HomeMy WebLinkAbout001176 Original Contract 0City of Port Angeles
Record # 001176
AGREEMENT FOR PROFESSIONAL SERVICES
BETWEEN THE
THE CIry OF PORT ANGELES
AND
NORTHWESTERN TERRITORIES, INC.
PSA-201 7-01 Professional Services Agreement
RELATING TO: GEOTECHNICAL SURVEYING AND INSPECTION SERVICES
THIS AGREEMENT is made and entered into, by and between THE Clry OF PORT
ANGELES, a non-charter code city of the State of Washington, (hereinafter called the "C|TY")
and Northwestern Territories, lnc., a Washington corporation authorized to do business in the
state of Washington (hereinafter called the "CONSULTANT').
WHEREAS, the CITY desires engineering and consulting assistance related to construction
inspection and materials testing.
WHEREAS, the CITY desires to engage the professional services and assistance of a qualified
consulting firm to perform the Scope of Services as detailed in Exhibit A, and
WHEREAS, the CONSULTANT represents that it is in full compliance with the statutes of the
State of Washington for professional registration and/or other appticable requirements, and
WHEREAS, the CONSULTANT represents lhat it has the background, experience, and ability
to perform the required work in accordance with the standards of the profession, and
WHEREAS, the CONSULTANT represents that it will provide qualified personnel and
appropriate facilities necessary to accomplish the work;
NOW THEREFORE, in consideration of the above representations and the lerms, conditions,
covenants, and agreements set forth below, the parties hereto agree as follows:
I SCOPE OF SERVICES
General Scope.
The Consultant will accomplish the work as described in scope of services atlached in Exhibit
A.
The CITY may review the CONSULTANT'S services, and if they do not meet the Professional
Standard of Care the CONSULTANT shall make such changes as may be required by the
CITY. Such changes shall not constitute "Extra Work" as related in Section Xll of this
Agreement. Any changes made necessary due to causes outside the CONSULTANT'S
reasonable control shall be provided as an extra work herein.
The CONSULTANT agrees that all services performed under this Agreement shall be in
accordance with the standards of the engineering profession for similar services on similar
projects of like size and nature and in compliance with applicable federal, state and local laws.
The Scope of Services may be amended upon written approval of both parties.
Page t of7
Upon completion of the work, all documents, exhibits, photographic negatives, or other
presentations of the work with the exception of those standard details and specifications
regularly used by the CONSULTANT in its normal course of business shall upon payment of all
amounls rightfully owed by the CITY to the CONSULTANT herein become the property of the
CITY for use without restriction and without representation as to suitability for reuse by any
other party unless specifically verified or adapted by the CONSULTANT. However, any
alteration of the documents, by the CITY or by others acting through or on behalf of the CITY,
will be at the CITY's sole risk.
II OWNERSHIP OF OOCUMENTS
III DESIGNATION OF REPRESENTATIVES
Each party shall designate its representatives in writing. The CONSULTANT'S representative
shall be subject to the approval of the CITY.
IV TIME OF PERFORMANCE
The CONSULTANT may begin work upon execution of this Agreement by both parties and
written direction to proceed from CITY and the duration of the Agreement shall extend through
December 31 , 2017.
V PAYMENT
The CITY shall pay the CONSULTANT as set forth in this section of the Agreement. Such
payment shall be full compensation for work performed, services rendered, and all labor,
materials, supplies, equipment and incidentals necessary to complete the work.
A. Payment shall be on the basis of the CONSULTANT'S cost for actual labor, overhead and
profit plus CONSULTANI'S direct non-salary reimbursable costs as set forth in the
attached Exhibit C.
B. The CONSULTANT shall submit invoices to the CITY on a monthly basis. lnvoices shall
detail the work, hours, employee name, and hourly rate; shall itemize with receipts and
invoices the non-salary direct costs; shall indicate the specific task or activity in the Scope
of Service to which the costs are related; and shall indicate the cumulative total for each
task.
C. TheClTYshall review the invoices and make payment forthe percentage of the project
that has been completed less the amounts previously paid.
D. The CONSULTANT invoices are due and payable within 30 days of receipt. ln the event
of a disputed billing, only the disputed portion will be withheld from payment.
E. Final payment for the balance due to the CONSULTANT will be made affer the completion
of the work and acceptance by the CITY.
F. Payment for "Extra Work" performed under Section Xll of this Agreement shall be as
agreed to by the parties in writing.
I
I
I
Page 2 ol7
VI MAXIMUM COMPENSATION
Unless otherwise agreed to in writing by both parties, the CONSULTANT'S total compensation
and reimbursement under this Agreement, including labor, direct non-salary reimbursable
costs and outside services, shall not exceed the maximum sum of $40,500.00 The budget for
each task is as set forth in the attached Exhibit B. Budgets for task(s) may be modified upon
mutual agreement between the two parties, but in any event, the total payment to
CONSULTANT shall not exceed 940,500.00.
VII INDEPENOENT CONTRACTOR STATUS
The relation created by this Agreement is that of owner-independent contractor. The
CONSULTANT is not an employee of the CITY and is not entitled to the benefits provided by
the CITY to its employees. The CONSULTANT, as an independent contractor, has lhe
autholity to control and direct the performance within the Scope of Service. The
CONSULTANT shall assume full responsibility for payment of all Federal, Stale, and local
taxes or contributions imposed or required, including, but not limited to, unemployment
insurance, Social Security, and income lax.
VIII EMPLOYMENT
Employees of the CONSULTANT, while engaged in the performance of any work or services
under this Agreement, shall be considered employees of the CONSULTANT only and not of
the CITY, and claims that may arise under the Workman's Compensation Act on behalf of said
employees while so engaged, and any and all claims made by a third party as a consequence
of any negligent act or omission on the part of the CONSULTANT'S employees while so
engaged, on any of the work or services provided to be rendered herein, shall be the sole
obligation and responsibility of the CONSULTANT.
ln performing this Agreement, the CONSULTANT shall not employ or contract with any CITY
employee without the CITY'S written consent.
IX NONDISCRIMINATION
The CONSULTANT shall conduct its business in a manner, which assures fair, equal and
non-discriminatory treatment of all persons, withoul respect to race, creed or national origin, or
other legally protecled classification and, in particular:
A. The CONSULTANT shall maintain open hiring and employmenl practices and will welcome
applications for employment in all positions, from qualified individuals who are members of
minorities protected by federal equal opportunity/af{irmative action requirements; and,
B. The CONSULTANT shall comply with all requirements of applicable federal, state or local
laws or regulations issued pursuant thereto, relating to the establishment of
nondiscriminatory requiremenls in hiring and employment practices and assuring the
service of all persons without discrimination as to any person's race, color, religion, sex,
Vietnam era veteran status, disabled veteran condition, physical or mental handicap, or
national origin.
P.ge 3 ol7
X SUBCONTRACTS
A. The CONSULTANT shall not sublet or assign any of the work covered by this Agreement
without the written consent of the ClW.
B. ln all solicitation either by competitive bidding or negotiation made by the CONSULTANT
for work to be performed pursuant to a subcontract, including procurement of materials
and equipment, each potential sub-consultant or supplier shall be notified by the
CONSULTANT of CONSULTANT'S obligations under this Agreement, inctuding the
nondiscrimination requiremenls.
XI CHANGES IN WORK
Other than changes directed by the CITY as set forth in Section I above, either party may
request changes in the Scope of Services. Such changes shall not become part of this
Agreement unless and until mutually agreed upon and incorporated herein by wriften
amendments to this Agreement executed by both parties.
XII EXTRA WORK
The CITY may desire to have the CONSULTANT perform work or render services in
connection with this Agreement, in addition to the Scope of Services set forth in Exhibit A and
minor revisions to satisfactorily completed work. Such work shall be considered as "Extra
Work" and shall be addressed in a written supplement to this Agreement. The CITY shall not
be responsible for paying for such extra work unless and until the written supplement is
execuled by both parties.
XIII TERMINATION OF AGREEMENT
A. The CITY may terminate this Agreement at any time upon not less than ten (10) days
written notice to the CONSULTANT. Written notice will be by certified mail sent to the
CONSULTANT's designated representative at the address provided by the CONSULTANT.
As a condition precedent to termination for cause the CONSULTANT shall be given the
notice period to cure such cause and shall have failed to so cure.
B. ln the event this Agreement is terminated prior to the completion of the work, a final
payment shall be made to the CONSULTANT, which, when added to any payments
previously made, shall compensate the CONSULTANT for the work completed.
C. ln the event this Agreement is lerminated prior to completion of the work, documents that
are the property ofthe CITY pursuant to Section Il above, shall be delivered to and
received by the CITY prior to transmittal of final payment to the CONSULTANT.
XIV INDEMNIFICATION/HOLD HARMLESS
CONSULTANT shall defend, indemniff and hold the CITY, its officers, officials, employees and
volunteers harmless from any and all claims, injuries, damages, losses or suits including
atlorney fees, arising out of or resulting from the acts, errors or omissions of the
CONSULTANT in performance of this Agreement, except for injuries and damages caused by
the sole negligence of the CITY.
Page 4 of 7
The CITY agrees to indemnify the CONSULTANT from any claims, damages, losses, and
costs, including, but not limited to, reasonable attorney's fees and litigation costs, arising out of
claims by third parties for property damage and bodily injury, including death, caused solely by
the negligence or willful misconduct of the CITY, the CITY's employees, or agenls in
connection with the work performed under this Agreement.
lf the negligence or willful misconduct of both CONSULTANT and the CITY (or a person
identified above for whom each is liable) is a cause of such damage or injury, the loss, cost, or
expense shall be shared between the CONSULTANT and the CITY in proportion to their
relative degrees of negligence or willful misconduct and the right of indemnity shall apply for
such proportion.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW
4.24.1'15, 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 ofthe
CONSULTANT, the CITY, and the ofricers, officials, employees, and volunteers of either, the
CONSULTANTS liability hereunder shall be only to the extent of the CONSULTANT'S
negligence. lt is further specifically and expressly understood that the indemnification provided
herein constitutes the CONSULTANT'S waiver of immunily under lndustrial lnsurance, Title 51
RCW, solely for the purposes of this indemnification. This waiver has been mutually
negotiated by the parties. The provisions of this section shall survive the expiration or
termination of this Agreement.
XV INSURANCE
No Limitation. CONSULTANT'S maintenance of insurance as required by the Agreement shall
not be construed to limit the liability of the CONSULTANT to the coverage provided by such
insurance, or otherwise limit the CITY'S recourse to any remedy available at law or in equity.
A. MINIMUM SCOPE OF INSURANCE
Consultanl shall obtain insurance of the types described below
1. Automobile Liabilitv insurance covering all owned, non-owned, hired and leased
vehicles. Coverage shall be written on lnsurance Services Office (lSO) form CA 00 01
or a substilute form providing equivalent liability coverage. lf necessary, lhe policy shall
be endorsed to provide contractual liability coverage.
2. Qenmercial General Liabilitv insurance shall be written on lS O occurrence form CG 00
01 and shall cover liability arising from premises, operations, independenl contractors
and personal injury and advertising injury. The CITY shall be named as an insured
under the Consultant's Commercial General Liability insurance policy with respect to the
work performed for the CITY.
Page 5 or 7
The CONSULTANT shall procure and maintain for the duration of the Agreement, insurance
against claims for injuries to persons or damage to property which may arise from or in
connection with the performance of the work hereunder by the CONSULTANT, its agents,
representatives, employees or subcontractors.
B. MINIMUM AMOUNTS OF INSURANCE
Consultant shall maintain the following insurance limils:
1. Automobile Liabilitv insurance with a minimum combined single limit for bodily injury and
property damage of $1,000,000 per accident.
2. Commercial General Liabilitv insurance shall be wriften with limits no less than
$1 ,000,000 each occurrence, $2,OOO,OO0 general aggregate.
3. Prgfessionel Liabilitv insurance shall be wriften with limits no less than $.1,000,000 per
claim and $1 ,000,000 policy aggregate limil.
C. OTHER INSURANCE PROVISION
The CONSULTANT'S Automobile Liability and Commercial General Liability insurance ooliciesare 10 contain, or be endorsed to contain ihat they shall be primary insuran6e as respeit iheCITY. Any lnsura_nce, self-insurance, or insuranie pool corieragehaintalned Uy ttri'Ctfv snattbe excess of the CONSULTANT'S insurance and shall not contiibute with it.
D. ACCEPTABILITY OF INSURERS
lnsurance is to be placed with insurers with a current A.M. Best rating of not less than A:Vll.
E. VERIFICATION OF COVERAGE
CONSULTANT shall furnish the clw with original certificates and a copy of the amendatoryendorsements, including but not necessarily lihited to the addilional inddreO enOorsemint
evidencing the insurancE requirements of the coNSULTANT uefore iomm;;d;ent oiiii;work.
F- NOTICEOFCANCELLATION
The,CONSULTANT shall provide the CITY with written notice of any policy cancellation, withintwo business days of their receipl of such notice.
G. FAILURE TO MAINTAIN INSURANCE
Failure on the part of the CONSULTANT to maintain the insurance as required shall constitute
a material breach of contract, upon which the clrY may, after qiving live business davs notice
to the CONSULTANT to correct the breach, immediatery termin-'ate lhe contract or, at its
discretion, procure or renew such insurance and pay any and all premiums in connection
therewith, with any sums so expended to be repaid io th-e ClTy oh demand, or at the sole
discretion of the CITY, offset against funds due the CONSULTANT from the ClTy.
3. workers' comoensation coverage as required by the lndustrial lnsurance laws of the
State of Washington.
4 rofes Liabili insurance appropriate to the Consultant's profession
Page 6 of 7
This Agreement shall be construed and interpreted in accordance with the laws of the State ofWashington, and in the event of dispute the venue of any litigation brought hereunder strait OeClallam County.
XVII EXH]BITS AND SIGNATURES
This Agreement, including its exhibits, constitutes the entire Agreement, supersedes all prior
wrilten or oral understandings, and may only be changed uy a written amendment executea byboth parties. The following exhibits are hereby madei pari of this Agreement:
XVI APPLICABLE LAW
Exhibit A - Scope of Services
Exhibil B - Budget
Exhibit C - Time Plus Expense Rate Schedule
Exhibit D - Schedule
xvilr
This Agreement is efiective and binding as of the date for the last signature affixed below
CITY OF PORT ANGELES APPROVED AS TO FORM:
(
DAN McKEEN, CITY MANAGER
oArE: al 6 lrt
WLLIAM E. BLOOR,
ATTEST:
RNEY
lLtt-- -(tt ,--b.'11,,,,-*o v{ltwlq'lA
J NNIF VENEKLASEN, CITY CLERK
ITLT CE
DATE: t- rr * t7
Pege 7 ol7
CONSULTANT
NORTHWESTERN TERRITORIES INC.
This scope of services provides technical support to the City,s engineering office; typical
services include geotechnical evaluation, geotechnical boring, site surveys, construclion
surveys, construction material testing and lab analysis, inspection, soil surveys, pre_
design surveys, etc.
Task 1, v1A lr308 Pump station 3 Geotechnical Evaluation: Geotechnical Evaluation
along Marine Drive adjacent to the Port of port Angeles Marina to support project
\ M03-08. The goal of this investigation work is to determine underground conditions
pertaining to the construction of a driven pile restraint syslem for the existing lnduskial
Waler Line trestle system, or, a driven sheet pile retaining wall lo buttress the
abandoned railroad fill prism. The following services will be performed by Northwestern
Territories lnc.:
. Mark 5 borehole locations at approximate intervals along the marina frontage.. Coordinate utility locates with on-call localing.. Engage a drilling subcontractor to drill the test borings and take Standard
Penetration or other drive samples based on encountered conditions.. NTI will retain the samples and perform an estimated five laboratory Unified Soil
Classification tests.. NTI will prepare a Geotechnical report of findings including: bore logs: site plan
of borings; laboratory test results; site geology, critical areas/geohazards;
groundwater; pile type recommendations; piling construction considerations;
trench excavation and backfill recommendations; and, slope protection/scour
recommendations.
Task 2, DR0213 H St. Stormwater Outfall Survey: Survey existing features as directed
along the proposed alignments of the H Street Stormwater Outfall project, located near
lhe intersection of Marine Drive and Hill skeet. The city engineering department will
provide GIS maps of the approximate location of the structures to be surveyed by the
CONSULTANT, additional information will be provided upon requesl.
o Coordinate with City/Consultants in the field to veril, survey limits and identify
specific features to be surveyed.
. Confirm or establish local control on the site.. Perform topographic field survey of two areas and spot elevations as indicated.. Reduce field survey data to provide coordinates to City in text file format.
EXHIBIT A
SCOPE OF SERVICES
Task 3, Landfill Post closure surveying support: survey landfill features to suppo( the
city in meeting the inspection and maintenance requirements of the Landfill post-
closure Plan. These requirements include an annual lransect survey of twelve locatrons
along the Port Angeles Landfill shoreline as designated in the May 20l6 operations and
Maintenance Plan for the Port Angeles seawall. Addilional transect locations may be
requested by the city. survey data will be collected in April 2017. survey accuracy and
layout shall be consistent with transects surveyed in 2008 through 2016. Additionally a
Biannual survey of the Mechanically Reinforced Earth (MRE) Slope be performed in
Aptil2017 with a follow up survey to be completed in October 201 7. MRE wall survey
work will consist of surveying 15 measurement points located both horizontally and
vertically across the MRE slope and buttress system. survey data shall be transmifted
to the city of Port Angeles in the form of a comma separated variable file (csv), within
'14 days of performing the survey.
Task 4, Directed Services Engineering: CONSULTANT shall provide land survey,
geotechnical lesting, material testing, and inspection services related to the clry's
various utilities at the specific direction of authorized clw staff. No such assistance or
services shall be provided unless specifically directed by the clry. The purpose of this
task is to facilitate timely response by CoNSULTANT to needs that are unforeseen at
this time. The budget for this task is essentially a contingency allowance that includes
labor and expenses.
END OF EXHIBIT
CONSULTANT will perform the scope of work in Exhibit A on an hourly basis per
Exhibit C - Standard Rate Schedule.
EXHIBIT B -- BUDGET
END OF EXHIBIT
Task Budget
I WW0308 Pump Station 3 Geotechnical Evaluation $20,000
$5,500
Landfill Post Closure g Support $5,000
4 Direcled Services Enginee ring $ 10,000
Total Contract Amounl $40,500
2.DR0213 H St. Stormwater Outfatt Survev
Consultant Labor Costs and Non-Salary Reimbursable Costs are shown on the
following pages.
EXHIBIT C - Consultant Labor Costs and Non-Salary Reimbursable Costs
2017 Rate Schedule
flo Be Provided)
END OF EXHIBIT
I
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PREVAILING WAGE RATE SCHEDULE AND BILLING PROCEDURES
N7t
Principal Engineer
Design Engineer
Geotechnical Engineer
Licensed Engineering Geologist
Geotechnical 2- Person Field Crew
Senior Technician - Office or Lab
Senior Technician - Field with Equipment
Technical Assistant
Court Testimony and Depositions
140.00 / hour
110.00 / hour
'I 15.00 / hour
1 15.00 / hour
170.00 / hour
80.00 / hour
90.00 / hour
40.00 / hour
175.00 / hour
Principal Surveyor
Project Surveyor
Senior Technician - Office
Technical Assislant
Land Surveying 1-Person Field Crew
Land Surveying 2-Person Field Crew
Land Surveying &Person Field Crew
Single Surveyor with GPS
Construction Surveying 1-Person Field Crew
Construclion Surveying 2-Person Field Crew
Construdion Surveying 3-Person Field Crew
Court Testimony and Deposilions
95 00 / hour
90.00 / hour
80.00 / hour
40.00 / hour
1 10.00 / hour
140.00 / hour
'175.00 / hour
150.00 / hour
150.00 / hour
180.00 / hour
215.00 / hour
175.00 / hour
Concrete, Mortar or Grout Compression Test
"for each cylinder logg€d into t le lab (broken or not) incbdes curing. testing, reportiog resutts
Concrete Cylinder Mold Cast by Others Added Charge
Dry Gradation (Sieve) Analysis (ASTM C-33 and C-136)
Wet Gradation (Sieve) Analysis (ASTM C-1 17 and C-136)
Particle Size Analysis wilh Hydrometer (ASTM D-422)
Sand Equivalent (MSHTO T-176 and ASTM D-1557)
Proctor (Soil Moistur+Density - ASTM D€98 or ASTM D-1557)
Fraclure Face (ASTM D'5821)
Liquid Limits, Plastic Limits and Plasticity lndex (ASTM D-4318)
Natural Moisture Content (ASTM 0-2216)
Organic Content, Loss by lgnition (ASTM D-2974)
Soil Classification I - Dry Sieve and USCS
Soil Classification ll - Wet Sieve and USCS
Soil Classification lll - Dry Sfeve, VSCS ang Aterberg Limits
30.00 / each
5.00 / each
75.00 / each
150.00 / each
165.00 / each
'100.00 / each
300.00 / each
25.00 / each
150.00 / each
15.00 / each
75.00 / each
100.00 / each
175.00 / each
200.00 / each
G: Cien/Rate Schedules/PEveiling Wego Rate Schedule €tfedive June 2016
MATERIALS
NTI
NTI ENGINEERING & LAND SURVEYING
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TIilE PLUS EXPENSE RATE SCHEDULE AND BILLING PROCEDURES
Principal Engineer
Design Engineer
Geotechnic€l Engineer
Licensed Engineering Geologist
Geotechnical 2- Person Field Crew
Senior Technician - Office or Lab
Senior Technician - Field with Equipment
Technical Assistant
Court Testimony and Depositions
140.00 / hour
'l '10.00 / hour
115.00 / hour
1 15.00 / hour
'170.00 / hour
80.00 / hour
90.00 / hour
40.00 / hour
175.00 / hour
Principal Surveyor
Projecl Surveyor
Senior Technician - ffice
Technical Assislant
Land Surveying 1-Person Field Crew
Land Surveying 2-Person Field Crew
Land Surveying $.Person Field Crew
Single Surveyor with GPS
Construclion Surveying 1-Person Field Crew
Construction Surveying 2-Person Field Crew
Construction Surveying }Person Field Crew
Court Testimony and Depositions
95.00 / hour
90.00 / hour
80.00 / hour
40.00 / hour
1 10.00 / hour
140.00 / hour
175.00 i hour
125.00 / hour
'120.00 / hour
150.00 / hour
185.00 / hour
'175.00 / hour
c oncrete, Mortar or Grout Compression Test
^ "fcr each_cylinder logged into lfu leb (broken or not) includeG curirE, iesting, roporting results
Concrete Cylinder Mold Cast by Others Added Charge -
.Dry Gradation (Sieve) Analysis (ASTTU C-33 and C-1it6)
Wet Gradation (Sieve) Analysis (ASTM C-1 17 and C-l36)
Particle Size Analysis with Hydrometer (ASTlf D-422)
Sand Equivalent (AASHTO T-176 and ASTM D-1557)
Proctor (Soil Moisture-Density - ASTM D69B or ASTM D-iS57)
Fraclure Face (ASTM D-5821)
Liquid Limils, Plastic Limits and ptasticity tndex (ASTM D-4318)
Natural Moisture Content (ASTM D-2216)
Organic Content, Loss by lgnition (ASTM D-2974)
Soil Classification I - Dry Sieve and USCS
Soil Classification ll - Wet Sieve and USCS
So!! Clgssrflcqtign f ll;-Dry $_iev.gl _U_SC]S and Atterberg Limits
30.00 / each
5.00 / each
75.00 / each
150.00 / each
165.00 / each
'100.00 / each
300.00 / each
25.00 / each
150.00 / each
15.00 / each
75.00 / each
100.00 / each
175.00 / each
200.00 / each
G: GsrrR te Scirdulos/Rale Sdledule ,or Time and Ep.nse Efiedirl! June 2016
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ENGINEERING
MATERIALS
GENERAL CONDITIONS
1. NTI'S standard hours of straight-time operation begin at E:00 AM and end at 5:00 PM, Monday through
Friday, with the exception of ureokends and some holidays. Overtime rates of 1.5 times the applicable
straight-tirne rat€ will be billed br any work perform€d between 6:00 PM and 6:00 AM, work in excess
of I straighl-time hours per day, and Saturdays work. Double time rates are 2-times the applicable
staight-time rate and will be billed for any work pe ormed on Sundays and/or holidays. Minimum
charge fo. professional services is one hour for office consultation, two hours for field consultation and
four hours for court bstimony.
2. Scheduling inspeclions must occur before close of business on the day preceding the request. All
services are billed portal to portal from NTI'S Testing Leboratory. 'Rush" laboratory testing (tumaround
less than 2 fulltyorking days) will be billed at 1 % times the applicable straillht-time laboratory rate.
3. Non-salary reimbursable expenses will include the following items
a) ltems outside of general overhead costs, such as special legal and accountjng expenses, sp€cial
consultants, backhoe services, laboratory charges, special copying services and printing and
binding at 15% above actual cost. ln-house non-salary reimbursable expenses including but not
limited to the following:
Labotatory Time - After Hours (3 hour minimum)
Same Day Call-ln For lnspection or Test (if an inspector is available)
Mileage (portal to portal)
'100.00 / hour
50.00 / charge
.60 / mile
b) Govemment fees directly related to the [oiect such as County survey recording fees and agency
review feas.
c) Out-of-to rn travel and living expenses related to the poject. Travel time shall be hourly per rates
listed above.
4. NTI maintains general liability insurance br bodily injury and property damage with an aggregate limit of
$1,000,000 per @curence as well as professional erro6 and omissions insurance and will fumish
certiticates evidencing such insurance upon request. lf Client requires insurance in excess of NTI'S
standard, and if such insurance is procurable, Client to reimburse NTI for any additional fes plus lOoA
incurred by NTI to fulfill Clients request for such.
5. Comprehensive cost estimates and pricing are available upon request and may vary ftom the Time Plus
Expense Rate Schedule. Scheduling and sequencing of a construction proiecl are controlled by
individuals and organizatons not owned or operated by NTl, therefore if an Estimate is generated, it
shall not guaranlee a maximum cost to compbte the gervices required and/or requested to complete
the construclion poject. The quantities included in our Estimate of Fees are based in part and upon
construction documents and schedules made available to NTI at the time of the proposal.
6. The rates as stated in the Time Plus Expense Rate Schedule are applicable through the last day of the
c€lendar year issued, unless otherwise contracted. The terms and conditions as outined in the Contract
for Services are incorporated herein fior reference
7. NTI Wll not issue tinal documents until all outstanding invoices for the proiect have been paid
G: GedRate Schedubs/Grne.al Condlior6 Page tor Strand.rd and Preyailing Waee Rat6 €tredive Juno ml6
CONSULTANT will perform the scope of work in Exhibit D in accordance with the
following Schedule.
Task 1 : WWo3OB Pump Station 3 Geotechnical Evaluation
Test hole boring: Commence 2-3 weeks after initial request
Geotechnical RLport: 5 weeks after completion of subsurface exploration
Task 2: OR0213 H St. Stormwater Outfall Survey
Topographic field survey: Commence 2-3 weeks after initial request
Field survey data delivered: 14 days after completion of the survey
Task 3: Landfill Post Closure Surveying Supporl
Shoreline Transect Survey: April 2017
MRE Slope Surv6y: April & October 201 7
Task 4: Directed Services Engineering
As directed for the duration of the agreement expiring December 31,2017 .
EXHIBIT D -- SCHEDULE
END OF EXHIBIT
o.Go'CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NUMBER:c!151802i188COVERAGES REVISION NUMBER
THIS IS TO CERTI FY THAT THE POLICIES OF INSURANCE LISTEO AEIOW HAVE BEEN ISSUEO TO THE INSUREO NA'UED AAOVE FOR THE POLICY PERIOD
INDICATED NOTWTHSTANOING ANY REQUIREMENT, TERM OR CONDII1ON OF ANY CONTFACT OR OTHER OOCUMENT WTH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN. THE INSURANCE AFFOROED BY THE POLICIES OESCREED HEREIN IS SUEJECT TO ALL THE TERMS,
EXCLUSIONSANO COT{OIIIONS OF SUCH POLICIES. LIMITS SIIOWV MAY HAVE BEEN REDI,,CED AY PAID CLAIMS,
COMMERCIAL GENERAL LIAAIL TY
GEIL AGGFEGATE LIM I APPLIES PER
5
DeEHrsFs rF5M..c.l
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AUIOiIOgLE LIAAIUTY
I]IREDAIJIOS
SCHECUL!D
AUTOS
BOOLY INJURY (Fd p6r&r)
BO01LY INJURY 1Ps aqironr)3
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WOFXIRS COTPEI{SATION
AXD EXPIOYEiE' IIABIUTY
ANY PR@R EIOR'PARTNER/EXECJTIVE
of FtcER/ltEMSER EXCIIJoEO?
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CERTIFICATE HOLOER CANCELLATIOT'I
City of Polt Ang€les
321 E sth Street
PorC Angelea, WA 98362
SHOULOAI{YOF THE ABOVE OESCRIEED POLICIES 8E CAIICELLED BEFOR€IHE EXPIRATIOII OATE THEREOF. NOTICE wlLL BE DELIVEiED IN
ACCORDAI{CE WIH IHE POLICY PROVISIoIIS.
AUT'IORIZEO REPRESEI{TATIVE
ADdy caUis/ANDY Atulx A4a
ACORO 25 (2010/05)O 19EE-20l0ACORD CORPORATION. All.ights reserv.d.
L/L2/20L-l
THIS CERTIFICA TE IS ISSUEO AS A IIATTER OF II{FORMATION ONLY AXD COI{FERS NO RIGHTS UPON THE CERTIFICATE HOLOER. THIS
CERTIFICATE DOES NOT AFFIRTSANVELY OR I{EGAITVELY ATIIEND, EXTEND OR ALTER THE COVERAGE AFFOROED BY THE POLICIES
BELOW TH|S CERnFTATE OF II{SURANCE OOES t{OT CONSTTTUTE A COI{TRACT BETWEEN THE |SSUTXG TNSURER(S), AUTHORTZED
REPRESENTA'IVE OR PROOUCER, AND THE CERNFICATE HOLDER.
ITIPORTANT: ll the ceitificate holdor is an ADDTTIONAL |i{SURED, tho po cy(tes)must bo endoBed, It SUAROGATION lS WAIVED, sublect to
tho toms and condhlons of the pollcy, cortaln pollcle8 may rsqulro ,n ondo,aomont. A statement on thk c.dmcat doe3 not confer rtghts to the
cortlllcate holdor in llgu orsuch endorsemo
PRO0(,CEi
CAIIIS 6 ASSOCIATES, INC
806 so vine St
Port Ange.L.s wA 98 362
Noe11€ Erzio
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noel.].ee c.Ilicitrsu!!nce . coD
INSURERIS) A FfORDING COVERAGE
rNslFER^ runderwriters at Lloydg, London
INgURED
JI,S 6roup Inc.
DBA: NorthFestErn territolies Inc.
717 S Peabody 8C
Port Ang€l€s WA 99352-6233
lltsuR€R 0
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oiQo*CERTIFICATE OF LIABILITY INSURANCE | / L2l20t1
THIS CER IFICATE IS laSUEO AS A IIATTER OF I}IFORIIATIOI{ OI{LY AI{D COI{FERS T{O RIGHTS UPON THE CERIIFICATE HOLDER IHIS
CERTIFICATE OOES NOT AFFIR ATIVELY OR NEGA'IIVELY AIf,END, EXTEiID OR ALTER THE COVERAGE AFFOROED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE OOES M)T CONSnTUTE A COi{TRACT BETWEEN THE tSSUtt{c |TSURER(S), AUTHORTZED
REPRESE},ITATIVE OR PRODUCER, AI{D THE CERTIFICATE HOLDER.
MPORTA N fl tf th€c6rtlllcato hold€r ts an AO DITIONA L NSU RE o the poli cy(lss)must be endo rsod,lf s UBR OGA TION WAIVED s ubj €ct tothetermsandconditionsofthpolcyc6ltainpoliciesayrequanndotst.statema nt n th s conl flcato doos ot nt6r tlghts to the
h oldgr llo of h d tseme nl(s )
Pt(x,lrcER
Cal.lir 6 Associatc!, Inc.
806 So Viac St
Eort Arg€Ies wA 93362
INSUiEO
ills Group IEc
Nortbrest€lD lolritolIcs
717 S Pe.Sody St
Polt lng.l,es IIA
Iac. dba N:tI
98352
fi!fi[fo r.rary eetzma
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Eif,^tss,*
(360) 452-231{[il-!e] (3so).52-rror
ryec.lJ.itillsur.nc.. co!
rnsuREfR{sl
ADe.i.can Inaur.nce Co ,44393
. ?1992
2401r
DrsuirR B Ohlo Seculi ty InsuraDce Co
rxsuRERc.Ih6 Ohi.o Cesual
II{SURER E;
COVERAGES
CERTIFICATE HOLDER
ACORO 25 (2014/01)
City of Port Angeles
321 E sth StreetPort Arge].es, tlA 98362
SHOULO AI{Y OF TItE AAOVE OESCRIBEO POLICIES EE CANCELLEO EEfORETHE EXPNANON DATE THEREOF, IIOTICE wlLL BE OELIVERED II{
ACCORDAI{CE WIH THE POLIGY PROVISIONS,
AUTHO@IEO RE?fi ESE|IIATIVE
A:lcy aalIj.s/ANDY 0,r/* A-eA
CERTIFICATE NUMBERf, I16122003130 R€VISION NUMEER:
CANCELLATION
O I 988-201 4 ACORD CORPORATION. All rlghb .eso.ved.
The ACORD name and logo ar€ registered ma,ks o, ACORD
: t6r-SE{-
NOTWTHSTAN
TAIN
HAVE
TH tss CTO ERTJFY THT POE tct SE OF NSU ENC ISTE BELOWo VE EB NE UEOtss THTO E SURN DE ABOVENAMED THEFOR rcYPOL E oRI D
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Ec RTIFICA TE BE SSUE ORo PER E NS EURANC EoR0 8Yo ETHTH DESCPOLTCTES IBEDR ERH E s BJECTSU TO THELL TERI\,4 S,rusEXC SroN N coND tTroNso o CHSU CPOLI ES.ML T SHs ow,i BEEN EDREDUC B o c
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.n.ddi.tioD!]. inlu!€d yith !.!pectr to th6 eeae!.1 Liability t,hele!.qui!ed by rritEea contract I provid.d onJ,y by the t.!as of forD cc881o. Iac].udes rv.iver of subrogation.nd Pll'oarY 6 Non-coEtlilrutory ehen Ecquir€d by }'EitteB coatlact. R€f6s to poficy(s) fot aII applic.blstalaa, conditions, eadoaselaat3 e:rd erclusioos.
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COMMERCIAL AUTO
cA 88 10 01 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT
This endorsemenl modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
Vvith respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement
COVERAGE INDEX
SUBJECT PROVISION NUMBER
ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT
ACCIDENTAL AIRBAG DEPLOYMENT
AMENDED DUTIES IN THE EVENT OF ACCIDENT. CLAIM. SUIT OR LOSS
AMENDEO FELLOW EMPLOYEE EXCLUSION
AUDIO, VISUAL ANO DATA ELECTRONIC EQUIPMENT COVERAGE
BROAD FORM INSURED
BODILY INJURY REDEFINED
EMPLOYEES AS INSUREDS (including employee hired auto)
EXTENDED CANCELLATION CONDITION
EXTRA EXPENSE - BROADENEO COVERAGE
GLASS REPAIR - WAIVER OF DEDUCTIBLE
HIRED AUTO PHYSICAL DAMAGE (including employee hired auto and loss of use)
HIRED AUTO COVERAGE TERRITORY
LOAN / LEASE GAP
PARKED AUTO COTLISION COVERAGE (WAIVER OF DEDUCTIBLE)
PERSONAL EFFECTS COVERAGE
PHYSICAL DAMAGE - ADOITIONAL TRANSPORTATION EXPENSE COVERAGE
RENTAL REIMBURSEMENT
SUPPLEMENTARY PAYMENTS
TOWNG AND LABOR
TWO OR MORE DEOUCTIBLES
UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
SECTION ll - LIABILITY COVERAGE is amended as lollows:
I. BROAD FORM INSURED
3
12
19
1
2
ZJ
'10
15
6
?0
14
16
11
8I
4
7
17
18
20
SECTION ll - LlABlLlry COVERAGE, paragraph A.1. -WHO lS AN INSURED is amended to include the
following as an insured:
d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the
policy period. However. 'insured' does nol include any organization that:
(1) ls a partnership orjoint venture: or
12) ls an insured under any other automobile policy; or
(3) Has exhausted its Limit of lnsurance under any other automobile policy.
Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of
this policy.
e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you
own more than 50 percent of the voting stock. This automalic coverage is afforded only for 180 days
from the date of acquisition or formation. However, coverage under this provision does not apply:
(1) lf there is similar insurance or a self-insured retention plan available to that organization,
ca 88 10 0t t3
O 201 3 Liberty Mutual lnsurance
lncjudes copyrighted maledal of lnsurance Services Office. lnc.. with its permission Page 1 of 7
(21 lf the Limits of lnsurance ol any other insurance policy have been exhausted, or
(3) To 'bodily injury" or "property damage' that oGurred before you acquired or formed the
organization.
2. EMPLOYEES AS INSUREOS
SECTION Il - LIABILITY COVERAGE, paragraph A.1. -Wl-lO lS AN INSUREO is amended lo include the
following as an insured:
f. Any'employee' of yours while using a covered 'auto" you do not own, hire or borrow, but only for acls
within the scope of their employment by you. lnsurance provided by this endorsement is excess over
any other insuEnce availablo to any "employe€'.
9. An "employee' of yours while op€rating an "auto' hired or borrowed under a wdtten contract or
agreement in that 'employee's' name, with your permission, while performing dulies related to the
conduct of your business and within the scope of their employment. lnsurance provided by lhis
endorsement is excess over any other insurance available to the "employee'.
3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT
SECTION ll - LIABILITY COVERAGE, paragraph A.1. -WiO lS AN INSURED is amended to include the
following as an insured:
h. Any person or organization with respect to the operation. mainlenance or use of a covered "auto",
povided that you and such person or organizalion have agreed in a written confart, agreement, or
permit issued to you by governmental or public authority, lo add such person, or organization, or
govemmental or public authority to this policy as an "insured'.
However, such person or organization is an'insured':
(1) Only with respect to lhe operation, maintenance or use of a covered 'auto',
(21 Only for "bodily injury" or'property damage' caused by an 'accident'which takes
place afrer you executed the written contract or agreement, or the permit has been
issued to you; and(3) Only for the duration of that contract, agreement or permit
4. SUPPLETUENTARYPAYMENTS
SECTION ll - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplemenlary Payments, paragraphs (2)
and (4) are replaced by the follor ring:
lz't Up to $3,000 for cost of bail bonds (including bonds for related traftic violations) required because of
an "accident' we @ver. We do not have to furnish these bonds.(4) All reasonable expenses incuned by the insured al our request, including actual loss of earnings up to
$500 a day because of time off from work.
5. AMENOED FELLOW EMPLOYEE EXCLUSION
ln those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the
employer by lhe workers compensalion exclusivity rule, or similar protection, the following provision is added:
SECTION ll - tlABlLlry, exclusion 8.5. FELLOW EMPLOYEE does not apply if the 'bodily intury' resutts from
lhe use of a covered 'auto'you own or hire.
SECfION lll - PHYSICAL DAMAGE COVERAGE is amended as follows:
6. HIRED AUTO PHYSICAL DAMAGE
Paragraph A.4. Coverage Exlensions of SECTION lll - PHYSICAL DAMAGE COVERAGE, is amended by
adding the following:
lf hired 'autos' are covered "autos' for Liability Coverage, and if Comprehensive, Specified Causes of Loss or
Collision coverag€ are provided under the Business Auto Coverage Form for any'auto'you own, then the
Physical Damage coverages provided are extended to'autos':
a. You hire, rent or borrow; or
@ 2013 Libedy Mutual lnsurance
CA 88 10 01 13 lncludes copyr(lhled malerial of Insurance Services Ofice, Inc.. wlh its pennissim. Page 2 Ol7
7
b. Your'employee" hires or rents under a written contract or agreement in that 'employee's' name, but
only it the damage occurs whila the vehicle is being used in the conduct ol your business.
subject to the following limit and deductible:
A. The most we will pay for "loss" in any one "accident' or "loss' is the smallesl of:
(1) $50,000; or
(2) The actual cash value of the damaged or stolen property as of the time of the 'loss'; or
(3) The cost of repairing or replacing the damaged or stolen property with other prope.ty of like
kind and quality, minus a deductible.
B. The deductible will be equal to the largest deduclible applicable to any owned 'autcf ,or that coverage.
C. Subject to the limit, deductible and axcesa provisions described in this provision, we will provide
coverage equalto the broadest coverage applicable to any covered 'auto' you own.
D. Subrect to a maximum of $1,000 per'accident', we will also cover the actual loss of use of ths hired
'aulo' if it results from an "accident", you are legally liable and the lessor incurs an actual tlnancial
loss.
E. This coverage extension does not apply to:
(l) Any'auto'that is hired, rented or borrowed with a drivei or
{2} Any "auto" that is hired, rented or bonowed from your'employee'.
For the purposes of this provision, SECTION V - DEFINITIONS is amended by adding the following:
"Total loss' means a 'loss' in which the cost of repairs plus the salvage value exceeds the actual cash value.
TOWI{G AND LABOR
SECT| ON lll - PHYSICAL oAMAGE COVERAGE, paraqaph A.2. Towing, is amended by the addition of the
lollowing:
We will pay towing and labor msts incurred, up to the limits shown below, each lime a covered "auto'
classified and rated as a private passenger type, .light truck' or 'medium truck' is disabled:
a. For private passenger type vehicles, we will pay up lo $50 per disablement.
b. For'light trucks", we will pay up to $50 per disablement. 'Light trucks'are trucks that have a gross
vehicle waight (GVV9 of 10,000 pounds or less.
c. For 'medium trucks" , we will pay up to $ 150 per disablement. "Medium trucks" are trucks that have a
gross vehicle weight (GVW of 10,001 - 20,000 pounds.
However, the labor must be pe ormed at the place of disablement.
PHYSICAL DAMAGE . AODITIONAL TRANSPORTATION EXPENSE COVERAGE
Paragraph A.4.a., Coverage Extension of SECTION lll - PHYSICAL DAMAGE COVERAGE, is amended lo
provide a limit of $50 per day and a maximum limit of $1,500
8
cA 88 10 0't '13
@ 201 3 Liberty Mutual lNurance
lJdud€s copyrighted fiEterial of lnslrance Service! Omce, hc., rrith il8 pormission Page 3 of 7
9 RENTAL REIMBURSEMENT
SECTION lll- PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding th€ follorring:
a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an
"auto" because of "accident" or 'loss', to an 'auto' for which we also Pay a 'loss" under
Comprehensive, Speciried Causes o, Loss or Collision Coverages. We will pay only for those
expenses incuned after the first 24 hours following the "accident' or "loss" to the covered 'auto.'
b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many c€ses may
be substantially less than $75 per day, and will only be allowed for the period of lime it should take to
repair or replace the vehicle with reasonable speed and similar quality, up lo a maximum of 30 days.
c. We will also pay up to $5OO for reasonable and necessary expenses incuned by you to remove and
replace your tools and equipment from the covered 'auto".
d. This coverage does not apply unless you have a business necessity that other'autos" available for
your use and operation cannot fill.
e. lf "loss' results from the total theft of a covered 'auto' of the private passenger type, we will pay under
this coverage only that amount of your rental reimbursement expenses which is not already provided
under Paragraph 4. coverage Extension.
f. No deductible appliss to this coverage.
For the purposes of this endorsement provision, materials and equipment do not include 'personal effects' as
defined in provision 11.
EXTRA EXPENSE . BROADENED COVERAGE
Under SECTION lll - PHYSICAL DAMAGE COVERAGE, A- COVERAGE, we will pay for the expense of
returning a stolen covered 'auto' to you. The maximum amount we will pay is $1 ,000.
PERSONAL EFFECTS COVERAGE
A. SECTION lll - PHYSICAL OAMAGE COVERAGE, A. COVERAGE, is amended by adding the
following:
lf you have purchased Comprehensive Coverage on this policy for an 'auto' you own and thal'auto" is stolen,
we will pay, without application of a deductible, up to $600 for "personal effects' stolen with the 'auto.'
The insurance provided under this provision is excess over any other collectible insurance.
B. SECTION V - DEFINITIONS is amended by adding the following:
For the purposes of this provision. "personal effects' mean tangible property that is worn or carried by an
insured.' "Personal effects' does not include lools, equipmBnt, jewelry, money or securities.
ACCIDENTAL AIRBAG DEPLOYMENT
SECTION lll - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the following:
lf you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for'loss' relating
to mechanical breakdown does not apply to the accidental dischsrge of an airbag.
Any insurance we provida shall be excess over any other collectible insurance or reimbursement by
manufacture/s warranly. However, we agree to pay any deductible applicable to the other coverage or
wananty.
AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE
SECTION lll - PHYSICAL DAMAGE CoVERAGE, B. EXCLUSIoNS, exception paragraph a. lo exclusions
4.c. and 4.d. is deleted and replaced with the following:
10.
11.
12.
13.
cA 88 't0 0l 13
O 201 3 Uberty Mututl lnsurance
lncftrde6 copyrighted malarial oI lnsuranca SeMcas ofiice. lnc., with ab permission Page 4 of 7
Exclusion 4.c. and 4.d, do not apply to
Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed
solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto' at
the time of the "loss' and such equipment is designed lo be solely operated by use of the power from
the 'auto's' electrical system, in or upon the covered 'auto' and physical damage coverages are
provided for the covered 'aulo'; or
lf the 'loss" occurs solely to audio, visual or data electronic eguipment or accessorles used with this
equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced
by a $100 deductible.
14. LOAN / LEASE GAP COVERAGE
A Paragraph C., LIMIT OF INSURANCE of SECTION lll - PHYSICAL DAMAGE COVERAGE is
amended by addang the follorr,ing:
The most we will pay for a "total loss'to a covered "auto'owned by or leased to you in any one
'accident' is the greater of lhe:
1. Balance due under the terms of the loan or lease to which the damaged covered 'auto' is
subject at the time ofthe'loss' less the amount of:
Overdue payments and financial penalties assocjated wilh those payments as of the
date of the 'loss',
Financial penalties imposed under a lease due to high mileEge, excessive use or
abnormal wear and tear,
Costs for extended wananties. Credit Life lnsurance, Health, Accidenl or Disability
lnsurance purchased with the loan or lease,
Transfer or rollover balances from previous loans or leases,
Final paymenl due under a'Balloon Loan',
The dollar amount of any unrepaired damage which occuned prior to the'tolal loss' of
a covered'auto',
Security deposits not retunded by a lessor,
All refunds payablo or paid to you as a result of the early termination of a leas€
agreement or as a result of the early termination of any wananty or extended service
agreement on a covGred "auto',
Any amount representing taxes,
Loan or leas6 terminalion fees: or
2. The actual cash value of the damage or stolen property as of lhe time of the 'loss'
An adjustment for depreciation and physical condition will be made in determining the actual cash
value at the time ofthe'loss'. This adjustment is not applicable in Texas.
B. ADDITIONALCONDITIONS
This coverage applies only to the original loan lor which the covered "auto' that incurred lhe loss
serves as collateral, or lease written on the covered'auto" that incured the loss.
C. SECTION V - DEFINTIONS is changed by adding the following:
As used in lhis endorsement provision, the following definitions apply:
'Total loss" means a "loss" in which the cost oI repairs plus the salvage value exceeds the actual cash
value.
A "balloon loan' is one with periodic payments thal are insuflicienl to repay the balance over lhe term
of the loan, thereby requiring a large linal payment.
a
a.
b.
c.
d.
e.
f.
s.
h.
cA 88 t0 01 13
@ 2013 UHy Mulual lnsurance
lndudes copyrighted material of lnsu.aice Services O,ftce, lnc., wilh its permi$ion.Page 5 of 7
15. GLASS REPAIR. WAIVER OF DEDUCTIBLE
Paragraph O. Deductible of SECTION lll - PHYSICAL DAMAGE COVERAGE is amended by the addition of
the following:
No deduclible applies to glass damage af the glass is repaired rather than replaced.
16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE|
Paragraph D. Deductible of SECTION lll - PHYSICAL DAMAGE COVERAGE is amended by the addition of
the following:
The deductible does not apply to 'loss' caused by collision to such covered 'auto" of the private passenger
type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as
maximum loaded weight the "auto' is designed to cany while it is:
a. ln the charge ofan "insured';
b. Legally parksd; andc. Unoccupied.
The'loss' must be reported to the police authorities within 24 hours of known damage.
The tolal amount of the damage to the covered 'aulo' must exceed the deduclible shown in the Declarations.
This provision does not apply to any "loss' if the covered 'auto' is in the charge of any person or organization
engaged in the automobile business.
17. TWO OR MORE DEDUCTIBLES
Under SECTION lll PHYSICAL DAMAGE COVERAGE, if two or more company policies or coverage forms
apply to the same accident, the following applies to paragraph O. Oeductible:
a. It the applicable Business Auto deductible is the smaller (or smallest) deductible it will be waived, or
b. lf the applicable Business Aulo deductible is not the smaller (or smallest) deductible it will be reduced
by the amount of the smaller (or smallest) deductible: or
c. lf the loss involves two or more Business Auto coverage forms or policies the smaller (or smallest)
deductible will be vvaived.
For the purpose of this endorsement company means any company that is part of the Liberty Mutual Group.
SECTION lV - BUSINESS AUTO CONDITIONS is amended as follor s:
18. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
SECTION lV- BUSINESS AUTO CONOITIONS, Paragraph B.2. is amended by adding the following:
lf you unintentionally tail to disclose any hazards, exposures or material facts existing as of the inception date
or renewal date of the Business Auto Coverage Form, the coverage afforded by this Policy will not be
prejudiced.
However, you must reporl lhe undisclosed hazard of exposure as soon as practicable afier its discovery, and
we have the right lo collecl additional premium for any such hazard or exposure.
I9. AMENDED DUTIES IN THE EVENT OF ACCIOENT, CLAIiI, SUIT, OR LOSS
SECTION lV - BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the following:
a. ln the event ol "accident', claim, "suit' or "loss", you must promptly notify us when it is knot/vn to:
1. You, if you are an individual.2. A parlner, if you are a partnership;
3. Member, if you are a limited liability company;4. An executive ofricer or the'employee" designated by the Named lnsured to give such notice,
if you are s corporation.
ca 88 10 01 13 Page 6 of 7
@ 2013 Liberty Mutual lnsurance
lndud$ copyrighted materialof lnsurance SeMces Offce, lnc., wilh ils permission.
To the extent possible, notice to us should include:
(l) How, when and where the 'accident' or 'loss" took place;
(2) The "insureds' name and addressi and
(3) The names and addresses of any iniured persons and witnesses.
20. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
SECTTON tV - BUSTNESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against
Others to Us, is amended by the addition of the following:
lfthepersonororganizationhaswaivedthoserightsbeforean'accident'or'loss'.ourrightsarewaivedalso.
21. HIRED AUTO COVERAGE TERRITORY
SECTTON tV - BUSTNESS AUTO CONDITIONS, paragraph 8.7., Policy Period, Coverage Tenitory, is
amended by the addition ot the following:
I For "autos' hired 30 days or less, the coverage territory is anywhere in the world, provided that the
insured's responsibility to pay for damages is determined in a 'suit', on the merits, in the United
States, lhe territories and possessions of the United States of America, Puerto Rico or Canada or in a
settlement we agres to.
This e)dension of covsrage does not apply to an 'auto' hired, leased, rented or borrowed with a driver.
SECTION V - DEFINITIONS ls amended as follows:
22. BODILY INJURY REDEFINED
Under SECTION V - OEFINTIONS, detinition C. is replaced by the following:
"Bodily injury' means physical injury, sickn*s or disease sustained by a person, including mental anguish,
mental injury, shock, tright or death resulting from any of these at any lime.
COMMMON POLICY CONDITIONS
23. EXTENDEDCANCELLATIONCONDITION
COMMON POLICY CONOITIONS, paragraph A.- CANCELLATION condition applies except as follows;
lf we cancel for any reason other than nonpayment of premium, we will mail to the first Named lnsured written
notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply
in those states which require more than 60 days prior notice of cancellation.
@ 2013 Liberty Mulual lnsuranc€
lncludes copyrighled material ot lnsuEnce Seryices Office, lnc., with its permisgionca 88 10 01 13 Page 7 of 7
COMMERCIAL GENERAL LIABILITY
cG 85 83 04 13
l_
:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
CONTRAGTORS . PRODUCTS/COMPLETED OPERATIONS
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Paragraph 2. under Sectlon ll - Who ls An lnsured is arn€nded to include as an insured any peEon or
organization whom you have agreed to add as an additional insured in a written contracl or written
agreement. Such person or organization is an additional insured but only with respect to liability for
'bodily injury' or'properly damage':
Caused by "your work' performed for that additional
contracl or wfitten agreemenl: and
insured that is the subject of the written
2. lncluded in the 'products-compleled operations hazard'.
However:
a) The insurance afforded to such additimal insured only applies to lhe extent permitted by law;
and
b) lf coverage provided to the additional insured is required by a contract or agreement, the
insurance afforded to such additional insured will not be broader than that which you are
required by the contract or agreement to provide for such additional insured
The insurance provided by this endorsement applies only lf the written contract or written agreement is
signed prior to the'bodily injury' or'property damage..
We have no duty to defend an additional insured under lhis endorsement until we receive written notice
of a'suif by the additional insured as required in Paragraph b. of Condition 2. Dutl$ ln The Event Of
Occurrenco, Offenso, Clalm Or Suit under Soction lV - Commercial General Liability Conditlons.
B. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2.
Exclusions under Section I - Coverage A . Bodily In ury And props y Damage Liability:
This insurance does not apply to:
l. 'Bodily injury' or "property damage' that occurs prior to you crmmencing operations at the
location where such 'bodily injury" or'property damage. occurs.
2. 'Bodily injury" or "property damage" arising out of the rendering of, or ihe failur€ to render, any
professional archilectural, engineering orsurveying services including:
a. The preparing, approving or failure to prepare or approve, maps, shop drawings, opinions.
reports, surveys, field orders, change ordors or drawing and specitications: and
b. Superyisory, inspection, architectural or engineering activities.
e 2ol3libeny Mutual lnsurance
lncludes copyrightgd maledal ot lnaurance Se.vices O'lIic€, hc., witr lts pgrmission
,l
cG 85 83 04 13 Page 1 ol 2
This endorsement modifies insurance provided under the following:
C. Wilh respect to lhe insurance afforded by this endorsement, exdusion l. Damage To Your Work of
Paragraph 2. Erclusions under Seclion l- Goverage A - Bodily lniury And Property Damage Llability is
replaced by the following:
L Damage To Your Work
'Property damage' lo 'your work' arising out of it or any part of it and included in the "products-
completed operations hazard'.
D. With respect to the insurance afforded to these additional insureds, the following is added to Soction ll .
Llmits of lnsurance:
lf coverage provided to the additional insured is rsquired by a contract or agreement. he most we will
pay on behalf of the additional insured is lhe amount of insurance:
'1. Required by contract or agreement; ot
2. Available under the applicable Llmits of lnsurance shown in the Declaration,
whichever is less.
This endorsement shall not increase the applic€ble Limits of lnsurance shown in the Declaratio ns.
E. With respect to the insurance afforded by this endorsement, Section lV - Commercial c€nerat Liability
Gondltions is amended as follows:
1. The following is added to Paragraph 2, Duties ln fhe Event Of Occurrence, Offense, Claims Or Suit:
An additional insured under this endorsement will as soon as pracucable:
a. Give written notice of an'occunence' or an oflense that may result in a claim or "suil" under
this insuran@ lo us;
b. Tender the defense and indemnity ot any claim or .suit, to all insurers whom atso have
insurance available to the additional insured; and
c. Agree to make available any other insurance which the additional lnsured has for a loss we
cover under this Coverage Parl.
d. We have no duty to defend or indemni, an additional insured under this endorsement untit we
receive written notice of a "suil' by the additional insured.
2. Paragraph 4. of S€ction lV - Commercial Gonoral Liability Conditions is am€nded as follows:
a. The following is added to Paragraph a. primary lnsurance:
lf an additional insured's policy has an Olher lnsurance provision making its policy excess,
and you have agreed in a written contrac{ or wdtten agreement lo provide the additional
insured @verage on a primary and nonclntribulory basis, this policy shall be primary and
we will not seek contribution from the additional insured's policy for damages we cover.
b. The following is added to Paragraph b. Excess lnsuranco:
When a written contracl or written agreement. other than a premises lease. facilities rental
contract or agreement, an equipment rental or lease contract or agreenrent, or permit
issued by a stale or political subdivision between you and an additional insured does not
require this insuEnce to be primary or primary and non-contributory, this insurancs is
exc€ss over any other insurance for which the additional lnsured is designated as a Named
lnsured.
Regardless of the written agreement between you and an additional insured,
ance is excess over any olher insurance whether primary, excess, contingent
other basis for which the additional insured has been added as an additionat
other policies.
@ 2o't 3 ub€rty Mutual lnsuranco
lncludes copy.lghted material of lnsurancs SeMcss Offic€, hc,, with its permisslon
this insur-
or on any
insured on
cG 85 83 04 t3 Page 2 ol 2
COI'IMERCIAL GENERAL LIABILITY
cG 88 10 0413
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY EXTENSION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
INDEX
SUBJECT
NONOWNEO AIRCRAFT
NON.OWNED WATERCRAFT
PROPERTY DAMAGE UABILITY - ELEVATORS
EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage)
MEDICAL PAYMENTS EXTENSION
EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B
ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT
PRIMARY AND NON.CONTRIBUTORY - ADDITIONAL INSURED EXTENSION
ADOITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "UMITS OF INSURANCE"
WHO IS AN INSURED - INCIOENTAL MEOICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED -
FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES
NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES
FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES
KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
LIBERALIZATION CLAUSE
BODILY INJURY REDEFINEO
EXTENDED PROPERTY DAMAGE
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -
WHEN REQUIRED IN A CONTRACT OR AGREE]IIENT WTH YOU
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@ 20'13 Libeny Mutual lnsurance
lncludes copyrighted malerial of lnsurance Sewices Office. lnc., wilh ils permissioncG 88 l0 0413 Page 'l of 8
With respect to covsrage afforded by this endorsement, the provisions of the Policy apply unless modified by the
endorsement.
A. NON-oWNED AIRCRAFT
Under Paragraph 2. Exclusions of Section I - Coverage A - Bodlly lnlury And Property Damage Liabllity,
exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided:
'1. lt is not owned by any insured;
2. lt is hired. charlered or loaned with a trained paid crew,
3. The pilot in command holds a currently etfective cerlificate, issued by the duly constituted authority of the
United States of America or Canada, designating her or him a commercial or airline pilot; and
4. lt is not being used to cary persons or property for a charge.
However, the insurance afforded by this provision does not apply if there is available to the insuted other valid and
collectible insurance, whether primiry, excess (other than insurance w tten to apply specifaally in excess of this
policl), contingent or on any other basis, that would also apply lo the loss covered under this provision.
B. NON.OWNEOWATERCRAFT
Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily ln,iury And Property Damage Liability,
Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by lhe following:
This exclusion does not apply to;
(2) A watercraft you do not own that is:
(a) Less than 52 feet long; and
(b) Nol being used to carry persons or property for a charge.
C. PROPERTY DAMAGE LIABILITY - ELEVATORS
l. Under Paragraph 2, Exclusions of Section I - coverage A - Bodily lnjury And ProPorty Damago
Liabllity, Subparagraphs (3), (4) and (5) of exclusion J. Damags To Property do not apply if such
"property damage' results frorn the use of ehvators. For the purpose of this provision, elevators do not
include vehicle lifts. Vehicle lifts are lifls or hoists used in automobile service or repair operalions.
2. The following is added to Section lV - Commercial General Liability Conditions, Condition 4. Othel
lnsurance, Paragraph b. Excess lnsurance:
The insurance afforded by this provision of this endorsement is excess over any property insurance,
whether primary, excess, contingenl or on any other basis.
D. EXTENDEo DAMAGE TO PROPERTY RENTED TO YOU (Tsnant's Property Damage)
lf Damage To Premises Rented To You is not otherwise excluded from this Coverage Part:
'1. Under Paragraph 2. Exclusions of Section I - Coverage A ' Bodily lnjury and Property Damage
Liability:
a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the
following:
Paragraphs ('l ), (3) and (4) of this exclusion do not apply to "property damage" (other than
damage by fare, lighlning, explosion, smoke, or leakage from an automatic fire protection syslem)
to:
(D Premises rented to you for a period of 7 oI fewer consecutive days: or
(ii) Contents that you rent or lease as part of a premises rental or lease agreement for a
period of more than 7 days.
Paragraphs (1), (3) and (4) of this exclusion do nol apply to "property damage" to conlents of
premises rented to you for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to this coverage as described in Section ll! - Limits of
lnsurance.
cG 88 10 04 13
e 201 3 Llbeiy Mdual lnsurance
lncludB copyriohled malerialof lnsurance Selvices Offce. lnc.. r\ith it! permission Page 2 of 8
b, The last paragraph of subsection 2. Exclusions is replaced by the following:
Exclusions c. through n. do not apply to damage by tire, lightning, explosion, smoke or leakage
from automatic fire protection systems to premises while rented to you or temporarily occupied by
you with permission of the owner. A separate limit of insurance applies to Damage To Premises
Rented To You as described in S€ctlon lll- Llmits Of lnsurance.
2. Paragraph 6. under Ssctlon lll - LlmlE Of lnsurance is replaced by the following:
6. Subject to Paragraph 5. above. the Damage To Premises Rented To You Limit is the most we will
pay under coverage A for damages because of "property damage'to:
a. Any one premis€:
(1) While rented to you; or
l2l White rented to you or temporarily occupied by you with permission of the owner
for damage by fir6, lightning, explosion, smoke or leakage from aulomalic
protection systems: or
b. Contents that you renl or lease as part of a premises rental or lease agre€ment
3. As regards coverage proviled by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO
YOU (Tenanfs Property Damage) - Paragraph 9.a. of Definitions is replaced with the following:
g.a. A contrac{ for a lease of premises. However, that portion of the contract for a lease of Premises
that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or
leakage from automatic fire protection systems to premises while rented to you or temporarily
occupied by you with the permission of the owner, or for damage to contents of such premises
that are included in your premises rental or lease agreement, is nol an "insured contracf'.
MEDICAL PAYMENTS EXTENSION
lf Coverage C lliedical Payments is not otheMise excluded, the Medical Payments provided by lhis policy are
amended as follows:
Under Paragraph L lnsuring Agreement of Sectlon I - coverage c - iledical PaymenB,
Subparagraph (b) oI Paragraph a. is replaced by the following:
(b) The expenses arB incurred and reported within three years of the date of the accident; and
EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B
1. Under Supplemsntary Paym.nts - cov.ragas A and B, Paragraph l.b. is replaced by the following:
b. Up to 33,000 for cost of bail bonds required because of accidents or traffic law violations arising
out of the use of any vehicle to which the Bodily lniury Liability Coverage applies. We do not have
to fumish these bonds.
2. Paragraph l.d. is replaced by the following:
d. All reasonable expenses incuned bythe insured al out requesl to assist us in the investigation or
defense of the claim or 'suit', including actual loss of earnings up to 0500 a day because of time
off frorn work.
ADDITIONAL INSUREDS . BY CONTRACT, AGREEIITENT OR PERMIT
1. Paragraph 2. under SecUon ll -Who ls An lnsured is amended lo include as an insured any person or
organization whom you have agreed to add as an additional insured in a written contracl, w'itten
agreemenl or permit. Such person or organization is an additional insured bul only with respect to liability
for 'bodily injury", 'property damage' or 'personal and advertising iniu4/ caused in whole or in part by:
a. Your acls or omissions, or the acts or omissions of those acting on your behalt, in the
performance of your on going operalions for the additional insured that are the subiect of the
written contract or written agreement providEd that the "bodily injuo/ or'properly damage" occurs.
or lhe 'personal and adverlising iniury' is committed, subsequent to the signing of such written
contract or written agre€ment; or
F
G
cG 88 10 0413 Page 3 of 8
E.
@ 20i 3 Lib€rty Mulual lnsu.ance
lnclude3 copyrighted malerial of lnsuranco SeMces Otflco, lnc.. r.vith its permission
Premises or facilities rented by you or used by you: or
The maintenance, operation or use by you of equipment rented or laased to you by such person
or organization; or
Operations performed by you or on your behalf for which the state or political subdivision has
issued a permit subject lo the following additional provisions:
(f) This insurance does not apPly to'bodily injury', 'property damage', or'personal and
advertising iniury' arising out of the operations performed for the state or political
subdivision;
(2) This insurance does not apply to 'bodily iniury' or "property damage' included within the
'completed operations hazard'.
(3) lnsurance applies lo premises you own, rent, or control but only with respect to the
following hazards:
al The existence, maantenance, repair, construction, ereclion, or removal of
advertising signs, awnings, canopies, cellar entrances, coal holes, driveways,
manhol€s, marquees, hoist away openings, sidewalk vaults, street banners, or
decorations and similar exposuresi or
(b) The construction, ereclion, or removal of elevators: or
(c) The ownership, maintenance, or use of any elevators covered by this insurance
However
The insurance afforded lo such additional insured only applies to the extenl permitted by law; and
lf coverage proMded to the additional insured is required by a contract or agreement, the insurance
afrorded to such additional insured will not be broader than that which you are required by the contract or
agreement to provide for such additional iosured.
With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured underthis
endorsomenl ends when:
(f) A[ work, including materials, parts or equipment fumished in connection with such work,
on the project (other than service, maintenance or repairs) to be performed by or on
behaf of thg additional insured(s) at the location of the covered oPerations has been
completedl or
(21 That portion of "your work" out of which the injury or damage arises has been put to its
intended use by any person or organization other than another contractor or subconlraclor
engaged in performing operatbns for a principal as a part of the same proiect.
With respect to Paragraph l.b. above, a person's or organization's stalus as an addilional insured undel this
endorsement ends when their written contract or written agreement with you for such premises or facililies Bnds
With respects to Paragraph Lc. above, this insurance does not apply to any'occurrence'which takes placa after
the equipmenl rental or lease agre€ment has expired or you have returned such equipment to the lessor.
The insurance provided by this endorsement applies only if the writlen contract or written agreement is signed
prior to the 'bodily iniury' or "property damage".
We have no duty to defend an additional insured under this endorsement until we receive written notice ol a 'suit'
by the additional insured as required in Paragraph b. of Condition 2. Duties ln tho Event Of Occurrence,
Offenss, Clalm Or Sult under Section lV - Commercial General Liabllity Conditions.
b.
c.
d.
1
Page 4 of 8
@ 2013 Liberty Mutual lnsurance
lndudes copyaighled malerial of lrcurance Services Omce, lnc., wilh its permissioncG 88 r0 04 13
a With respect to the insurance Provided by this endorsement, lhe tollowing are added to Paragraph 2.
Exclusions under Section I - Coverage A - Bodily lnjury And Property Damage Liability:
This insurance does not apply to:
a. 'Bodily injury' or 'property damage' arising from the sole negligence of the additional insured.
b. "Bodily injury'or "property datrage'thal occurs prior to you commsncing operations at the
location where such 'bodily iniu4a or'property damage' occurs
c. "Bodily iniury', "property damage" or "psrsonal and adveltising injur/' arising out of the rendering
of, or ihe faiiure to render, any professional architectural, engineering or surveying services,
including:
(f) The preparing. approving, or failing to prepare or approve, maps, shop drawings,'
opinions, reports, surveys, field orders, change orde6 or drawings and specifications; or
l2l Supervisory, inspection, architecturalorengineeringactivities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the
supervision, hiring, employment, training or monitoring of others by that insured, if the 'occunence' which
caused the "bodily injuqr or 'property damage" or the offense which caused the "personal and advertising
injuq/, invofued the rendering of, or the failure lo render, any professional architectural, engineering or
surveyrng servrces.
d. "Bodily injury'or "properly damage'occuning after:
(1) All work, including materials. parts or equipment furnished in connection with such work,
on the project (other than service, maintenance or repairs) to be performed by or on
behalf of the additional insured(s) at the location of the covered operations has been
completedi or
l2l That portion of 'your work" out of which the injury or damage arises has been put to its
intended use by any p€rson or organization olher than another contractor or subcontractor
engaged in performing operations for a principal as a part of the same proiec{.
e. Any person or organization specifically designated as an additional insured for ongoing operations
by a separare ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS
endorsement issued by us and made a part of this policy.
3. With respect to the insurance afforded to these additional insureds, lhe following is added to Section lll -
Limits Of lnsurance:
If coverage provided to the additional insured is required by a contract or agreement, the most we will pay
on behalf of lhe additional insured is the amount of insurance:
a. Required by the contract or agreement; or
b. Avaihble under the applicable Limits of lnsurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable Limits of lnsurance shown in the Declarations.
H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION
This provision applies to any person or organization who qualifles as an additional insured under any form or
endorsement under this policy.
Condition 4. Othe, lnsurance of SECTION lV - COMMERCIAL GENERAL LIABILITY CONDITIONS is
amended as follows:
a. The follolving is added to Paragraph a. Primary lnsurance:
ll an additional insured's policy has an Other lnsurance provision making its policy excess, and
you have agreed in a written contract or written agreement to provide the additional insured
coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek
contribution from the additional insured's policy for damages we cover.
cG 8E to 04 i3 rncrudes copyrrhted maff'or1"t:T,*:LTl 31'ffi, ,n".. *,n ," o"-,"",on page s of I
t.
b. The follorving is added to Paragraph b. Excess lnsuranco:
When a witton contract or written agreement, other than a premises lease, facilities rental
crntract or agreemenl, an equipmenl rental or lease contraGl or agreement, or permit issued by a
state or political subdivision bet\^€en you and an additional insured does not require this insurance
to be primary or primary and non-contributory, this insurance is excess over any olher insurance
for which the additional insured is designated as a Named lnsured.
Regardless of lhe written agreement between you and an additional insured, this insurance is
excess over any other insurance whether primary, excess, crntingent or on any other basis for
which the additional insured has been added as an additional insured on other policies.
ADDITIONAL INSUREOS . EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE"
This provision applies lo any person or organization who qualifies as an additional insured under any form or
endorsement under this policy.
1. The following is added to Condition 2. Duties ln The Evsnt Of Occurrence, Offense, Claim ot Suit:
An additional insured under this endorsement will as soon as practicable:
a. Give written notice of an "occunence" or an offense thal may result in a claim or'suit' under this
insurance to us:
Tender the defense and indemnity of any claim or 'suit' to all insurers whom also have insurance
available to the additional insured: and
Agree to make available any other insurance which the additional insured has for a loss w€ cover
under this Coverage Part.
We have no duty to defend or indemnity an additional insured under this endorsement until we
receive written notbe oI a "suit" by the additional insured.
2. The limits of insurance applicable to the additional insured are those specitied in a written contract or
written agreement or the limits of insurance as slated in the Declarations of this policy and defined in
Section lll - Limits of lnsurance of this policy, whichever are less. These limits are inclusive of and not
in addition to the Iimits of insurance available under this policy.
WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS / MALPRACTICE
WHO IS AN INSURED. FELLOW EMPLOYEE EXTENSION . MANAGEMENT EMPLOYEES
Paragraph 2,a.(l ) of Sectlon ll - Who ls An lnsured is replaced with the follo ing
(ll "Bodily injury" or "personal and advertising injury':
(a) To you, to your partners or members (if you are a partnership orjoint venture), to your members
(if you are a limited liability company), to a co-"Bmployee" while in the cours€ of his or her
employment or performing duties related to the conduct of your business, or to your other
"volunteer workers" while performing duties relaled to the conduct of your business;
(b) To the spouse, child, parent, brolher or sister of that co-"employee" or "volunteer worke/'as a
consequence of Paragraph (l) (a) above;
(c) For which there is any obligation to share damages with or repay someone else who must pay
damages because of the injury described in Paragraphs (1) (a) or (b) above; or
(d) Arising out of his or her providing or failing to provide professional health care services. However,
if you are nol in the business of providing professional health care services or providing
protessional heallh care personnel to others, or if coverage for providing professional health care
services is not olherwise excluded by separate andorsement, this provision (Paragraph (d)) does
not apply.
b.
c.
d
J
cG 8E 10 04 13 Page 6 of I
@ 2013 Ljbe.ty Mutual lnsurance
lndudes copyrighled malerialot lnsurance Services Office. lnc., lvith ils permission
paragraphs (al and (b) above do not apply to 'bodily injuof or 'personal and adverlising injuqf caused by an
'emp-loyie' ritro ls aiting in a supewisory capacity for you. Suprvisory capacity as us€d herein means the
"employee's'job responiibilities assignei biyou, includes the direct supervision of other 'employe€s' of yours.
Howevir, none of these 'employees' are iniureds for'bodily injury'or "p€rsonal and advertjsing inju4/ arising out
of their willful conduct, whictr is ilefined as the purposeful or willful intent to cause "bodily injur/' or "personal and
advertising injury', or caused in whole or in part by their intoxication by lhuor or controlled subslances.
The coverage provided by provision J. is excess over any other valid and colleclable insurance available to your
'employee'.
K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES
Paragraph 3. of Section ll - who ls An lnsured is replaced by the lollowing:
3. Any organization you newly acquire or form and over which you maintain.ownership.or majority interest,
witiqujtity as a ttimed tnsured i{ there is no other similar insurance available to that organization.
However:
a. Coverage under this provision is afforded only until the expiration of the policy period in which the
entity was acquired or formed by you;
b. Coverage A does not apply to "bodily injury" or "property damage" that occured before you
acquired or formed the organization; and
c. Coverage B does not apply to "personal and advertising iniury" arising out of an ofiense
committed before you acquired or formed the organization.
d. Records and descriptions of operalions must be maintained by the firsl Named lnsured.
No person or organization is an insured with respect to lhe conduct of any currenl or past partnership, ioint venture
or tinrited tlaOititf company that is not shown as a Named lnsured in the Declarations or qualifies as an insured
under this provision.
L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES
Under Section lV - Commercial ceneral Llabllity Conditlons, the following is added to Condition 6.
Representations:
Your failure to disclose all hazards or prior 'occurrences' existing as of the inception date of the policy
shall not prejudice the coverage alfordsd by this policy provided such failure to disclose all hazards or
prior 'occurrences' is nol intenlional.
M. KNOWLEOGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
Under Section lV - Commercial General Liability Conditions, the following is added to Condition 2. Duties ln
The Event ot Occurence, Offense, Claim Or Suit:
Knowledge of an 'occurrence', offense, claim or'suit' by an agent. servant or'employee" of any insured
shall not in itsetf constitute kno',t/ledge of the insured unless an insured listed under Paragraph 1. of
Sectlon ll - Who ls An lnsured or a person who has been designated by them to receive reporls of
"occurrences', offenses, claims or "suits' shall have received such notice from the agent, servant or
"employee'.
N. LIBERALIZATIONCLAUSE
lf we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional
premium charge, your policy will aulomatically provide the coverage as of the day the revision is effective in your
state.
O. BODILY INJURY REDEFINED
UndBr Section V - Definitions, Definition 3. is replaced by the following:
3. "Bodily lnjury' means physical iniury, sickness or disease sustained by a person. This includes mental
anguish. mental injury, shock, fright or death that results from such physical injury, sickness or disease.
cc 88 to o,t ts rndudes copy,ishred ma;"1t;ti:TlJgi[1'ffi. rn".,,,'n rc pu,.c"ion. Pase 7 or I
P EXTENDED PROPERTY DAMAGE
Excluslon a. o, COVERAGE A. BODILY INJURY AND PROPERW DAMAGE LIABILITY is replaced by the
following:
a.Expected Or lntended lnjury
"Bodily injury' or "prop€dy damage" expeded or intended from tho standpoint of the insured. This
exclusion does not apply to "bodily injury' or 'property damage' resulting from the use of
reasonable force to protect persons or property.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US -WHEN REQUIRED IN A
CONTRACT OR AGREEMENT WITH YOU
Under Section lV - Commorcial ceneral Liability conditions, the following is added to Condition 8. Transfer
Of Rights Of Recovery Against Others To Us:
We waive any right of recovery lve may have against a person or organization because of payrnents we make for
injury or damage arising out of your ongoing operations or 'your work" done under a contract with that person or
organization and included in the "products-completed operations hazard" providsd:
l. You and that person or organization have agreed in writing in a contract or agreement that you waive such
rights against that person or organizalion; and
2. The injury or damage occurs subsequent to lhe execution of the written contract or written agreement.
@ 2013 Uberty Mutual ln8lrance
hdudes copyrighted maledal of lnsuranc€ Seryices Ofiice, lnc., ,.{ith its pe.mission,
o.
cG 88 10 04 t3 Page 8 of 8
sratf (x wsHrtcrol{
Department of Labor & lndustries
Certificate of Workers' Compensation Coverage
January I 3, 201 7
WA UBI No.
L&l Aount lD
Legal Business Name
Doing Business As
workers Comp Pramium Status:
Eslimated Workers Reported
(See Description Below)
Account Representative
Licensed Contrador?
@2 179 864
3728200
JLS GROUP INC
NORTHWESTERN TERRITORIES INC
Account is cunent.
Quarter 3 of Year 2016 "11 to 20 workers"
Employer SeMces l-lelp Line, (360) 9024817
No
What does "Estimated Workers Reponed" mean?
Estimated workers reported represents the number of full time position requirinq at least 480 hours of work
per calendar quarter. A single 480 hour position may be filled by one person, or several pan time workers.
lndustrial lnsurance lnformation
Employers report and pay premiums each quarter based on hours of employee work already performed, and
are liable for premiums found later to be due. lndustrial insurance accounts have no policy periods,
cancellation dates, limitations of coverage or waiver of subrogation (See RCW 5l .l 2.050 and 5L!..10=l-99).