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HomeMy WebLinkAbout000177 Original ContractAGREEMENT FOR PROFESSIONAL SERVICES BETWEEN THE THE CITY OF PORT ANGELES AND TA 17 Mod 3, Preparation of Staff Reports City of Port Angeles RELATING TO: Preparation of memorandums for presentation to the Utility Advisory Committee and City Council for consideration of the acceptance of sewage from 17 parcels (approximately 46 equivalent residential units) adjacent to the Lower Elwha Klallam Tribe THIS AGREEMENT is made and entered into this no day of \Jta 11-- 2011, by and between THE CITY OF PORT ANGELES, a non charter code city of the State of Washington, (hereinafter called the "CITY and Gene Unger Engineering, LLC, 1401 W 7 Street, Port Angeles, WA authorized to do business in the state of Washington (hereinafter called the "CONSULTANT 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 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; I SCOPE OF WORK Record #000177 NOW, THEREFORE, in consideration of the above representations and the terms, conditions, covenants, and agreements set forth below, the parties hereto agree as follows: 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 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 compliance with applicable federal, state and local laws. The Scope of Work may be amended upon written approval of both parties. 1I 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 6/27/2011 N: \GLENN \Task Orders \TA 17 Mod 3 Unger Contract Rev I.docx 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 execution of a Task Agreement between the City and the National Park Service for the services listed in Exhibit "A" and the duration of the Agreement shall extend through October 1, 2011. Upon mutual agreement between the CITY and CONSULTANT the TIME OF PERFORMANCE may be extended. 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 lump sum cost and shall include actual labor, overhead and profit plus CONSULTANT'S direct non -salary reimbursable costs as set forth in the attached Exhibit A. B. The CONSULTANT shall submit invoices to the CITY on a monthly basis. Invoices shall detail the work and employee name; shall indicate the specific task or activity in the Scope of Work to which the costs are related. 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 $6,175.00 (six thousand one 6/27/2011 C:\ Users \Gene\AppData \Local \Microsoft \Windows \Temporary Internet Files \Content.Outlook\ZDOIGV9P \TA 17 Mod 3 Unger Contract Rev I (2).docx hundred seventy five dollars and no cents). Budgets for task(s) may be modified upon mutual agreement between the two parties, but in any event, the total payment to CONSULTANT shall not exceed $6,175.00 (six thousand one hundred seventy five dollars and no cents). 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. 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. 6/27/2011 C:\ Users \Gene\AppData \Local \Microsoft \Windows \Temporary Internet Files \Content.Outlook\ZDOIGV9P \TA 17 Mod 3 Unger Contract Rev I (2).docx 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 by 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 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 CONSULTANT shall defend, indemnify and hold the CITY, its officers, officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees, arising out of or resulting from the acts, errors or omissions of the CONSULTANT in performance of this Agreement, except for injuries and damages caused by the sole negligence of the CITY. 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 6/27/2011 C:\ Users \Gene\AppData \Local \Microsoft \Windows \Temporary Internet Files \Content.Outlook\ZDOIGV9P \TA 17 Mod 3 Unger Contract Rev I (2).docx 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. 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. No Limitation. CONSULTANT'S maintenance of insurance as required by the agreement shall not be construed to limit the liability of the CONSULTANT to the coverage provided by such insurance, or otherwise limit the CITY'S recourse to any remedy available at law or in equity. 6/27/2011 C:\ Users \Gene\AppData \Local \Microsoft\Windows \Temporary Internet Files \Content.Outlook\ZDOIGV9P \TA 17 Mod 3 Unger Contract Rev I (2).docx A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage; and, 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, and personal injury and advertising injury. The City shall be named as an insured under the Consultant's Commercial General Liability insurance policy with respect to the work performed for the City; and, 3. Workers' Compensation coverage as required by the Industrial Insurances laws of the State of Washington; and 4. Professional Liability insurance appropriate to the Consultant's profession. B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. 3. Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability, Professional Liability and Commercial General Liability insurance: 1. The Consultant's insurance coverage shall be primary insurance as respect the City. Any insurance, self- insurance, or insurance pool coverage maintained by the City shall be excess of the Consultant's insurance and shall not contribute with it. 2. The Consultant shall provide the City and all additional insured's with written notice of any policy cancellation, within two (2) business days of their receipt of such cancellation. 6/27/2011 C:\ Users \Gene\AppData \Local \Microsoft\Windows \Temporary Internet Files \Content.Outlook\ZDOIGV9P \TA 17 Mod 3 Unger Contract Rev I (2).docx 3. Any payment of deductible or self insured retention shall be the sole responsibility of the CONSULTANT. 4. 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. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. E. Verification of Coverage Consultant shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Consultant before commencement of the work. Failure on the part of the Consultant to maintain the insurance as required shall constitute a material breach of contract, upon which the City may, after giving five (5) business days notice to the Consultant to correct the breach, immediately terminate the Contract or, at its discretion, procure or renew such insurance and pay any and all premiums in connection there with, with any sums so expended to be repaid to the City on demand, or at the sole discretion of the City, offset against funds due the Consultant from the City. 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. 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 and Lump Sum Cost XVII Additional Provisions Prohibition on Text Messaaina and Usina Electronic Eauipment Supplied by the Government while Driving Executive Order 13513., Federal Leadership On Reducing Text Messaging While Driving, was signed by President Barack Obama on October 1, 2009 (ref.: http: /edocket.access.aao.aov /2009 /Ddf /E9- 24203.Ddf). This Executive Order introduces a Federal Government -wide prohibition on the use of text messaging while driving on official business or while using Government supplied equipment. In accordance with Section 4 of that Executive Order, the National Park Service encourages the City and its contractors to adopt 6/27/2011 C:\ Users \Gene\AppData \Local \Microsoft\Windows \Temporary Internet Files \Content.Outlook\ZDOIGV9P \TA 17 Mod 3 Unger Contract Rev I (2).docx and enforce policies that ban text messaging while driving when on official business or performing any work under this Task Agreement. The National Park Service also encourages the City and its contractors to adopt and enforce initiatives of the type described in Section 3(a) of the Executive Order. Contractor is encouraged to ban text messaging while driving when on official business or performing any work under this contract. IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year first written above. CITY OF PORT ANGELES CONSULTANT TITLE: i s rd n CQ a, i rn.e �rr✓Ll /Lc_ APPROVED AS TO FORM: ATTEST: anager Bennis Dickson Assistant City Attorney SSA HURD, CITY CLERK 6/27/2011 C: \Documents and Settings \Igunders \Local Settings \Temporary Internet Files \Content.Outlook \970AAOTD \TA 17 Mod 3 Unger Contract Rev I (2).docx Exhibit A Scope of Work and Budget for Each Task The Scope of Work shall include 3 Tasks to be performed: 1. Develop a list of issues to be included in a new contract or an amendment to the existing contract between the City and LEKT to permit acceptance of the additional sewage from the 17 parcels (approximately 46 ERUs). To be completed no later than July 29, 2010. 2. Prepare a Utility Advisory Committee (UAC) Memorandum requesting that the UAC forward a favorable recommendation to the City Council to approve the concept of accepting the sewage from 17 parcels (approximately 46 equivalent residential units) adjacent to the Lower Elwha Klallam Tribe's reservation. The memorandum shall provide factual support for the recommendation. To be completed no later than July 29, 2010. 3. If a favorable recommendation is forwarded by the UAC then prepare a City Council (CC) Memorandum requesting that the CC approve the concept of accepting the sewage from 17 parcels (approximately 46 equivalent residential units (ERUs)) adjacent to the Lower Elwha Klallam Tribe's reservation. To be completed no later than August 26, 2010, if authorized to prepare the memorandum for the City Council. Consultant shall utilize but not be limited to use of documents listed on attachment #1. Estimates. Consultant's estimate to provide the above mentioned services: not -to- exceed estimated lump sum cost listed below. This does cover any outside expense or fees. Consultant will not exceed this amount without written authorization. Task 1 $2,375.00 Task 1 .$2,375.00 Task 3 $1,425.00 Hourly Rate is $95.00 6/27/2011 C:\ Users \Gene\AppData \Local \Microsoft \Windows \Temporary Internet Files \Content.Outlook\ZDOIGV9P \TA 17 Mod 3 Unger Contract Rev 1 (2).docx Relevant Documents for Off Reservation Parcel Connections 1. Utility Advisory Committee (UAC) Memo dated February 11, 2003 (Revised for February 24, 2003) 2. LEKT Request for Sewer Connection UAC Memo dated February 24, 2003 3. LEKT Request for Sewer Connection City Council Memo dated March 4, 2003 4. LEKT Request for Sewer Connection UAC Memo dated April 9, 2007 5. LEKT Request for Sewer Connection City Council Memo dated April 17, 2007 6. LEKT Wastewater Agreement City Council Memo dated May 1, 2007 7. Lower Elwha Klallam Tribe (LEKT) Wastewater Agreement, May 30, 2007 8. Robert Elofson E -mail dated May 17, 2011, 3:38 PM 9. Foster Pepper Memo dated June 4, 2010 10. US Department of the Interior, National Park Service letter dated April 4, 2011 11. Port Angeles Municipal Code (PAMC) Current Edition (Online) Attachment #1 C:\ Users\ Gene \AppData \Local \Microsoft \Windows \Temporary Internet Files \Content.Outlook \ZDOIGV9P \TA 17 Mod 3 Relevant Documents for Off Reservation Parcel Connections (2).docx ACC)RO CERTIFICATE OF LIABILITY INSURANCE DATE (Ml Y) 06/22//2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE 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). PRODUCER Phone (360) 598 -3700 Fax (360) 598 -3703 CONTACT MICHAEL J. HALL COMPANY NAME MICHAEL J. HALL COMPANY PHONE Exn (360) 598 -3700 F4' Nol (360) 598 -3703 (A/C No. (A/C HALL COMPANY E -MAIL 19660 10TH AVENUE N.E. ADDRESS PRODUCER 2278 POULSBO WA 98370 CUSTOMER ID Agency Lic# 91- 1461089 INSURED Gene Unger Engineering Inc 1401 W 7Th St Port Angeles, WA 98363 -5401 COVERAGES CERTIFICATE NUMBER: 139919 REVISION NUMBER: 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 SI POLIC S. 1 IMITS SHOWN MAY HAVFJ{FFN RE 21ICFD BY PPID CI AIMS INSR TYPE OF INSURANCE ADD'L SUBR POLICY EFF POLICY EXP C LTR INSR VWD POLICY NU MBER IMM /DD/YWYI IMM /DDI1Y TY1 LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ICLAIMS -MADE I OCCUR GEN'L AGGREGATE LIMIT APPLIES PER I PRODUCTS COMP /OP AGG 7 POLICY I I Pp ILOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAB EXCESS LAB DEDUCTIBLE RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, descnbe under DESCRIPTION OF OPERATIONS below OCCUR CLAIMS -MADE A Professional Liability Claims Made Form Y/N N/A 105250560 INSURER A INSURER B INSURER C INSURER D INSURER E INSURER F DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION City Of Port Angeles PO Box 1150 Port Angeles, WA 98362 -0217 Attention: INSURER(S) AFFORDING COVERAGE Travelers Casualty and Surety Co of America AUTHORIZED REPRESENTATIVE EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurencel MED EXP (Any one person) PERSONAL ADV INJURY GENERAL AGGREGATE COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) I$ I$ EACH OCCURRENCE IAGGREGATE TORY LIMITS I I OTnH E L EACH ACCIDENT E L DISEASE -EA EMPLOYEE I E L DISEASE POLICY LIMIT I 03/17/11 03/17/12 $1,000,000 Per Claim $1,000,000 Aggregate 31194 NAIC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Hur /e" ACORD 25 (2009/09) ©1988 -2009 AGORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PRODUCER (360)452 -2314 Callis Associates, Inc 806 So Vine St Port Angeles, WA 98362 Andy Callis INSURED Gene Unger Engineering, Inc. 1401 W. 7th St. Port Angeles, WA 98363 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 fn'1 A 113.R I TYPE OF INSURANCE POLICY NUMBER R A ACORD CERTIFICATE OF LIABILITY INSURANCE GENERAL LIABILITY X I COMMERCIAL GENERAL LIABILITY I 1 CLAIMS MADE X OCCUR GEN'L AGGREGATE LIMIT APPLIES PER X I POLICY n PRO- JECT n LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS /UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE yyyy��yy���(( RETENTION yy V /�W[Jltl[X NIYMA�XXi EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED'? If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS :ertificate holder is additional insured per the terms of CG2010 only. Evidence Only. lefer to policy for all applicable CERTIFICATE HOLDER City of Port Angeles 321 East 5th Street Port Angeles, WA 98362 FAX (360)452 -1701 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. INSURERS AFFORDING COVERAGE NAIC INSURER A 1 INSURER B INSURER C INSURER D 1 INSURER E Zurich North America POLICY EFFECTIVE I POLICY EXPIRATION I nA TU (MM /DD /YYI DATF (MM /Dfl PAS 40474893 05/16/2011 05/16/2012 EACH OCCURRENCE DAMAGE TO RENTED PRFMISFS 4F= nr.r. 'e) MED EXP (Any one person) PERSONAL ADV INJURY GENERAL AGGREGATE PRODUCTS COMP /OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) terms, conditions, exclusions and endorsements. PROPERTY DAMAGE (Per accident) AUTO ONLY EA ACCIDENT LIMITS OTHER THAN EA ACC AUTO ONLY EACH OCCURRENCE (AGGREGATE AGG I TORY IM TS I I FR DATE (MM /DD/YYYY) 06/20/2011 E L EACH ACCIDENT E L DISEASE EA EMPLOYEE E L DISEASE POLICY LIMIT 1 1,000,000 1,000,000 10,000 1,000,000 2,000,000 2,000,000 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 Call is /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. V OHH USAA® 9800 Fredericksburg Road San Antonio, Texas 78288 June 24, 2011 Please use this as evidence of auto insurance; however, this does not take the place of an insurance identification card. Registered owner: Address: USAA policy Policy effective: Policy expiration: Vehicle: VIN: Bodily injury liability limit: Property damage liability limit: Comprehensive deductible: Collision deductible: b/ G4/ GU11 Z 1k5: Zil PM PAUxt. 2/002 Fax Server GENE H UNGER 1401 W 7TH ST PORT ANGELES WA 98363 -5401 USAA 00111 00 62U 7101 5 March 8, 2011 September 8, 2011 2001 DODGE DAKOTA 1B7GL22XX1 S314806 $1,000,000 each person $1,000,000 each accident $300,000 each accident $250 $250 Meets Washington minimum statutory liability requirements This confirmation of coverage neither affirmatively nor negatively amends, extends or alters the coverage given by the policy issued by United Services Automobile Association. If you have questions, please call us at 1- 800 -531 -USAA (8722). Thank you, United Services Automobile Association USAA 111 00 62. 59431- E9693- A0.A0318 93127 -0511