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Home My WebLink AboutCAG2024-268 - Original - Eagle Asphalt Sealcoating Company, LLC - Seatcoat & Repair Morrill Meadows Park Parkinglot - 06/03/2024 FOR CITY OF KENT OFFICIAL USE ONLY Sup/Mgr: Agreement Routing Form Dir. Assist:x�' • For Approvals,Signatures and Records Management KE N T This form combines&replaces the Request for Mayor's Signature and Contract Cover 11C1I IcroN Sheet forms. Dlr/Dep Dil Originator: Department: Shayla Ott Parks, Recreation & Community Services Date Sent: Date Required: > 05/22/2024 05/27/2024 0 CL Authorized to Sign: Date of Council Approval: QDirector or Designee NA Budget Account Number: Grant? YesFI/iNo P21082.64190.5410 851 W Budget?W]Yes No Type: N/A Vendor Name: Category: Eagle Asphalt Sealcoating Company, LLC Contract Vendor Number: Sub-Category: = 104531 Original 0 parking Project Name: Sealcoat arkin lot at Morrill Meadows Park 1.1. Project Details:Vendor to repair, pave and sealcoat parking lot at Morrill Meadows Park. 0 _ a, Agreement Amount: $1 0 862.97 Basis for Selection of Contractor: Other `Memo to Mayor must be attached Start Date: 05/27/2024 Termination Date: 07/31/2024 Im Q Local Business? Yes1ZNo* If meets requirements per KCC3.70.100,please complete"Vendor Purchase-Local Exceptions'form on Cityspace. Business License Verification:Yes In-Process Exempt(KCC 5.01.045) Notice required prior to disclosure? Contract Number: YesONo CAG2024-268 Comments: Im _ 3 4) H •� i N 3 f0 _ V1 Date Routed to the City Clerk's Office: 6/4/24 ,c«w»373__,0 Visit Documents.KentWA.gov to obtain copies of all agreements rev.20210513 KENT WAS 1 1 1-N PUBLIC WORKS AGREEMENT between City of Kent and Eagle Asphalt Sealcoating Company, LLC THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Eagle Asphalt Sealcoating Company, LLC organized under the laws of the State of Washington, located and doing business at 11219 Benston Dr E. Puyallup, WA 98372-2843; Contact Name: Bryce Wilson; Contact Number: (253)862-9554 (hereinafter the "Contractor"). AGREEMENT The parties agree as follows: I. DESCRIPTION OF WORK. The Contractor shall perform the following services for the City in accordance with the following described plans and/or specifications: Vendor to repair cracks, pave and sealcoat parking lot at Morrill Meadows Park as outlined in Exhibit A. The Contractor 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 such services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above within 15 business days after the City issues its Notice to Proceed. Upon the effective date of this Agreement, all physical work shall thereafter be completed by July 31s' 2024. The term of this Agreement shall continue until all work has been completed, final acceptance has occurred, and all Contractor obligations have been fulfilled. III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed TEN THOUSAND EIGHT HUNDRED SIXTY TWO DOLLARS AND NINETY SEVEN CENTS ($10,862.97), including any applicable Washington State Sales Tax, for the work and services contemplated in this Agreement. The City shall pay the Contractor eighty-five percent (85%) of the Contract amount upon completion and acceptance of the work by the City, or at such earlier time as the City may determine is appropriate. The City will pay the remaining Contract amount upon fulfillment of the conditions listed below and throughout this Agreement. Card Payment Program. The Contractor 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 Contractor. If the Contractor voluntarily participates in this Program, the Contractor will be solely responsible for any fees imposed by financial institutions or credit card companies. The Contractor shall not charge those fees back to the City. PUBLIC WORKS AGREEMENT - 1 ($20K or Less and No Performance Bond) A. No Payment and Performance Bond. Because this contract, including applicable sales tax, is $150,000 or less, and pursuant to Chapter 39.08 RCW, the Contractor, in lieu of providing the City a payment and performance bond, has elected to have the City retain the final ten percent (10%) of the Contract amount for a period of thirty (30) days after the date of final acceptance, or until receipt of all necessary releases from the State Department of Revenue, the State Department of Labor & Industries, and the State Employment Security Department, and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. B. Retainaae. The City shall also hold back a retainage in the amount of five percent (5%) of any and all payments made to the Contractor for a period of sixty (60) days after the date of final acceptance, or until receipt of all necessary releases from the State Department of Revenue, the State Department of Labor & Industries, and the State Employment Security Department, and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. The amount retained shall be placed in a fund by the City pursuant to RCW 60.28.011(4)(a), unless otherwise instructed by the Contractor within fourteen (14) calendar days of the Contractor's signature on the Agreement. C. Defective or Unauthorized Work. The City reserves its right to withhold payment from the Contractor for any defective or unauthorized work. Defective or unauthorized work includes, without limitation: work and materials that do not conform to the requirements of this Agreement; and extra work and materials furnished without the City's written approval. If the Contractor is unable, for any reason, to satisfactorily complete any portion of the work, the City may complete the work by contract or otherwise, and the Contractor 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 Contract price specified above. The City further reserves its right to deduct the cost to complete the Contract work, including any Additional Costs, from any and all amounts due or to become due the Contractor. D. Final Payment: Waiver of Claims. THE CONTRACTOR'S ACCEPTANCE OF FINAL PAYMENT (EXCLUDING WITHHELD RETAINAGE) SHALL CONSTITUTE A WAIVER OF CONTRACTOR'S CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY CONTRACTOR AS UNSETTLED AT THE TIME FINAL PAYMENT IS MADE AND ACCEPTED. 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 Contractor 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 Contractor maintains and pays for its own place of business from which the Contractor's services under this Agreement will be performed. C. The Contractor 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 Contractor's services and is a service other than that furnished by the City, or the Contractor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Contractor 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. PUBLIC WORKS AGREEMENT - 2 ($20K or Less and No Performance Bond) E. The Contractor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by the Contractor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Contractor has a valid contractor registration pursuant to Ch. 18.27 RCW or an electrical contractor license pursuant to Ch. 19.28 RCW. G. The Contractor maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. The City may terminate this Agreement for good cause. "Good cause" shall include, without limitation, any one or more of the following events: A. The Contractor's refusal or failure to supply a sufficient number of properly skilled workers or proper materials for completion of the Contract work. B. The Contractor's failure to complete the work within the time specified in this Agreement. C. The Contractor's failure to make full and prompt payment to subcontractors or for material or labor. D. The Contractor's persistent disregard of federal, state or local laws, rules or regulations. E. The Contractor's filing for bankruptcy or becoming adjudged bankrupt. F. The Contractor's breach of any portion of this Agreement. If the City terminates this Agreement for good cause, the Contractor shall not receive any further money due under this Agreement until the Contract work is completed. After termination, the City may take possession of all records and data within the Contractor's possession pertaining to this project which may be used by the City without restriction. VI. PREVAILING WAGES. The Contractor shall file a "Statement of Intent to Pay Prevailing Wages," with the State of Washington Department of Labor & Industries prior to commencing the Contract work. The Contractor shall pay prevailing wages in effect on the date the bid is accepted or executed by the Contractor, and comply with Chapter 39.12 of the Revised Code of Washington, as well as any other applicable prevailing wage rate provisions. The latest prevailing wage rate revision issued by the Department of Labor and Industries is attached. VII. CHANGES. The City may issue a written change order for any change in the Contract work during the performance of this Agreement. If the Contractor determines, for any reason, that a change order is necessary, the Contractor must submit a written change order request to the person listed in the notice provision section of this Agreement, Section XVI(D), within fourteen (14) calendar days of the date the Contractor 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 Contractor'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 Contractor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Contractor shall proceed with the change order work upon receiving either a written change order from the City or an oral order from the City before actually receiving the written change order. If the Contractor fails to require a change order within the time specified in this paragraph, the Contractor waives its right to make any claim or submit subsequent change order requests for that portion of the contract work. If the Contractor disagrees with the equitable adjustment, the Contractor must complete the change order work; however, the Contractor may elect to protest the adjustment as provided in subsections A through E of Section IX, Claims, below. PUBLIC WORKS AGREEMENT - 3 ($20K or Less and No Performance Bond) The Contractor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by the Contractor 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. VIII. 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 Contractor 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 Contractor 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 Contractor 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 Contractor to fulfill its obligations under this Agreement. Except as expressly contemplated by this section, all other costs will be borne by the Contractor. IX. CLAIMS. If the Contractor disagrees with anything required by a change order, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Contractor may file a claim as provided in this section. The Contractor 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 Contractor 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 to have been waived by the Contractor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Contractor'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: PUBLIC WORKS AGREEMENT - 4 ($20K or Less and No Performance Bond) 1. The date of the Contractor'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 Contractor is asserting a schedule change or disruption. B. Records. The Contractor 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 Contractor'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. Contractor's Duty to Complete Protested Work. In spite of any claim, the Contractor 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 Contractor 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 Contractor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). X. LIMITATION OF ACTIONS. CONTRACTOR 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 CONTRACTOR'S ABILITY TO FILE THAT CLAIM OR SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. XI. WARRANTY. The Contractor warrants that it will faithfully and satisfactorily perform all work provided under this Agreement in accordance with the provisions of this Agreement. The Contractor shall promptly correct all defects in workmanship and materials: (1) when the Contractor knows or should have known of the defect, or (2) upon the Contractor's receipt of notification from the City of the existence or discovery of the defect. In the event any parts are repaired or replaced, only original replacement parts shall be used—rebuilt or used parts will not be acceptable. When defects are corrected, the warranty for that portion of the work shall extend for an additional year beyond the original warranty period applicable to the overall work. The Contractor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Contractor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Contractor shall pay all costs incurred by the City in order to accomplish the correction. XII. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Contractor, its sub-contractors, or any person acting on behalf of the Contractor 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 Contractor shall execute the attached City of Kent Non-Discrimination Policy Declaration, and comply with City Administrative Policy 1.2. XIII. INDEMNIFICATION. The Contractor 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 Contractor's PUBLIC WORKS AGREEMENT - 5 ($20K or Less and No Performance Bond) 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 Contractor'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 Contractor and the City, its officers, officials, employees, agents and volunteers, the Contractor's duty to defend, indemnify, and hold the City harmless, and the Contractor's liability accruing from that obligation shall be only to the extent of the Contractor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'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 Contractor 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 Contractor's part, then the Contractor 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 Contractor's part. The provisions of this section shall survive the expiration or termination of this Agreement. XIV. INSURANCE. The Contractor 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. XV. WORK PERFORMED AT CONTRACTOR'S RISK. The Contractor 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 Contractor's own risk, and the Contractor 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. XVI. 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 XIII of this Agreement. PUBLIC WORKS AGREEMENT - 6 ($20K or Less and No Performance Bond) 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 Contractor. 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 Contractor 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 Contractor'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 Contractor 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 Contractor 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 Contractor 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, the 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 PUBLIC WORKS AGREEMENT - 7 ($20K or Less and No Performance Bond) to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. CONTRACTOR: CITY OF KENT: BYrah LevehG�a m By: By: [man Levenhagen May 29,2024 35 PDT Print Name: Bryce Wilson Print Name: Brian Levenhagen Its Project Manager Its: Deputy Parks Director DATE: Jun 3,2024 DATE: May 29, 2024 NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONTRACTOR: CITY OF KENT: Bryce Wilson Ben Levenhagen Eagle Asphalt Sealcoating Company, LLC City of Kent 11219 Benston Dr E 220 Fourth Avenue South Puyallup, WA 98372-2842 Kent, WA 98032 (253)862-9554 (telephone) (253) 856-5133 (telephone) Bryce@Eagle-AsphaIt.com (email) Blevenhagen@kentwa.gov (email) ATTEST: ec� 6w3b Kent City Clerk PUBLIC WORKS AGREEMENT - 8 ($20K or Less and No Performance Bond) 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 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 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 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: � (� For: Eagle Asphalt Sealcoating Co. LLC Title: Project Manager Date: Jun 3, 2024 EEO COMPLIANCE DOCUMENTS - 4 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 BIDDER RESPONSIBILITY CRITERIA Certification of Compliance with Wage Payment Statutes This certification is required by state law (RCW 39.04.350(2)) to be submitted to the City before the contract can be awarded. The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date (05/10/2024), the bidder is not a "willful" violator, as defined in RCW 49.48.082, of any provision of chapters 49.46, 49.48, or 49.52 RCW, as determined by a final and binding citation and notice of assessment issued by the Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Eagle Asphalt Sealcoating Company, LLC By: Signature of Authorized Official* Printed Name: Bryce Wilson Title: Project Manager Date: Jun 3,2024 City and State: Puyallup,WA *If a corporation, proposal must be executed in the corporate name by the president or vice- president (or any other corporate officer accompanied by evidence of authority to sign). If a co- partnership, proposal must be executed by a partner. BIDDER RESPONSIBILITY CRITERIA - 1 Eagle Asphalt Sealcoating Co., LLC Exhibit A Complete Commercial Residential Asphalt Maintenance. April 9,2024 Attention: Ben Levenhagen Job# Quote Contractor: Kent Parks,Recreation and Community Services Customer PO# Address: 220 4th Ave South City: Kent Phone: - State: WA Cell: 253-740-4179 Zip: 98032 Fax: - E-Mail: Blevenhagen@KentWA.gov Job Name: Morrill Meadows Park Sealcoat Address: 10600 SE 248th St Kent,WA 98030 On-site: Weekday Work-Prevailing Wages Apply ITEM DESCRIPTION QTY UM Unit Amount Sealcoat: Block off area(s)of work delineators,cones&ribbon as needed. Prep lot as needed,apply 2 coats of Armor A-100 commercial grade sealer. The first coat applied by squeegee machine,2nd coat by spray. 1 (1)Mobilization(s)no charge,additional mobilizations at$1,250.00 Each. 30,730.00 SF $0.25 $7,682.50 Crack Fill: Prep&clean cracks 1/4"or wider up to 3/4"prior to placing Durafill HS sealer. Pour hot Durafill HS sealer from pots into cracks,squeegee or broom flush with 2 surface. 1.00 LS $400.00 $400.00 Stripe: Spot clean as needed prior to re-striping. Re-stripe lot back to existing configuration with traffic paint. 3 (1)Mobilization(s)no charge,additional mobilizations at$1,000.00 Each. 1.00 LS $1,775.00 $1,775.00 4 TOTAL: I 1 1 $9,857.50 Quote valid: 30 Days Terms: Net 30 unless agreed otherwise and specified by contract Exclusions: This quote does not include the following: Washington State Sales Tax,Use Tax or Resale Certificate permits,fees,bonds.Third party affilation costs. Utility adjustment,material testing,soil sterilization,surveying,staking or layout.Union affiliation. Not responsible for others prep work or subgrade failures.Damaged landscaping behind new or existing extruded curbs or islands. Premium time or special plant open ings.Traffic control.Water/vacuum trucks or pressure-washing.Sprinkler or gate loops. No warranty on sealer applied over oil spots,alligated asphalt areas or reverse percolation. Material pricing is subject to change,and shall be adjusted by documented oil and material cost. This document&the exclusions/inclusions listed above shall be included as an appendix to any subcontract between Eagle Asphalt Sealcoating Company LLC and the General Contractor. Any changes,additions,deletions to this original contact MUST be approved in writing by the Project Manager and the authorized on-site representative or General Contractor.Approved changes to the original contract must have verified field measurements and approved by both parties. This quote does not include any items not listed on this quote. The undersigned agrees to pay EAGLE ASPHALT SEALCOATING COMPANY,LLC interest of 1.5%per month.Or at the maximum rate allowed by law if less on any past due accounts, plus reasonable attorney's fees,and cost incurred in collection of said account. Sincerely, This quote&its terms have been approved by: r3rNc.& V U' 15,o-w Bryce Wilson Customer Signature Date Office: (253)862-9554 Cell: (253)266-5996 Fax: (253)862-3855 Bryce@eagle-asphalt.com Exhibit Insurance Requirements 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: Commercial General Liability insurance shall be written on Insurance Services Office (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. Automobile Liability insurance providing bodily injury and property damage liability coverage for all owned, non-owned, hired, and leased vehicles used in the performance of this Agreement. This coverage must be on a primary and non-contributory basis only. Coverage shall be written on 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. Workers' Compensation coverage for the employees of Contractor and subcontractors as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: Commercial General Liability insurance shall be written with limits no less than $1,000,000 per occurrence, $2,000,000 general aggregate, and a $2,000,000 products-completed operations aggregate limit. Stop Gap Liability - $1,000,000/$1,000,000/$1,000,000 Primary Non-Contributory Additional Insured coverage for the City of Kent, et. al. Waiver of Subrogation Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per occurrence. The above policy limits may be obtained with excess liability (umbrella) insurance. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions: 1. The Contractor's insurance coverage shall be primary insurance with respect to the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be in excess of the Contractor's insurance policies and shall not contribute to the Contractor's insurance policies. 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 has been given to the City, sent via certified mail, return receipt requested. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) with respect to work performed by or on behalf of the Contractor and a copy of the endorsement naming the City as an 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 claims are made or suit is brought, except with respect 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 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. The City waives no rights, and the Contractor is not excused from performance if Contractor fails to provide the City with a copy of the endorsements naming the City as a Primary Non-Contributory Additional Insured. F. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverage for subcontractors shall be subject to all the same insurance requirements as stated herein for the Contractor. Client#: 165974 EAGLASPH DATE(MM/DD/YYYY) ACORD.. CERTIFICATE OF LIABILITY INSURANCE 5/10/2024 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Pamela Clayton Propel Insurance PHONE g00 499-0933 FAX 866 577-1326 A/C,No,Ext: FAX No): 1201 Pacific Avenue; Suite 1000 E-MAIL ADDRESS: pamea.clla ro elinsurance.com Yton@P p COM Construction INSURER(S)AFFORDING COVERAGE NAIC# Tacoma,WA 98402-4321 INSURER A:Cincinnati Insurance Company 10677 INSURED INSURER B:Evanston Insurance Company 35378 Eagle Asphalt Sealcoating Co., LLC INSURER C PO Box 1564 INSURER D: Sumner,WA 98390 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 CONTRACTOR 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. LT R TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EPP0654208 5/19/2023 05/19/2026 EACH OCCURRENCE $1,000,000 CLAIMS-MADE �X OCCUR PREMISES ERENTED ccr nce $500,000 X BI/PD Ded:1,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENT AGGREGGATTELIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X1 JECOT LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY EPP0654208 5/19/2023 05/19/202 Ea aocid.n SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ A X UMBRELLA LIAB X OCCUR EPP0654208 5/19/2023 05/19/2026 EACH OCCURRENCE s4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s4,000,000 DED X RETENTION$0 $ WORKERS COMPENSATION EPP0654208 05/19/2023 05/19/2026 X PER OTH- AND EMPLOYERS'LIABILITY TAT TE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WA Stop Gap E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Pollution CPLM0L116958 5/19/2023 05/19/202 $1,000,000/Ded: $2500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Morrill Meadows Park Sealcoat- 10600 SE 248th St, Kent WA 98030 City of Kent is Additional Insured per attached form(s). Waiver of Subrogation applies per attached form(s). CERTIFICATE HOLDER CANCELLATION Kent Parks, Recreation and SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Community Services ACCORDANCE WITH THE POLICY PROVISIONS. 220 4th Ave South Kent,WA 98032 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S6633682/M6157834 PC00 This page has been left blank intentionally. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage.......................................................................................2 2. Unintentional Failure To Disclose Hazards.............................................................................8 3. Damage To Premises Rented To You......................................................................................8 4. Supplementary Payments...................................................................................................... 10 5. Medical Payments................................................................................................................... 10 6. 180 Day Coverage For Newly Formed Or Acquired Organizations ................................... 10 7. Waiver Of Subrogation........................................................................................................... 10 8. Automatic Additional Insured -Specified Relationships: .................................................. 10 (a) Managers Or Lessors Of Premises (b) Lessor Of Leased Equipment (c) Vendors (d) State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises (e) Mortgagee, Assignee Or Receiver 9. Property Damage To Borrowed Equipment......................................................................... 13 10. Employees As Insureds - Specified Health Care Services And Good Samaritan Services ................................................................................................................................... 14 11. Broadened Notice Of Occurrence......................................................................................... 14 12. Nonowned Aircraft.................................................................................................................. 14 13. Bodily Injury Redefined.......................................................................................................... 15 14. Expected Or Intended Injury Redefined ............................................................................... 15 15. Former Employees As Insureds............................................................................................ 15 16. Voluntary Property Damage Coverage and Care, Custody Or Control Liability Coverage.................................................................................................................................. 15 17. Broadened Contractual Liability-Work Within 50' Of Railroad Property......................... 17 18. Alienated Premises................................................................................................................. 17 B. Limits Of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $1,000,000 Aggregate Limit: $3,000,000 Deductible Amount: $ 1,000 3. Damage To Premises Rented To You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail Bonds: $2,500 b. Loss Of Earnings: $ 500 Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 1 of 17 5. Medical Payments Medical Expense Limit: $10,000 9. Property Damage To Borrowed Equipment Each Occurrence Limit: $10,000 Deductible Amount: $ 250 16. Voluntary Property Damage Coverage (Coverage D) and Care, Custody Or Control Liability Coverage Limits Of Insurance Voluntary Property Damage Coverage: $1,000 Each Occurrence $5,000 Aggregate Care, Custody Or Control Liability Coverage: $5,000 Each Occurrence unless otherwise stated $ Deductible Amount(Each Occurrence) Voluntary Property Damage Coverage: $250 Care, Custody Or Control Liability Coverage: $250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) (c) Gross Sales (d) Units (e) Other Care, Custody Or Control $ Liability TOTAL ANNUAL PREMIUM $ C. Coverages 1) The amount we will pay for damages is limited 1. Employee Benefit Liability Coverage as described in C. Cov- a. The following is added to Section I - erages, 1. Employee Coverages: Benefit Liability Cover- age, c. Limits Of Insur- EMPLOYEE BENEFIT LIABILITY ance of this endorse- COVERAGE ment; and (1) Insuring Agreement 2) Our right and duty to (a) We will pay those sums that defend ends when we the insured becomes legally have used up the insuapplrance cable limit of insurance obligated to pay as damag- in the payment of judg- es caused by any act, error ments or settlements. or omission of the insured, or of any other person for No other obligation or liabil- whose acts the insured is ity to pay sums or perform legally liable, to which this acts or services is covered insurance applies. We will unless explicitly provided for have the right and duty to under Supplementary Pay- defend the insured against ments. any suit seeking those damages. However, we will (b) This insurance applies to have no duty to defend damages only if the act, er- against any "suit" seeking ror or omission is negligently damages to which this in- committed in the "admin- surance does not apply. We istration" of your "employee may, at our discretion, in- benefit program"; and vestigate any report of an 1) Occurs during the policy act, error or omission and period; or settle any claim or suit that may result. But: Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 2 of 17 2) Occurred prior to the fraudulent, criminal or mali- "first effective date" of cious act, error or omission, this endorsement pro- committed by any insured, vided: including the willful or reck- a) You did not have less violation of any statute. knowledge of a (c) Failure To Perform A Con- claim or"suit" on or tract before the "first ef- fective date" of this Damages arising out of fail- endorsement. ure of performance of con- tract by any insurer. You will be deemed to have (d) Insufficiency Of Funds knowledge of a Damages arising out of an claim or "suit" insufficiency of funds to when any insured meet any obligations under listed under C. any plan included in the Coverages, 1. "employee benefit program". Employee Benefit Liability Coverage, (e) Inadequacy Of Perfor- b. Who Is An In- mance Of Invest- sured, (1) of this ment/Advice Given With endorsement or Respect To Participation any "employee" authorized by you Any claim based upon: to give or receive 1) Failure of any invest- notice of a claim or ment to perform; "suit": i) Reports all, or 2) Errors in providing in- any part, of the formation on past per- formance of investment act, error or vehicles; or omission to us or any other 3) Advice given to any insurer; person with respect to ii Receives a that person's decision to participate or not to par- written or ver- ticipate in any plan in- bal demand or cluded in the "employee claim for dam- benefit program". ages because of the act, er- (f) Workers' Compensation ror or omis- And Similar Laws sion; and Any claim arising out of your b) There is no other failure to comply with the applicable insur- mandatory provisions of any ance. workers' compensation, un- employment compensation insurance, social security or This insurance does not apply to: disability benefits law or any similar law. (a) Bodily Injury, Property Damage Or Personal And (g) ERISA Advertising Injury Damages for which any in- "Bodily injury", "property sured is liable because of li- damage" or "personal and ability imposed on a fiduci- advertising injury". ary by the Employee Re- tirement Income Security (b) Dishonest, Fraudulent, Act of 1974, as now or Criminal Or Malicious Act hereafter amended, or by any similar federal, state or Damages arising out of any local laws. intentional, dishonest, Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 3 of 17 (h) Available Benefits (a) An individual, you and your Any claim for benefits to the spouse are insureds, but on- ly with respect to the con- extent that such benefits are duct of a business of which available, with reasonable you are the sole owner. effort and cooperation of the insured, from the applicable (b) A partnership or joint ven- funds accrued or other col- ture, you are an insured. lectible insurance. Your members, your part- ners, and their spouses are (i) Taxes, Fines Or Penalties also insureds but only with Taxes, fines or penalties, in- respect to the conduct of cluding those imposed un- your business. der the Internal Revenue (c) A limited liability company, Code or any similar state or you are an insured. Your local law. members are also insureds, (j) Employment-Related Prac- but only with respect to the tices conduct of your business. Your managers are in- Any liability arising out of sureds, but only with respect any: to their duties as your man- 1) Refusal to employ; agers. p 2) Termination of employ- (d) An organization other than a partnership, joint venture or ment; limited liability company, you 3) Coercion, demotion, are an insured. Your "execu- evaluation, reassign- tive officers" and directors ment, discipline, defa- are insureds, but only with mation, harassment, respect to their duties as humiliation, discrimina- your officers or directors. tion or other employ- Your stockholders are also ment-related practices, insureds, but only with re- acts or omissions; or spect to their liability as stockholders. 4) Consequential liability as a result of 1), 2) or 3) (e) A trust, you are an insured. above. Your trustees are also in- sureds, but only with respect This exclusion applies to their duties as trustees. whether the insured may be held liable as an employer (2) Each of the following is also an or in any other capacity and insured: to any obligation to share (a) Each of your "employees" damages with or repay who is or was authorized to someone else who must pay administer your "employee damages because of the in- benefit program"; jury. (3) Supplementary Payments (b) Any persons, organizations or "employees" having prop- Section I - Supplementary Pay- er temporary authorization ments - Coverages A and B also to administer your "employ- apply to this Coverage, however ee benefit program" if you 1.b. and 2. of the Supplementary die, but only until your legal Payments provision do not apply. representative is appointed; or b. Who Is An Insured (c) Your legal representative if As respects Employee Benefit Liabil- you die, but only with re- ity Coverage, Section II - Who Is An spect to duties as such. That Insured is replaced by the following: representative will have all (1) If you are designated in the Dec- your rights and duties under larations as: this Coverage Part. Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 4 of 17 (3) Any organization you newly ac- dorsement is the most we will quire or form, other than a part- pay for all damages sustained by nership, joint venture or limited any one "employee", including liability company, and over which damages sustained by such you maintain ownership or major- "employee's" dependents and ity interest, will qualify as a beneficiaries, as a result of: Named Insured if no other similar insurance applies to that organi- (a) An act, error or omission; or zation. However, coverage under (b) A series of related acts, er- this provision: rors or omissions, regard- (a) Is afforded only until the less of the amount of time 180th day after you acquire that lapses between such or form the organization or acts, errors or omissions; the end of the policy period, negligently committed in the whichever is earlier; and "administration" of your "employ- (b) Does not apply to any act, ee benefit program". error or omission that was However, the amount paid under committed before you ac- this endorsement shall not ex- quired or formed the organi- ceed, and will be subject to the zation. limits and restrictions that apply c. Limits Of Insurance to the payment of benefits in any plan included in the "employee As respects Employee Benefit Liabil- benefit program." ity Coverage, Section III - Limits Of Insurance is replaced by the follow- (4) Deductible Amount ing: (a) Our obligation to pay dam- (1) The Limits of Insurance shown in ages on behalf of the in- Section B. Limits Of Insurance, sured applies only to the 1. Employee Benefit Liability amount of damages in ex- Coverage of this endorsement cess of the Deductible and the rules below fix the most Amount shown in Section B. we will pay regardless of the Limits Of Insurance, 1. Em- number of: ployee Benefit Liability Cov- erage of this endorsement (a) Insureds; as applicable to Each Em- ployee. The limits of insur- ance shall not be reduced brought; by the amount of this de- (c) Persons or organizations ductible. making claims or bringing (b) The Deductible Amount "suits"; shown in Section B. Limits (d) Acts, errors or omissions; or Of Insurance, 1. Employee Benefit Liability Coverage of (e) Benefits included in your this endorsement applies to "employee benefit program". all damages sustained by (2) The Aggregate Limit shown in any one "employee", includ- ingSection B. Limits Of Insurance, such "employee's" de- l. Employee Benefit Liability pendents and beneficiaries, because of all acts, errors or Coverage of this endorsement is omissions to which this in- the most we will pay for all dam- ages because of acts, errors or surance applies. omissions negligently committed (c) The terms of this insurance, in the "administration" of your including those with respect "employee benefit program". to: (3) Subject to the limit described in 1) Our right and duty to (2) above, the Each Employee defend the insured Limit shown in Section B. Limits against any "suits" Of Insurance, 1. Employee Bene- seeking those damag- fit Liability Coverage of this en- es; and Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 5 of 17 2) Your duties, and the du- You must see to it that ties of any other in- we receive written no- volved insured, in the tice of the claim or"suit" event of an act, error or as soon as practicable. omission, or claim; c. You and any other in- apply irrespective of the ap- volved insured must: plication of the Deductible Amount. (1) Immediately send us copies of any (d) We may pay any part or all demands, notices, of the Deductible Amount to summonses or le- effect settlement of any gal papers re- claim or "suit" and, upon no- ceived in connec- tification of the action taken, tion with the claim you shall promptly reim- or "suit"; burse us for such part of the Deductible Amount as we (2) Authorize to have paid. tain records and other information; d. Additional Conditions (3) Cooperate with us As respects Employee Benefit Liabil- in the investigation ity Coverage, Section IV - Commer- or settlement of the cial General Liability Conditions is claim or defense amended as follows: against the "suit"; (1) Item 2. Duties In The Event Of and Occurrence, Offense, Claim Or (4) Assist us, upon our Suit is replaced by the following: request, in the en- 2. Duties In The Event Of An forcemeat of any right against any Act, Error, Omission, person or organi- Claim Or Suit zation which may a. You must see to it that be liable to the in- we are notified as soon sured because of as practicable of an act, an act, error or error or omission which omission to which may result in a claim. this insurance may To the extent possible, also apply. notice should include: d. No insured will, except (1) What the act, error at that insured's own or omission was cost, voluntarily make a and when it oc- payment, assume any curred; and obligation, or incur any expense without our (2) The names and consent. addresses of any- one who may suf- (2) Item 4. Other Insurance is re- fer damages as a placed by the following: result of the act, 4. Other Insurance error or omission. l If other valid and collectible b. If a claim is made or "suit" brought against insurance is available to the insured for a loss we cover any insured, you must: under this Employee Benefit (1) Immediately record Liability Coverage, our obli- the specifics of the gations are limited as fol- claim or "suit" and lows: the date received; a. Primary Insurance and (2) Notify us as soon This insurance is prima- ry except when c. below as practicable. applies. If this insurance Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 6 of 17 is primary, our obliga- scope of "employee tions are not affected benefit programs"; unless any of the other insurance is also prima- b. Interpreting the "em- ry. Then, we will share ployee benefit pro- with all that other insur- grams"; ance by the method de- c. Handling records in scribed in Paragraph b. connection with the below. "employee benefit pro- b. Method Of Sharing grams"; or If all of the other insur- d. Effecting, continuing or ance permits contribu- terminating any "em- tion by equal shares, ployee's" participation in we will follow this meth- any benefit included in od also. Under this ap- the "employee benefit proach each insurer program". contributes equal However, "administration" amounts until it has does not include: paid its applicable limit of insurance or none of a. Handling payroll deduc- the loss remains, tions; or whichever comes first. b. The failure to effect or If any of the other in- maintain any insurance surance does not permit or adequate limits of contribution by equal coverage of insurance, shares, we will contrib- including but not limited ute by limits. Under this to unemployment insur- method, each insurer's ance, social security share is based on the benefits, workers' com- ratio of its applicable pensation and disability limit of insurance to the benefits. total applicable limits of insurance of all insur- 2. "Cafeteria plans" means ers. plans authorized by applica- ble law to allow "employees" c. No Coverage to elect to pay for certain This insurance shall not benefits with pre-tax dollars. cover any loss for which 3. "Employee benefit pro- the insured is entitled to grams" means a program recovery under any providing some or all of the other insurance in force following benefits to "em- previous to the effective ployees", whether provided date of this Employee through a "cafeteria plan" or Benefit Liability Cover- otherwise: age. a. Group life insurance; e. Additional Definitions group accident or health As respects Employee Benefit Liabil- insurance; dental, vision and hearing plans; and ity Coverage, Section V- Definitions flexible spending ac- is amended as follows: counts; provided that no (1) The following definitions are one other than an "em- added: ployee" may subscribe to such benefits and 1. "Administration" means: such benefits are made a. Providing information to generally available to those "employees" who "employees", including satisfy the plan's eligibil- their dependents and ity requirements; beneficiaries, with re- spect to eligibility for or Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 7 of 17 b. Profit sharing plans, b. Any other alternative employee savings dispute resolution pro- plans, employee stock ceeding in which such ownership plans, pen- damages are claimed sion plans and stock and to which the in- subscription plans, pro- sured submits with our vided that no one other consent; or than an "employee" may subscribe to such c. An appeal of a civil pro- benefits and such bene- ceeding. fits are made generally 2. Unintentional Failure To Disclose Haz- available to all "employ- ards ees" who are eligible under the plan for such Section IV- Commercial General Liabil- benefits; ity Conditions, 6. Representations is c. Unemployment insur- amended by the addition of the following: ance, social security Based on our dependence upon your rep- benefits, workers' com- resentations as to existing hazards, if un- pensation and disability intentionally you should fail to disclose all benefits; and such hazards at the inception date of your d. Vacation plans, includ- policy, we will not reject coverage under this Coverage Part based solely on such ing buy and sell pro- failure. grams; leave of ab- sence programs, includ- 3. Damage To Premises Rented To You ing military, maternity, family, and civil leave; a. The last paragraph of 2. Exclusions tuition assistance plans; under Section I - Coverage A- Bod- transportation and ily Injury And Property Damage Li- health club subsidies. ability is replaced by the following: 4. "First effective date" means Exclusions c. through n. do not apply the date upon which cover- to damage by fire, explosion, light- age was first effected in a ning, smoke or soot to premises while series of uninterrupted re- rented to you or temporarily occupied newals of insurance cover- by you with permission of the owner, age. for which the amount we will pay is limited to the Damage To Premises (2) The following definitions are de- Rented To You Limit as described in leted in their entirety and re- Section III - Limits Of Insurance. placed by the following: b. The insurance provided under Sec- 5. "Employee" means a person tion I - Coverage A- Bodily Injury And actively employed, formerly Property Damage Liability applies to employed, on leave of ab- "property damage" arising out of wa- sence or disabled, or retired. ter damage to premises that are both "Employee" includes a rented to and occupied by you. "leased worker". "Employee" does not include a "tempo- As respects Water Damage Legal Li- rary worker". ability, as provided in Paragraph 3.b. above: 18. "Suit" means a civil proceed- ing in which money damag- The exclusions under Section I - es because of an act, error Coverage A - Bodily Injury And Prop- or omission to which this in- erty Damage Liability, 2. Exclusions, surance applies are alleged. other than i. War and the Nuclear "Suit" includes: Energy Liability Exclusion (Broad Form), are deleted and the following a. An arbitration proceed- are added: ing in which such dam- ages are claimed and to This insurance does not apply to: which the insured must (a) "Property damage": submit or does submit with our consent; Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 8 of 17 (i) Assumed in any contract or conditioning, fire protection sys- agreement; or tems, or other equipment, (i i) Caused by or resulting from any caused by or resulting from o freezing, unless: f the following: best to 1) Wear and tear; (i) t in heatYu did nu the building for 2) Rust or other corrosion, de- structure; or cay, deterioration, hidden or (i i) You drained the equipment latent defect or any quality in and shut off the water supply property that causes it to if the heat was not main- damage or destroy itself; tained. 3) Smog; (d) "Property damage" to: 4) Mechanical breakdown, in- (i) Plumbing, heating, air condi- cluding rupture or bursting tioning, fire protection sys- caused by centrifugal force; tems, or other equipment or 5) Settling, cracking, shrinking appliances; or or expansion; (i i) The interior of any building 6) Nesting or infestation, or or structure, or to personal discharge or release of property in the building or waste products or secre- structure, caused by or re- tions, by insects, birds, ro- sulting from rain, snow, sleet dents or other animals; or or ice, whether driven by wind or not. 7) Presence, growth, prolifera- tion, spread or any activity of c. Limit Of Insurance fungus, including mold or With respect to the insurance afford- mildew, and any mycotoxins, ed in Paragraphs 3.a. and 3.b. above, spores, scents or byproducts the Damage To Premises Rented To produced or released by You Limit as shown in the Declara- fungi. tions is amended as follows: (b) "Property damage" caused di- (1) Paragraph 6. of Section III - Lim- rectly or indirectly by any of the its Of Insurance is replaced by following: the following: (i) Earthquake, volcanic erup- 6. Subject to Paragraph 5. tion, landslide or any other above, the Damage To earth movement; Premises Rented To You (i i) Water that backs up or over- Limit is the most we will pay flows or is otherwise dis- under Coverage A - Bodily charged from a sewer, drain, Injury And Property Damage sump, sump pump or related Liability for damages be- equipment; cause of "property damage" to any one premises: (iii) Water under the ground sur- face pressing on, or flowing a. While rented to you, or or seeping through: temporarily occupied by you with permission of 1) Foundations, walls, the owner; floors or paved surfac- es; b. In the case of damage by fire, explosion, light- 2) Basements, whether ning, smoke or soot, paved or not; or while rented to you; or 3) Doors, windows or other c. In the case of damage openings. by water, while rented (c) "Property damage" caused by or to and occupied by you. resulting from water that leaks or (2) The most we will pay is limited as flows from plumbing, heating, air described in Section B. Limits Of Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 9 of 17 Insurance, 3. Damage To Prem- the insured has waived its right of recov- ises Rented To You of this en- ery in a written contract, written agree- dorsement. ment, written permit or written authoriza- tion. Such waiver by us applies only to 4. Supplementary Payments the extent that the insured has waived its Under Section I - Supplementary Pay- right of recovery against such additional ments - Coverages A and B: insured prior to loss. a. Paragraph 1.b. is replaced by the fol- 8. Automatic Additional Insured - Speci- lowing: fied Relationships Up to the limit shown in Section B. a. The following is added to Section II - Limits Of Insurance, 4.a. Bail Bonds Who Is An Insured: of this endorsement for cost of bail (1) Any person(s) or organization(s) bonds required because of accidents described in Paragraph 8.a.(2) of or traffic law violations arising out of this endorsement (hereinafter re- the use of any vehicle to which the ferred to as additional insured) Bodily Injury Liability Coverage ap- whom you are required to add as plies. We do not have to furnish these an additional insured under this bonds. Coverage Part by reason of a b. Paragraph 1.d. is replaced by the fol- written contract, written agree- lowing: ment, written permit or written authorization. All reasonable expenses incurred by the insured at our request to assist us (2) Only the following persons or Or- in the investigation or defense of the ganizations are additional in- claim or "suit", including actual loss of sureds under this endorsement, earnings up to the limit shown in Sec- and insurance coverage provided tion B. Limits Of Insurance, 4.b. Loss to such additional insureds is lim- Of Earnings of this endorsement per ited as provided herein: day because of time off from work. (a) Managers Or Lessors Of 5. Medical Payments Premises The Medical Expense Limit of Any One The manager or lessor of a Person as shown in the Declarations is premises leased to you you amended to the limit shown in Section B. are required per Paragraph Limits Of Insurance, S. Medical Payments 8.a.(1) of this endorsement of this endorsement. to provide insurance, but on- ly with respect to liability for 6. 180 Day Coverage For Newly Formed "bodily injury", "property Or Acquired Organizations damage" or "personal and Section II - Who Is An Insured is advertising injury" caused, in amended as follows: whole or in part, by you or those acting on your behalf Subparagraph a. of Paragraph 3. is re- in connection with the own- placed by the following: ership, maintenance or use of that part of the premises a. Coverage under this provision is af- leased to you, subject to the forded only until the 180th day after following additional exclu- you acquire or form the organization sions: or the end of the policy period, whichever is earlier; This insurance does not ap- ply to: 7. Waiver Of Subrogation (i) Any "occurrence" which Section IV- Commercial General Liabil- takes place after you ity Conditions, 8. Transfer Of Rights Of cease to be a tenant in Recovery Against Others To Us is that premises; amended by the addition of the following: (ii) Structural alterations, We waive any right of recovery against new construction or any additional insured under this en- demolition operations dorsement, because of any payment we performed by or on be- make under this endorsement, to whom Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 10 of 17 half of such additional damages that the insured. vendor would have in the absence of (b) Lessor Of Leased Equip- the contract or ment agreement; Any person(s) or organiza- 2) Any express war- tion(s) from whom you lease ranty unauthorized equipment you are required by you; per Paragraph 8.a.(1) of this endorsement to provide in- 3) Any physical or surance. Such person(s) or chemical change in organization(s) are insureds the product made only with respect to liability intentionally by the for "bodily injury", "property vendor; damage" or "personal and advertising injury" caused, in 4) Repackaging, ex- whole or in part, by your cept when un- maintenance, operation or packed solely for use of equipment leased to the purpose of in- you by such person(s) or or- spection, demon- ganization(s). A person's or stration, testing, or organization's status as an the substitution of additional insured under this parts under in- endorsement ends when structions from the their contract or agreement manufacturer, and with you for such leased then repackaged in equipment ends. However, the original con- this insurance does not ap- tainer; ply to any "occurrence" 5) Any failure to make which takes place after the such inspections, equipment lease expires. adjustments, tests (c) Vendors or servicing as the vendor has agreed Any person or organization to make or normal- (referred to below as ven- ly undertakes to dor) you are required per make in the usual Paragraph 8.a.(1) of this en- course of busi- dorsement to provide insur- ness, in connection ance, but only with respect with the distribution to liability for "bodily injury" or sale of the or "property damage" arising products; out of "your products" which are distributed or sold in the 6) stallation, servicing Demonstration, in- are regular course of the ven- dor's business, subject to or repair opera- the following additional ex- tions, except such clusions: operations per- formed at the ven- (i) The insurance afforded dor's premises in the vendor does not connection with the apply to: sale of the product; 1) "Bodily injury" or 7) Products which, af- "property damage" ter distribution or for which the ven- sale by you, have dor is obligated to been labeled or re- pay damages by labeled or used as reason of the as- a container, part or sumption of liability ingredient of any in a contract or other thing or sub- agreement. This stance by or for the exclusion does not vendor; or apply to liability for Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 11 of 17 8) "Bodily injury" or Permits Or Authorizations "property damage" Relating To Premises arising out of the sole negligence of Any state or governmental the vendor for its agency or subdivision or po- own acts or omis- litical subdivision you are sions or those of required per Paragraph its employees or 8.a.(1) of this endorsement anyone else acting to provide insurance, subject on its behalf. How- to the following additional ever, this exclusion provision: does not apply to: This insurance applies only a) The excep- with respect to the following tions contained hazards for which the state in Paragraphs or governmental agency or (c)(i)4) or 6) of subdivision or political sub- this endorse- division has issued a permit ment; or or authorization in connec- tion with premises you own, b) Such inspec- rent or control and to which tions, adjust- this insurance applies: ments, tests or servicing as (i) The existence, mainte- the vendor has nance, repair, construc- agreed to tion, erection or removal make or nor- of advertising signs, mally under- awnings, canopies, cel- takes to make lar entrances, coal in the usual holes, driveways, man- course of holes, marquees, hoist business, in away openings, side- connection walk vaults, street ban- with the distri- ners or decorations and bution or sale similar exposures; of the prod- (ii) The construction, erec- ucts. tion or removal of eleva- (ii) This insurance does not tors; or apply to any insured (iii) The ownership, mainte- person or organization: nance or use of any el- l) From whom you evators covered by this have acquired insurance. such products, or (e) Mortgagee, Assignee Or any ingredient, part Receiver or container, enter- ing into, accompa- Any person or organization nying or containing you are required per Para- such products; or graph 8.a.(1) of this en- s) When liability in- dorsement to provide insur- cluded within the ance, but only with respect "products- to their liability as mortga- completed opera- gee, assignee or receiver tions hazard" has and arising out of the own- been excluded un- ership, maintenance or use der this Coverage of the premises by you. Part with respect to However, this insurance does not apply to structural such products. alterations, new construction (d) State Or Governmental and demolition operations Agency Or Subdivision Or performed by or for that per- Political Subdivision - son or organization. Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 12 of 17 (3) The insurance afforded to addi- Automatic Additional Insured Pro- tional insureds described in Par- vision agraph 8.a.(1) of this endorse- ment: This insurance applies only if the "bodily injury" or "property damage" (a) Only applies to the extent occurs, or the "personal and advertis- permitted by law; ing injury" offense is committed: (b) Will not be broader than that (1) During the policy period; and which you are required by the written contract, written (2) Subsequent to your execution of agreement, written permit or the written contract or written written authorization to pro- agreement, or the issuance of a vide for such additional in- written permit or written authori- sured; and zation, described in Paragraph 8.a.(1). (c) Does not apply to any per- son, organization, vendor, d. Section IV - Commercial General state, governmental agency Liability Conditions is amended as or subdivision or political follows: subdivision, specifically Condition 4. Other Insurance is named as an additional in- amended to include: sured under any other provi- sion of, or endorsement Primary And Noncontributory In- added to, this Coverage surance Part, provided such other provision or endorsement This insurance is primary to and will covers the injury or damage not seek contribution from any other for which this insurance ap- insurance available to an additional plies. insured per Paragraph 8.a.(1) of this endorsement provided that: b. With respect to the insurance afford- ed to the additional insureds de- (1) The additional insured is a scribed in Paragraph 8.a.(1) of this Named Insured under such other endorsement, the following is added insurance; and to Section III- Limits Of Insurance: (2) You have agreed in writing in a The most we will pay on behalf of the contract, agreement, permit or additional insured is the amount of in- authorization described in 8.a.(2) surance: of this endorsement that this in- surance would be primary and (1) Required by the written contract, would not seek contribution from written agreement, written permit any other insurance available to or written authorization described the additional insured. in Paragraph 8.a.(1) of this en- dorsement. For the purpose of 9• Property Damage To Borrowed Equip- determining the required amount ment of insurance only, we will include a. The following is added to Exclusion the minimum amount of any Um- 2J. Damage To Property under Sec- brella liability or Excess Liability tion I - Coverage A- Bodily Injury And coverage required for that addi- Property Damage Liability: tional insured in that written con- tract, written agreement, written Paragraphs (3) and (4) of this exclu- permit or written authorization; or sion do not apply to tools or equip- (2) Available under the applicable ment loaned to you, provided they are limits of insurance; not being used to perform operations at the time of loss. whichever is less. b. With respect to the insurance provid- This endorsement shall not increase ed by this section of the endorse- the applicable limits of insurance. ment, the following additional provi- sions apply: c. Section IV - Commercial General Liability Conditions is amended to (1) The Limits of Insurance shown in include the following: the Declarations are replaced by the limits shown in Section B. Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 13 of 17 Limits Of Insurance, 9. Property 1) Your "employees" who provide pro- Damage To Borrowed Equip- fessional health care services on your ment of this endorsement with behalf as a duly licensed nurse, respect to coverage provided by emergency medical technician or this endorsement. These limits paramedic in the jurisdiction where an are inclusive of and not in addi- 'occurrence" or offense to which this tion to the limits being replaced. insurance applies takes place; or The Limits of Insurance shown in Section B. Limits Of Insurance, 2) Your "employees" or "volunteer work- 9. Property Damage To Bor- ers", other than an employed or vol- rowed Equipment of this en- unteer doctor, providing first aid or dorsement fix the most we will good samaritan services during their pay in any one 'occurrence" re- work hours for you will be deemed to gardless of the number of: be acting within the scope of their employment by you or performing du- (a) Insureds; ties related to the conduct of your (b) Claims made or "suits" business. brought; or 11. Broadened Notice Of Occurrence (c) Persons or organizations Paragraph a. of Condition 2. Duties In making claims or bringing The Event Of Occurrence, Offense, "suits". Claim Or Suit under Section IV - Com- mercial General Liability Conditions is replaced by the following: (a) Our obligation to pay dam- a. You must see to it that we are notified ages on your behalf applies as soon as practicable of an "occur- only to the amount of dam- rence" or an offense which may result ages for each 'occurrence" in a claim. To the extent possible, no- which are in excess of the tice should include: Deductible Amount shown in Section B. Limits Of Insur- (1) How, when and where the "oc- ance, 9. Property Damage currence" or offense took place; To Borrowed Equipment of this endorsement. The limits (2) The names and addresses of of insurance will not be re- any injured persons and wit- duced by the application of nesses; and such deductible amount. (3) The nature and location of any (b) Section IV - Commercial injury or damage arising out of General Liability Conditions, the 'occurrence" or offense. 2. Duties In The Event Of This requirement applies only when Occurrence, Offense, Claim the 'occurrence" or offense is known Or Suit, applies to each to any insured listed under Paragraph claim or "suit" irrespective of 1. of Section II - Who Is An Insured or the amount. any "employee" authorized by you to (c) We may pay any part or all give or receive notice of an "occur- of the deductible amount to rence" or offense. effect settlement of any 12. Nonowned Aircraft claim or "suit" and, upon no- tification of the action taken, The following is added to Exclusion 2.g. you shall promptly reim- Aircraft, Auto Or Watercraft under Sec- burse us for such part of the tion I - Coverage A - Bodily Injury And deductible amount as has Property Damage Liability: been paid by us. This exclusion does not apply to an air- 10. Employees As Insureds - Specified craft you do not own, provided that: Health Care Services And Good Samar- itan Services a. The pilot in command holds a current effective certificate, issued by a duly Paragraph 2.a.(1)(d) under Section II - constituted authority of the United Who Is An Insured does not apply to: States of America or Canada, desig- nating that person as a commercial or airline transport pilot; Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 14 of 17 b. The aircraft is rented with a trained, 2) Damage occurs while in paid crew; and your possession. c. The aircraft does not transport per- At your written request, we sons or cargo for a charge. will make this payment re- gardless13. BodilyInjury Redefined of whether you are J rY at fault for the "property Section V - Definitions, 3. "Bodily injury" damage". is replaced by the following: If you, at our request, re- 3. "Bodily injury" means bodily harm or place, or make any repairs injury, sickness, disease, disability, to, damaged property of humiliation, shock, fright, mental an- others, the amount we will guish or mental injury, including care, pay under Voluntary Proper- loss of services or death resulting ty Damage Coverage will be from any of these at any time. determined by your actual cost to replace or repair the 14. Expected Or Intended Injury Redefined damaged property, exclud- The last sentence of Exclusion 2.a. Ex- ing any profit or overhead. pected Or Intended Injury under Sec- Any payment we make un- tion I - Coverage A - Bodily Injury And der Voluntary Property Property Damage Liability is replaced by Damage Coverage shall not the following: be interpreted as an admis- This exclusion does not apply to "bodily Sion of liability by you or by us. injury" or"property damage" resulting from the use of reasonable force to protect per- It shall be your duty, not our sons or property. duty, to defend any claim or "suit" to which this insurance 15. Former Employees As Insureds applies. The following is added to Paragraph 2. No other obligation or liabil- under Section II -Who Is An Insured: ity to pay sums or perform 2. Each of the following is also an in- acts or services is covered. sured: (b) This insurance applies to Any of your former "employees", di- "property damage" only if: rectors, managers, members, part- 1) The "property damage" ners or "executive officers", including takes place in the "cov- but not limited to retired, disabled or erage territory"; and those on leave of absence, but only for acts within the scope of their em- 2) The "property damage" ployment by you or for duties related occurs during the policy to the conduct of your business. period. 16. Voluntary Property Damage Coverage (2) Exclusions a. Section I - Coverages is amended to This insurance does not apply to include the following: "property damage" that would be COVERAGE D - VOLUNTARY excluded by Coverage A- Bodily PROPERTY DAMAGE COVERAGE Injury And Property Damage Lia bility, 2. Exclusions, except for j. (1) Insuring Agreement Damage To Property, Para- graphs (3), (4), (5) and (6), k. (a) We will pay the cost to re- Damage To Your Product, and I. pair or replace "property Damage To Your Work. damage" to property of oth- ers arising out of operations (3) Definitions incidental to your business For purposes of Voluntary Prop- when: erty Damage Coverage only, the 1) Damage is caused by following definitions under Sec- you; or tion V - Definitions are replaced by the following: Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 15 of 17 13. "Occurrence" means an in- "property damage" under this cident, including continuous Coverage Part. or repeated exposure to substantially the same gen- c. Limits Of Insurance And Deducti- eral harmful conditions that bles result in "property damage". For purposes of the coverage provid- 17. "Property damage" means ed by Voluntary Property Damage physical injury to tangible Coverage and Care, Custody Or Con- property. Electronic data is trol Liability Coverage, Section III - not tangible property, and Limits Of Insurance is amended to "property damage" does not include the following: include disappearance, ab- (1) The Limits of Insurance shown in straction or theft. the Declarations are replaced by As used in this definition, the limits shown in Section B. electronic data means in- Limits Of Insurance, 16. Volun- formation, facts or pro- tary Property Damage Coverage grams, stored as or on, cre- and Care, Custody Or Control ated or used on, transmitted Liability Coverage in this en- to or from computer soft- dorsement. These limits are in- ware, including systems and clusive of, and not in addition to, applications software, hard the limits being replaced. The or floppy disks, CD-ROMs, Limits of Insurance shown in the tapes, drives, cells, data Schedule fix the most we will pay processing devices or any regardless of the number of: other media which are used (a) Insureds; with electronically controlled equipment. (b) Claims made or "suits" b. Care, Custody Or Control Liability brought; or Coverage (c) Persons or organizations For purposes of the coverage provid- making claims or bringing "suits". ed by Care, Custody Or Control Lia- bility Coverage in this endorsement (2) (a) Subject to (3) below, the only: Voluntary Property Damage (1) Section I - Coverage A - Bodily Coverage Each Occurrence Injury And Property Damage Lia- Limit Of Insurance is the most we will pay for the sum bility, 2. Exclusions, j. Damage of damages under Voluntary To Property, Paragraphs (3), (4) Property Damage Coverage; and (5) do not apply to "property damage" to the property of oth- (b) The Care, Custody Or Lon- ers described therein. trol Liability Coverage Each (2) It shall be your duty, not our duty, Occurrence Limit Of Insur- ance is the most we will pay to defend any claim or "suit" to for the sum of damages un- which this insurance applies. der Care, Custody Or Con- No other obligation or liability to trol Liability Coverage; pay sums or perform acts or ser- because of all "property damage" vices is covered. arising out of any one "occur- This Paragraph (2) supersedes rence". any provision in the Coverage (3) The Voluntary Property Damage Part to the contrary. Coverage, Aggregate Limit Of (3) "Property damage" for which Insurance is the most we will pay Care, Custody Or Control Liabil- for the sum of all damages under ity Coverage provides coverage Voluntary Property Damage shall be deemed to be caused by Coverage. This limit applies sep- an "occurrence" but shall not arately to each "coverage term". serve to limit or restrict the ap- (4) Deductible Clause plicability of any exclusion for Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 16 of 17 (a) Our obligation to pay dam- you shall promptly reim- ages on your behalf applies burse us for such part of the only to the amount of dam- Deductible Amount as has ages for each "occurrence" been paid by us. which are in excess of the Deductible Amount shown in 17. Broadened Contractual Liability - Work Section B. Limits Of Insur- Within 50' Of Railroad Property ance, 16. Voluntary Property Section V - Definitions, 9. "Insured con- Damage Coverage and tract" is amended as follows: Care, Custody Or Control Liability Coverage. The lim- a. Paragraph c. is replaced by the fol- its of insurance will not be lowing: reduced by the application of such Deductible Amount. c. Any easement or license agree- ment; (b) Section IV - Commercial General Liability Conditions, b. Paragraph f.(1) is deleted in its entire- 2. Duties In The Event Of ty• Occurrence, Offense, Claim 18. Alienated Premises Or Suit, applies to each claim or "suit" irrespective of Exclusion 2 j. Damage To Property, Para- the amount. graph (2) under Section I - Coverage A - (c) We may pay any part or all Bodily Injury And Property Damage Liabil- ity does not apply if the premises are of the Deductible Amount to "your work". effect settlement of any claim or "suit" and, upon no- tification of the action taken, Includes copyrighted material of Insurance GA 233 09 20 Services Office, Inc., with its permission. Page 17 of 17 This page has been left blank intentionally. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ADDITIONAL INSURED - AUTOMATIC STATUS AND AUTOMATIC WAIVER OF SUBROGATION WHEN REQUIRED IN WRITTEN CONTRACT, AGREEMENT, PERMIT OR AUTHORIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Additional Insured - Owners, Lessees Or cluded in the "products-completed Contractors - Automatic Status For Other operations hazard", but only if: Parties When Required In Written Contract Or Agreement With You (1) The Coverage Part to which this endorsement is attached pro- 1. Section II - Who Is An Insured is vides coverage for"bodily injury" amended to include as an additional in- or "property damage" included sured any person or organization you within the "products-completed have agreed in writing in a contract or operations hazard"; and agreement to add as an additional in- sured on this Coverage Part. Such per- (2) The written contract or written son(s) or organization(s) is an additional agreement requires you to pro- insured only with respect to liability for: vide additional insured coverage included within the "products- a. "Bodily injury", "property damage" or completed operations hazard" "personal and advertising injury" for that person or organization. caused, in whole or in part, by the performance of your ongoing opera- If the written contract or written tions by you or on your behalf, under agreement requires you to provide that written contract or written additional insured coverage included agreement. Ongoing operations does within the "products-completed oper- not apply to "bodily injury"or"proper- ations hazard" for a specified length ty damage"occurring after: of time for that person or organiza- tion, the "bodily injury" or "property (1) All work, including materials, damage" must occur prior to the ex- parts or equipment furnished in piration of that period of time in order connection with such work, on for this insurance to apply. the project (other than service, maintenance or repairs) to be If the written contract or written performed by or on behalf of the agreement requires you to provide additional insured(s) at the loca- additional insured coverage for a tion of the covered operations person or organization per only ISO has been completed; or additional insured endorsement form number CG 20 10, without specifying (2) That portion of"your work"out of an edition date, and without specifi- which the injury or damage aris- cally requiring additional insured es has been put to its intended coverage included within the "prod- use by any person or organiza- ucts-completed operations hazard", tion other than another contrac- this Paragraph b. does not apply to for or subcontractor engaged in that person or organization. performing operations for a prin- cipal as a part of the same pro- 2. If the written contract or written agree- ject; and ment described in Paragraph 1. above specifically requires you to provide addi- b. "Bodily injury' or "property damage" tional insured coverage to that person or caused, in whole or in part, by "your organization: work" performed under that written contract or written agreement and in a. Arising out of your ongoing opera- tions or arising out of"your work"; or Includes copyrighted material of Insurance GA 472 09 18 Services Office, Inc., with its permission. Page 1 of 3 b. By way of an edition of an ISO addi- 2. With respect to the insurance afforded to tional insured endorsement that in- the additional insureds described in Para- cludes arising out of your ongoing graph B.1., the following additional exclu- operations or arising out of "your sions apply: work"; This insurance does not apply to: then the phrase caused, in whole or in part, by in Paragraph A.1.a. and/or Para- a. "Bodily injury , "property damage" or graph A.1.b. above, whichever applies, is "personal and advertising injury" aris- replaced by the phrase arising out of ing out of operations performed for the federal government, state or mu- 3. With respect to the insurance afforded to nicipality; or the additional insureds described in Para- graph A.1., the following additional exclu- b. "Bodily injury' or "property damage" sion applies: included within the "products- completed operations hazard." This insurance does not apply to "bodily injury', "property damage" or "personal C. The insurance afforded to additional insureds and advertising injury" arising out of the described in Paragraphs A.and B.: rendering of, or the failure to render, any 1. Only applies to the extent permitted by professional architectural, engineering or law; and surveying services, including: 2. Will not be broader than that which you a. The preparing, approving or failing to are required by the written contract, writ- prepare or approve, maps, shop ten agreement, written permit or written drawings, opinions, reports, surveys, authorization to provide for such addition- field orders, change orders or draw- al insured; and ings and specifications; or b 3• Does not apply to any person, organiza- . Supervisory, inspection, architectural tion, state, governmental agency or sub- or engineering activities. division or political subdivision specifically This exclusion applies even if the claims named as an additional insured for the against any insured allege negligence or same project in the schedule of an en- other wrongdoing in the supervision, hir- dorsement added to this Coverage Part. ing, employment,training or monitoring of D. With respect to the insurance afforded to the others by that insured, if the "occurrence" additional insureds described in Paragraphs which caused the "bodily injury" or "prop- A. and B., the following is added to Section III erty damage", or the offense which -Limits Of Insurance: caused the"personal and advertising inju- ry", involved the rendering of, or the fail- The most we will pay on behalf of the addi- ure to render, any professional architec- tional insured is the amount of insurance: tural, engineering or surveying services. 1. Required by the written contract, written 4. This Paragraph A. does not apply to addi- agreement, written permit or written au- tional insureds described in Paragraph B. thorization described in Paragraphs A. B. Additional Insured -State Or Governmental and B.; or Agency Or Subdivision Or Political Subdi- 2. Available under the applicable Limits of vision - Automatic Status When Required Insurance shown in the Declarations; In Written Permits Or Authorizations whichever is less. 1. Section II - Who Is An Insured is amended to include as an additional in- This endorsement shall not increase the appli- sured any state or governmental agency cable Limits of Insurance shown in the Decla- or subdivision or political subdivision you rations. have agreed in writing in a contract, E. Section IV - Commercial General Liability agreement, permit or authorization to add Conditions is amended to add the following: as an additional insured on this Coverage Part. Such state or governmental agency Automatic Additional Insured Provision or subdivision or political subdivision is an additional insured only with respect to op- This insurance applies only if the "bodily inju- erations performed by you or on your be- ry" or "property damage" occurs, or the "per- half for which the state or governmental sonal and advertising injury' offense is com- agency or subdivision or political subdivi- mitted: sion issued, in writing, a contract, agree- 1. During the policy period; and ment, permit or authorization. Includes copyrighted material of Insurance GA 472 09 18 Services Office, Inc., with its permission. Page 2 of 3 2. Subsequent to your execution of the writ- As used in this endorsement, wrap-up insur- ten contract or written agreement, or the ance means any insurance provided by a con- issuance of a written permit or written au- solidated (wrap-up) insurance program. thorization, described in Paragraphs A. and B. Primary And Noncontributory Insurance When Required By Written Contract, F. Except when G. below applies, the following is Agreement, Permit Or Authorization added to Section IV - Commercial General Liability Conditions, 5. Other Insurance, Except when wrap-up insurance applies to the and supersedes any provision to the contrary: claim or "suit' on behalf of the additional in- sured, this insurance is primary to and will not When Other Additional Insured Coverage seek contribution from any other insurance Applies On An Excess Basis available to the additional insured described in This insurance is primary to other insurance Paragraphs A.and B. provided that: available to the additional insured described in 1. The additional insured is a Named In- Paragraphs A.and B.except: sured under such other insurance; and 1. As otherwise provided in Section IV - 2. You have agreed in writing in a contract, Commercial General Liability Condi- agreement, permit or authorization de- tions, 5. Other Insurance, b. Excess In- scribed in Paragraph A. or B. that this in- surance; or surance would be primary and would not 2. For any other valid and collectible insur- seek contribution from any other insur- ance available to the additional insured. ance available to the additional insured as an additional insured by attachment of an As used in this endorsement, wrap-up insur- endorsement to another insurance policy ance means any insurance provided by a con- that is written on an excess basis. In such solidated (wrap-up) insurance program. case, this insurance is also excess. H. Section IV - Commercial General Liability G. The following is added to Section IV - Com- Conditions, 9. Transfer Of Rights Of Re- mercial General Liability Conditions, 5. covery Against Others To Us is amended by Other Insurance, and supersedes any provi- the addition of the following: sion to the contrary: We waive any right of recovery we may have Primary Insurance When Required By Writ- against any additional insured under this en- ten Contract, Agreement, Permit Or Au- dorsement against whom you have agreed to thorization waive such right of recovery in a written con- tract, written agreement, written permit or writ- Except when wrap-up insurance applies to the ten authorization because of payments we claim or "suit' on behalf of the additional in- make for injury or damage arising out of your sured, this insurance is primary to any other ongoing operations or 'your work" done under insurance available to the additional insured a written contract, written agreement, written described in Paragraphs A. and B. provided permit or written authorization. However, our that: rights may only be waived prior to the "occur- 1. The additional insured is a Named In- rence" giving rise to the injury or damage for sured under such other insurance; and which we make payment under this Coverage Part. The insured must do nothing after a loss 2. You have agreed in writing in a contract, to impair our rights. At our request, the insured agreement, permit or authorization de- will bring "suit' or transfer those rights to us scribed in Paragraph A. or B. that this in- and help us enforce those rights. surance would be primary to any other in- surance available to the additional in- sured. Includes copyrighted material of Insurance GA 472 09 18 Services Office, Inc., with its permission. Page 3 of 3 This page has been left blank intentionally. COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 This page has been left blank intentionally. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CinciPlus° BUSINESS AUTO XCO (EXPANDED COVERAGE) ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. A. Who is an Insured-Amended policy or the exhaustion of such poli- SECTION II - LIABILITY COVERAGE, A. cys limits of insurance. Coverage, 1. Who is an Insured is amended 3. Any of your "employees" while using a by adding the following: covered "auto" in your business or your personal affairs, provided you do not own, The following are "insureds": hire or borrow that"auto". 1. Any subsidiary which is a legally incorpo- B. Liability Coverage Extensions - Supple- rated entity of which you own a financial mentary Payments-Higher Limits interest of more than 50% of the voting stock on the effective date of this cover- SECTION II - LIABILITY COVERAGE, A. age form. Coverage, 2. Coverage Extensions, a. Sup- However, the insurance afforded by this plementary Payments is amended by: provision does not apply to any subsidiary 1. Replacing the $2,000 Limit of Insurance that is an "insured" under any other au- for bail bonds with $4,000 in (2); and tomobile liability policy, or would be an "insured" under such policy but for termi- 2. Replacing the $250 Limit of Insurance for nation of such policy or the exhaustion of reasonable expenses with $500 in (4). such policy's limits of insurance. C. Amended Fellow Employee Exclusion 2. Any organization that is newly acquired or SECTION II - LIABILITY COVERAGE, B. Ex- formed by you and over which you main- clusions, 5. Fellow Employee is modified as tain majority ownership. follows: The insurance provided by this provision: Exclusion 5. Fellow Employee is deleted. a. Is effective on the date of acquisition D. Hired Auto -Physical Damage or formation, and is afforded for 180 days after such date; If hired "autos" are covered "autos"for Liability Coverage, then Comprehensive and Collision b. Does not apply to "bodily injury" or Physical Damage Coverages as provided un- "property damage" resulting from an der SECTION III - PHYSICAL DAMAGE "accident" that occurred before you COVERAGE of this Coverage Part are ex- acquired or formed the organization; tended to "autos" you hire, subject to the fol- c. Does not apply to any newly acquired lowing: or formed organization that is a joint 1. The most we will pay for "loss" to any venture or partnership; and hired "auto" is $35,000 or the actual cash d. Does not apply to an insured under value or cost to repair or replace, which- any other automobile liability policy, ever is the least, minus a deductible. or would be an insured under such a 2. The deductible will be equal to the largest policy but for the termination of such deductible applicable to any owned "auto" Includes copyrighted material of ISO AA 265 01 16 Properties, Inc., with its permission. Page 1 of 3 for that coverage, or$1,000,whichever is under SECTION III - PHYSICAL DAM- less. AGE COVERAGE, A. Coverage, 4. 3. Hired Auto - Physical Damage coverage Coverage Extensions. is excess over any other collectible insur- F. Transportation Expense- Higher Limits ante. SECTION III - PHYSICAL DAMAGE COV- 4. Subject to the above limit, deductible, and ERAGE, A. Coverage, 4. Coverage Exten- excess provisions we will provide cover- sions is amended by replacing $20 per day age equal to the broadest coverage appli- with $50 per day, and $600 maximum with cable to any covered "auto" you insured $1,500 maximum in Extension a. Transporta- under this policy. tion Expenses. Coverage includes loss of use of that hired au- G. Airbag Coverage to, provided it results from an "accident" for which you are legally liable and as a result of SECTION III - PHYSICAL DAMAGE COV- which a monetary loss is sustained by the ERAGE, B. Exclusions, 3.a. is amended by leasing or rental concern. The most we will adding the following: pay for any one"accident" is$1,000. However, the mechanical and electrical If a limit for Hired Auto - Physical Damage is breakdown portion of this exclusion does not shown in the Schedule, then that limit replac- apply to the accidental discharge of an airbag. es, and is not added to, the $35,000 limit indi- This coverage for airbags is excess over any cated above. other collectible insurance or warranty. E. Rental Reimbursement H. Loan or Lease Gap Coverage SECTION III - PHYSICAL DAMAGE is 1. SECTION III - PHYSICAL DAMAGE amended by adding the following: COVERAGE, C. Limit of Insurance is deleted in its entirety and replaced by the 1. We will pay for rental reimbursement ex- following, but only for private passenger penses incurred by you for the rental of type "autos"with an original loan or lease, an "auto" because of a "loss" to a covered and only in the event of a "total loss" to "auto". Payment applies in addition to the such a private passenger type"auto": otherwise applicable amount of each cov- erage you have on a covered "auto". No a. The most we will pay for"loss" in any deductible applies to this coverage. one"accident" is the greater of: 2. We will pay only for those expenses in- (1) The amount due under the terms curred during the policy period beginning of the lease or loan to which 24 hours after the "loss" and ending, re- your covered private passenger gardless of the policy's expiration, with type"auto" is subject, but will not the lesser of the following number of include: days: (a) Overdue lease or loan pay- a. The number of days reasonably re- ments; quired to repair the covered "auto". If (b) Financial penalties imposed "loss" is caused by theft, this number under the lease due to high of days is added to the number of mileage, excessive use or days it takes to locate the covered abnormal wear and tear; "auto" and return it to you; or b. 30 days. (c) Security deposits not re- funded by the lessor; 3. Our payment is limited to the lesser of the (d) Costs for extended warran- following amounts: ties, Credit Life Insurance, a. Necessary and actual expenses in- Health, Accident or Disabil- curred; or ity Insurance purchased with the loan or lease; and b. $40 per day. (e) Carryover balances from 4. This coverage does not apply while there previous loans or leases, or are spare or reserve "autos" available to you for your operations. (2) Actual cash value of the stolen or damaged property. 5. We will pay under this coverage only that amount of your rental reimbursement ex- b. An adjustment for depreciation and penses which is not already provided for physical condition will be made in de- Includes copyrighted material of ISO AA 265 01 16 Properties, Inc., with its permission. Page 2 of 3 termining actual cash value at the 2. A partner, if you are a partnership; time of"loss". 3. An executive officer or insurance manag- 2. SECTION V - DEFINITIONS is amended er, if you are a corporation; or by adding the following, but only for the purposes of this Loan or Lease Gap 4. A member or manager, if you area lim- Coverage: ited liability company. 'Total loss" means a "loss" in which the K. Unintentional Failure to Disclose Hazards cost of repairs plus the salvage value ex- SECTION IV - BUSINESS AUTO CONDI- ceeds the actual cash value. TIONS, B. General Conditions is amended I. Glass Repair-Waiver of Deductible by adding the following: SECTION III - PHYSICAL DAMAGE COV- If you unintentionally fail to disclose any haz- ERAGE, D. Deductible is amended by adding ards existing on the effective date of this Cov- the following: erage Form, we will not deny coverage under this Coverage Form because of such failure. No deductible applies to glass damage if the glass is repaired in a manner acceptable to us L. Mental Anguish Resulting from Bodily Inju- rather than replaced. ry J. Duties in the Event of an Accident, Claim, SECTION V - DEFINITIONS, C. "Bodily inju- " is deleted in its entirety and replaced b Suit or Loss-Amended ry y p y the following: SECTION IV - BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 2. Duties in the "Bodily injury"means bodily injury,sickness or Event of Accident, Claim, Suit or Loss, a. is disease sustained by a person, including men- amended by adding the following: tal anguish and death sustained by the same person that results from such bodily injury, This condition applies only when the "acci- sickness or disease. "Bodily injury" does not dent" or"loss" is known to: include mental anguish or death that does not 1. You, if you are an individual; result from bodily injury, sickness or disease. Includes copyrighted material of ISO AA 265 01 16 Properties, Inc., with its permission. Page 3 of 3 This page has been left blank intentionally. �N City of Kent General. Business License KENT 2024 License Number 2140492 UBI 6022898320010001 City of Kent Licensee: 220 4th Avenue S Eagle Asphalt Sealcoating Company, LLC Kent, WA 98032 11219 Benston Dr E :' 253-856-5200 Puyallup, WA 98372 Kentwa.gov customerservice@kentwa.gov License is issued for this application www.FileLocal.org '9 Issued: 02/16/2024 Expires: 12/31/2024 Not Transferable Post Conspicuously 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: 5/9/2024 County Trade Job Classification Wage Holiday Overtime Note *Risk Class King Laborers Air, Gas Or Electric Vibrating $59.07 15J 11 P 8Y View Screed King Laborers Airtrac Drill Operator $60.90 15J 11 P 8Y View King Laborers Ballast Regular Machine $59.07 15J lip 8Y View King Laborers Batch Weighman $50.07 15J lip 8Y View King Laborers Brick Pavers $59.07 15J lip 8Y View King Laborers Brush Cutter $59.07 15J lip 8Y View King Laborers Brush Hog Feeder $59.07 15J lip 8Y View King Laborers Burner $59.07 15J lip 8Y View King Laborers Caisson Worker $60.90 15J lip 8Y View King Laborers Carpenter Tender $59.07 15J lip 8Y View King Laborers Cement Dumper-paving $60.15 15J lip 8Y View King Laborers Cement Finisher Tender $59.07 15J lip 8Y View King Laborers Change House Or Dry Shack $59.07 15J lip 8Y View King Laborers Chipping Gun (30 Lbs. And $60.15 15J lip 8Y View Over) King Laborers Chipping Gun (Under 30 Lbs.) $59.07 15J 11P 8Y View King Laborers Choker Setter $59.07 15J lip 8Y View King Laborers Chuck Tender $59.07 15J lip 8Y View King Laborers Clary Power Spreader $60.15 15J lip 8Y View King Laborers Clean-up Laborer $59.07 15J lip 8Y View King Laborers Concrete Dumper/Chute $60.15 15J lip 8Y View Operator King Laborers Concrete Form Stripper $59.07 15J lip 8Y View King Laborers Concrete Placement Crew $60.15 15J lip 8Y View King Laborers Concrete Saw Operator/Core $60.15 15J lip 8Y View Driller King Laborers Crusher Feeder $50.07 15J lip 8Y View King Laborers Curing Laborer $59.07 15J lip 8Y View King Laborers Demolition: Wrecking It Moving $59.07 15J lip 8Y View (Incl. Charred Material) King Laborers Ditch Digger $59.07 15.1 11 P 8Y View King Laborers Diver $60.90 15J 11 P 8Y View King Laborers Drill Operator (Hydraulic, $60.15 15J lip 8Y View Diamond) King Laborers Dry Stack Walls $59.07 15.1 lip 8Y View King Laborers Dump Person $59.07 15J lip 8Y View King Laborers Epoxy Technician $59.07 15.1 lip 8Y View King Laborers Erosion Control Worker $59.07 15J lip 8Y View King Laborers Faller Et Bucker Chain Saw $60.15 15J lip 8Y View King Laborers Fine Graders $59.07 15.1 lip 8Y View King Laborers Firewatch $50.07 15J lip 8Y View King Laborers Form Setter $60.15 15.1 lip 8Y View King Laborers Gabian Basket Builders $59.07 15.1 lip 8Y View King Laborers General Laborer $59.07 15J lip 8Y View King Laborers Grade Checker Et Transit Person $62.49 15J lip 8Y View King Laborers Grinders $59.07 15J lip 8Y View King Laborers Grout Machine Tender $59.07 15J lip 8Y View King Laborers Groutmen (Pressure) Including $60.15 15.1 lip 8Y View Post Tension Beams King Laborers Guardrail Erector $59.07 15J lip 8Y View King Laborers Hazardous Waste Worker (Level $60.90 15J lip 8Y View A) King Laborers Hazardous Waste Worker (Level $60.15 15J lip 8Y View B) King Laborers Hazardous Waste Worker (Level $59.07 15J lip 8Y View C) King Laborers High Scaler $60.90 15J lip 8Y View King Laborers Jackhammer $60.15 15J lip 8Y View King Laborers Laserbeam Operator $60.15 15J lip 8Y View King Laborers Maintenance Person $59.07 15.1 lip 8Y View King Laborers Manhole Builder-Mudman $60.15 15J lip 8Y View King Laborers Material Yard Person $59.07 15J lip 8Y View King Laborers Mold Abatement Worker $59.07 15.1 lip 8Y View King Laborers Motorman-Dinky Locomotive $62.59 15J lip 8Y View King Laborers nozzleman (concrete pump, $62.49 15.1 lip 8Y View green cutter when using combination of high pressure air Et water on concrete Et rock, sandblast, gunite, shotcrete, water blaster, vacuum blaster) King Laborers Pavement Breaker $60.15 15J lip 8Y View King Laborers Pilot Car $50.07 15J lip 8Y View King Laborers Pipe Layer (Lead) $62.49 15.1 lip 8Y View King Laborers Pipe Layer/Tailor $60.15 15J lip 8Y View King Laborers Pipe Pot Tender $60.15 15J lip 8Y View King Laborers Pipe Reliner $60.15 15J lip 8Y View King Laborers Pipe Wrapper $60.15 15J lip 8Y View King Laborers Pot Tender $59.07 15J lip 8Y View King Laborers Powderman $60.90 15J lip 8Y View King Laborers Powderman's Helper $59.07 15J lip 8Y View King Laborers Power Jacks $60.15 15J lip 8Y View King Laborers Railroad Spike Puller - Power $60.15 15J lip 8Y View King Laborers Raker -Asphalt $62.49 15J lip 8Y View King Laborers Re-timberman $60.90 15J lip 8Y View King Laborers Remote Equipment Operator $60.15 15J lip 8Y View King Laborers Rigger/Signal Person $60.15 15J lip 8Y View King Laborers Rip Rap Person $59.07 15J lip 8Y View King Laborers Rivet Buster $60.15 15J lip 8Y View King Laborers Rodder $60.15 15J lip 8Y View King Laborers Scaffold Erector $59.07 15J lip 8Y View King Laborers Scale Person $59.07 15J lip 8Y View King Laborers Sloper (Over 20") $60.15 15J lip 8Y View King Laborers Sloper Sprayer $59.07 15J lip 8Y View King Laborers Spreader (Concrete) $60.15 15J lip 8Y View King Laborers Stake Hopper $59.07 15J lip 8Y View King Laborers Stock Piler $59.07 15J lip 8Y View King Laborers Swinging Stage/Boatswain $50.07 15J 11P 8Y View Chair King Laborers Tamper & Similar Electric, Air &t $60.15 15J lip 8Y View Gas Operated Tools King Laborers Tamper (Multiple Ft Self- $60.15 15J lip 8Y View propelled) King Laborers Timber Person - Sewer (Lagger, $60.15 15J lip 8Y View Shorer Et Cribber) King Laborers Toolroom Person (at Jobsite) $59.07 15J lip 8Y View King Laborers Topper $59.07 15J lip 8Y View King Laborers Track Laborer $59.07 15J lip 8Y View King Laborers Track Liner (Power) $60.15 15J lip 8Y View King Laborers Traffic Control Laborer $53.54 15J lip 9C View King Laborers Traffic Control Supervisor $56.73 15J lip 9C View King Laborers Truck Spotter $59.07 15J lip 8Y View King Laborers Tugger Operator $60.15 15J lip 8Y View King Laborers Tunnel Work-Compressed Air $175.79 15J lip 9B View Worker 0-30 psi King Laborers Tunnel Work-Compressed Air $180.82 15J lip 9B View Worker 30.01-44.00 psi King Laborers Tunnel Work-Compressed Air $184.50 15J lip 9B View Worker 44.01-54.00 psi King Laborers Tunnel Work-Compressed Air $190.20 15J lip 9B View Worker 54.01-60.00 psi King Laborers Tunnel Work-Compressed Air $192.32 15J lip 9B View Worker 60.01-64.00 psi King Laborers Tunnel Work-Compressed Air $197.42 15J lip 9B View Worker 64.01-68.00 psi King Laborers Tunnel Work-Compressed Air $199.32 15J lip 9B View Worker 68.01-70.00 psi King Laborers Tunnel Work-Compressed Air $201.32 15J lip 9B View Worker 70.01-72.00 psi King Laborers Tunnel Work-Compressed Air $203.32 15J lip 9B View I Worker 72.01-74.00 psi King Laborers Tunnel Work-Guage and Lock $62.59 15J lip 8Y View Tender King Laborers Tunnel Work-Miner $62.59 15J lip 8Y View King Laborers Vibrator $60.15 15J lip 8Y View King Laborers Vinyl Seamer $59.07 15J lip 8Y View King Laborers Watchman $45.51 15J lip 8Y View King Laborers Welder $60.15 15J lip 8Y View King Laborers Well Point Laborer $60.15 15J lip 8Y View King Laborers Window Washer/Cleaner $45.51 15J lip 8Y View Signature: Garin Lee(May 3, 02409:01 PDT) Signature: Kent Parks(May 23,20 Email: glee@kentwa.gov Email: parkscontracts@kentwa.gov Signature: �1�MeCo� Melissa McCormick(Jun 4,202406:54 PDT) Email: cityclerk@kentwa.gov OPS-052124-EagleAsphalt-MorrillMeadowsSeal coat Final Audit Report 2024-06-04 Created: 2024-05-22 By: Shayla Ott(sott@kentwa.gov) Status: Signed Transaction ID: CBJCHBCAABAATkM_k6PHgMzkbsA10NwCFVvv5lfuk8mh "OPS-052124-EagleAsphalt-MorrillMeadowsSealcoat" History Document created by Shayla Ott (sott@kentwa.gov) 2024-05-22-3:38:04 PM GMT Document emailed to glee@kentwa.gov for signature 2024-05-22-3:50:09 PM GMT Email viewed by glee@kentwa.gov 2024-05-23-4:00:30 PM GMT Signer glee@kentwa.gov entered name at signing as Garin Lee 2024-05-23-4:01:25 PM GMT Document e-signed by Garin Lee (glee@kentwa.gov) Signature Date:2024-05-23-4:01:27 PM GMT-Time Source:server Document emailed to Kent Parks (parkscontracts@kentwa.gov) for signature 2024-05-23-4:01:30 PM GMT Email viewed by Kent Parks (parkscontracts@kentwa.gov) 2024-05-24-0:29:00 AM GMT d4 Document e-signed by Kent Parks (parkscontracts@kentwa.gov) Signature Date:2024-05-24-0:30:32 AM GMT-Time Source:server Document emailed to bjlevenhagen@kentwa.gov for signature 2024-05-24-0:30:35 AM GMT Email viewed by bjlevenhagen@kentwa.gov 2024-05-29-3:35:06 PM GMT Powered by Adobe �� KENT Acrobat Sign �p Signer bjlevenhagen@kentwa.gov entered name at signing as Brian Levenhagen 2024-05-29-3:35:26 PM GMT dp Document e-signed by Brian Levenhagen (bjlevenhagen@kentwa.gov) Signature Date:2024-05-29-3:35:28 PM GMT-Time Source:server Document emailed to Bryce Wilson (bryce@eagle-asphalt.com) for signature 2024-05-29-3:35:30 PM GMT Email viewed by Bryce Wilson (bryce@eagle-asphalt.com) 2024-05-29-3:52:37 PM GMT Email viewed by Bryce Wilson (bryce@eagle-asphalt.com) 2024-06-01 -3:32:51 AM GMT Email viewed by Bryce Wilson (bryce@eagle-asphalt.com) 2024-06-03-1:20:09 PM GMT �p Document e-signed by Bryce Wilson (bryce@eagle-asphalt.com) Signature Date:2024-06-03-2:09:18 PM GMT-Time Source:server Document emailed to Kim Komoto (kkomoto@kentwa.gov)for signature 2024-06-03-2:09:20 PM GMT Email viewed by Kim Komoto (kkomoto@kentwa.gov) 2024-06-03-2:33:17 PM GMT dg Document e-signed by Kim Komoto (kkomoto@kentwa.gov) Signature Date:2024-06-03-2:33:31 PM GMT-Time Source:server Document emailed to cityclerk@kentwa.gov for signature 2024-06-03-2:33:33 PM GMT Email viewed by cityclerk@kentwa.gov 2024-06-04-1:51:28 PM GMT Signer cityclerk@kentwa.gov entered name at signing as Melissa McCormick 2024-06-04-1:54:13 PM GMT Document e-signed by Melissa McCormick (cityclerk@kentwa.gov) Signature Date:2024-06-04-1:54:15 PM GMT-Time Source:server Agreement completed. 2024-06-04-1:54:15 PM GMT Powered by Adobe L�KEN7 Acrobat Sign