HomeMy WebLinkAboutS-3216 KC Special Use Permit FileInsurance
cities
P.O.Box 88030
Tukwila,WA 98138
02-Jul-12 Cert#:7861
Phone:206-575-6046
King County Real Estate Services
Fax:206-575-7426
Attn:Aaron R.Halley,Real Property Agent
500 Fourth Ave.,Room 500
Seattle,WA 98 104-2337
RE:City of Renton
King County Special Use Consent Permit SUPSI2-0036
Evidence of Coverage
The above captioned entity is a member of the Washington Cities Insurance Authority
(WCJA),which is a self insured pool of over 150 municipal corporations in the State of
Washington.
WCIA has at least $1 million per occurrence combined single limit of liability coverage
in its self insured layer that may be applicable in the event an incident occurs that is
deemed to be attributed to the negligence of the member.
WCIA is an Interlocal Agreement among municipalities and liability is completely self
funded by the membership.As there is no insurance policy involved and WCJA is not
an insurance company,your organization cannot be named as an “additional insured”.
Sincerely,
Eric B.Larson
Deputy Director
cc:Gary Lamb
D.Christensen
cletter
Facilities Management Division
Real Estate Services Section
King County Administration Building
500 Fourth Avenue ADM-ES-0830
Seattle,WA 98104KingCOUfltype,,206-296-7456,FAX 206-296-0196
SPECIAL USE PERMIT
Use of County Owned Property
‘ERMIT NUMBER:SUPS12-0036 DATE:06/26/2012
‘ERMITEE:
Dity of Renton -David Christensen
1055 S.Grady Wy.
Renton,WA 98057
)AY PHONE:(425)430-7212 OTHER PHONE:FAX:
PURPOSE:
fo operate &maintain approximately 189 ft.of 12 in.sewer main.
LEGAL DESCRIPTION:Primary 1/4 Sec Twp Rge Account No Kroll Page
NW 23 23 05 1081800510 816W
Legal Description:Briarwood West Tract AWithin the boundaries of the above referenced parcel.
Renewal of S-260-06
EXPIRATION:This permit shall not be valid for more than 5 years &expires on the day of 2017.
Administrative Fee (New or Renewal)$500.00 Land Use Fee -RES $859.54
Bond/Insurance Amount $1,000,000.00
Permittee MUST notify RICK OUELLET AT:206-205-3555 AT LEAST 72 HOURS PRIOR TO PERFORMING ANY
WORK AND IMMEDIATELY UPON COMPLETION
ssued By:Aaron Halley Phone:206-205-0655
By this permit King County authorizes the use of the above described property:
Dustodial Approval:Date:
ea1 Estate Services Approval:Date:
The Permittee agrees to comply with the terms and conditions contained herein.
SEE REVERSE SIDE FOR TERMS AND
signature of Permittee:Date:7%)/
NOTE:Permit not valid without all necessary signatures and expiration date.
King County Code 14.30
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1.ANTI-DISCRIMINATION -In all hiring or employment made possible or resulting from this Permit,there shall be no
discrimination against any employee or applicant for employment because of race,color,ancestry,religion,national origin,age,sex,sexual
orientation,marital status,or the presence of any sensory,mental or physical handicap in an otherwise qualified handicapped person unless
based upon a bona fide occupational qualification,and this requirement shall apply to but not be limited to the following employment,
advertising,lay-off or termination,rates of pay or other forms of compensation,and selection for training including apprenticeship.No
person shall be denied,or subjected to discrimination in receipt of the benefit of any services or activities made possible by or resulting from
this Permit on the grounds of race,color,ancestry,religion,national origin,age (except minimum age and retirement provisions),sex,
sexual orimtation,marital status,parental status,the presence of any sensory,mental or physical handicap,or the use of a trained guide-dog
by a blind or deaf person.Any violation of this provision shall be considered a violation of a material provision of this Permit and shall be
grounds for cancellation,termination or suspension in whole or in part of the Permit by the County,and may result in ineligibility for further
County permits.
2.NON-EXCLUSIVE RIGHT -This Permit shall not be deemed or construed to be an exclusive right.It does not prohibit the
County from granting any other permits to other public or private entities,nor shall it prevent the County from using any public place for
any and all public use or affect its jurisdiction over any part of them.
3.TER1’HNATION -The Permittee may terminate the Permit by written notice to the Manager of Real Estate Services Section.
Upon revocation,termination,or abandonment,the Permittee shall remove at his expense all facilities placed on said property by the
Permittee,and restore the premises to a condition which is equivalent in all respects to the condition existing prior to installation of the
facilities,or to a condition which is satisfactory to the County.If the Permittee has not accomplished removal and restoration at the end of
a ninety-day period following the effective date of revocation,termination,expiration,or abandonment,the County may accomplish all of
the necessary work and charge all of the costs to the Permittee.
4.RESTORATION -After completion of work authorized by this Permit,the Permittee shall restore the property to a condition which
is equivalent in all respects to the condition of the property prior to starting work,or a condition satisfactory to King County.if the
Permittee delays the restoration beyond expiration of the Permit,the County may accomplish all the necessary work and charge all the costs
to the Permittee.
5.REPAIRiNG DAMAGE BY PERMITTEE -In the event that damage of any kind is caused by the Permittee in the course of
performing work authorized by this Pei-mit,Pennittee will repair said damage at its sole cost and expense.Repair work shall begin without
delay and continue without interruption until completed.if damage is extensive,the time allowed for repair will be prescribed by the
County agent.If the County determines it is necessary,the County may accomplish the work and charge all the costs to the Permittee.
6.RIGHTS RESERVED TO COUNTY -CONFORMANCE AND PAYMENT OF COST REOUIRED -The County reserves the
right to use,occupy,and enjoy its property for such purposes as it shall desire including,but not limited to,constructing or installing
structures and facilities on the property,or developing,improving repairing or altering the property.The Permittee,upon written notice,
will at its own cost and expense remove,repair,relocate,change or reconstruct its installations to conform with the plans of work
contemplated or ordered by the County according to a time schedule contained in the written notice.
7.RE-ENTRY -After completion of work authorized by this Permit,if the Permittee desires to re-enter upon the property describedhereinforanyreconstruction,notice shall be provided in advance to King County together with the plans and specifications for the workproposed,and shall not be permitted without the County’s consent.
8.TITLE -This Permit grants only the right to use King County’s interest in the herein described property,and the granting of thisPermitisnotawarrantythatgoodtitletoanyspecificpropertyisvestedinKingCounty.
9.PERMIT REVOCATION -This Permit is revocable at any time by King County.The right to revoke is expressly reserved toKingCounty.
10.INDEMNITY AND HOLD HARMlESS -The Permittee agrees to indemnify and hold harmless King County as provided hereintothemaximumextentpossibleunderlaw.Accordingly,the Permittee agrees for itself,its successors and assigns to defend,indemnify,and hold harmiess King County,its appointed and elected officials,and employees from and against liability for all claims,demands,suits,and judgments including costs of defense thereof for injury to persons,death,or property damage which is caused by,arises out of,or isincidentaltoPermittee’s exercise of rights and privileges granted by this Permit.The Permittee’s obligation under this section shall includea)Indemnification for such claims whether or not they arise from the sole negligence of either the County or the Permittee,the concurrentnegligenceofbothparties,or the negligence of one or more third parties.b)The duty to promptly accept tender of defense and providedefensetotheCountyatthePermittee’s own expense.c)Indemnification of claims made by the Permittee’s own employees or agents.d)Waiver of the Permittee’s immunity under the industrial insurance provisions of Title 51 RCW,which waiver has been mutually negotiatedbytheparties.
In the event it is necessary for the County to incur attorney’s fees,legal expenses,or other costs to enforce the provisions of thissection,all such fees,expenses,and costs shall be recoverable from the Permittee.
In the event it is determined that RCW 4.24.115 applies to this agreement,the Permittee agrees to defend,hold harmless,andindemnifyKingCountytothemaximumextentpermittedthereunder,and specifically for its negligence concurrent with that of KingCountytothefullextentofPermittee’s negligence.Permittee agrees to defend,indemnify,and hold harmless the County for claims byPermittee’s employees and agrees to waiver of its immunity under Title 51 RCW,which waiver has been mutually negotiated by the parties.
11.ASSESSMENTS -Permittee shall be required to pay any general or special assessments incurred by King County which are directlyattributabletoorarisingfromanyactions,occupancy,or usage authorized herein.
12.ABATEMENT OF UNSAFE CONDITIONS -The County representative may at any time,do,order,or have done all workconsiderednecessarytorestoretoasafeconditionanyareadescribedinPermitleftbythePermitteeinaconditiondangeroustolifeorproperty.The Perniittee shall pay,upon demand,to the County all costs of such work,materials,etc.Nothing in this section shall relievethePermitteeofdutiesunderTermsandConditionsNo.2 above.
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13.NOTICE -Permittee agrees to obtain information from other utility operators regarding the location and current status of their
installations before starting work.Property,owners adjoining,or in proximity to,the project as described herein shall be notified by
Permittee when such property is exposed to the possibility of injury or damage through performance of work on the project authorized by
this Permit.Permittee shall make all advance arrangements necessary to protect such property or utility from injury or damage.
14.OTHER APPLICABLE LAWS -Issuance of this Permit does not in any way relieve the Permittee from complying with any other
applicable,laws in performing the work subject to this Permit.
15 SPECIAL TERMS AND CONDITIONS:
a.The permittee will restrict all use of King County property to those described in the Letter dated 11/29/06 and shown on the
attached site plans.
b.If at any time the authorized use of this permit creates a condition which could pose a danger to the public,the Permittee will be
responsible for posting temporary signage,using approved barricades,or talcing other approved measures to facilitate continued
safe use of the property.
c.The permittee shall restore the property to its original or better condition upon completion of the work.
d.The permittee shall be responsible for the repair and/or replacement of any improvements damaged as a result of the authorized
activities associated with this permit.
e.The permittee shall be responsible for obtaining and providing proof of all necessary permits prior to beginning work.
f.The permittee shall not make any additional improvements or alterations to the property that is not specifically addressed in this
permit.
g.King County reserves the right to set additional terms as unforeseen conditions at this time,may warrant in the future.
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15h.INSURANCE:
Minimum Scope and Limits of Insurance -Minimum Scope and Limits of Insurance
Coverage shall be at least as broad as:
General Liability:
Insurance Services Office form number CO 0001 (Ed.11-88)covering COMMERCIAL GENERAL LIABILiTY.The permittee
shall maintain limits no less than $1,000,000 combined single limit per occurrence for bodily injury,personal injury and property
damage.
AUTOMOBILE LIABILITY:Insurance Services Office form number (CA 00 01 Ed.12-90 or its equivalent)covering
BUSINESS AUTO COVERAGE,symbol 1 ‘any auto”,or the combination of symbols 2,8 and 9.Limits shall be no less than
$1,000,000.Combined Single Limit Bodily Injury and Property Damage.
WORKERS COMPENSATION:Workers Compensation coverage,as required by the Industrial Insurance Act of the State of
Washington;
EMPLOYERS LIABILITY or “Stop-Gap”:The protection by the Workers Compensation policy Part 2 (Employers Liability)or,
in states with monopolistic state funds,the protection provided by the “Stop-Gap”endorsement to the General Liability policy.
Limits shall be no less than $1,000,000.
10.Acceptability of Insurers -Unless otherwise approved by the County,insurance is to be placed with insurers with a Bests’rating
cf no less than A:Vifi,or,if not rated with Bests’,with minimum surpluses the equivalent of Bests’surplus size VIII.
11.Verification of Coverage -The permittee shall furnish the King County Real Property Division with certificates of insurance and
endorsements required by this permit.The County reserves the right to require complete,certified copies of all required insurance
policies at any time.
12.Municipal or State Agency Provision -If the Permittee is a Municipal Corporation or an agency of the State of Washington and is
self-insured for any of the above insurance requirements,a certification of self-insurance shall be attached hereto and be
incorporated by reference and shall constitute compliance with this section.
2.I)eductibles and Self-Insured Retentions -The deductible andlor self-insured retention of the policies shall not limit or apply to
the permittee’s liability to the County and shall be the sole responsibility of the permittee.
3.Other Insurance Provisions -The insurance policies required in this permit are to contain,or be endorsed to contain the following
provisions
a.All Liability policies except Workers Compensation:
1.The County,its officers,officials,employees and agents are to be covered as insured as respects liability arising out of
activities performed by or on behalf of the permittee in connection with this permit.
2.Insurance coverage shall be primary insurance as respects the County,its officers,officials,employees and agents.Any
insurance and/or self-insurance maintained by the County,its officers,officials,employees or agents should not contribute with the
permittee’s insurance or benefit the permittee in any way.
3.The permittee’s insurance shall apply separately to each insured against whom a claim is made and/or lawsuit is brought,
except with respect to the limits of the insurer’s liability.
b.All Policies:
Coverage shall not be suspended,voided,cancelled,reduced in coverage or in limits prior to the expiration date of this specialusepermit,unless forty-five (45)days prior notice,return receipt requested,has been given to the County.
4.Acceptability of Insurers -Unless otherwise approved by the County,insurance is to be placed with insurers with a Bests’rating
of no less than A:Vifi,or,if not rated with Bests’,with minimum surpluses the equivalent of Bests’surplus size Vifi.
5.Verification of Coverage -The permittee shall furnish the King County Real Property Division with certificates of insurance and
endorsements required by this permit.The County reserves the right to require complete,certified copies of all required insurance
policies at any time.
6.Municipal or State Agency Provision -If the Pennittee is a Municipal Corporation or an agency of the State of Washington and isself-insured for any of the above insurance requirements,a certification of self-insurance shall be attached hereto and beincorporatedbyreferenceandshallconstitutecompliancewiththissection.
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7.Minimum Scope and Limits of Insurance -Minimum Scope and Limits of Insurance
Coverage shall be at least as broad as:
General Liability:
Insurance Services Office form number CG 0001 (Ed.11-88)covering COMMERCIAL GENERAL LIABILITY.The permittee
shall maintain limits no less than $1,000,000 combined single limit per occuffence for bodily injury,personal injury and property
damage.
AUTOMOBILE LIABILITY:Insurance Services Office form number (CA 00 01 Ed.12-90 or its equivalent)covering
BUSINESS AUTO COVERAGE,symbol 1 ‘any auto”,or the combination of symbols 2,8 and 9.Limits shall be no less than
$1,000,000.Combined Single Limit Bodily Injury and Property Damage.
WORKERS COMPENSATION:Workers Compensation coverage,as required by the Industrial Insurance Act of the State of
Washington;
EMPLOYERS LIABILiTY or “Stop-Gap”:The protection by the Workers Compensation policy Part 2 (Employers Liability)or,
in states with monopolistic state funds,the protection provided by the “Stop-Gap’endorsement to the General Liability policy.
Limits shall be no less than $1,000,000.
8.I)eductibles and Self-Insured Retentions -The deductible andlor self-insured retention of the policies shall not limit or apply to
the permittee’s liability to the County and shall be the sole responsibility of the permittee.
9.Other Insurance Provisions -The insurance policies required in this permit are to contain,or be endorsed to contain the following
provisions
a.All Liability policies except Workers Compensation:
1.The County,its officers,officials,employees and agents are to be covered as insured as respects liability arising out of
activities performed by or on behalf of the permittee in connection with this permit.
2.Insurance coverage shall be primary insurance as respects the County,its officers,officials,employees and agents.Any
insurance andlor self-insurance maintained by the County,its officers,officials,employees or agents should not contribute with the
permittee’s insurance or benefit the permittee in any way.
3.The permittee’s insurance shall apply separately to each insured against whom a claim is made andlor lawsuit is brought,
except with respect to the limits of the insurer’s liability.
h.All Policies:
Coverage shall not be suspended,voided,cancelled,reduced in coverage or in limits prior to the expiration date of this special
use permit,unless forty-five (45)days prior notice,return receipt requested,has been given to the County.
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