HomeMy WebLinkAbout5.615 Original Contract
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· M:'OSSBAY GROUP
Work Order PACOOl
Moss Bay Group, Inc., a Washington corporation, proposes to provide the City of Port
Angeles the consulting services described below:
Work Order Title
InformatIOn Technology Department Audit
Scope of Work
The consultants will analyze the operations needs, and staffing of the City's Information
Technology vision in order to identify any issues affecting performance, security, and
reliability. During the course of this engagement the consultants will also provide the
City Manager information regarding non-technical issues affecting the department's
performance.
Tasks
1. Review IT operations, staffing loads and qualifications
2. Gather documentation
3. Interview IT department and appropriate Finance department personnel
4. Analyze data gathered
5. Meet with City Manager
6. Prepare Final Report
Deliverables
The project deliverables shall be in the form ofa brief report summarizing the
engagement's purpose, methodology, findings, and recommendations, and a meeting with
the City Manager to discuss findings and recommendations.
Deliverable Format
All deliverables WIll be provided electronically in Adobe PDF format.
Term
Start date: July 8, 2002
End date: July 31, 2002
Compensation
Estimate = not-to-exceed 60 hours @ $150/hour for a total not-to-exceed fee of
$9,00000
Authorized Si!!natures
MOSS BAY GROUP
City of Port Angeles
9Jnv
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Naml,--~
Title ;
6100 219th St SW, SUite 380
Mountlake Terrace, WA 98043
206 235.5305
Page 1 of 1
David M Nicksic
Pnnclpal
PROFESSIONAL SERVICES AGREEMENT
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Moss Bay Group, Inc., whose address is 6100 219th Street SW, Suite 380, Mountlake
Terrace, Washington 98043 (hereinafter the "Consultant"), and the City of Port Angeles
whose address is 321 E. 5th Street, Port Angeles, W A 98362 (hereinafter the "Client")
agree and contract as follows:
I. SERVICES BY CONSULTANT
A. The Consultant agrees to perform consulting services for Client in the
general technical area of Technology Consulting.
B. All services, and all duties incidental or necessary thereto, shall be
conducted and performed diligently and completely and in accordance
with professional standards of conduct and performance.
II. COMPENSATION
A. Each service engagement assigned by Client shall be accompanied by an
official Work Order to the Client noting the purpose of the work, the
previously negotiated hours required by the Consultant to complete the
work, and an approximate completion date. Said ~ument and
subsequent correspondences for future engagements shall become an
attachment to this agreement and shall be signed by both parties before
work commences.
The quoted fees include all labor, materials, and expenses required for the
completion of these services. Professional fees for changes orders to an
agreed work order will according to the schedule provided in Attachment
A.
B. Payment to the Consultant by the Client in accordance with the terms
specified in Section II.A. above shall be the total compensation for all
work performed under this Agreement and supporting documents hereto
as well as all subcontractors' fees and expenses, supervision, labor,
supplies, materials, equipment or the use thereof, reimbursable expenses,
and other necessary incidentals.
C. The Consultant shall be paid monthly on the basis of invoices submitted.
Invoicing will be on the basis of percentage complete or on the basis of
time, whichever is applicable in accordance with the terms of this
Agreement.
Moss Bay Group, Inc.
Page 1
D. Unless otherwise specified in this Agreement, any payment shall be
considered timely if a check or warrant is mailed or is available within 30
days of the date of actual receipt by the Client of an invoice conforming in
all respects to the terms of this Agreement.
. III. TERMINATION OF AGREEMENT
The Client reserves the right to terminate or suspend this Agreement at any time,
with or without cause, by giving ten (10) days notices to Consultant in writing. In
the event of termination, all finished or unfinished reports, or other material
prepared by the Consultant pursuant to this Agreement, shall be provided to the
Client. In the event the Client terminates prior to completion without cause,
Consultant may complete such analyses and records as may be necessary to place
its files in order. Consultant shall be entitled to receive just and equitable
compensation for any work completed on the project prior to the date of
suspension or termination, not to exceed the payment ceiling set forth above.
IV. OWNERSHIP OF WORK PRODUCT
A. Ownership of the originals of any reports, data, studies, surveys, charts,
maps, drawings, specifications, figures, photographs, memoranda, and any
other documents that are developed, compiled, or produced as a result of
this Agreement, whether or not completed, shall be vested in the Client.
Any reuse of these materials by the Client for projects or purposes other
than those that fall within the scope ofthis contract or the project to which
it relates, without written concurrence by the Consultant,. will be at the
sole risk of the Client. --~
The Client acknowledges the Consultant's plans and specifications as
instruments of professional service. The Consultant acknowledges that
the Client is a public institution and the plans and specifications prepared
under this Agreement shall become the property of the Client upon
completion of the work, and are subject to public review in accordance
with RCW requirements for information disclosure. The Client agrees to
hold harmless and indemnify Consultant against all claims made against
Consultant for damage or injury, including defense costs, arising out of
any reuse of such plans and specifications by any third party without the
written authorization of the Consultant.
B. Methodology, materials, software, logic, and systems developed under this
Contract are the property of the Consultant and the Client, and may be
used as either the Consultant or the Client see fit, including the right to
revise or publish the same without limitation.
Moss Bay Group, Inc.
Page 2
V. GENERAL ADMINISTRATION AND MANAGEMENT
The City Manager for the Client shall review and approve the Consultant's
invoices to the Client under this Agreement, shall have primary responsibility for
overseeing and approving services to be performed by Consultant, and shall
coordinate all communications with the Consultant from the Client.
VI. WORK PROGRESS
Consultant will diligently proceed with the work contracted for, but Consultant
shall not be held responsible for delays occasioned by factors beyond its control
that could not reasonably have been foreseen at the time of the execution of this
Agreement. If such a delay arises, Consultant shall forthwith notify the Client.
VII. SUCCESSORS AND ASSIGNS
The Consultant shall not assign, transfer, convey, pledge, or otherwise dispose of
this Agreement or any part of this Agreement without prior written consent of the
Client.
VIII. NONDISCRIMINATION
The Consultant shall, in all hiring or employment made possible or resulting from
this Agreement, take affirmative action to ensure that there shall be no unlawful
discrimination against any employee or applicant for employment because of sex,
race, age, color, creed, national origin, marital status, or the presence of any
sensory, mental, or physical handicap, unless based upon a bonafide occupational
qualification, and this requirement shall apply to but not be limited to the
following: employment, advertising, layoff or termination, rates of payor other
forms of compensation, and selection for training, including apprenticeship.
No person shall be denied or subjected to discrimination in receipt of the benefit
of any services or activities made possible by or resulting from this Agreement on
the grounds of sex, race, color, creed, national origin, age except minimum age
and retirement provisions, marital status, or the presence of any sensory, mental,
or physical handicap.
IX. HOLD HARMLESSIINDEMNIFICA TION
The Client agrees to indemnify, defend, and save harmless the Consultant and its
officers, agents, and employees from any claim, real or imaginary, filed against
the Consultant or its officers, agents, or employees alleging damage or injury
arising out of the subject matter of this Agreement; provided, however, that such
provision shall not apply to the extent that damage or injury results from the fault
of the Consultant or its officers, agents, or employees. "Fault" as herein used
shall have the same meaning as set forth in RCW 4.22.015.
Moss Bay Group, Inc.
Page 3
X. COMPLIANCE WITH LAWS
The Consultant shall comply with all applicable State, Federal, and local laws,
ordinances, regulations, and codes, and this agreement shall be interpreted and
governed in all respects by the laws of the State of Washington.
XI. CONFIDENTIALITY
The Consultant shall comply with all Client 'I t~confidentiality policies and
will be held liable for any intentional breach of confidentiality. The Client agrees
to make all confidentialitY policies with which the Consultant shall comply
available to the Consultant prior to project initiation.
XII. INSURANCE
The Consultant maintains the following insurance coverage: Errors and
Omissions, $1,000,000; Auto Liability, $1,000,000; General Liability,
$1,000,000; and Workers Compensation as required by law. The Consultant
agrees to, at a minimum, maintain the coverage for the duration of this agreement:
This insurance is maintained at the expense of the Consultant.
XIII. INDEPENDENT CONTRACTOR
Consultant is and shall be at all times during the term of this Agreement an
independent contractor and not an employee of the Client. Consultant agrees that
he is solely responsible for the payment of taxes applicable to the service
performed under this Agreement and agrees to comply with all Feqeral, State, and
local laws regarding the reporting of taxes, maintenance of insuranc?and records,
and all other requirements and obligations imposed on him as a result of his status
as an independent contractor. The Consultant is responsible for providing the
office space and clerical support necessary for the performance of services under
this Agreement. The Client shall not be responsible for withholding or otherwise
deducting Federal income tax or social security or for contributing to the state
industrial insurance or unemployment compensation programs or otherwise
assuming the duties of an employer with respect to the Consultant or any
employee of the Consultant.
XIV. EXTENT OF AGREEMENTIMODIFICATION
This Agreement, together with all attachments and addenda, represents the entire
and integrated Agreement between the parties hereto and supersedes all prior
negotiations, representations, or agreements, either written or oral. This
Agreement may be amended, modified, or added to only by written instrument
properly signed by both parties hereto.
XV. TERM
The term of this Agreement shall begin in July 2002, and remain in effect until
terminated in writing by the Client or Consultant.
Moss Bay Group, Inc.
Page 4
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the dates
written below:
CONSULTANT:
CLIENT:
tlJ,tv
BY:~~
City of Port Angeks
Date: //..y6..z-.
By:
David Nicksic
Date:
6/28/02
Moss Bay Group, Inc.
Page 5
Attachment A
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FEE SCHEDULE
The fees are based on the following hourly rates, which would also apply to any change
orders approved during the project:
Principal
Senior Consultant
Consultant
$150 per hour
$125 per hour
$105 per hour
'--......
Moss Bay Group, Inc.
Page 6
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-.(i)MOSS B
~ GROUP
Work Order PAC002
Moss Bay Group, Inc., a Washington corporation, proposes to provide the City of Port
Angeles the consulting services described below:
Work Order Title
Information Technology Department Planning and Documentation Support
Scope of Work
The consultants will begin develop, population and deployment of an information
technology reference manual containing standards, methodology and procedures and
develop an information technology plan for supporting finance system implementation.
Deliverables
The project deliverables shall be in the form of findings and recommendations to assist
the successful implementation of the Finance Department software system, and the
creation of an initial information technology reference database.
Deliverable Format
All deliverables will be provided electronically.
Term
Start date: July 30, 2002
End date: August 30, 2002
Compensation
Estimate = total not-to-exceed fee of $5,880.00
Contract
This work order is authorized by Professional Services Agreement number one executed
by the City of Port Angeles on July 3, 2002.
Authorized Signatures
MOSS BAY GROUP
City of Port Angeles
fj),v
David M. Nicksic
Principal
Name
Title
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eta;;;. - ~ ~/t
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6100 219th St SW, SUite 380
Mountlake Terrace, WA 98043
206 235.5305
Page 1 of 1
5.&;/5
PROFESSIONAL SERVICES AGREEMENT
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Moss Bay Group, Inc., whose address is 6100 219th Street SW, Suite 380, Mountlake
Terrace, Washington 98043 (hereinafter the "Consultant"), and the City of Port Angeles whose
address is 321 E. 5th Street, Port Angeles, W A 98362 (hereinafter the "Client") agree and
contract as follows:
I. SERVICES BY CONSULTANT
A. The Consultant agrees to perform consulting services for Client rn the general
technical area of Technology Consultrng.
B. All services, and all duties incidental or recessary thereto, shall be conducted
and performed diligently and completely and in accordance with professional
standards of conduct and performance.
II. COMPENSATION
A. Each service engagement assigned by Client shall be accompanied by an offiCIal
Work Order to the ClIent noting the purpose of the work, the previously
negotiated hours required by the Consultant to complete the work, and an
approximate completion date. Said document and subsequent
correspondences for future engagements shall become an attachment to this
agreement and shall be signed by both parties before work commences.
The quoted fees include all labor, materials, and expenses required for the
completion of these services. Professional fees for changes orders to an agreed
work order will according to the schedule provided in Attachment A.
B. Payment to the Consultant by the Client in accordance with the terms specified
in Section II.A. above shall be the total compensation for all work performed
under this Agreement and supporting documents hereto as well as all
subcontractors' fees and expenses, supervision, labor, supplies, matenals,
equipment or the use thereof, relffibursable expenses, and other necessary
incidentals.
C. The Consultant shall be paid monthly on the basis of invoices submitted.
Invoicrng Will be on the basis of percentage complete or on the basis of time,
whichever is applicable in accordance with the terms of thIs Agreement.
Moss Bay Group, Inc.
Page 1
D. Unless otherwise specified in this Agreement, any payment shall be considered
timely if a check or warrant is mailed or is available WIthin 30 days of the date
of actual receipt by the Client of an invoice conforming in all respects to the
terms of thIs Agreement.
III. TERMINATION OF AGREEMENT
The Client reserves the right to terminate or suspend this Agreement at any time, with or
without cause, by gIving ten (10) days notices to Consultant m writing. In the event of
terminatlOn, all finished or unfinished reports, or other material prepared by the
Consultant pursuant to this Agreement, shall be provIded to the Client. In the event the
Client terminates prior to completlon without cause, Consultant may complete such
analyses and records as may be necessary to place its files in order. Consultant shall be
entitled to receive just and equitable compensatlon for any work completed on the
project prior to the date of suspension or termination.
N. OWNERSHIP OF WORK PRODUCT
A. Ownership of the originals of any reports, data, studies, surveys, charts, maps,
drawings, specifications, figures, photographs, memoranda, and any other
documents that are developed, compiled, or produced as a result of tills
Agreement, whether or not completed, shall be vested in the Chent. Any reuse
of these materials by the Client for projects or purposes other than those that
fall within the scope of this contract or the project to which it relates, without
wntten concurrence by the Consultant, will be at the sole risk of the Client.
The Client acknowledges the Consultant's plans and specificatlons as
instruments of professional service. The Consultant acknowledges that the
Client is a pubhc institution and the plans and specificatlons prepared under thIs
Agreement shall become the property of the Client upon completion of the
work, and are subject to public review in accordance with RCW requirements
for information disclosure. The Client agrees to hold harmless and indemnifY
Consultant against all claims made against Consultant for damage or injury,
including defense costs, arising out of any reuse of such plans and specifications
by any third party without the written authorization of the Consultant.
B. Methodology, materials, software, logic, and systems developed under this
Contract are the property of the Consultant and the Client, and may be used as
eIther the Consultant or the Client see fit, mch.1ding the nght to reVlse or publish
the same without limltation.
V. GENERAL ADMINISTRATION AND MANAGEMENT
The Fmance Drrector for the Client shall review and approve the Consultant's invoices
to the Client under this Agreement, shall have primary responsIbility for overseeing and
Moss Bay Group, Inc.
Page 2
approving services to be performed by Consultant, and shall coordinate all
communicatIOns with the Consultant from the Client.
VI. WORK PROGRESS
Consultant will diligently proceed WIth the work contracted for, but Consultant shall not
be held responsible for delays occasioned by factors beyond its control that could not
reasonably have been foreseen at the time of the execution of this Agreement. If such a
delay arises, Consultant shall fOrthWIth notifY the Client.
VII. SUCCESSORS AND ASSIGNS
The Consultant shall not assign, transfer, convey, pledge, or otherwise dispose of this
Agreement or any part of this Agreement WIthout prior wntten consent of the Client.
VIII. NONDISCRIMINATION
The Consultant shall, in all hmng or employment made pOSSIble or resulting from this
Agreement, take affirmative action to ensure that there shall be no unlawful
discnminatIOn agamst any employee or applicant for employment because of sex, race,
age, color, creed, national origin, marital status, or the presence of any sensory, mental,
or physical handicap, unless based upon a bonafide occupational qualification, and thIs
reqUIrement shall apply to but not be limited to the following: employment, advertising,
layoff or termination, rates of payor other forms of mmpensation, and selection for
traming, including apprenticeship.
No person shall be demed or subjected to discrimination in receIpt of the benefit of any
services or activities made possible by or resulting from this Agreement on the grounds
of sex, race, color, creed, national ongin, age except minimum age and retirement
provisions, marital status, or the presence of any sensory, mental, or physical handicap.
IX. HOLD HARMLESS/INDEMNIFICATION
The Client agrees to mdemnifY, defend, and hold harmless the Consultant and ItS
officers, agents, and employees from any claim filed against the Consultant or Its
officers, agents, or employees allegmg damage or i11iury arising out of the
subject matter of this agreement and resultIng from the fault of the ClIent or is
officers, agents, or employees.
The Consultant agrees to indemnifY, defend, and hold harmless the Client and its
officers, agents, and employees from any claim filed against the Client or its
officers, agents, or employees alleging damage or injury arising out of the
subject matter of this agreement and resulting from the fault of the Consultant or
its officers, agents, or employees.
"Fault" as used herein shall have the same meaning as set forth in RCW 4.22.015.
Moss Bay Group, Inc.
Page 3
X. COMPLIANCE WITH LAWS
The Consultant shall comply WIth all applIcable State, Federal, and local laws,
ordinances, regulatIons, and codes, and this agreement shall be interpreted and
governed in all respects by the laws of the State of Washington.
XI. CONFIDENTIALITY
The Consultant shall comply with all Client confidentialIty policies and will be held lIable
for any intentional breach of confidentiality. The Client agrees to make all confidentialIty
policies with which the Consultant shall comply available to the Consultant prior to
project initiation.
XII. INSURANCE
The Consultant maintams the following insurance coverage: Errors and OnnsslOns,
$1,000,000; Auto Liability, $1,000,000; General Liability, $1,000,000; and Workers
Compensation as required by law. The Consultant agrees to, at a minImum, maintam
the coverage for the duration of this agreement. ThIs insurance IS mamtained at the
expense of the Consultant.
XIII. INDEPENDENT CONTRACTOR
Consultant is and shall be at all tImes during the term of this Agreement an independent
contractor and not an employee of the Client. Consultant agrees that he is solely
responsIble for the payment of taxes applicable to the servIce performed under this
Agreement and agrees to comply with all Federal, State, and local laws regarding the
reporting of taxes, maintenance of insurance and records, and all other requirements and
obligations Imposed on him as a result of his status as an independent contractor. The
Consultant is responsible for providing the office space and clerical support necessary
for the performance of services under this Agreement. The Client shall not be
responsible for withholding or otherwise deducting Federal income tax or SOCIal security
or for contributing to the state industrial insurance or unemployment compensation
programs or otherwise assuming the duties of an employer with respect to the
Consultant or any employee of the Consultant.
XIV. EXTENT OF AGREEMENT/MODIFICATION
Tills Agreement, together with all attachments and addenda, represents the entire and
integrated Agreement between the parties rereto and supersedes all prior negotiations,
representations, or agreements, either written or oral. This Agreement may be
amended, modified, or added to only by written instrument properly signed by both
parties hereto.
Moss Bay Group, Inc.
Page 4
xv. TERM
The term of this Agreement shall begin in August 2002, and remain in effect until
terminated in writing by the Client or Consultant.
IN WITNESS WHEREOF, the partIes hereto have executed this Agreement on the dates
written below:
CONSULTANT:
CLIENT:
~
Date:
8/1/02
By: ~,,..,,--
,.- City of Port Angeles
J .. -Z 7- t:/ z---
By:
DaVId Nlcksic
Date:
Moss Bay Group, Inc.
Page 5
Attachment A
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FEE SCHEDULE
The fees are based on the following hourly rates, whIch would also apply to any change orders
approved during the project:
Principal
Senior Consultant
Consultant
$150 per hour
$125 per hour
$105 per hour
Moss Bay Group, Inc.
Page 6
Client#: 7627
MOSSBAY1
~'j
ACORDTM
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYY)
09/30/02
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCER
Armfield, Harrison & Thomas, Inc.
2033 Sixth Avenue, Suite 730
Seattle, WA 98121
206.269.0122
INSURERS AFFORDING COVERAGE
INSURERA ST PAUL FIRE & MARINE INS. CO.
INSURED
Moss Bay Group
6100 . 219th Street SW
Suite 380
Mountlake Terrace, WA 98043
INSURER B
INSURER C
INSURER D
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR TYPE OF INSURANCE POLICY NUMBER Pgk!fEY(~~5g~~ p~~fJ ,'Flrr,'~l)$.N LIMITS
LTR
A GENERAL LIABILITY VP04601236 09/10/02 09/10/03 EACH OCCURRENCE $1 000000
c--,
..x- COM M ERCIAL GENERAL L1AB 11ITY FIRE DAMAGE (Anyone fire) $250 000
I-- ~ CLAIMS MADE W OCCUR MED EXP (Anyone person) $10 000
PERSONAL & ADV INJURY $1 000 000
GENERAL AGGREGATE $2 000.000
GEN'L AGGREGATE lIM IT APPlS PER PRODUCTS -COMP/OP AGG $2,000.000
n POLICY n ~~gT LOC
~OMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accldenl)
I--
I-- ALL OWNED AUTOS BODILY INJURY
(Per person) $
SCHEDULED AUTOS
I--
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per accident)
-
PROPERTY DAMAGE $
(Per accident)
RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS LIABILITY EACH OCCURRENCE $
:=J OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $ ,
RETE~.I.!!?!l__..!..._____ ------------- $
WORKERS COMPENSATION AND VP04601236 09/10/02 09/10/03 X IT"X~~T~i~~ I IOJ~-
A EMPLOYERS' LIABILITY E L EACH ACCIDENT $1,000,000
E L DISEASE. EA EMPL OYEE $1,000,000
E L DISEASE - POLICY LIMIT $1,000,000
A OTHER Property VP04601236 09/10/02 09/10/03 $113,300 Limit
A Frrors & VP04601236 09/10/02 09/10/03 $1,000,000 Limit
:>missions
OESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The City of Port Angeles, and/or its assigns, are named Additional Insureds as their interest may appear.
CERTIFICATE HOLDER I X I ADDITIONAlINSURED'INSURERLETTER A CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Port Angeles DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3D- DAYS WRITTEN
321 East Fifth Street NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUT FAILURE TODOSOSHALL
Port Angeles, WA 98362 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURER,ITS AGENTS OR
REPRESENTATIVES
A(:U~RIZED REPRESENTATIVE
I . II..
ACORD 25-5 (7/97)1
of2
#S33462/M33459
MTC
@ ACORD CORPORATION 1988
..
IMPORT ANT
If the certificate holder IS an ADDITIONAL INSURED, the policY(les) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain poliCies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder In lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse Side of this form does not constitute a contract between
the Issuing Insurer(s), authorized representative or producer, and the certificate holder, nor does It
affirmatively or negatively amend, extend or alter the coverage afforded by the poliCies listed thereon.
ACORD 25-5 (7/97)2 of 2 #S33462/M33459
AqORf]TM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDNY)
08/20/02
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Armfield, Harrison & Thomas, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
2033 Sixth Avenue, Suite 730 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Seattle, WA 98121
206-269-0122 INSURERS AFFORDING COVERAGE
INSURED INSURER A ST PAUL FIRE & MARINE INS. CO.
Moss Bay Group INSURER B
6100 - 219th Street SW INSURER C
Suite 380 INSURER D
I Mountlake Terrace, WA 98043 INSURER E
Client#. 7627
MOSSBA Y1
5. t.o/5-;)
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSR TYPE OF INSURANCE POLICY NUMBER Pgk!fEYI~'J,5~J.}~~ P%~fJ l'il:J~~J)$\N LIMITS
LTR
A GENERAL LIABILITY VP04601236 09/1 0/01 09/1 0/02 EACH OCCURRENCE $1 000 000
-
X COMM ERCIAL GENERAL L1AB ILlTY FIRE DAMAGE (Anyone fire) $250 000
I CLAIMS MADE W OCCUR MED EXP (Anyone person) $10,000
PERSONAL & ADV INJURY $1 000 000
-
GENERAL AGGREGATE $2 000 000
-
GEN'L AGGREGATE L1M IT APPLIES PER PRODUCTS -COMP/OP AGG $2 000 000
I nPRO- n
POLICY JECT LOC
A ~TOMOBILE LIABILITY VP04601236 09/1 0/01 09/1 0/02 COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $1,000,000
-
- ALL OWNED AUTOS BODILY INJURY
(Per person) $
SCHEDULED AUTOS
-
X HIRED AUTOS BODILY INJURY
- $
lL NON-OWNED AUTOS (Per accident)
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS LIABILITY EACH OCCURRENCE $
:::J OCCUR D CLAIMS MADE AGGREGATE $
$
==i DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND VP04601236 09/1 0/01 09/1 0/02 xT-r~~-~Tf;,1,!'/';, I IOJ~-
A EMPLOYERS' LIABILITY $1 000 000
E L EACH ACCIDENT
E L DISEASE - EA EMPL OYEE $1,000,000
E L DISEASE - POLICY LIMIT $1 000000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The City of Port Angeles, and/or its assigns, are named Additional Insureds as their interest may appear.
CERTIFICATE HOLDER I X I ADDITIONALlNSURED INSURER LETTER A CANCELLATION
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Port Angeles DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL3D-DAYSWRITTEN
321 East Fifth Street NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAlLURE TODOSOSHALL
Port Angeles, W A 98362 1M POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
AUn: Ms. Yvonne Ziomkowski REPRESENTATIVES
A'fit~RIZED REPRESENTATIVE
I 'A~ .~
v
ACORD 25-S (7/97)1 of 2
#32335
MTC
@ ACORD CORPORATION 1988
,- -
..
IMPORTANT
If the certificate holder IS an ADDITIONAL INSURED, the policY(les) must be endorsed. A statement
on this certificate does not confer nghts to the certificate holder In lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement A statement on this certificate does not confer rights to the certificate
holder In lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the Issuing Insurer(s), authonzed representative or producer, and the certificate holder, nor does It
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-5 (7/97)2 of 2 # 3 2 3 3 5
I' $~nJ-~_~~10:':~0i~k Ord~ OQ1.~es!
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-.@MOSSBAY GROUP
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