declaration and comply with City Administrative Policy 1.2. XII. INDEMNIFICATION. The Vendor 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 Vendor'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 Vendor's work when completed shall not be grounds to avoid any of these covenants of indemnification. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'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 Vendor 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 Vendor's part, then the Vendor 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 Vendor's part. The provisions of this section shall survive the expiration or termination of this Agreement. XIII. INSURANCE. The Vendor 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. XIV. WORK PERFORMED AT VENDOR'S RISK. The Vendor 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 Vendor's own risk, and the Vendor 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. XV. 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. GOODS & SERVICES AGREEMENT - 5 ($20,000 or Less, including WSST) 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 XII of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and the Vendor. 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 Vendor 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 Vendor'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 Vendor 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 Vendor 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 GOODS & SERVICES AGREEMENT - 6 ($20,000 or Less, including WSST) to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. VENDOR: CITY OF KENT: 46r6cvr 7LL* Print Name: sukhvindersingh Print Name: Garin Lee Its; replacing cricket pitch mat Its: Park Operations Superintendent DATE: Apr 8,2023 DATE: Apr 7,2o2s NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Sukhvinder Singh Ben Levenhagen Devgan Construction, LLC City of Kent 30519 1281h PI SE 220 Fourth Avenue South Auburn, WA 98092 Kent, WA 98032 (206) 349-7628 (telephone) (253) 856-5133 (telephone) Sukhdhiman@outlook.com (email) Blevenhagen@Kentwa.gov (email) ATTEST: KWAO Kent City Clerk GOODS & SERVICES AGREEMENT - 7 ($20,000 or Less, including WSST) 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 - 1 of 5 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, or is threatened with litigation by a subcontractor, or supplier because of such EEO COMPLIANCE DOCUMENTS - 2 of 5 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 EEO COMPLIANCE DOCUMENTS - 3 of 5 compliance with Title VI, you must take reasonable steps to ensure that LEP persons have meaningful access to your programs (70 Fed. Reg. at 74087 to 74100); xii. Title IX of the Education Amendments of 1972, 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: IccG�l�vrh�n — For: Deevgan consturction tic Title: replacing cricket pitch mat Date: Apr 8, 2023 EEO COMPLIANCE DOCUMENTS - 4 of 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. EEO COMPLIANCE DOCUMENTS - 5 of 5 d� Sign +� Print � Download EXHIBIT A INVOICE Devgan Construction Llc Payment Terms 30519, 128th pl se Due upon receipt AUBURN, WA 98092 Invoice # 42 Phone: (206) 349-7628 (tel:(206) 349-7628) Email: SUKHDHIMAN@OUTLOOK.CCMate 04/03/2023 (mailto:SUKHDHIMAN@OUTLOOK.COM) Description removal of old mat and dump sanding of concrete making an proper level installation of new mat Includes all the parts and labor Subtotal $5,110.00 tax $516.11 Total $5,626.11 EXHIBIT B INSURANCE REQUIREMENTS FOR SERVICE CONTRACTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Contractor shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all autos used for the purpose of fulfilling this agreement. 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 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The Commercial General Liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 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 Contractor 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, and a $2,000,000 products-completed operations aggregate limit. EXHIBIT B (Continued) C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Contractor's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. E. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. F. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. A ® 7OT3/03/202 E /YYYY) CERTIFICATE OF LIABILITY INSURANCE 3 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Next First Insurance Agency,Inc. PHONE (g55)222-5919 FAx PO Box 60787 A/C No Ext: A/C No), Palo Alto,CA 94306 E-MAIL ADDRESS: support@nextinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: State National Insurance Company,Inc. 12831 INSURED INSURER B: devgan consturction Ilc 30519 128th PI SE INSURER C Auburn,WA 98092 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:652079346 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DDIYYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000.00 DAMAGE TCLAIMS-MADE � OCCUR PREM SESOEa occur RENTEante $100,000.00 MED EXP(Any one person) $15,000.00 A NXTPK3WW73-00-GL 03/03/2023 03/03/2024 PERSONAL&ADV INJURY $1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000.00 POLICY❑ PRO- ❑ LOC PRODUCTS-COMP/OP AGG $2,000,000.00 X JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident L $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Each Occurrence: $25,000.00 A Contractors Errors and Omissions NXTPK3WW73-00-GL 03/03/2023 03/03/2024 Aggregate: $50,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Proof of Insurance. CERTIFICATE HOLDER CANCELLATION devgan consturction Ilc LIVE CERTIFICATE 30519 128th PI SE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Auburn,WA 98092 y� THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Click or scan to view @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Nexr POLICY DOCUMENTS HELL4D 1 • Enclosed you will find the policy documents that make up your insurance contract. Please read through all of these documents. If you have any questions or need to update any of your information, please contact us. A few key insurance terms to help navigate these documents Need to file a claim? • Declarations:States that your business is the named insured and specifies limits. We are here to assist and protect your • Policy:The formal contract issued by the insurance company. interests.Please report a claim as soon as an • Endorsements:Included"extras"in the policy. incident occurs,even if you're not at fault. • Exclusions:What is not covered in the policy. Login to the customer portal or contact support and share your details about the claim. 0 support@nextinsurance.com (855)222-5919 CD nextinsurance.com Q PO Box 60787, Palo Alto,CA 94306 SIGNATURE PAGE In Witness Whereof, we have caused this policy to be executed and attested, and, if required by state law, this policy shall not be valid unless countersigned by our authorized representative. (signature) (signature) Secretary President NXT-0001 IL 10 17 Page 1 of 1 STATE NATIONAL INSURANCE COMPANY, INC. (a stock insurance company) 1900 L Don Dodson Dr. Bedford, Texas 76021 (800) 877-4567 Administered by: Next First Insurance Agency, Inc. PO Box 60787 Palo Alto, CA 94306 (855) 222-5919 COMMON POLICY DECLARATIONS POLICY NUMBER:NXTPK3WW73-00-GL Named Insured and Mailing Address: SUKHVINDER SINGH devgan consturction Ilc 30519 128th PI SE Auburn,WA 98092 Policy Period: From: 03/03/2023 To: 03/03/2024 at 12:01 AM standard time at the mailing address shown above DESCRIPTION OF BUSINESS: General Contractor IN RETURN FOR THE PAYMENT OF PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. PREMIUM BOILER AND MACHINERY COVERAGE PART $ COMMERCIAL AUTOMOBILE COVERAGE PART $ COMMERCIAL CRIME COVERAGE PART $ COMMERCIAL GENERAL LIABILITY COVERAGE PART $975.00 COMMERCIAL INLAND MARINE COVERAGE PART $ COMMERCIAL PROPERTY COVERAGE PART $ EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART $ FARM COVERAGE PART $ LIQUOR LIABILITY COVERAGE PART $ POLLUTION LIABILITY COVERAGE PART $ PROFESSIONAL LIABILITY COVERAGE PART $ COMMERCIAL UMBRELLA/ EXCESS COVERAGE PART $ TOTAL: $ 975.00 Premium shown is payable: $ at inception. NXT-0340 BM GL 0120 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 2 with its permission. SCHEDULE OF POLICY FORMS AND ENDORSEMENTS These Declarations, together with the Common Policy Conditions, and the Coverage Form(s)and endorsement(s), complete the above numbered policy. Listed below are the forms and endorsements attached to this policy at the time of issue: Title Form Number and Edition Date Signature Page NXT-0001 IL 1017 Common Declarations Page NXT-0340 BM GL 0120 Calculation Of Premium IL 00 03 09 08 Nuclear Energy Liability Exclusion Endorsement(Broad Form) IL 00 21 09 08 Washington Changes- Defense Costs IL 01 23 11 13 Washington Common Policy Conditions IL 01 46 08 10 Privacy Notice NXT-0002 IL 0218 NXT-0340 BM GL 0120 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 2 with its permission. IL 00 03 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CALCULATION OF PREMIUM This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART The following is added: The premium shown in the Declarations was com- puted based on rates in effect at the time the policy was issued. On each renewal, continuation, or anni- versary of the effective date of this policy, we will compute the premium in accordance with our rates and rules then in effect. IL 00 03 09 08 © ISO Properties, Inc., 2007 Page 1 of 1 ❑ IL 00 21 09 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (Broad Form) This endorsement modifies insurance provided under the following: COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART UNDERGROUND STORAGE TANK POLICY 1. The insurance does not apply: C. Under any Liability Coverage, to "bodily injury" A. Under any Liability Coverage, to "bodily injury" or "property damage" resulting from "hazard- or"property damage": ous properties" of"nuclear material", if: (1) With respect to which an "insured" under (1) The "nuclear material" (a) is at any "nuclear the policy is also an insured under a nu- facility" owned by, or operated by or on be- clear energy liability policy issued by Nu- half of, an "insured" or (b) has been dis- clear Energy Liability Insurance Associa- charged or dispersed therefrom; tion, Mutual Atomic Energy Liability (2) The "nuclear material" is contained in Underwriters, Nuclear Insurance Associa- "spent fuel" or "waste" at any time pos- tion of Canada or any of their successors, sessed, handled, used, processed, stored, or would be an insured under any such pol- transported or disposed of, by or on behalf icy but for its termination upon exhaustion of an "insured"; or of its limit of liability; or (3) The "bodily injury" or "property damage" (2) Resulting from the "hazardous properties" arises out of the furnishing by an "insured" of "nuclear material" and with respect to of services, materials, parts or equipment in which (a) any person or organization is re- connection with the planning, construction, quired to maintain financial protection pur- maintenance, operation or use of any "nu- suant to the Atomic Energy Act of 1954, or clear facility", but if such facility is located any law amendatory thereof, or (b) the "in- within the United States of America, its terri- sured" is, or had this policy not been issued tories or possessions or Canada, this ex- would be, entitled to indemnity from the clusion (3) applies only to "property dam- United States of America, or any agency age" to such "nuclear facility" and any thereof, under any agreement entered into property thereat. by the United States of America, or any 2. As used in this endorsement: agency thereof, with any person or organi- zation. "Hazardous properties" includes radioactive, toxic B. Under any Medical Payments coverage, to or explosive properties. expenses incurred with respect to "bodily in- "Nuclear material" means "source material", "spe- jury" resulting from the "hazardous properties" cial nuclear material"or"by-product material". of "nuclear material" and arising out of the op- eration of a "nuclear facility" by any person or organization. IL 00 21 09 08 © ISO Properties, Inc., 2007 Page 1 of 2 0 "Source material", "special nuclear material", and (c) Any equipment or device used for the proc- "by-product material" have the meanings given essing, fabricating or alloying of "special them in the Atomic Energy Act of 1954 or in any nuclear material" if at any time the total law amendatory thereof. amount of such material in the custody of "Spent fuel" means any fuel element or fuel com- the "insured" at the premises where such ponent, solid or liquid, which has been used or ex- equipment or device is located consists of posed to radiation in a "nuclear reactor". or contains more than 25 grams of pluto- nium or uranium 233 or any combination "Waste" means any waste material (a) containing thereof, or more than 250 grams of uranium "by-product material" other than the tailings or 235; wastes produced by the extraction or concentra- tion of uranium or thorium from any ore processed (d) Any structure, basin, excavation, premises primarily for its "source material" content, and (b) place prepared or used for the storage or di resulting from the operation by any person or or- ganizationdisposal of any "nuclear facility" included under and includes the site on which any of the foregoing the first two paragraphs of the definition of "nu- is located, all operations conducted on such site clear facility". and all premises used for such operations. "Nuclear facility" means: "Nuclear reactor" means any apparatus designed (a) Any"nuclear reactor"; or used to sustain nuclear fission in a self- supporting chain reaction or to contain a critical (b) Any equipment or device designed or used mass of fissionable material. for(1) separating the isotopes of uranium or plutonium, (2) processing or utilizing "spent "Property damage" includes all forms of radioac- fuel", or(3) handling, processing or packag- tive contamination of property. ing "waste"; Page 2 of 2 © ISO Properties, Inc., 2007 IL 00 21 09 08 0 STATE NATIONAL INSURANCE COMPANY, INC. (a stock insurance company) 1900 L Don Dodson Dr. Bedford, Texas 76021 (800) 877-4567 Administered by: Next First Insurance Agency, Inc. PO Box 60787 Palo Alto, CA 94306 (855) 222-5919 COMMERCIAL GENERAL LIABILITY DECLARATIONS CERTAIN COVERAGES IN THE POLICY MAY BE WRITTEN ON A CLAIMS-MADE BASIS. PLEASE READ YOUR POLICY CAREFULLY. POLICY NUMBER:NXTPK3WW73-00-GL Named Insured and Mailing Address:SUKHVINDER SINGH devgan consturction Ilc 30519 128th PI SE Auburn,WA 98092 Policy Period: From:03/03/2023 To: 03/03/2024 at 12:01 AM standard time at the mailing address shown above DESCRIPTION OF BUSINESS Insured is: Individual/Sole Proprietor Partnership/Joint Venture X Limited Liability Company Trust Other- Corporation Business of Insured: General Contractor LIMITS OF INSURANCE Each Occurrence Limit $1,000,000.00 Damages to Premises Rented to You Limit $100,000.00 Any one premises Medical Expense Limit $15,000.00 Any one person Personal &Advertising Injury Limit $1,000,000.00 Any one person or organization General Aggregate Limit $2,000,000.00 Products/Completed Operations Aggregate Limit $2,000,000.00 NXT-0337 BM GL 0120 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 3 with its permission. CLASSIFICATION AND PREMIUM LOCATION CLASSIFICATION CODE PREMIUM RATE ADVANCE PREMIUM NUMBER NO. BASE Prem/ Prod/Comp Prem/ Prod/Comp Ops Ops Ops Ops 91583 SUBCOST 045.29 $164.89 91585 UBCOST 162.56 $164.89 91584 SUBCOST 067.48 $169.89 State Tax Or Other(if applicable) $0.00 TOTAL PREMIUM (SUBJECT TO AUDIT) $975.00 PREMIUM SHOWN IS PAYABLE: At Inception $ At Each Anniversary $ (If policy period is more than one year and premium is paid in annual installments) AUDIT PERIOD (IF APPLICABLE) X Annually Semi-Annually Quarterly Monthly NXT-0337 BM GL 0120 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 3 with its permission. SCHEDULE OF POLICY FORMS AND ENDORSEMENTS These Declarations, together with the Common Policy Conditions, and the Coverage Form(s)and endorsement(s), complete the above numbered policy. Listed below are the forms and endorsements attached to this policy at the time of issue: Title Form Number and Edition Date Commercial General Liability Declarations NXT-0337 BM GL 0120 Commercial General Liability Coverage Form CG 00 01 04 13 Stop Gap- Employers Liability Coverage Endorsement-Washington CG 04 42 11 03 Washington Changes-Who Is an Insured CG 04 50 05 08 Additional Insured-Owners, Lessees or Contractors-Automatic Status CG 20 33 04 13 When Required in Construction Agreement With You Exclusion -Access or Disclosure of Confidential or Personal Information and CG 21 06 05 14 Data-Related Liability-With Limited Bodily Injury Exception Exclusion- Designated Work CG 21 3401 87 Employment-Related Practices Exclusion CG 21 47 12 07 Total Pollution Exclusion Endorsement CG 21 49 09 99 Exclusion- Designated Ongoing Operations CG 21 5301 96 Limited Exclusion-Designated Operations Covered By a Consolidated CG 21 5401 96 (Wrap-Up) Insurance Program Fungi or Bacteria Exclusion CG 21 67 12 04 Exclusion of Certified Acts of Terrorism CG 21 7301 15 Exclusion- Exterior Insulation and Finish Systems CG 21 86 12 04 Silica or Silica-Related Dust Exclusion CG 21 96 03 05 Exclusion- Engineers,Architects or Surveyors Professional Liability CG 22 43 04 13 Exclusion- Damage to Work Performed by Subcontractors on Your Behalf CG 22 94 10 01 Washington-Exclusion-Viral or Bacterial Infections- Exception for CG 40 43 04 22 Designated Infection, Ongoing Operations or Products Exclusion For Injury To Volunteer Workers NXT-0019 BM GL 0918 Total Professional Services Exclusion NXT-0059 BM GL 0318 Earth Movement Exclusion NXT-0074 BM GL 0218 Prior Completed and Abandoned Work Exclusion NXT-0075 BM GL 0218 Continuous or Progressive Injury and Damage Exclusion NXT-0076 BM GL 0218 Cross Suits Exclusion NXT-0077 BM GL 0218 Bodily Injury to Employees Exclusion-Washington NXT-0078 BM GL WA 0218 Exclusion-Asbestos Exclusion NXT-0080 BM GL 0218 Prior Damages Exclusion NXT-0081 BM GL 0218 Limitation of Coverage to Business Description NXT-0082 BM GL 0218 Blanket Additional Insured NXT-0115 BM GL 0218 Sexually Transmitted Diseases Exclusion NXT-0116 BM GL 0218 Unintentional E&O, Knowledge of Occurrence, Notice of Occurrence NXT-0235 BM GL 0218 Contractor/Subcontractor Insurance Requirements NXT-0307 BM GL 0218 Additional Insured Automatic Status NXT-0308 BM GL 0619 Contractor Professional Liability Limited Exclusion NXT-0312 BM GL 0218 Contractors Errors and Omissions Coverage-Washington NXT-0313 BM GL WA 0120 Foreign Drywall Contaminants NXT-0314 BM GL 0218 Condominium,Townhome,Timeshare,and Tract Home Exclusion NXT-0350 BM GL 0318 Exclusion- Lead Exclusion NXT-0079 BM GL 0218 Non Compensatory Damages Exclusion NXT-0083 BM GL 0218 Concurrent Causation NXT-A01 GL WA 1117 Exclusion Of Punitive Damages Related To A Certified Act Of Terrorism CG 21 76 01 15 Notice of Terrorism NXT-0073 BM GL 0218 OFAC Notice SNC-IL-0719-OFAC-N (SNIC) Trade or Economic Sanctions SNC-IL-0719-TOES-E(SNIC) NXT-0337 BM GL 0120 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 3 with its permission. ;� KENT Welcome Shayla Oft Home Basic Information Legal Entity Name UBI License Type Reissuance FileLocal Application Id Application Status Devgan Construction LLC 6048254600010001 BLOC Q O 11581 Under Review O Printable Application Basic Information Business Information Payment Review Notes Business Name Trade Name (DBAs) Devgan Construction LLC I Devgan Construction LLC State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Washington State Prevailing Wage The PREVAILING WAGES listed here include both the hourly wage rate and the hourly rate of fringe benefits. On public works projects, worker's wage and benefit rates must add to not less than this total. A brief description of overtime calculation requirements are provided on the Benefit Code Key. Journey Level Prevailing Wage Rates for the Effective Date: 4/5/2023 County Trade Job Classification Wage Holiday Overtime Note *Risk Class King Laborers Air, Gas Or Electric Vibrating $56.80 15J 4V 8Y View Screed King Laborers Airtrac Drill Operator $58.56 15J 4V 8Y View King Laborers Ballast Regular Machine $56.80 15J 4V 8Y View King Laborers Batch Weighman $48.14 15J 4V 8Y View King Laborers Brick Pavers $56.80 15J 4V 8Y View King Laborers Brush Cutter $56.80 15J 4V 8Y View King Laborers Brush Hog Feeder $56.80 15J 4V 8Y View King Laborers Burner $56.80 15J 4V 8Y View King Laborers Caisson Worker $58.56 15J 4V 8Y View King Laborers Carpenter Tender $56.80 15J 4V 8Y View King Laborers Cement Dumper-paving $57.84 15J 4V 8Y View King Laborers Cement Finisher Tender $56.80 15J 4V 8Y View King Laborers Change House Or Dry Shack $56.80 15J 4V 8Y View King Laborers Chipping Gun (30 Lbs. And $57.84 15J 4V 8Y View Over) King Laborers Chipping Gun (Under 30 Lbs.) $56.80 15J 4V 8Y View King Laborers Choker Setter $56.80 15J 4V 8Y View King Laborers Chuck Tender $56.80 15J 4V 8Y View King Laborers Clary Power Spreader $57.84 15J 4V 8Y View King Laborers Clean-up Laborer $56.80 15J 4V 8Y View King Laborers Concrete Dumper/Chute $57.84 15J 4V 8Y View Operator King Laborers Concrete Form Stripper $56.80 15J 4V 8Y View King Laborers Concrete Placement Crew $57.84 15J 4V 8Y View King Laborers Concrete Saw Operator/Core $57.84 15J 4V 8Y View Driller King Laborers Crusher Feeder $48.14 15J 4V 8Y View King Laborers Curing Laborer $56.80 15J 4V 8Y View King Laborers Demolition: Wrecking Et Moving $56.80 15J 4V 8Y View (Incl. Charred Material) King Laborers Ditch Digger $56.80 15J 4V 8Y View King Laborers Diver $58.56 15J 4V 8Y View King Laborers Drill Operator (Hydraulic, $57.84 15J 4V 8Y View Diamond) King Laborers Dry Stack Walls $56.80 15J 4V 8Y View King Laborers Dump Person $56.80 15J 4V 8Y View King Laborers Epoxy Technician $56.80 15J 4V 8Y View King Laborers Erosion Control Worker $56.80 15J 4V 8Y View King Laborers Faller 8t Bucker Chain Saw $57.84 15J 4V 8Y View King Laborers Fine Graders $56.80 15J 4V 8Y View King Laborers Firewatch $48.14 15J 4V 8Y View King Laborers Form Setter $57.84 15J 4V 8Y View King Laborers Gabian Basket Builders $56.80 15J 4V 8Y View King Laborers General Laborer $56.80 15J 4V 8Y View King Laborers Grade Checker Ft Transit Person $59.85 15J 4V 8Y View King Laborers Grinders $56.80 15J 4V 8Y View King Laborers Grout Machine Tender $56.80 15J 4V 8Y View King Laborers Groutmen (Pressure) Including $57.84 15J 4V 8Y View Post Tension Beams King Laborers Guardrail Erector $56.80 15J 4V 8Y View King Laborers Hazardous Waste Worker (Level $58.56 15J 4V 8Y View A) King Laborers Hazardous Waste Worker (Level $57.84 15J 4V 8Y View B) King Laborers Hazardous Waste Worker (Level $56.80 15J 4V 8Y View C) King Laborers High Scaler $58.56 15J 4V 8Y View King Laborers Jackhammer $57.84 15J 4V 8Y View King Laborers Laserbeam Operator $57.84 15J 4V 8Y View King Laborers Maintenance Person $56.80 15J 4V 8Y View King Laborers Manhole Builder-Mudman $57.84 15J 4V 8Y View King Laborers Material Yard Person $56.80 15J 4V 8Y View King Laborers Mold Abatement Worker $56.80 15J 4V 8Y View King Laborers Motorman-Dinky Locomotive $59.95 15J 4V 8Y View King Laborers nozzleman (concrete pump, $59.85 15J 4V 8Y View green cutter when using combination of high pressure air 8t water on concrete $ rock, sandblast, gunite, shotcrete, water blaster, vacuum blaster) King Laborers Pavement Breaker $57.84 15J 4V 8Y View King Laborers Pilot Car $48.14 15J 4V 8Y View King Laborers Pipe Layer (Lead) $59.85 15J 4V 8Y View King Laborers Pipe Layer/Tailor $57.84 15J 4V 8Y View King Laborers Pipe Pot Tender $57.84 15J 4V 8Y View King Laborers Pipe Reliner $57.84 15J 4V 8Y View King Laborers Pipe Wrapper $57.84 15J 4V 8Y View King Laborers Pot Tender $56.80 15J 4V 8Y View King Laborers Powderman $58.56 15J 4V 8Y View King Laborers Powderman's Helper $56.80 15J 4V 8Y View King Laborers Power Jacks $57.84 15J 4V 8Y View King Laborers Railroad Spike Puller - Power $57.84 15J 4V 8Y View King Laborers Raker - Asphalt $59.85 15J 4V 8Y View King Laborers Re-timberman $58.56 15J 4V 8Y View King Laborers Remote Equipment Operator $57.84 15J 4V 8Y View King Laborers Rigger/Signal Person $57.84 15J 4V 8Y View King Laborers Rip Rap Person $56.80 15J 4V 8Y View King Laborers Rivet Buster $57.84 15J 4V 8Y View King Laborers Rodder $57.84 15J 4V 8Y View King Laborers Scaffold Erector $56.80 15J 4V 8Y View King Laborers Scale Person $56.80 15J 4V 8Y View King Laborers Sloper (Over 20") $57.84 15J 4V 8Y View King Laborers Sloper Sprayer $56.80 15J 4V 8Y View King Laborers Spreader (Concrete) $57.84 15J 4V 8Y View King Laborers Stake Hopper $56.80 15J 4V 8Y View King Laborers Stock Piler $56.80 15J 4V 8Y View King Laborers Swinging Stage/Boatswain $48.14 15J 4V 8Y View Chair King Laborers Tamper Et Similar Electric, Air $57.84 15J 4V 8Y View Et Gas Operated Tools King Laborers Tamper (Multiple Et Self- $57.84 15J 4V 8Y View propelled) King Laborers Timber Person - Sewer (Lagger, $57.84 15J 4V 8Y View Shorer Et Cribber) King Laborers Toolroom Person (at Jobsite) $56.80 15J 4V 8Y View King Laborers Topper $56.80 15J 4V 8Y View King Laborers Track Laborer $56.80 15J 4V 8Y View King Laborers Track Liner (Power) $57.84 15J 4V 8Y View King Laborers Traffic Control Laborer $51.48 15J 4V 9C View King Laborers Traffic Control Supervisor $54.55 15J 4V 9C View King Laborers Truck Spotter $56.80 15J 4V 8Y View King Laborers Tugger Operator $57.84 15J 4V 8Y View King Laborers Tunnel Work-Compressed Air $158.87 15J 4V 9B View Worker 0-30 psi King Laborers Tunnel Work-Compressed Air $163.90 15J 4V 9B View Worker 30.01-44.00 psi King Laborers Tunnel Work-Compressed Air $167.58 15J 4V 9B View Worker 44.01-54.00 psi King Laborers Tunnel Work-Compressed Air $173.28 15J 4V 9B View Worker 54.01-60.00 psi King Laborers Tunnel Work-Compressed Air $175.40 15J 4V 9B View Worker 60.01-64.00 psi King Laborers Tunnel Work-Compressed Air $180.50 15J 4V 9B View Worker 64.01-68.00 psi King Laborers Tunnel Work-Compressed Air $182.40 15J 4V 9B View Worker 68.01-70.00 psi King Laborers Tunnel Work-Compressed Air $184.40 15J 4V 9B View Worker 70.01-72.00 psi King Laborers Tunnel Work-Compressed Air $186.40 15J 4V 9B View Worker 72.01-74.00 psi King Laborers Tunnel Work-Guage and Lock $59.95 15J 4V 8Y View Tender King Laborers Tunnel Work-Miner $59.95 15J 4V 8Y View King Laborers Vibrator $57.84 15J 4V 8Y View King Laborers Vinyl Seamer $56.80 15J 4V 8Y View King Laborers Watchman $43.76 15J 4V 8Y View King Laborers Welder $57.84 15J 4V 8Y View King Laborers Well Point Laborer $57.84 15J 4V 8Y View King Laborers Window Washer/Cleaner $43.76 15J 4V 8Y View Devgan Construction - North Meridian Contract Final Audit Report 2023-04-11 Created: 2023-04-07 By: Shayla Ott(sott@kentwa.gov) Status: Signed Transaction ID: CBJCHBCAABAAg3g4dTmabU5FcXsuxFLcTbioiD8VuuPO "Devgan Construction - North Meridian Contract" History Document created by Shayla Ott (sott@kentwa.gov) 2023-04-07-5:45:17 PM GMT Document emailed to glee@kentwa.gov for signature 2023-04-07-5:49:23 PM GMT Email viewed by glee@kentwa.gov 2023-04-07-9:19:09 PM GMT d4 Signer glee@kentwa.gov entered name at signing as Garin Lee 2023-04-07-9:20:52 PM GMT �a Document e-signed by Garin Lee (glee@kentwa.gov) Signature Date:2023-04-07-9:20:54 PM GMT-Time Source:server Document emailed to sukhdhiman@outlook.com for signature 2023-04-07-9:20:55 PM GMT Email viewed by sukhdhiman@outlook.com 2023-04-08-6:58:17 AM GMT d4 Signer sukhdhiman@outlook.com entered name at signing as sukhvinder singh 2023-04-08-7:07:02 AM GMT �p Document e-signed by sukhvinder singh (sukhdhiman@outlook.com) Signature Date:2023-04-08-7:07:04 AM GMT-Time Source:server Document emailed to cityclerk@kentwa.gov for signature 2023-04-08-7:07:06 AM GMT Email viewed by cityclerk@kentwa.gov 2023-04-11 -3:48:54 PM GMT Powered by Adobe �� KENT Acrobat Sign Document signing delegated to Kim Komoto (KKomoto@kentwa.gov) by cityclerk@kentwa.gov 2023-04-11 -3:55:10 PM GMT Document emailed to Kim Komoto (KKomoto@kentwa.gov)for signature 2023-04-11 -3:55:10 PM GMT Email viewed by Kim Komoto (KKomoto@kentwa.gov) 2023-04-11 -3:55:45 PM GMT Document e-signed by Kim Komoto (KKomoto@kentwa.gov) Signature Date:2023-04-11 -4:30:53 PM GMT-Time Source:server Agreement completed. 2023-04-11 -4:30:53 PM GMT Names and email addresses are entered into the Acrobat Sign service by Acrobat Sign users and are unverified unless otherwise noted. 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