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Home My WebLink AboutCAG2022-161 - Amendment - #1 - Custom Coating Consultants, LLC - 6MG1 Reservoir Recoating and Vent Replacement - 04/21/2022 FOR CITY OF KENT OFFICIAL USE ONLY Sup/Mgr: Agreement Routing Form DirAsst: • For Approvals,Signatures and Records Management Dlr/Dep: KE N T This form combines&replaces the Request for Mayor's Signature and Contract Cover (optional) W ASH INGTGN Sheet forms. Originator: Department: Dani Hodgins for Brian Shields Public Works Date Sent: Date Required: c 11/16/2023 11/22/2023 Q Director or Designee to Sign. Date of Council Approval: Q N/A Budqet Account Number: Grant?:Yes ZNo W20091 Budget?W]YesDNo Type: N/A Vendor Name: Category: Custom Coatings Consultants, LLC Contract Vendor Number: Sub-Category: Amendment 0 ProjectName: 6MG1 Reservoir Recoating and Vent Replacement - Amd. 1 E ProjectDetails:An Amendment to extend the time of completion to December 31, 2024 as a contingency for support at the one-year inspection point. c wAgreement Amount: $94,263.75 Basis for Selection of Contractor: Bid *Memo to Mayor must be attached a� Start Date: 11/16/2023 Termination Date: 12/31/2024 Q Local Business?0YesF--]No* If meets requirements per KCC3.70.100,please complete'Vendor Purchase-Local Exceptions"formonCityspoce. Business License Verification:YesElln-ProcessElExempt(KCC 5.01.045) Notice required prior to disclosure? Contract Number: �Yes(No CAG2022-161 Comments: 3 GJ y •� i GJ 3 M C N Date Routed to the City Clerk's Office: 11/16/23 Interlocal Agreement has been uploaded to website: ad«W22373_1_20 Visit Documents.KentWA.gov to obtain copies of all agreements rev.20210513 • KENT WASHINGTON AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: Custom Coatinci Consultants, LLC CONTRACT NAME & PROJECT NUMBER: 6MG1 Reservoir and Vent Replacement ORIGINAL AGREEMENT DATE: 4/21/2022 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: An amendment to extend the completion date is necessary as a contingency for support at the one-year inspection point. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, 'Compensation," are modified as follows: Original Contract Sum, $94,263.75 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $94,263.75 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $94,263.75 AMENDMENT - 1 OF 2 Original Time for Completion 12/31/2023 (insert date) Revised Time for Completion under N/A prior Amendments (insert date) Add'I Days Required (f) for this 365 calendar days Amendment Revised Time for Completion 12/31/2024 (insert date) The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTANT/VENDOR: CITY OF KENT: By: �/" �-�-�� By: f� � Print Name: V'-1 '°'V C- r: CGG>A Print Name: Eric Connor Its 00►`a-� Its: Construction Engineering Manager DATE: p bo I-;L as3 DATE: 11/16/23 ATTEST: APPROVED AS TO FORM: (applicable if Mayor's signature required) on behalf of Kent City Clerk Kent Law Department P:%Admin\Co th is\Oani AMENDMENT - 2 OF 2 mID * CERTIFICATE OF LIABILITY INSURANCE F�T 0 613 012 0 2 YY) 06/30/2023 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 be endorsed. If SUBROGATIONIS 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 USI INSURANCE SERVICES LLC/PHS NAME: 41715776 PHONE (877)532-3486 FAX (A/C,No,Ext): (A/C,No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio,TX 78251 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: Hartford Casualty Insurance Company 29424 CUSTOM COATING CONSULTANTS INSURER B: PO Box 73760 INSURER C: PUYALLUP WA 98373-0760 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DD/YYYY MMIDD/Y YYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED $300 000 PREMISES Ea occurrence X General Liability MED EXP(Any one person) $10,000 A X 41 SBA ES5039 04/13/2023 04/13/2024 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY❑PRO I—XI LOC PRODUCTS-COMP/OPAGG $4,000,000 JECT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) HIRED NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE DED RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY ISTATUTE I ER ANY Y/N E.L.EACH ACCIDENT $1,000,000 A PROPRIETOR/PARTNER/EXECUTIVE N/A 41 SBA ES5039 04/13/2023 04/13/2024 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below A EMPLOYMENT PRACTICES 41 SBA ES5039 04/13/2023 04/13/2024 Each Claim Limit $5,000 LIABILITY Aggregate Limit $5,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations. Notice of Cancellation will be provided in accordance with Form SS1223,attached to this policy.Certificate holder is an additional insured per the Business Liability Coverage Form SS0008,attached to this policy. CERTIFICATE HOLDER CANCELLATION City of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 220 4TH AVE S BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED KENT WA 98032-5838 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I�I'41eoLl�6f ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THE HARTFORD BUSINESS SERVICE CENTER THE 3600 WISEMAN BLVD HARTFORD SAN ANTONIO TX 78251 June 30, 2023 City of Kent 220 4TH AVE S KENT WA 98032-5838 Account Information: Contact Us Policy Holder Details : CUSTOM COATING Need Help? CONSULTANTS Chat online or call us at (866)467-8730. We're here Monday- Friday. Enclosed please find a Certificate Of Insurance for the above referenced Policyholder. Please contact us if you have any questions or concerns. Sincerely, Your Hartford Service Team WLTRO05 Policy number: 03695439-9 CUSTOM COATING Page 2 of 4 Auto coverage schedule 1, 2017 GMC Canyon Actual Cash Value (plus$2,000.00 Permanently Attached Equip) VIN: 1GTP6DE14H1235769 Garaging Zip Code: 98373 Radius: 300 Liability Liability UIM BI1. UIM PD Premium $1,028 $164 $28 Comp Comp Collision Collision Physical Damage Deductible Premium Deductible Premium ........................... . ...................................................................................................... Premium $500 $61 $500 $326 Roadside Roadside Other Coverages Limit Premium Auto Total ............................................................................................................................................ ..................... Premium Selected $6 $1,613 2. 2022 Subaru XV Crosstrek Stated Amount: *$30,000(including Permanently Attached Equip) VIN: 1F2GTHSC7NH224288 Garaging Zip Code: 98373 Radius: 100 Liability liability UIM BI UIM PD Premium $831 $205 $25 Comp Comp Collision Collision Physical Damage Deductible Premivar Deductible Premium Auto Total ......... . .............. ................................................ Premium $500 $85 $500 $273 ; $1,419 *A vehicle's stated amount should indicate its current retail value,including any special or permanently attached equipment. In the N event of a total loss,the maximum amount payable is the lesser of the Stated Amount or Actual Cash Value,less deductible. Be sure o to check stated amount at every renewal in order to receive the best value from your Progressive Commercial Auto policy. o U Premium discounts Policy o ........................................................................................................................................................... c 03695439-9 Business Experience,Paid In Full and Package o Loss Payee information U Q a .................................................................................................................................................................... a 1 . Loss Payee Auto 1 ALASKA USA FCU PO BOX 196613 ANCHORAGE,AL 99519 2017 GMC Canyon(1GTP6DE14H1235769) .................................................................................................................................................................... 2 . Loss Payee Auto 2 SUBARU AMERICAN CR PO BOX 390858 MINNEAPOLIS,MN 55439 2022 Subaru XV Crosstrek(JF2GTHSC7NH224288) Additional Insured information ..................................................................................................................................... 1 . Additional Insured LAKEHAVEN UTILITY D 31627 1 ST AVE S FEDERAL WAY,WA 98003 .................................................................................................................................................................... 2 . Additional Insured COMMUNITY TRANSIT 7100 HARDESON R EVERETT,VA 98203 Continued Form 6489 WA(04112) PROGRESSIVE PR08RE111YE' PO BOX 94739 COMMERCIAL CLEVELAND,OH 44101 Named insured Policy number: 03695439-9 Underwritten by: United Financial Casualty Company CUSTOM COATING September 20,2023 CONSULTANTS LLC PO BOX 73760 Policy Period:Sep 19,2023-Sep 19,2024 PUYALLUP,WA 98373 Page 1 of 4 agent.progressive.com Online Service Make payments,check billing activity,print policy documents,or check the status of a Commercial Auto claim. 1-800-444-4487 Insurance Coverage Summary For customer service and day,7 days claimwee service, This is your revised Renewal 24 hours Declarations Page Your coverage began on September 19,2023 at 12:01 a.m. This policy expires on September 19,2024 at 12:01 a.m. This coverage summary replaces your prior one.Your insurance policy and any policy endorsements contain a full explanation of your coverage.The policy limits shown for an auto may not be combined with the limits for the same coverage on another auto,unless the policy contract allows the stacking of limits.The policy contract is form 6912(02/19),The contract is modified by forms 2852WA (02/19), 1890(02/19), 1891 (02/19), 1198(01104),Z313(02/19),4852WA (02/19),4881 WA (02/19)and Z228(01/11), The named insured organization type is a corporation. Outline of coverage i Di Limits Deductible Premium ..escr.......ption ...... . ..................................................................................................................................................... ....... Liability To Others $1,859 Bodily Injury and Property Damage Liability $2,000,000 combined single limit ............................... Hired Auto Liability To Others 109 Bodily Injury and Pro . perty Da ma. .ge Liability.. .. ...........$2,000,000 combined single limit . . .. . . . . ...... ...................................................................................................... Employer Non-Owned Auto Liability To Others 96 Bodily Injury and Property Damage Liability $.2.,.0.0,0,,.0.0,0.co.mb,i,ne.d.s.i.n.g,le..Iim.it. Underinsured Motorist Bodily Injury $2,000 000 combined single limit 369 ....I— ......... ........ ......... ... .................................................................................. . Underinsured Motorist Property Damage $1,000,000 each accident $100 53 $300 hit&run Personal Injury Protection Rejected ....................................... .............................................................................................. Comprehensive 146 See Auto Coverage Schedule Limit of liability less deductible Collision ...599 See Auto Coverage Schedule Limit of liability less deductible ..........................y................................................... Roadside Assistance 6 See Auto Coverage Schedule ............................................................................................................................................................................. Total 12 month policy premium $3,237 Number of Employees: (0-10) Cost of Hire: $5,000 or less(if any) Rated drivers ....................................................................................................................................................................... 1. MARK C FICCA ........................................................... .......................................................................................................... 2. LISA FICCA Continued Form 6489 WA(04/12)