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Home My WebLink About5.527 Original Contract , 5. 5:2 7 AGREEMENT FOR PROFESSIONAL SERVICES BETWEEN THE THE CITY OF PORT ANGELES AND OLYMPIC DESIGN WORKS, INC. PS RELATING TO: CARNEGIE LIBRARY RESTORATION/RENOVATION THIS AGREEMENT IS made and entered Into this I (jJ ~y of December ,1999 , by and between THE CITY OF PORT ANGELES, a non-charter code city of the State of Washington, (hereinafter called the "CITY") and Olympic Design Works Inc PS a Washington Corporation (hereinafter called the "CONSULTANT") WHEREAS, the CITY desires to develop a predeslgn for the Carnegie Library BUilding Renovation/Restoration WHEREAS, the CITY desires to engage the professional services and assistance of a qualified consulting firm to perform the scope of work as detailed In Exhibit A and WHEREAS, the CONSULTANT represents that It IS In full compliance with the statutes ofthe State of Washington for professional registration and/or other applicable requirements, and WHEREAS, the CONSULTANT represents that 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 appropnate facilities necessary to accomplish the work, NOW, THEREFORE, In consideration of the above representations and the terms, conditions, covenants and agreements set forth below, the parties hereto agree as follows. SCOPE OF WORK The scope of professional services to be performed and the results to be achieved by the CONSULTANT shall be as detailed In the attached Exhibit A and shalllncluoe all services and material necessary to accomplish the work The CITY may review the CONSULTANT'S work product, and if It IS not satisfactory, the CONSULTANT shall make such changes as may be reqUired by the CITY Such changes shall not constitute "Extra Work" as related in Section XI of this Agreement The CONSULTANT agrees that all services performed under this Agreement shall be In accordance with the standards of the profession and In compliance with applicable federal, state and local laws. The Scope of Work may be amended upon wntten approval of both parties II OWNERSHIP OF DOCUMENTS Upon completion of the work, all documents, exhibits, photographic negatives, or other presentations of the work shall bocome the property of the CITY for use Without restriction and Without representation as to suitabIlity for reuse by any other party unless specifically venfied or adapted by the CONSUL TAtir. However, any alteration or reuse of the documents, by the City or by others acting through or on behalf of the City, Will be at the City's sole nsk. III DESIGNATION OF REPRESENTATIVES J 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. The work shall be completed In accordance With the schedule set forth In the attached Exhibit B V PAYMENT The CITY shall pay the CONSULTANT as set forth in this section of the Agreement Such paymmt 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 fee schedule, overhead and profit Included, CONSULTANT'S direct non-salary reimbursable costs as set forth in the attached Exhibit B. Labor costs shall be based on the hourly rates shown In Exhibit B Hourly rates shall be based upon an indiVidual's hourly rate, times the total number of hours worked. City of Port Angeles - [December, 1999] General clerical time shall be considered an overhead Item, except where spa:;ific work Items are Involved that reqUire one hour or more continued effort, In which case time will be charged on the basis of hours worked 2 The direct non-salary reimbursable costs are those directly Incurred In fulfilling the terms of this Agreement, including, but not limited to, travel, subsistence, telephone, CADD computer, reproduction and printing, supplies and fees of outside services and consultants Ten percent (10%) overhead and profit may be added to direct non-salary reimbursable costs B The CONSULTANT shall submit invoices to the CITY on a monthly basIs InvoIces shall detail the work, hours, employee name, and hourly rate, shall itemize With receipts and inVOiceS the non-salary direct costs; shall indicate the speclfictask or activity in the Scope of Work to which the costs are related, and shall indicate the cumulative total for each task C The CITY shall review the inVOiceS and make payment for the 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. In the event of a disputed billing, only the disputed portion will bewlthheld from payment E Final payment for the balance due to the CONSULTANT will be made upon the completion of the work and acceptance by the CITY. F. Payment for "Extra Work" performed under Section XI of this Agreement shall be as agreed to by the parties In writing VI MAXIMUM COMPENSATION Unless otherwise agreed to In writing by both parties, the CONSULTANTS total compensation and reimbursement under thiS Agreement, including labor, direct non- salary reimbursable costs and outside services, shall not exceed the maximum sum of $ 14.33900 VII 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 underthe 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. In performing this Agreement, the CONSULTANT shall not employ or contract With any CITY employee Without the City's written consent VIII NONDISCRIMINATION The CONSULTANT shall conduct ItS business In a rranner, which assures fair, equal and non-discriminatory treatment of all persons, Without respect to race, creed or national Origin, or other legally protected classification and, In particular. A The CONSULTANT shall maintain open hiring and employment practices and will welcome applications for employment In all positions, from qualified individuals who are members of minOrities protected by federal equal opportunity/affirmative 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 non discriminatory requirements 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 IX SUBCONTRACTS A The CONSULTANT shall not sublet or assign any of the work covered by thiS Agreement Without the written consent of the CITY B The CONSULTANT Will be using the firms submitted With ItS proposal as subcontractors Subcontractors other than those listed shall not be permitted Without the written consent of the CITY C In 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 subcxmsultant or supplier shall be notified by the CONSULTANT of Consultant's obligations under thiS Agreement, including the nondiscrimination requirements X CHANGES IN WORK Other than changes directed by the CITY as set forth in Section I above, either party may r6:luest changes in the scope of work Such changes shall not become part of this Agreement unless and until mutually agreed upon and incorporated herein by written amendments to thiS Agreement executed by both parties XI EXTRA WORK The CITY may desire to have the CONSULTANT perform work or render services In connection With thiS proJect, in addition to the Scope of Work 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 executed by both parties. City of Port Angeles - [December, 1999J XII TERMINATION OF AGREEMENT A The CITY may terminate this Agreement at any time upon not less than ten (10) days wntten notice to the CONSULTANT. Wnten notice will be by certified mall sent to the consultant's designated representative at the address provided by the CONSULTANT B In the event this Agreement IS terminated pnor 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 percentage of work completed C In the event this Agreement IS terminated pnor to completion of the work, documents that are the property of the CITY pursuant to Section II above, shall be delivered to and received by the CITY pnor to transmittal of final payment to the CONSULTANT. XIII INDEMNIFICA TION/HOLD HARMLESS The CONSULTANT agrees to indemnify the CITY from any claims, damages, losses, and costs, including, but not limited to, attaney's fees and litigation costs, anslng out of claims by third parties for property damage and bodily inJury, including death, caused solely by the negligence or Willful misconduct of the CONSULTANT, CONSULTANT employees, affiliated corporations, officers, and subcontractors In connection With the work performed under thiS Agreement The CITY agrees to indemnify the CONSULTANT from any claims, damages, losses, and costs, including, but not limited to, attaney's fees and litigation costs, anslng 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, CITY's employees, or agents in connection With the work performed under thiS Agreement If the negligence or Willful misconduct of both CONSULTANT and CITY (or a person Identlfia:! 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 4.24.115, then, In the event of lIabllty for damages arising out of bodily Injury to persons or damages to property caused by or resulting from the concurrent negligence of the CONSULTANT and the CITY, ItS officers, offiCials, employees, and volunteers, the CONSULTANTS lIablllly hereunder shall be only to the extent of the CONSULTANT'S negligence. It IS further speCifically and expressly understood that the indemnification prOVided herein constitutes the CONSULTANT'S waiver of Immunity under Industnallnsurance, 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 However, the CONSULTANT expressly reserves ItS nghts as a third person set forth In RCW 51.24.035 XIV INSURANCE 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 anse from or in connection With the performance of the work hereunder by the CONSULTANT, ItS agents, representatives, employees or subcontractors The CONSULTANT shall prOVide a Certificate of Insurance eVidencing 1 Automobile Liabllltv Insurance with limits no less than $1,000,000 combined Single limit per aCCident for bodily injury and property damage, and, 2 Commercial General Liabllitv Insurance wntten on an occurrence basIs with limits no less than $1,000,000 combined Single limit per occurrence and $2,000,000 aggregate for personal inJury, bodily injury and property damage Coverage shall Include but not be limited to' blanket contractual, products/completed operations, broad form property damage; explOSion, collapse and underground (XCU) If applicable, and employer's liability, and, 3 ProfeSSional Liabllltv Insurance With limits no less than $1,000,000 per occurrence shall be prOVided by the sub-consultant responSible for the structural analYSIS and report as set forth in the attached Exhibit A. Any payment of deductible or self Insured retention shall be the sole responSibility of the CONSULTANT The CITY shall be named as an additional Insured on the Commercial General Liability Insurance policy, as respects work performed by or on behalf of the Consultant and a copy of the endorsement naming the CITY as additional insured shall be attached to the Certificate of Insurance The CITY reserves the nght to review a certified copy of all reqUired Insurance policies in the CONSULTANT's office The CONSULTANTS insurance shall contain a clause stating that coverage shall apply separately to each Insured against whom claim IS made or SUltJS brought, except With respects to the limits of the Insurer's liability. The CONSULTANTS Insurance shall be primary Insurance as respec's the CITY, and the CITY shall be given thirty (30) days pnor wntten notice of any cancellation, suspension or matenal change In coverage XV APPLICABLE LAW This Agreement shall be construed and interpreted In accordance WIth the laws of the State of Washington, and In the event of dispute the venue of any litigation brought hereunder shall be Clallam County. City of Port Angeles - [December, 1999] XVI EXHIBITS AND SIGNATURES This Agreement, including its exhibits, constitutes the entire Agreement, supersedes all prior written or oral understandings, and may only be changed by a written amendment executed by both parties The following exhibits are hereby made a part of thIs Agreement: Exhibit A - Scope of Work Exhibit B - Consultant Labor Costs ExhIbit B - Non-salary Reimbursable Costs Exhibit B - Schedule for the Work In WITNESS THEREOF, the parties hereto have executed this Agreement as of the day and year first written above CITY OF PORT ANGELES C\ ~/~(b.A MAYOR\ () ()....-l ..... ^--' CONstAN~ . ~o~~ TITLE. ~\...\c...\4?A' A~ * ?~\O~l ATTEST: \, ( .' PW-04iO~~.WPd [ ',' ',' {/~ " r ,\ \ ~ j "' \ ' City of Port Angeles - [December, 1999] " EXHIBIT A PROPOSED SCOPE OF WORK CARNEGIE LIBRARY PROGRAMMING PHASE STRUCTURAL AND COST STUDY PART ONE OF PHASE TWO A. Programming phase Structural Review A structural study to determine the physical condition of the building, it's components, and connections, then to analyze these in light of two possible paths for renewal; Renovation or Restoration. 1) Perform building inspection 12 hours Structural Engineer 12 hours Principal Architect a. Determine footing configuration b. Uncover concealed connections . Wall to roof and ceiling connection . Intermediate floor to wall connection . Interior bearing wall configuration c. Perform mortar inspection d. Some tool rental may be required as an additional service Coordination and procurement @ hourly rate for Associate Architect; $60.00/hour, cost of rental tools as reimbursable expense. . Rotohammer, Jackhammer 2) Investigative Tasks or testing a. Soils report investigation 1 hour Principal Architect . Investigate for other studies that may have been done in the area; Safeway, CC Courthouse b. Some independent testing may be required as an additional service at Owners expense Coordination at hourly rate for Associate Architect; $60.00/hour . Soils testing . Prism testing for brick is a possibility 3) Basic Structural Analysis 12 hours Structural Engineer a. Perform analysis b. Determine basic building forces 4) General Design for Potential Remedies 16 hours Structural Engineer 8 hours Principal Architect Programnnng Phase Proposal October 19th, 1999 OLYMPIC DESIGN WORKS, INC. PS " EXHIBIT A 5) Prepare report 36 hours Structural Engineer 8 hours Principal Architect a. Analysis of 2 possibilities; Renovation vs. Restoration b. Options for remedies c. Methods of analysis vs. applicable Codes d. Architects review and detail sketching 6) Publish Structural report 2 hours Principal Architect 10 hours Clerical a. Review of findings with P .E. b. Publish report B. Comparative Cost Analysis A comparative cost analysis covering the implications of taking the two different paths of Renovation or Restoration. 1) Determine scope of work for cost comparison analysis based on information found to date 1 hour Principal Architect a. Organizational outline 2) Pursue cost data from numerous sources 12 hours Principal Architect a. Personal local experience b. Local Contractors c. Regional cost data d. "Lost art" craftsmen e. Allied Professionals 3) Determine implications of Renovation or Restoration 17 hours Principal Architect a. Review the structural remedial tasks and their applicable governing code. b. Review renewal tasks outside ofthe scope ofthe Structural Study. c. Review funding opportunity implications d. Explore comparative philosophies of the two paths 4) Produce cost comparison document( s) 1 hour Principal Architect 9 hours Clerical Programming Phase Proposal October 19th, 1999 OLYMPIC DESIGN WORKS, INC. PS EXHIBIT A c. Post-phase Review, Report and Owner Coordination. We propose a formal review of project progress at the conclusion of each design phase. This does not preclude the day-to-day coordination with the Owner's Project Manager & Building Official. 1) Written report to Project Manager 2 hours Principal Architect a. Project progress. b. Options and decisions needed. c. Current cost and funding estimates. d. Current schedule implications 2) Project Meeting and subsequent project phase follow-up 4 hours Principal Architect 4 hours Structural Engineer a. Decisions and resolutions needed for subsequent design phase. b. Review of next design phase. c. Negotiation of design phase contract. Programmmg Phase Proposal October 19th, 1999 OLYMPIC DESIGN WORKS, ING. PS EXHIBIT B Programming Phase Proposal Professional Service hours charged at hourly rates plus 10% mark-up for Consultant fees: 80 hours Structural Engineer @ $88.00/hour= $7040.00 8 hours Clerical @ $25.00/hour= $200.00 Subtotal $7240.00 Consultant Services Markup @ 10% = Subtotal $724.00 $724.00 68 hours Principal Architect @ $ 75. OO/hour= 11 hours Clerical @ $25.00/hour= Subtotal $5100.00 $275.00 $5375.00 Total for Professional Service hours $13,339.00 Services listed as additional are billed @ $60.00/hour Reimbursable Expenses: The following expenses are considered reimbursable and are charged at actual cost plus 10% mark-up, rece1pts provided. Travel outside 50 mile radius @ .25/mile Subsistence outside of 50 mile radius Telephone and FAX charges directly related to Project Costs of Document Reproduction @ .05/B&W sheet, .99/color Supplies and Services directly related to Project: . Small tools; saw blades, tool rentals, etc. . Photographic materzals and development . Others approved by Owner prior to occurrence We propose a cap on reimbursables not to exceed $1000.00. It is our understanding that this is renegotiable should it become a hardship to our offices. Insurance: It 1S our understanding that the insurance levels carrzed by Olympic Design Works, Inc PS are sufficient for the Programming phase in the light of our structural sub-consultant carrying E&O to the required levels. Therefore, we have not figured the Architects overhead for ProfesslOnal Liability into this proposal. It is also our understanding that this requirement may be modified zn subsequent phases of further Programming or Design Contracts. Schedule: The work will be completed within 60 days of Contract initiation with the follOWing milestones. Buzlding Inspection within 2 weeks Analysis of siesmic design forces within 4 weeks Potential remedies / alternative methods within 6 weeks Structural report and cost analysis within 8 weeks Final Report withzn 60 days Programming Phase Proposal October 191\ 1999 OLYMPIC DESIGN WORKSj INC. PS " DATE (MM/DDIYY) . ACORD~ CERTIFICA TE OF LIABILITY INSURANCE DEC 8 99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY HUDSON INSURANCE AGENCY, INC. , AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS PO BOX 381 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE THE DALLES OR 97058-0381 AFFORDED BY THE POLICIES BELOW PHONE: 541-296-2268 , i COMPANIES AFFORDI~.G COVERAGE FAX: 541-296-9427 I , ' " - . ,,, ~ rcoM'PANY AWESTPORnNSURANCE-CORPORA TION I ' , ' Jc;OMPANY B .. ., INSURED- 'l -,. ~ . " " CRAIG OWEN, CONSULTING ENGINEER ['COMPANY c:: 220 E 1ST STREET icOMPANY D , PORT ANGELES WA 98362 i , \ COMPANY E COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR. THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR, LTRI TYPE OF INSURANCE POLICY NUMBER ~OLlCY EFFECTIVE I POLICY EXPIRATION I I ' OA TE IMMlOOIYYI OA TE IMMJOOIYYI LIMITS i GENERAL LIABILITY II COMMERCIAL GENERAL LIABILITY : I n-j CLAIMS MADE i~ OCCUR ii' - 1- ~J I GEN'L AGGREGATE LIMIT APPLIES PER ---: POLICY 1'----;1 PRO. 1---1 LOC I JECT' I AUTOMOBILE LIABILITY r~l ANY AUTO i'l ALL OWNED AUTOS 0' SCHEDULED AUTOS I I HIRED AUTOS II NON.OWNED AUTOS r-\, . . ' in-.j -----------,- ,n -..- -- i " I_EACH OCCURf~~NC~__j $ i_FIRE DAMAGE (Any One Fire) ! $ fMED EXP (Any One Person) i $ PERSONAL & ADV INJURY ($ GENERAL AGGREGATE 1$ I PRODUCTS.COMPIOP AGG t=--------- 1$ I rp~~~Le;i~)URY-------I~----'---- r' ---------1'------------- BODILY INJURY (Per aCCident) $ 1------------.---- ---1- ---- -- -.-:. -.on --- ." -I P~OPE~TY DAMAGE $ , !' ". ' I I AUTO ONL Y . EA ACCIDENT ! $ I' OT~~RO~~~N EA ACC l~--------- AU AGG 1$ I EACH OCCURRENCE ]$ AGGREGATE 1$ 1$ [$ lS-------- I I WC ~~js.L....lf~~1 : E l ~~~ ACCIDENT i $ . f E L DI~EA~E'EA EMPLOYEE 1:________. E L DISEASE.POLlCY LIMIT 1$ $1,000,000 EACH CLAIM & ANNUAL AGGREGATE COMBINED SINGLE LIMIT (Ea aCCident) I, .", j"-' I GARAGE LIABILITY n ANY AUTO II I EXCESS LIABILITY II OCCUR D CLAIMS ~ADE 6 DEDUCTIBLE II RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHEK A PROFESSIONAL LIABILITY AEPL 1006330 MA Y 1 99 MAY 1 01 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER I ADDITIONAL INSURED, INSURER LEITER CANCELLATION CITY OF PORT ANGELES PO BOX 1150 PORT ANGELES, WA 98362 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL 30 DAYS WRIITEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT Attention: CRAIG KNUTSEN ACORD 25-5 (7197) 1453 25QD5 -, 06-0 1-1V99 ..... DECLARATIONS PAGE MATCH 01058 STATE FARM ".18l. ~ STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY INSURANCE @ 4600 25TH AVENUE NORTH EAST SALEM OR 97313 12 . 11 10 NAMED INSURED POLICY NUMBER 336 1203-E05-47E 01058 47-2225-221Q BONNEY, STUART 95 HEATHER PARK RD PORT ANGELES WA 98362-9449 POLlCYPERIOMAY 03 1999 ToNOV 05 1999 5 3 -2_ 11.1..1..1...11..11....1.11.1...1..1.1..11.1..1.1...1.1...1.11 DO NOT PAY PREMIUMS SHOWN ON THIS PAGE. SEPARATE STATEMENT ENCLOSED IF AMOUNT DUE. -- DESCRIBED YEAR MAKE MODEL VEHICLE 1991 CHEVROLET K2500 COVERAGES (AS DEFINED IN POLICY) SYMBOL-PREMIUM-COVERAGE NAME-LIMITS OF LIABILITY BODY STYLE PICKUP VEHICLE IDENTIFICATION NUMBER 1GCFK24KOMZ208165 CLASS 1HOH401 .4. $231.91 P2 $51.84 0250 $42.54 G500 $76.62 H $3.64 U $34.37 U1 $2.02 BODILY INJURY/PROPERTY DAMAGE LIABILITY LIMIT OF LIABILITY-COVERAGE A 1,000,000 EACH ACCIDENT PERSONAL INJURY PROTECTION (SEE POLICY SCHEDULE FOR LIMITS. $250 DEDUCTIBLE COMPREHENSIVE $500 DEDUCTIBLE COLLISION EMERGENCY ROAD SERVICE UNDERINSURED MOTOR VEHICLE-BODILY INJURY LIMITS OF LIABILITY-U EACH PERSON, EACH ACCIDENT 250,000 500,000 UNDERINSURED MOTOR VEHICLE-PROPERTY DAMAGE LIMITS OF LIABILITY-U1-PROPERTY DAMAGE EACH ACCIDENT $442.94 TOTAL PREMIUM FOR POLICY PERIOD MAY 03 1999 TO NOV 05 1999 $438.06 CURRENT 6 MONTH PREMIUM FOR MAY 05 1999 TO NOV 05 1999 ------------------------------------------------------------------------------ EXCEPTIONS AND ENDORSEMENTS FINANCED- KEY BANK, PO BOX 5794, CINCINNATI OH 45201-5794. 6038HH.1 AMENDMENT OF DEFINED WORDS, MEDICAL PAYMENTS AND PHYSICAL DAMAGE COVERAGES AND CONDITIONS. 6289AT SINGLE LIMIT OF LIABILITY. \.. THIS IS YOUR DECLARATIONS PAGE. AGE NT: RAY G R U V E R PLEASE ATTACH ITTO YOUR AUTO POLICY BOOKLET PHON E: (360) 457-4567 2225 - 486 YOUR POLICY CONSISTS OF THIS PAGE, ANY ENDORSEMENTS, AND THE POLICY BOOKLET, FORM 9847.6 PLEASE KEEP TOGETHER REPLACED POLICY 3361203-470 MUTL VOL 155-4976 STATE ,AIlM &. INWAANCl, State Farm Mutual Automobile Insurance Company 4600 25th Avenue North East Salem OR 97313 12 !<'OLlCY NUMBER 11 10 336 1203-E05-47E 9 STATE FARM INSURANCE COMPANIES AUTO RENEWAL 1991 CHEVROLET K2500 NOV 05 1999 to MAY 05 2000 DATE DUE NOV 05 1999 Coverages and Limits PLEASE PAY THIS AMOUNT $383.10 Premiums I 2212 -2225 A A liability 1,000,000 Bodily Injury & Property Damage 197.75 P2 Personal Injury Protection Includes Medical 25,000 Income Loss 200/wk/1 yr 44.25 D 250 Deductible Comprehensive 36.25 G 500 Deductible Collision 65.25 H Emergency Road Service 3.60 U Undennsured Motor Vehicle Bodily Injury 250,000/500,000 34.00 U1 Underinsured Motor Vehicle Property Damage 2.00 . '$38'3 ;-10- ~ BONNEY STUART 95 HEAtHER PARK RD PORT ANGELES WA 98362-9449 11.1..1..1...11..11....1.11.1...1..1.1..11.1..1.1...1.1...1.11 Your premium is based on the following. . .If not correct, contact your agent. 1991 CHEVROLET K2500 VIN 1 GCFK24KOMZ208165 ClaBB 1 H3H401 Drivers of vehicle in your household... There are no male or unmarried female drivers under age 25. , . - Amount Due -' - -- ---- Your premium has already'been adjuste by the following: // Premium Redu;ctions Multicar Accident Free I \ \, The following list of drivers is sho~n for infor~~tional purposes only and does no~ exte'nd or eX;~d coverage beyond that contained in this automobile policy. Our records indicate the persons listed below are the only licen'sed drivers reported to us: Younger drivers included if rated on another car insured with us. Ordinary use of vehicle... Business. Driven over 12,000 miles annually. 54.96 54.50 Additional Information... This policy expires on the date due if premium is not paid. fO 1I/6111'7 STUART BONNEY, CATHERINE BONNEY. If the above information is inaccurate or incomplete, please contact your agent immediately to make corr ctions. Based on your driving record, you have our accident-free discount for preferred customers. 7kis>~M;~uC~F'" Agent RAY GRUVER Telephone (360)457-4567 or (360)457-4578 See reverse side for important information. Please keep this part for your record. Prepared SEP 30 1999 <i& Identification IF YOU HAVE PAID YOUR PREMIUM, RETAIN THIS PART OF YOUR RENEWAL NOTICE. IN~\JIl"N(:' .. IFYOU HAVE AN ACCIDENT - NOTIFY THE POLICE IMMEDIATELY, and: 1. Wnte down names, addresses, telephone numbers, and license number of persons involved and of witnesses. Also wnte down the license plate number and state of each vehicle involved. 2 Notify your State Farm agent promptly. If you're out of town, call INFORMATION for the telephone number of the nearest State Farm agent or claim office 3. Do not admit fault. Do not discuss the accident with anyone except State Farm or the police. ACCIDENT RECORD RATING PLAN. Applicable to Private Passenger Cars Only Accident-Free Discount - Policyholders without chargeable accidents receive State Farm's lowest accident-free rates A 10%, 15%, or 20% discount applies If your policy has been In force and free of chargeable accidents for at least three, six, or ten years respectively ThiS discount applies as long as the policy remains In force and there are no chargeable accidents. Chargeable accidents are those for which State Farm paid at least $750 ($400 prior to Apnl 1, 1999) or more under property damage liability and Collision coverages combined for-an at fault accident Surcharges - Policyholders with chargeable accidents may lose their accident-free discount and receive accident surcharges If the accident is the first In nine years and the policy has been in force for at least nine years, the accident-free discount will continue and no surcharge will be applied The surcharge for each accident depends upon the number and timing of the accidents. Each surcharge will remain in effect for three years from the renewal date on which It first takes effect. Surcharges will be removed If satisfactory eVidence IS furnished that the dnver Involved IS no longer a member of the household or will not be driving the car In the future. If that driver IS Insured on another State Farm policy, his or her driving record will be conSidered in the rating of the other policy. These discounts and surcharges do not apply to all coverages For complete details of these programs, see your State Farm agent. PREMIUM ADJUSTMENT Comprehensive and colliSIOn rates are based upon State Farm's loss experience. ThiS loss experience IS reviewed periodically to determine which makes and models have earned decreases or Increases from State Farm's standard comprehensive and collision rates. If you carry comprehensive andlor collision coverages, these adjustments are reflected In the rates shown on the front of this renewal notice. if you have any questions, please contact your State Farm agent If any coverage you carry IS changed to give broader protection, Without additional premium, we will give you the broader protection Without the Issuance of a new policy, effective on the date we adopt the broader protection 138-3076 E.1 Rev. 03.1999 (01 a3121 c) . Poi'icy Number 98-C2-4208-2 DECLARATIONS PAGE STATE FARM FIRE AND CASUALTY COMPANY 4600 25TH AV N EAST, SALEM OR 97313-1000 A STOCK COMPANY WITH HOME OFFICES IN BLOOMINGTON, ILLINOIS STAn; 'AI" A INSUIUINCE .. Named Insured and Mailing Address 2313-F486 K BONNEY, STUART DBA OLYMPIC DESIGN WORKS INCPS 809 W 6TH ST PORT ANGELES WA 98363-2116 Cov A -Inflation Coverage Index: N/A BUSINESS POLICY - SPECIAL FORM 3 Cov B - Consumer Pricelndex: 164.5 AUTOMATIC RENEWAL - If the POLICY PERIOD is shown as 12 MONTHS, this policy will be renewed automatically subject to the premiums, rules and forms in effect for each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee/Lienholder written notice in compliance wilH the policy provisions or as required by law. Policy Period: 12 Months The policy penod begins and ends at 12 01 am standard time at the Effective Date: MAR 26 1999 premises location Expiration Date: MAR 26 2000 Named Insured IndiVidual Location of Covered Premises: 809 W 6TH ST PORT ANGELES WA 98363-2116 Coverages & Property Section I A BUildings B Business Personal Property C Loss of Income Limits of Insurance Occupancy: Offlce Excluded $ 20,000 $ Actual loss Section II L Business liability M Medical Payments Products-Completed Operations (PCO) Aggregate General Aggregate (Other Than PCO) Deductibles - Section I I 1,000,000 5,000 2,000,000 2,000,000 $ 500 Basic $ In case of loss under this policy, the deductible will be applied to each occurrence and will be deducted from the amount of the loss. Other deductibles may apply - refer to policy. POLICY PREMIUM $ 208.00-' Forms, Options, and Endorsements Special Form 3 WA Amendatory Endorsement Special Form 3 Endorsement Policy Endorsement Amendatory Collapse Debns Removal Endorsement Policy Endorsement FP-6103 FE-62471 FE-6500 FE-6464 FE-6551 FE-6451 FE-6503 Agent (r>1f2172b\ Policy Number 98-C2-4208-2 CONTINUED FROM FRONT SIDE BUSINESS POLICY - SPECIAL FORM 3 Forms,OPtions,l..and Endorsements Domestic Abuse t:.ndorsement Glass Deductible Deletion Prepared APR 13 1999 FE-6562 FE-6538.1 _...---2~,;,-~1' 99 \fED 1-1: U3 J-H 125391.Ii695 --I " STATE FARM WA FIRE ~UU~ KMS PolICY No 9B-C2-4208-~ F~2A (7/BB) ..,." ,..... A ~DDITIONAL INSURED ENDORSEMENT (>wners, Lessees or Contractors (Form B) 11U.....C\ Polky No.: SlB-C2-4208-:2 Named Insured: BONNEY, STUART DEA OLTIrPIC DESIGN WORKS INC PS Name of Person or Organizatlt In: CITY OF PORT ANGELES PO BOX J.l50 PORT ANGELES WA 98362 WHO IS AN INSURED. under ~ ;ECTION II DESIGNATION OF INSURED. is amended to inclu Ie as an insured the person or organization show 1 above. but only with respect to liability arising out of your WOlle for that insured by or for you ,t FE~324 I'IU) Prlme.:1ln USA