HomeMy WebLinkAbout5.1118 Original ContractAGREEMENT FOR PROFESSIONAL SERVICES
BETWEEN THE
THE CITY OF PORT ANGELES
AND
NORTHWESTERN TERRITORIES, INC.
PROJECT WW 03 -2010
RELATING TO: CONSTRUCTION MANAGEMENT SERVICES
THIS AGREEMENT is made and entered into this day of 4 1 -C::""•— a.,/ y
2011, by and between THE CITY OF PORT ANGELES, a non charter code city of the State of
Washington, (hereinafter called the "CITY and NORTHWESTERN TERRITORIES, INC., a
Washington Corporation authorized to do business in the state of Washington (hereinafter
called the "CONSULTANT
WHEREAS, the CITY desires construction management services for the First Street
Stormwater Separation, Project WW 03 -2010; and
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 of the
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
appropriate facilities necessary to accomplish the work;
NOW, THEREFORE, in consideration of the above representations and the terrhs, conditions,
covenants, and agreements set forth below, the parties hereto agree as follows:
I SCOPE OF WORK
2011 Northwestern Territories. Inc., Agreement, Project WW 03 -2010
Page 1 of 7
040-14.-
5,i116
The scope of professional services to be performed for Tasks 1 -3 and the results to be
achieved by the CONSULTANT shall be as detailed in the attached Exhibit A and shall include
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 XII of this Agreement.
The CONSULTANT agrees that all services performed under this Agreement shall be in
accordance with the standards of the engineering profession and in compliance with applicable
federal, state and local laws.
The Scope of Work may be amended upon written 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 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.
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 the
duration of the Agreement shall extend through September 30, 2011. The work shall be
completed in accordance with the schedule set forth in the attached Exhibit D.
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 CONSULTANT'S direct non -salary reimbursable costs as set forth in the
attached Exhibit B.
1. Labor costs shall be based on the hourly rates shown in Exhibit C. Hourly rates shall be
based upon an individual's hourly wage, times the total number of hours worked, times
a multiplier of 1.0. The multiplier shall include overhead, CADD, computer and profit.
General clerical time shall be considered an overhead item, except where specific
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,
reproduction and printing, supplies and fees of outside services and consultants. No
overhead and profit may be added to direct non -salary reimbursable costs.
2011 Northwestern Territories Inc Agreement, Project WW 03 -2010
Page 2 of 7
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 specific task 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 be withheld from payment.
E. Final payment for the balance due to the CONSULTANT will be made after the completion
of the work and acceptance by the CITY.
F. Payment for "Extra Work" performed under Section XII 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 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 $136,513.00. The budget
for Tasks 1 -4 are as set forth in the attached Exhibit B.
VII INDEPENDENT CONTRACTOR STATUS
The relation created by this Contract is that of owner independent contractor. The Contractor
is not an employee of the City and is not entitled to the benefits provided by the City to its
employees. The Contractor, as an independent contractor, has the authority to control and
direct the performance of the details of the services to be provided. The Contractor shall
assume full responsibility for payment of all Federal, State, and local taxes or contributions
imposed or required, including, but not limited to, unemployment insurance, Social Security,
and income tax.
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.
In performing this Agreement, the CONSULTANT shall not employ or contract with any CITY
employee without the City's written consent.
2011 Northwestern Territories Inc Agreement, Project WW 03 -2010
Page 3 of 7
IX NONDISCRIMINATION
The CONSULTANT shall conduct its business in a manner, 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.
X 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. 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 subconsultant or supplier shall be notified by the
CONSULTANT of Consultant's obligations under this Agreement, including the
nondiscrimination requirements.
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 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 bjr both parties.
XII 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.
XIII TERMINATION OF AGREEMENT
2011 Northwestern Territories. Inc Agreement, Project WW 03 -2010
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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.
B. In 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 percentage of work
completed.
C. In the event this Agreement is terminated prior 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 prior to transmittal of final payment to the CONSULTANT.
XIV INDEMNIFICATION /HOLD HARMLESS
The CONSULTANT agrees to indemnify the CITY from any claims, damages, losses, and
costs, including, but not limited to, 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 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, 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, 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 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
4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or
damages to property caused by or resulting from the concurrent negligence of the
CONSULTANT, the CITY, and the officers, officials, employees, and volunteers of either, the
CONSULTANT'S liability 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 Industrial Insurance, 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 rights as a
third person set forth in RCW 51.24.035.
2011 Northwestern Territories. Inc., Agreement, Project WW 03 -2010
Page 5 of 7
XV 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 arise 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 Liability insurance with limits no less than $1,000,000 combined single limit per
accident for bodily injury and property damage; and,
2. Commercial General Liability insurance written 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 Liability insurance with limits no less than $1,000,000 per claim.
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 right to review a certified copy of all required
insurance policies in the CONSULTANT's office.
The CONSULTANT'S insurance shall contain a clause stating that coverage shall apply
separately to each insured against whom claim is made or suit is brought, except with respects
to the limits of the insurer's liability.
The CONSULTANT'S insurance shall be primary insurance as respects the CITY, and the
CITY shall be given thirty (30) days prior written notice of any cancellation, suspension or
material change in coverage Consultant's insurer will provide notification of a cancellation in
coverage, and Consultant will provide notification of any material change.
XVI 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.
2011 Northwestern Territories. Inc Agreement, Project WW 03 -2010
Page 6 of 7
XVII 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 Budget for Each Task
Exhibit C Consultant Labor Costs and Non -salary Reimbursable Costs
Exhibit D Schedule for the Work
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and
year first written above.
CITY OF PORT ANGELES
CITY MANAGE
CONSULTANT
T U A- 7
TITLE:CoriO, Sec- /Tr.ea -er
2011 Northwestern Territories Inc., Agreement, Project WW 03 -2010
Page 7 of 7
APPROVED AS TO FORM:
b.-1'1111 lit CK-Sc A SQ. A-ss'T CITY i ry
ATTEST:
C-
A SSA HURD, CITY CLERK
PROJECT ABSTRACT
EXHIBIT "A"
SCOPE OF WORK
FIRST STREET STORM WATER SEPARATION
CONSTRUCTION MANAGEMENT
PROJECT WW 03 -2010
This project will install a 24" diameter storm drain pipeline and appurtences to collect,
treat and dispose of the storm drainage along First Street between Lincoln and Valley
Streets that is now directed into the sanitary sewer system. The project will include the
removal of pavement; excavation of trenches; installation of pipes, catch basins,
manholes and treatment facilities; backfilling of trenches, re- construction of the roadway
base and installation of a new asphalt roadway surface on the south half of First Street.
Additionally, the north half of First Street will have grade adjustment and asphalt
resurfacing. All restored pavement will have new striping including parking stalls, lane
markings and crosswalks.
SCOPE OF CONSTRUCTION MANAGEMENT WORK
The scope of Construction Management of this project is summed up in three following
goals:
Ensuring that the Contractor provides the product that the Owner is anticipating
in a manner that is sensitive to the needs of all parties.
Communicating with the Contractor, the Owner and the affected public to ensure
that unanticipated consequences are minimized and that all responses are
prompt.
Preparing and maintaining project documentation to ensure that all local, state
and federal audit trails are properly documented. This shall include all prevailing
wage compliance, Davis -Bacon compliance, format of all scope of work
documents, pay requests and any other documentation process needed for the
project's compliance.
The Project Team has been structured to provide not only technical chains of command
but also to provide communication channels for all parties to ensure that information is
passed on quickly and accurately. This is especially needed with the creation of dual
inspection teams to adequately service the anticipated long, over -night construction
schedule.
The construction management functions include the following three tasks:
1
TASK 1 PRE CONSTRUCTION /MOBALIZATION
Hold preconstruction meeting and follow through
Meet with the property owners tenants to begin the liaison
process
Implement the project's Traffic Control Plan
Initiate weekly project meeting to begin all needed
coordination activities
Initiate document control program to coordinate flow of
information between Contractor, Engineering Consultant,
City Project Manager, and Construction Manager
Coordinate Contractor submittals with Engineering
Consultant
TASK 2 CONSTRUCTION MANAGEMENT ACTIVITIES
Daily construction inspection in two overlapping one -man
shifts when needed and one one -man shift when possible.
Ensure that the project makes the conversion from
Commercial to Construction in the afternoon and from
Construction to Commercial in the morning
Weekly project meetings to ensure open communication
channels from the Contractor to the City and property
owners through the Construction Management team
Insure materials testing including both laboratory and field
tests for compliance with the specifications
Weekly tally of the project's materials and quantities
Weekly assessment of the project's state of completion with
project schedule updates and milestone achievements.
Weekly financial reporting on the state of the Construction
Management budget
Monthly project pay estimate processing
Tracking of the progress of the project construction elements
Tracking the project cost
Processing of RFI's and field orders as required
2
Record keeping of inspections, materials submittals, RFI's,
Field Orders, and other project related reports
TASK 3 PROJECT CLOSE OUT ACTIVITIES
Process the final monthly project pay estimate
Perform a project documentation audit
PROJECT DELIVERABLES
Various deliverable items will be provided by the Consultant to the City of Port Angeles.
This list includes but is not limited to the following:
Daily inspection reports for both 1 2 nd inspection shifts
Inspection reports for both laboratory and field testing if
needed
Inspection reports of "as needed" Geo- technical and /or
Structural inspections
Weekly construction progress meetings and minutes
Weekly construction management budget report
Monthly pay- estimate processing for Contractor payment.
Request For Information (RFI) Change Order (CO)
processing correspondence coordination.
Bound RFI and CO report/log booklet with all related
correspondence
Bound end -of -job inspection report/log booklet with all
inspection reports and testing results
Coordination of the preparation of Record Drawings
(as- builts).
3
Task
Nos
I NTI
Tasks IWho IMan Hrs IRate 'Cost
I I I
I I I
11PRECONSTRUCTION /MOBALIZATION I l
1 11 -A Pre Bid /Bid /Pre Construct Prol Mgr I 24! $95 00
Task 1 -A Sub Total
1 -B Startup
Task 1 -B Sub Total
TASK 1 TOTAL
2 -A Construction Daily
Feb 14,2011
Monday Thursday
2 man crew for 8 wks
1 man crew alt for 12 wks
Daily Sub Total
Number of Work Days
Daily Sub Total
Laboratory Allowance
2 hrs per day for 48 days
Laboratory subtotal
2 -A Sub Total
2 -B Construction Weekly
Friday meetings
Inspector 8 $80 00
Liason 8 $80 00
Geo -Tech 8 $90 00
Document 4 $90 00
Prot Mgr
Inspector
Liason
Geo -Tech
Structural
Document
Prot Mgr
Lead Insp
Liason
Geo -Tech
Structural
Document
Pay /COIRFI
8
8
8
8
0
4
1
7
05
0
0
1
05
$95 00
$80 00
$80 00
$90 00
$90 00
$90 00
$95 00
$75 00
$80 00
$90 00
$90 00
$90 00
$90 00
Lab Testing 4 $700 00
Field Testing 96 $80 00
Prot Mgr 1 $95 00
Lead Insp 4 $75 00
Liason 0 $80 00
Geo -Tech 0 $90 00
Structural 0 $90 00
Document 0 $90 00
Pay /CO /RFI 0 5 $90 00
CONSULTANT LABOR COSTS
FIRST STREET STORMWATER SEPARATION
CONSTRUCTION MANAGEMENT
PROJECT WW 03 -2010
I Zenovic
IWho
$2,280 00 'Assist PM
$640 00 I Inspector
$640 00 ILiason
$720 00 IGeo-Tech
$360 00 !Document
$4,640.00 1
$760 00 'Assist PM
$640 00 I Inspector
$640 00 I Liason
$720 00 I Geo -Tech
$0 00 'Structural
$360 00 I Document
$3,120.00 I
$7,760.00 I
$95 00
$525 00
$40 00
$0 00
$0 00
$90 00
$45 00
$795.00
48
$38,160.00
Assist PM
Assist Insp
Liason
Geo -Tech
Structural
Document
Pay /CO /RFI
$2,800 00 Lab Testing
$7,680 00 Field Testing
$10,480.00 I
$48,640.00 I
$95 00 'Assist PM
$300 00 'Assist Insp
$0 00 I Liason
$0 00 IGeo -Tech
$000 !Structural
$0 00 !Document
$45 00 I Pay /CO /RFI
EXHIBIT B
IMan Hrs
Rate
16 $95 00
8 $80 00
O $80 00
O $90 00
4 $90 00
8 $95 00
8 $80 00
0 $80 00
O $90 00
O $90 00
4 $90 00
0 5 $95 00
7 $75 00
n/a $80 00
0 $90 00
0 $90 00
1 $90 00
0 5 $90 00
O 0
0 0
0 5 $95 00
4 $75 00
0 $80 00
O $90 00
0 $90 00
O $90 00
0 5 $90 00
I Exeltech
Cost IWho
1
$1,520 00 !Assist PM
$640 00 !Inspector
$0 00 I Liason
$0 00 I Geo -Tech
$360 00 I Doucment
$2,520.00 1
$760 00 'Assist PM
$640 00 'Inspector
$0 00 I Llason
$0 00 I Geo -Tech
$0 00 1 Structural
$360 00 'Document
$1,760.00 I
$4,280.00
$47 50 !Assist PM
$525 00 'Inspection
$80 00 I Liason
$0 00 Geo -Tech
$0 00 1Structural
$90 00 Document
$45 00 Pay /CO /RFI
$787.50
48
$37,800.00
$0 00 Lab Testing
$0 00 Field Testing
$0.00
$39,423.00
$47 50 Assist PM
$300 00 Inspection
$0 00 Liason
$0 00 I Geo -Tech
$0 00 1 Structural
$0 00 !Document
$45 00 I Pay /CO /RFI
IMan Hrs
8
0
0
0
8
4
0
0
0
0
8
Rate
$95 00
$80 00
$80 00
$90 00
$90 00
$95 00
$80 00
$80 00
$90 00
$90 00
$90 00
2 (CONSTRUCTION MANAGEMENT I I I I I
0 5 $95 00
0 $75 00
0 $80 00
0 $90 00
O $90 00
1 $90 00
0 5 $90 00
O 0
of 0
0 5 $95 00
O $75 00
0 $80 00
0! $90 00
01 $90 00
0 51 $90 00
01 $90 00
Cost
$760 00
$0 00
$0 00
$0 00
$720 00
$1,480 00
$380 00
$0 00
$0 00
$0 00
$0 00
$720 00
$1,100 00
$2,580.00
$47 50
$0 00
$0 00
$0 00
$0 00
$90 00
$45 00
$182.50
20
$3,650.00
$0 00
$0 00
$0.00
$4,035.00
$47 50
$0 00
$0 00
$0 00
$0 00
$45 00
$0 00
Total Team
Coat 1 of total I
$4,560 00
$1,280 00
$640 00
$720 00
$1,440 00
$8,640.00
$1,900 00
$1,280 00
$640 00
$720 00
$0 00
$1,440 00
$5,980 00
$14,620.00 I
$190 00 I
$1,050 00
$120 00 I
$0 00 I
$0 00 I
$270 00 1
$135 00 I
$1,765 00
$79,610.00
$2,800 00
$7,680 00
$10,480 00
$92,098.00
$190 00
$600 00
$0 00
$0 00
$0 00
$45 00
$90 00
10.7%
Daily Sub Total
Number of Work Days
2 -B Sub Total
2 -C Construction Monthly
Feb, Mar Apr May
Last Friday of Month
Daily Sub Total
Number of Pay Estimates
2 -C Sub Total
TASK 2 TOTAL
PROJECT CLOSEOUT ACT
Protect Close -Out
Jun 30, 2011
Last pay estmate, etc
TASK 3 TOTAL
I Project Total
!Project Percentage
Prot Mar
Inspector
Liason
Geo -Tech
Structural
Document
Pay/CO/RFI
VITIES
Proi Mgr
Inspector
Liason
Geo -Tech
Structural
Document
Pav /CO /RFI
4 $95 00
4 $80 00
O $80 00
0 $90 00
O $90 00
1 $90 00
1 $90 00
$440.00 I
161
$7,040.00 I
1
$380 00 (Assist PM
$320 00 'Inspector
$0 00 Liason
$0 00 (Geo -Tech
$0 00 'Structural
$90 00 I Document
$90 00 I Pav /CO /RFI
$880.00 I
3 1
$2,640.00 I
8 $95 00 $760 00 'Assist PM
8 $80 00 $640 00 'Inspector
2 $80 00 $160 00 I Liason
O $90 00 $0 00 I Geo -Tech
0 $90 00 $0 00 'Structural
2 $90 00 $180 00 IDocument
2 $90 00 $180 00 I Pay /CO /RFI
$1,920 00 I
$68,000.00
498%
2 $95 00
4 $80 00
0 $80 00
O $90 00
O $90 00
2 $90 00
6 $90 00
$58,320.00 $49,393.00
$392.50 I
161
$6,280.00 I
1
$190 00 'Assist PM
$320 00 I Inspector
$0 00 I Liason
$0 00 (Geo -Tech
$0 00 'Structural
$180 00' Document
$540 00 (Pav /CO /RFI
$1,230.00 I
31
$3,690.00 I
1 $95 00
O $80 00
0 $80 00
O $90 00
o I $90 00
61 $90 00
21 $90 00
$92.50 I
161
$1,480 00 I
$95 00
$0 00
$0 00
$0 00
$0 00
$540 00
$180 00
$815.00
3
$2,445.00
$7,960.00
8 $95 00 I $760 00 'Assist PM 41 $95 00 $380 00
8 $80 00 I $640 00 [Inspector 01 $80 00 $0 00
O $80 00 1 $0 00 I Liason 0 I $80 00 $0 00
O $90 00 1 $0 00 I Geo -Tech 01 $90 00 $0 00
O $90 00 1 $0 00 'Structural 01 $90 00 $0 00
4 $90 00 $360 00 'Document 81 $90 00 $720 00
8 $90 00 I $720 00 I Pay /CO /RFI 81 $90 00 $720 00
$2,480.00 I I $1,820 00
1
1
$56,153.00 I I $12,360.00
I 41.1 %1 I I 9.1%1
$925 00
$14.800.00
$665 00
$640 00
$0 00
$0 00
$0 00
$810 00
$810 00
$2,925 00
$8,775.00
$115,673.00
84.7%
$1,900 00
$1,280 00
$160 00
$0 00
$0 00
$1,260 00
$1,620 00
$6,220.00 1 4.6%
$136,513.00 100.0 %I
1000%
EXHIBIT C
CONSULTANT LABOR COSTS AND NON SALARY REIMBURSABLE COSTS
(Northwestern Territories, Inc., Expense Rate Schedule Attached)
EXHIBIT C CONTINUED
Nri
r mn n
TIME- PLUS EXPENSE RATE SCHEDULE AND BILLING PROCEDURES
ENGINEERING AND LAND SURVEYING HOURLY RATE
EFFECTIVE JANUARY 1 SUBJECT TO REVISION
cr 1.raion, 1 701/1 vin^
NTI ENGINEERING LAND SURVEYING
717 SOUTH DEABODY STREET. PORT ANGELES. WA 98362
Engineers Land Surveyors Geologists
Construction Inspection Materials Testing
(360% 452.8491 FAX A52-8 •ww ntiAd cam -4121 •r.fcrena"u _cm
PRINCIPAL ENGINEER OR SURVEYOR. S95 00
GEOLOGIST, PROJECT ENGINEER OR PROJECT SURVEYOR $90 00
SENIOR TECH OFFICE OR LAB S75 00
SENIOR TECH FIELD INSPECTOR WITH EQUIPMENT (INCLUDES MILEAGE) $80 00
TECHNICIAN 565 00
TECHNICAL ASSISTANT. $40 00
LAND SURVEYING 1- PERSON FIELD CREW. $110.00
LAND SURVEYING 2- PERSON FIELD CREW 5140 00
LAND SURVEYING 3- PERSON FIELD CREW $175.00
CONSTRUCTION SURVEYING 2- PERSON FIELD CREW $150.00
CONSTRUCTION SURVEYING 3- PERSON FIELD CREW.. $185.00
COURT TESTIMONY DEPOSITIONS $175.00
1 Unless otherwise noted, hourly rates include materials, equipment and vehicular mileage
2 Minimum charge for professional services is one hour for office consultation, two hours for field consultation,
and four hours for court testimony
3. Work in excess of eight hours and Saturdays is to be billed at time and one -half; Sunday and Holidays at
double time. Travel in excess of eight hours will be billed at regular full time hourly rates listed above.
Non -salary reimbursable expenses will include the following items
a. Items outside of general overhead costs, such as special lecal and accounting expenses, special
consultants, backhoe services, laboratory charges. special copying services and printing and binding
at 10% above actual cost.
b Government fees directly related to the project such as County survey recording fees and agency
review fees
c
Out-of-town travel and living expenses related to the project. Travel time shall be hourly per rates
listed above
MATERIALS TESTING LABORATORY SERVICES (Per item tests include all laboratory labor unless noted)
CONCRETE, MORTAR OR GROUT COMPRESSION TEST 30 00 Each
-For each cylinder logged into the lab break or not.
Includes curing, testing and reporting of specimens
CONCRETE CYLINDER MOLD CAST BY OTHERS ADDED CHARGE S 5 00 Each
DRY GRADATION (SIEVE) ANALYSIS (ASTM C -33 and C -136). S 75 00 Each
WET GRADATION (SIEVE) ANALYSIS (ASTM C -117 and C -136) 150 00 Each
SAND EQUIVALENT (AASHTO D -4313 and ASTM D -2419) 100,00 Each
PROCTOR (SOIL MOISTURE- DENSITY, ASTM D-698 or ASTM 0 -1557) S 300 00 Each
LABORATORY TIME AFTER HOURS (3 HR MINIMUM) S 100 00 Hour
SAME DAY CALL-IN FOR INSPECTION OR TEST (If an inspector is available) S 25 00 Charge
NOTE Samples that require extra processing prier to testing or require the testing of a large amount of sample (i e
performing save analysis on material with large particle sizes) will be billed at an hourly rate
I Begin CM Contract
I Preconstruction Conference
Construction Startup
Construction Project Substantial Completion
Construction Project Physical Completion
CM Closeout
EXHIBIT D
SCHEDULE FOR THE WORK
7 February, 2011
Week of 7 February, 2011
I February 22, 2011
June 30, 2011
July 31, 2011
September 30, 2011
1
1
PRODUCER (360)452 -2314 FAX (360)452 -1701
Callis Associates, Inc
806 So Vine St
Port Angeles, WA 98362
Andy Callis
INSURED ]LS Group, Inc.
dba Northwestern Territories Inc.
717 S Peabody St
Port Angeles, WA 98362
HU IL,CK I Irui., I G Ur LIHCSI L I 1 T INOUKHIVI.0 I 02/17/2011
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.
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 %OD'
A
A
TYPE OF INSURANCE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER
POLICY n PRO 1]
JECT f I
AUTOMOBILE LIABILITY
X
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
GARAGE LIABILITY
ANY AUTO
EXCESS /UMBRELLA LIABILITY
I OCCUR n CLAIMS MADE
DEDUCTIBLE
RETENTION
XIXd XIVO IXXXX% XXrXXXX
EMPLOYERS' LIABILITY
A ANY PROPRIETOR/PARTNER /EXECUTIVE
OFFICER/MEMBER EXCLUDED'?
If yes, descnbe under
SPECIAL PROVISIONS below
OTHER
Evidence Only.
lefer to Policy for all applicable terms,
CERTIFICATE HOLDER
LOC
City of Port Angeles
321 East 5th Street
Port Angeles, WA 98362
POLICY NUMBER
C25 10 -17 -32
INSURERS AFFORDING COVERAGE
INSURER A
INSURER B
INSURER C
INSURER D
INSURER E
POLICY EFFECTIVE POLICY EXPIRATION
nATF (MM /M/YY) DATF (MM /l)ILYY)
12/21/2010 12/21/2011 EACH OCCURRENCE
C25 10 -17 -32 12/21/2010 12/21/2011
North Pacific Insurance Co.
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
AUTO ONLY EA ACCIDENT
OTHER THAN
AUTO ONLY
EACH OCCURRENCE
AGGREGATE
conditions, endorsements and exclusions.
LIMITS
DAMAGE TO RENTED
PRFMI.SFS (F=
MED EXP (Any one person)
PERSONAL ADV INJURY
GENERAL AGGREGATE
PRODUCTS COMP /OP AGG
EA ACC
AGG
C25 10 -17 -32 12/21/2010 12/21/2011 I WCSTATU- I X I OTH-
TORY LIMITS ER
WA STATE STOP GAP E L EACH ACCIDENT
E L DISEASE EA EMPLOYE
E L DISEASE POLICY LIMIT
NAIC
41939
1,000,000
100,000
5,000
1,000,000
2,000,000
2,000,000
1,000,000
1,000,000
1,000,000
1,000,000
DESCRIPTION QF QPERATIONS I LOCATIONS VEHICLES EJ(CI,USIONS AQDED BY ENDORSEMENT SPECIAL PROVISIONS
The Certificate Holder is an additional insured with respect to the General Liability as required by
Nritten contract per the terms of form: GL Master Pak 8416 Blanket Additional Insured.
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Andy Callis /ANDY
ACORD 25 (2001/08) ACORD CORPORATION 1988
ACORD 25 (2001/08)
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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.
CG 841612 03
E 600 00
COMMERCIAL GENERAL LIABILITY
CG 841612 03
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
GENERAL LIABILITY MASTER PAK PLUS®
FOR CONSTRUCTION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
INDEX
Subig Page,
Blanket Additional Insured (Owners, Lessees or Contractors) 2
Fire, Lightning, Explosion and Sprinkler Leakage Damage to Premises You Rent 3
Non -Owned Watercraft 4
Supplementary Payments (Bail Bonds) 4
Personal And Advertising Injury Electronic Publication Extension 5
Aggregate Limits (Per Location) 5
Aggregate Limits (Per Project) 5
Voluntary Property Damage Coverage 6
Off Premises Care, Custody or Control Coverage 6
Newly Formed or Acquired Organizations 7
Duties in the Event of Occurrence, Offense, Claim or Suit 7
Bodily Injury (Mental Anguish) 8
Waiver of Transfer of Rights of Recovery Against Others 8
Medical Payments 8
Broad Named Insured 8
Broadened Mobile Equipment 8
Incidental Malpractice Liability 8
Non -Owned Aircraft 9
Property Damage Elevators 9
Includes copyrighted material of ISO Properties, Inc., with its permission Page 1 of 9
1. BLANKET ADDITIONAL INSURED (Owners, Lessees Or Contractors)
(Includes a Primary/Non- Contributory provision)
Section II Who Is An Insured is amended to include as an insured any person or organization whom
you are required to name as an additional insured on this policy in a written contract or written
agreement. The written contract or written agreement must be currently in effect or becoming effective
during the term of this policy and executed prior to the "bodily injury," "property damage" or "personal
and advertising injury."
The insurance provided the additional insured is limited as follows:
A. The person or organization is only an additional insured with respect to liability
1. Arising out of real property, as described in a written contract or written agreement, that you
own, rent, lease or occupy; or
2. Caused by your ongoing operations performed for the additional insured.
The insurance provided the additional insured in 1.A.2. above does not apply to:
a. Coverage A Bodily Injury and Property Damage Liability, Coverage B Personal and
Advertising Injury Liability or defense coverage under the Supplementary Payments
arising out of an architect's, engineer's or surveyor's rendering of or failure to render any
professional services including:
(1) The preparing, approving, or failing to prepare or approve maps, shop drawings,
opinions, reports, surveys, field orders, change orders or drawings and specifications;
and
All work, including materials, parts or equipment furnished in connection with such work,
on the project (other than service, maintenance or repairs) that was performed by or on
behalf of the additional insured(s) at the site where the covered operations have been
completed; or
(2) 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
subcontractor engaged in performing operations for a principal as part of the same
project.
B. The limits of insurance applicable to the additional insured are those specified in a written contract or
written agreement or the limits of Insurance as stated in the Declarations of this policy and defined in
Section III Limits Of Insurance of this policy, whichever are less. These limits are inclusive of and
not in addition to the limits of insurance available under this policy.
C. The insurance provided the additional insured does not apply to the liability resulting from the sole
negligence of the additional insured.
CG 841612 03
E 601 00
(2) Supervisory, inspection, architectural or engineering activities
b. "Bodily injury" or "property damage" occurring after:
(1)
Includes copyrighted material of ISO Properties, Inc., with its permission. Page 2 of 9
D. As respects the coverage provided to the additional insured under this endorsement, Section IV-
Conditions is amended as follows:
1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim, or
Suit:
CG 841612 03
E 602 00
An additional insured under this endorsement will as soon as practicable:
a. Give written notice of an "occurrence" or an offense, that may result in a claim or "suit" under
this insurance to us;
b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have
insurance available to the additional insured; and
c. Agree to make available any other insurance which the additional insured has for a loss we
cover under this Coverage Part.
2. The following is added to Condition 3. Legal Action Against Us:
We have no duty to defend or indemnify an additional insured under this endorsement until we
receive written notice of a claim or "suit" from the additional insured.
3. The following is added to Paragraph a., Primary Insurance of Condition 4. Other Insurance:
If the additional insured's policy has an Other Insurance provision making its policy excess, and
a Named Insured has 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.
4. The following is added to Paragraph b., Excess Insurance of Condition 4. Other Insurance:
Except as provided in Paragraph 4.a. Primary Insurance as amended above, any coverage
provided hereunder shall be excess over any other valid and collectible insurance available to
the additional insured whether primary, excess, contingent or on any other basis In the event an
additional insured has other coverage available for an "occurrence" by virtue of also being an
additional insured on other policies, this insurance is excess over those other policies.
2. FIRE, LIGHTNING, EXPLOSION AND SPRINKLER LEAKAGE DAMAGE TO PREMISES YOU RENT
If Damage To Premises Rented To You under Coverage A is not otherwise excluded from this policy,
the following applies.
A. The last paragraph of 2. Exclusions of Section I Coverage A is replaced by the following:
If Damage To Premises Rented To You is not otherwise excluded, Exclusions c. through n. do
not apply to damage by fire, lightning, "explosion" or sprinkler leakage to premises while rented to
you or temporarily occupied by you with permission of the owner A separate limit of insurance
applies to this coverage as described in Section III Limits Of Insurance.
B. Paragraph 6. of Section III Limits Of Insurance is replaced by the following:
6. Subject to 5. above, the higher of $300,000 or the Damage To Premises Rented To You Limit
shown in the Summary of Limits and Charges section of this policy is the most we will pay under
Coverage A for damages because of "property damage" to premises rented to you or
temporarily occupied by you with the permission of the owner arising out of any one fire,
lightning, "explosion" or sprinkler leakage incident.
Includes copyrighted material of ISO Properties, Inc with its permission. Page 3 of 9
C. Paragraph b.(1)(b) of Condition 4. Other Insurance (Section IV Conditions) is replaced by the
following:
(1) That is Fire, Lightning, Explosion or Sprinkler Leakage insurance for premises rented to you or
temporarily occupied by you with the permission of the owner;
D. Paragraph 9.a. of the definition of "insured contract" in Section V- Definitions is replaced by the
following:
9. "Insured contract" means.
a. A contract for the lease of premises However, that portion of the contract for a lease of
premises that indemnifies any person or organization for damages by fire, lightning,
"explosion" or sprinkler leakage to premises while rented to you or temporarily occupied by
you with the permission of the owner is not an "insured contract
E. The following definition is added to Section V Definitions:
"Explosion" means a sudden release of expanding pressure accompanied by a noise, a bursting
forth of material and evidence of the scattering of debris to locations further than would have
resulted by gravity alone.
"Explosion" does not include any of the following:
1. Artificially generated electrical current including electrical arcing that disturbs electrical devices,
appliances or wires;
2. Rupture or bursting of water pipes;
3. Explosion of steam boilers, steam pipes, steam engines or steam turbines owned or leased by
you, or operated under your control; or
4. Rupture or bursting caused by centrifugal force.
3. NON -OWNED WATERCRAFT
Subparagraph g.(2) of Paragraph 2., Exclusions of Section I Coverage A is replaced by the following.
(2) A watercraft you do not own that is
(a) Less than 51 feet long; and
(b) Not being used to carry persons or property for a charge;
4. SUPPLEMENTARY PAYMENTS
In the Supplementary Payments Coverages A and B provision:
The limit for the cost of bail bonds in Paragraph 1.b. is changed from $250 to $1000.
CG 841612 03
E 603 00
Includes copyrighted material of ISO Properties, Inc with its permission. Page 4 of 9
5. PERSONAL AND ADVERTISING INJURY ELECTRONIC PUBLICATION EXTENSION
Paragraphs 14.b., d. and e. of Section V Definitions are replaced by the following:
b. Malicious prosecution or abuse of process;
d. Oral, written, televised, videotaped or electronic publication of material that slanders or libels a
person or organization or disparages a person's or organization's goods, products or services;
e. Oral, written, televised, videotaped or electronic publication of material that violates a person's right
of privacy;
The following is added to Paragraph 14. "Personal and Advertising Injury" of Section V Definitions:
h. Discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but
only if such discrimination or humiliation is:
(1) Not done intentionally by or at the direction of:
(a) An insured; or
(b) Any "executive officer" director, stockholder, partner or member of the insured; and
(2) Not directly or indirectly related to the employment, prospective employment or termination of
employment of any person or persons by any insured.
Subparagraphs b. and c of 2., Exclusions of Section I Coverage B Personal And Advertising
Injury Liability are replaced by the following:
b. Material Published With Knowledge Of Falsity
"Personal and advertising injury" arising out of oral, written, televised, videotaped or electronic
publication of material, if done by or at the direction of the insured with knowledge of its falsity;
c. Material Published Prior To Policy Period
"Personal and advertising injury" arising out of oral, written, televised, videotaped or electronic
publication of material whose first publication took place before the beginning of the policy period;
6. AGGREGATE LIMITS OF INSURANCE (PER LOCATION)
The General Aggregate Limit under Section III Limits Of Insurance applies separately to each of your
"locations" owned by or rented to you or temporarily occupied by you with the permission of the owner.
"Location" means premises involving the same or connecting lots, or premises whose connection is
interrupted only by a street, roadway, waterway or right -of -way of a railroad.
7. AGGREGATE LIMITS OF INSURANCE (PER PROJECT)
The General Aggregate Limit under Section III Limits Of Insurance applies separately to each of your
projects away from premises owned by or rented to you.
CG 841612 03
E 604 00
Includes copyrighted material of ISO Properties, Inc., with its permission. Page 5 of 9
8. VOLUNTARY PROPERTY DAMAGE COVERAGE
At your request, we will pay for "loss" to property of others caused by your business operations. The
most we will pay for this coverage is $500 each "occurrence." The "loss" must occur during the policy
period. The "occurrence" must take place in the "coverage territory".
"Loss" means unintended damage or destruction. "Loss" does not mean disappearance, abstraction or
theft.
This coverage does not apply to:
1. Damage arising out of the use of any "auto
2. Property you own, occupy, rent or lease from others; or
3. Property on your premises for sale, service, repair or storage.
None of the other policy exclusions apply to this coverage.
If the policy to which this endorsement is attached is written with a property damage liability deductible,
the deductible shall apply to Voluntary Property Damage. The limit of coverage stated above shall not
be reduced by the amount of this deductible.
9. OFF PREMISES CARE, CUSTODY OR CONTROL COVERAGE
A. We will pay those sums that you become legally obligated to pay as damages because of "property
damage" to personal property of others while in your or your "employees" care, custody or control or
real property of others over which you or your "employees" are exercising physical control if the
"property damage" arises out of your business operations. This Coverage is subject to sections B.,
C., D. and E. below.
B. Exclusions
This insurance shall not apply to:
1. "Property damage" of property at premises owned, rented, leased, operated or used by you;
2. "Property damage" of property while in transit;
3. The cost of repairing or replacing:
(a) Any of your work defectively or incorrectly done by you or by others on your behalf; or
(b) Any product manufactured, sold or supplied by you, unless the "property damage" is caused
directly by you after delivery of the product or completion of the work and resulting from a
subsequent undertaking; or
4. "Property damage" of property caused by or arising out of the "products- completed
operations hazard
C. Limits Of Insurance The most we will pay for "property damage" under this Section 9. is $25,000
for each "occurrence". The most we will pay for the sum of all damages covered under this Section
9. because of "property damage" is an annual aggregate limit of $25,000.
The Limits Of Insurance provided under this Section 9 are inclusive of and not in addition to any
other limits provided in the policy or endorsements attached to it.
D. Deductible We will not pay for "property damage" in any one "occurrence" until the amount of
"property damage" exceeds $250. If the policy to which this endorsement is attached contains a
"property damage" deductible, that deductible shall apply if it is greater than $250.
E. In the event of "property damage" covered by this endorsement, you shall, if requested by us,
replace the property or furnish the labor and materials necessary for repairs thereto at your actual
cost, excluding profit or overhead charges.
CG 841612 03
E 605 00
Includes copynghted material of ISO Properties, Inc., with its permission Page 6 of 9
10. NEWLY FORMED OR ACQUIRED ORGANIZATIONS
A. Paragraph 4. of Section II Who Is An Insured is deleted and replaced by the following:
4. Any business entity acquired by you or incorporated or organized by you under the laws of any
individual state of the United States of America over which you maintain majority ownership
interest exceeding fifty percent. Such acquired or newly formed organization will qualify as a
Named Insured if there is no similar insurance available to that entity. However:
a. Coverage under this provision applies only until the expiration of the policy period in which
the entity was acquired or incorporated or organized by you.
b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before the
entity was acquired or incorporated or organized by you.
c. Coverage B does not apply to "personal and advertising injury" arising out of an offense
committed before the entity was acquired or incorporated or organized by you
d. Records and descriptions of operations must be maintained by the first Named Insured.
B. This Section 10. does not apply to newly formed or acquired organizations if coverage is excluded
either by provisions of the Coverage Part or by other endorsement(s) attached to it
11. DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
A. The requirements in Section IV Conditions, Paragraph 2.a., that you must see to it that we are
notified of an "occurrence" applies only when the "occurrence" is known to:
1. You, if you are an individual;
2. A partner, if you are a partnership;
3. A member or manager, if you are a limited liability company;
4. An executive officer or designee, if you are a corporation,
5. A trustee, if you are a trust; or
6. A designee, if you are any other type of organization.
B. The requirements in Section IV Conditions Paragraph 2.b that you must see to it that we receive
written notice of a claim or "suit" will not be considered breached unless the breach occurs after
such claim or "suit" is known to:
1. You, if you are an individual;
2. A partner, if you are a partnership;
3. A member or manager if you are a limited liability company;
4. An executive officer or designee, if you are a corporation;
5. A trustee, if you are a trust; or
6. A designee, if you are any other type of organization.
Knowledge of an "occurrence," claim or "suit" by the agent, servant or "employee" of any insured
shall not in itself constitute knowledge of the insured unless an officer or designee shall have
received notice from its agent, servant or "employee
12. BODILY INJURY
Paragraph 3. of the definition of "bodily injury" in the Section V Definitions is replaced by the
following:
3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental
anguish or death resulting from any of these at any time.
CG 841612 03
E 606 00
Includes copyrighted material of ISO Properties, Inc., with its permission Page 7 of 9
13. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS
We have the right to recover our payments from anyone liable for an injury covered by this policy. We
will not enforce our right against any person or organization for whom you perform work under a written
contract that requires you to obtain this agreement from us.
This agreement shall not operate directly or indirectly to benefit anyone not named in the agreement.
14. MEDICAL PAYMENTS
If Coverage C Medical Payments is not otherwise excluded, the Medical Expense Limit provided by this
policy shall be the greater of:
A. $10,000; or
B. The amount shown in the Declarations.
15. BROAD NAMED INSURED
Paragraph 2.a.(1)(d) of Section II Who Is An Insured is replaced by the following:
(d) Arising out of his or her providing or failing to provide professional health care services. However,
this exclusion does not apply to nurses, emergency medical technicians or paramedics who are
employed by you to provide medical or paramedical services to your employees.
16. BROADENED MOBILE EQUIPMENT
Paragraph 12.f.(1) of Section V Definitions is replaced by the following:
(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction or resurfacing; or
(c) Street cleaning provided that vehicles have a Gross Vehicle Weight of 1,000 pounds or greater;
17. INCIDENTAL MALPRACTICE LIABILITY
Paragraph 3. of Section V Definitions is replaced by the following:
3. "Bodily injury" means bodily injury, sickness, disease or "incidental medical malpractice" sustained
by a person, including mental anguish or death resulting from any of these at any time.
The following is added to Section V Definitions:
23. "Incidental medical malpractice" means injury arising out of the negligent rendering or failure to
render medical or paramedical services to persons by any physician, dentist, nurse, emergency
medical technician or paramedic who is employed by you to provide such services to your
employees, provided you are not engaged in the business or occupation of providing any
services referred to in this definition.
18. NON -OWNED AIRCRAFT
The following is added to Subparagraph g. of 2., Exclusions of Section I Coverage A Bodily Injury
And Property Damage Liability:
(6) An aircraft with a paid crew, that is hired, chartered or loaned but is not owned by any insured.
CG 8416 12 03
E 607 00
Includes copyrighted material of ISO Properties, Inc., with its permission. Page 8 of 9
19. PROPERTY DAMAGE ELEVATORS
The following is added to Subparagraph j. of 2., Exclusions of Section I Coverage A Bodily Injury
And Property Damage Liability:
Paragraphs (3) and (4) of this exclusion do not apply to damages that result from the use of elevators.
All other terms and conditions of your policy remain unchanged.
CG 841612 03
E 608 00
Includes copyrighted material of ISO Properties, Inc., with its permission. Page 9 of 9