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Home My WebLink About5.1012 Original ContractHOLD HARMLESS AND INDEMNITY AGREEMENT FOR USE OF PREMISES RECEIVED APR 5 2010 PORT ANGELES LEGAL DEPARTMENT This Agreement is made this 30t day of March, 2010 between the City of Port Angeles, Washington, a municipal corporation, hereafter "City," and Morningside Industries, a Washington corporation, hereafter "Morningside" by and through their authorized representatives. The City owns Ocean View Cemetery, located at 3127 West 18 Street, Port Angeles, Washington (hereafter, "the Premises Morningside desires to use the Premises for a client assessment on approximately April 5 th 9th, 2010. In consideration of the use of the Premises, Morningside agrees to defend, hold harmless, and indemnify the City, and its officials, employees, and agents from any and all injuries, claims, losses, and/or damages arising out of, or in any way connected with, the activities of Morningside or its client on said Premises. I \Fo ms\Mommgside Hold Harmless\Mommgside Hold Harmless 033010wpd wpd Morningside Industries By.��.��I!U Title LEGAL DEPARTMENT DATE: April 6, 2010 William E. Bloor City Attorney To: Janessa Hurd, City Clerk [4531] FROM: William E. Bloor, City Attorney Dennis Dickson Sr. Assistant City RE: Hold Harmless and Indemnity Agreement Attorney [4532] Heidi L. Greenwood Assistant City Attorney [4562] Diana Lusby Legal Administrative Assistant [4536] Jeanie DeFrang Legal Administrative Assistant [4536] Randi Mahlum Legal Records Specialist [4576] Holly Moore Legal Administrative Assistant [4530] W A S H I N G T O N poR NGEL ES U.S.A. Hi Janessa, Attached for your records is the original of a Hold Harmless and Indemnity Agreement for Use of Premises signed by Morningside Industries. William E. Bloor City Attorney cc: Corey Delikat, Streets Parks Superintendent Attachment WEB:di G \LEGAL\MEMOSVMEMOS 2010 \Clerk Onginals 021210 Hurd wpd 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 THIS CERTIFICATE OF INSURANCE DOES NOT CONSITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed If 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) 1 PRODUCER I COMPANIES AFFORDING COVERAGE CANFIELD ASSOCIATES 451 DIAMOND DRIVE EPHRATA, WASHINGTON 98823 PHONE (509) 754 -2027 FAX (509) 754 -3406 INSURED Morningside P.O. Box 7936 Olympia, WA 98501 TYPE OF INSURANCE POLICY NUMBER POLICY EFF DATE 1 GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY N 1- A2 -RL- 0000013 -03 06/01/2011 '06/01/2012 OCCURRENCE FORM INCLUDES STOP GAP (LIABILITY IS SUBJECT TO A $25,000 SIR PAYABLE FROM POOL FUNDS) I AUTOMOBILE LIABILITY ANY AUTO N1- A2- RL- 0000013 -03 06/01/2011 (LIABILITY IS SUBJECT TO A 25,000 SIR PAYABLE FROM POOL FUNDS) 1 PROPERTY City of Port Angeles PO Box 1150 Port Angeles, WA 98362 2518632 Non Profit Insurance Program CERTIFICATE OF INSURANCE ISSUE DATE: 05/1712011 N1- A2 -RL- 0000013 -03 06/01/2011 06/01/2012 (PROPERTY IS SUBJECT TO A 25,000 SIR PAYABLE FROM POOL FUNDS) MISCELLANEOUS PROFESSIONAL LIABILITY 06/01/2011 06/01/2012 (LIABILITY IS SUBJECT TO A SIR PAYABLE FROM POOL FUNDS) 1 DESCRIPTION OF OPERATIONS] LOCATIONS I VEHICLES I SPECIAL ITEMS GENERAL LIABILITY American Alternative Insurance Corporation AUTOMOBILE LIABILITY American Alternative Insurance Corporation PROPERTY American Alternative Insurance Corporation MISCELLANEOUS PROFESSIONAL LIABILITY 1 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, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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 POLICY EXP DESCRIPTION DATE 06/01/2012 PER OCCURRENCE PER MEMBER AGGREGATE PRODUCT COMP /OP PERSONAL ADV INJURY ANNUAL POOL AGGREGATE COMBINED SINGLE LIMIT ANNUAL POOL AGGREGATE ALL RISK PER OCC EXCL EQ FL EARTHQUAKE PER OCC FLOOD PER OCC ANNUAL POOL AGGREGATE PER CLAIM ANNUAL POOL AGGREGATE Regarding Cleaning Services. City of Port Angeles is named as Additional Insured regarding these services only and is subject to policy terms, conditions and exclusions Additional Insured endorsement is attached. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS CERTIFICATE HOLDER 1 AUTHORIZED REPRESENTATIVE Morn8 5jO12. LIMITS $5,000,000 $10,000,000 $5,000,000 $5,000,000 $50,000,000 $5,000,000 NONE $50,000,000 $3,000,000 EXCLUDED NONF POLICY NUMBER: N1- A2 -RL- 0000013 -03 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under th i following: SCHEDULE COMMERCIAL GENERAL LIABILITY COVERAGE PART Name Of Additional Insured Person(s) Or Organizations) City of Port Angeles PO Box 1150 Port Angeles, WA 98362 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II Who Is An Insured is amended to in- clude as an additional insured the person(s) or organi- zation(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 2518632 I ISO Properties, Inc., 2004 Page 1 of 1