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Home My WebLink AboutSWP273658(17) CITY OF RENTON CAG-15-032 CALL FOR BIDS Sunset Terrace Regional Stormwater Facility Project-SWP-27-3658 Sealed bids will be received until 2:30 p.m.,Tuesday, March 24, 2015, at the City Clerk's office, 7th floor, and will be opened and publicly read in Conference Room 511 on the 5th floor, Renton City Hall, 1055 South Grady Way, Renton WA 98057. The work to be performed within 90 working days from the date of commencement under this contract shall include, but not be limited to: • Excavating and disposing of approximately 4,200 cubic yards of native material. • Construction,surveying,staking,and as-builts, replacing survey monuments. • Traffic control and installing and maintaining erosion control. • Installing the new storm system in portions of NE 10`h Street including approximately 360 feet of 18-inch CPEP pipe,four Type II catch basins, one Type I catch basins and a 60-inch diameter manhole flow splitter. • Constructing two water quality treatment bioretention stormwater cells with a combined approximate 1500 square foot floor area and 3H:1V side slope. • Constructing a 150 foot by 70 foot underground infiltration gallery under the stormwater cells, consisting of a one foot treatment soil layer and 3 feet of drain rock. Installing five 12-inch diameter slotted underdrain pipes at 15 foot spacing, each 250 feet in length within the level aggregate layer. Installing a Type II catch basin on one end of each underdrain, and a clean-out on the other end of each underdrain pipe. Connecting the maintenance manholes by an 18-inch storm drain to form a manifold. Connecting the manifold to a 60-inch downstream manhole flow control structure. • Installing a new storm system in portions of Sunset Lane NE including 270 feet of 18-inch CPEP pipe and seven Type II catch basins. Removal and replacement of asphalt concrete pavement, asphalt overlay, concrete curbs, gutters, and driveways. Landscape and property restoration. Trench excavation, including removal of existing unsuitable material, stockpiling excavated material, and maintenance of existing utilities. • Installing and maintaining adequate TESC measures and restoring all disturbed areas. This project will be funded in part by the Washington State Department of Ecology's FY2012 Stormwater Retrofit and LID Competitive Grant Program. Neither the State of Washington nor any of its departments or employees are, or shall be, a party to any contract or any subcontract resulting from this solicitation for bids. The estimated project cost is$690,000 to$860,000. The City reserves the right to reject any and/or all bids and to waive any and/or all informalities. Bid documents will be available March 10, 2015. Plans, specifications, addenda, and the plan holders list for this project are available on-line through Builders Exchange of Washington, Inc., at httpaNv,srw,hx,,Na`corn. Click on "bxwa.com"; "Posted Projects", "Public Works", "City of Renton", "Projects Bidding". (Note: Bidders are encouraged to "Register as a Bidder," in order to receive automatic email notification of future addenda and to be placed on the"Bidders List.") Questions about the project shall be addressed to: Hebe C. Bernardo, Public Works Dept., 1055 South Grady Way, Fifth Floor, Renton,WA, 98057,or 425-430-7264, or hbernardo@rentonwa.gov. A certified check or bid bond in the amount of five percent(5%)of the total of each bid must accompany each bid. The City's Fair Practices, Non-Discrimination,and American th Disability Act Policies shall apply. Jas Seth, y C Published: Daily Journal of Commerce Mach 9, 2015 Daily Journal of Commerce March 16, 2015 C:\Users\iseth\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\ZVWBFSEN\06-CALL for BIDS- ClerkForm.doc\HCBtp { See i ad f-I s�=S 11:40001$40 CH2M Hill Engineers, Inc. 1100 112th Avenue NE STE 400 Ch • Bellevue, WA 98004 zm! Tel 425-453-5000 Fax 425-462.5957 Please remit to: RECEIVED CH2M Hill Engineers, Inc PO Box 201869 City of Renton DEC 17 2015 Dallas,TX 75320-1869 ATTN: Neil Watts CITY OF RENTON Date: 17-Dec-15 Public Works Department UTILITY SYSTEMS Project No.: 469392 1055 S. Grady Way Client Ref#: 000771 Renton, WA 98057 Invoice No.: 381051094 FINAL INVOICE For professional services May 30, 2015, through December 11, 2015, in connection with the Sunset Terrace Regional Stormwater Facility, Reference#CAG-13-021. Task 1 -Proiect Manaaement Professional Services Title Name Hours Rate Amount Project Manager Atchison, Dustin 0.5 $63.90 $31.95 Project Accountant Burnett, Lori Lynne 3.1 $26.40 $81.84 Contracts Administrator Levine, Jeff 1.0 $28.60 $28.60 Total Direct Salary Cost(DSC) $142.39 Overhead Rate(OH)of 149.5%x DSC= $212.87 Subtotal of DSC+OH $355.26 20%Fee on Labor $71.05 Subtotal DSC,OH &Fee: $426.31 Subtotal Task 01: $426.31 Task 8-Services During Bidding &Construction Professional Services Title Name Hours Rate Amount Design Manager Atchison, Dustin 1 5 $63.90 $95.85 Task Engineer-Water Chung, Raymond 52 $55 54 $288.81 Task Engineer-Civil Thatcher, Erin L 20 $35.37 $70 74 Trans/Traffic Design Tech Tyler, Jacqueline 1.0 $55 02 $55 02 Total Direct Salary Cost(DSC) $510.42 Overhead Rate(OH)of 149.5%x DSC= $763 08 Subtotal of DSC+OH $1,273.50 20% Fee on labor $254 70 Subtotal DSC,OH&Fee: $1,528.20 Direct Expenses Subconsultant/Lab Services Houch Beck& Baird, Inc. Inv#10991 $314.60 Markup on Subconsultant/Lab Services $6 29 Subtotal of Expenses: $320.89 Subtotal Task 08: $1,849.09 CREDIT ADJUSTMENT (total project contract limit) -$4.18 TOTAL E.!HI9 BILUNG PERIOD D 2,271.221 Budget Status CH2M HILL Project#469392 Sunset Terrace Regional Stormwater Facility Previously Current Invoiced to Budget Percent Task Description Budget Invoiced Invoice Date Remaining Complete 12/1112015 12111/2015 1 Project Management(thru Amend 2) $27,262.12 $29,996.35 $422.13 $30,418.48 ($3,156.36) 112% 2 Basemap Prep&Supplemental Survey $17,254.00 $17,109.83 $0.00 $17,109.83 $144.17 99% 3 Public Involvement $4,594.00 $364.43 $0.00 $364.43 $4,229.57 8% 4 Hydrologic/Hydraulic Modeling $15,956.00 $12,086.84 $0.00 $12,086.84 $3,869.16 76% 5 Final Geotechnical Report $3,357.00 $2,291.35 $0.00 $2,291.35 $1,065.65 68% 6 Permit Support $3,112.00 $1,639.93 $0.00 $1,639.93 $1,472.07 53% Final Design, Construction Docs& Cost Estimate and 7 Landscape Architecture-HBB(thru Amend 2) $118,567.88 $129,294.74 $0.00 $129,294.74 ($10,726.86) 109% 8 Services During Bidding & Construction $5,621.00 $669.31 $1,849.09 $2,518.40 $3,102.60 45% Total Tasks $195,724.001 $193,462.78 $2,271.22 $195,724.00 $0.00 100.0% chZM10 December 15,2015 Allen Quynn City of Renton 1055 S. Grady Way Renton,WA 98057 Subject: Sunset Community Low Impact Development Retrofit Project- Sunset Terrace Regional Stormwater Facility Invoice No.9 Through December 11th,2015 Dear Allen: Enclosed is invoice No. 9 for the above captioned task. Please see the attached progress report and table summarizing the percent complete of each subtask.This is the final invoice for the project. If you have any questions please give me a call at 206.612.8901. Sincerely, CH2M HILL Dustin Atchison,P.E. Project Manager PROGRESS REPORT Through December 11 th,2015 Status of Activities Current Invoiced to Budget Task Description Budget Invoice Date Remaining 12111/2015 12/11/2015 1 Project Management $27,262.12 $422.13 $30,418.48 $3,156.36 Basemap Prep& 2 Supplimental Survey $17,254.00 $0.00 $17,109.83 $144.17 3 Public Involvement $4,594.00 $0.00 $364.43 $4,229.57 Hydrologic/Hydraulic 4 Modelinq $15,956.00 $0.00 $12,086.84 $3,869.16 5 Final Geotechnical Report $3,357.00 $0.00 $2,291.35 $1,065.65 6 Permit Support $3,112.00 $0.00 $1,639.93 $1,472.07 Final Design,Construction 7 Does&Cost Estimate $118,567.88 $0.00 $129,294.74 $10,726.86) Services During Bidding & 8 Construction $5,621.00 $1,849.09 $2,518.40 $3,102.60 Total Tasks $195 724.00 $2 271.22 $195 724.00 $0.00 Activities Performed During This Period: Task 1 -Project Management • Project administration. • Project Status reports and invoicing • Sub-consultant coordination Task 2-Basemap Prep &Supplemental Survey • Completed Task 3-Public Involvement • Completed Task 4-Hydrologic/Hydraulic Modeling • Completed Task 5-Final Geotechnical Report • Completed Task 6-Permit Support • Completed Task 7--Final Design,Construction Docs&Cost Estimate • Completed Task 8-Services During Bidding&Construction • Field meeting 8/6 • Prepare sketches for Flow Splitter modifications. • Address questions for plants availability and topsoil. • Address questions for irrigation waterline valve location. 3 r Q.C(S5 H S -63- lccx S' �p CH2M Hill Engineers, Inc. 7� 1100 112th Avenue NE STE 400 Bellevue, WA 98004 Tel 425453-5000 Fax 425-462-5957 Please remit to: CH2M Hill Engineers, Inc PO Box 201869 Dallas, TX 75320-1869 City of Renton P,r1-7- C7'r o V E d ATTN: Neil Watts Date: 4-Jun-15 Public Works Department n 5 Project No.: 469392 2015 1055 S. Grady Way Client Ref#: 000771 Renton, WA 98057 C, I , ,.- r ENTON Invoice No.: 381030663 For professional services January 01, 2015, through May 29, 2015, in connection with the Sunset Terrace Regional Stormwater Facility, Reference#CAG-13-021. Task 1 -Proiect Management Professional Services Title Name Hours Rate Amount Project Manager Atchison, Dustin 6.0 $60.86 $365.16 Project Accountant Burnett, Lori Lynne 15.1 $26.40 $398.64 Task Engineer-Water Caley, Guy T 19.0 $56.53 $1,074.07 Task Engineer-Water Chung, Raymond 1.0 $54.45 $54.45 Contracts Administrator Totten, Cheryl Anne 1.0 $42.51 $42.51 Total Direct Salary Cost(DSC) $1,934.83 Overhead Rate(OH)of 149.5% x DSC = $2,892.57 Subtotal of DSC+OH $4,827.40 20% Fee on Labor $965.48 Subtotal DSC, OH &Fee: $5,792.88 Subtotal Task 01: $5,792.88 Task 2- Basemap Preparation & Supplemental Survey Professional Services Title Name Hours Rate Amount Survey/Cartography Brooks, Gregory 4.0 $45.94 $183.76 Survey/Cartography Soares, Edgar Brugnago 2.0 $26.17 $52.34 Total Direct Salary Cost(DSC) $236.10 Overhead Rate(OH)of 149.5% x DSC= $352.97 Subtotal of DSC+OH $589.07 20% Fee on Labor $117.81 Subtotal DSC,OH & Fee: $706.88 Subtotal Task 02: $706.88 Task 4-Hydrologic/Hydraulic Modeling Professional Services Title Name Hours Amount Task Engineer-Water Chung, Raymond 13.0 $54.45 $707.85 Total Direct Salary Cost(DSC) $707.85 Overhead Rate(OH) of 149.6%x DSC= $1,058.24 Subtotal of DSC +OH $1,766.09 20% Fee on Labor $353.22 Subtotal DSC, OH& Fee: $2,119.31 Subtotal Task 04: $2,119.31 Task 7-Final Design, Construction Documents&Cost Estimate Professional Services Title Name Hours Rate Amount Project Manager Atchison, Dustin 3.0 $60.86 $182.58 Task Engineer-Water Caley, Guy T 8.0 $56.53 $452.24 Task Engineer-Water Chung, Raymond 55.5 $54.45 $3,021.98 Sr Geotechnical Engineer Dawson, Karen 2.0 $67.69 $135.38 Task Engineer-Civil Thatcher, Erin L 56.0 $34.18 $1,914.08 Trans/Traffic Design Tech Tyler, Jacqueline 65.0 $53.94 $3,506.10 Total Direct Salary Cost(DSC) $9,212.36 Overhead Rate(OH)of 149.5%x DSC= $13,772.48 Subtotal of DSC+OH $22,984.84 20% Fee on Labor $4,596.97 Subtotal DSC, OH S Fee: $27,581.81 Direct Expenses Subconsultant/Lab Services Houch Beck& Baird, Inc. Inv#10873 $2,937.84 Markup on Subconsultant/Lab Services $58.76 Subtotal of Expenses: $2,996.60 Subtotal Task 07: $30,578.41 Task 8-Services During Bidding &Construction Professional Services Title Name Hours Rate Amount Design Manager Atchison, Dustin 1.5 $60.86 $91.29 Project Accountant Burnett, Lori Lynne 3.1 $26.40 $81.84 Contracts Administrator Le, Connie Kim 1.0 $38.20 $38.20 Survey/Cartography Smids, Kirsten Pauline 0.5 $24.43 $12.22 Total Direct Salary Cost(DSC) $223.55 Overhead Rate(OH) of 149.5% x DSC = $334.21 Subtotal of DSC+OH $557.76 20% Fee on Labor $111.55 Subtotal DSC, OH & Fee: $669.31 Subtotal Task 08: $669.31 TOTAL DUE THIS ILUNG PERIOD 39,866.79 Budget Status CH2M HILL Project#469392 Sunset Terrace Regional Stormwater Facility Previously Current Invoiced to Budget Percent Task Description Budget Invoiced Invoice Date Remaining Complete 5/29/2016 6/29/2015 1 Project Management(thru Amend 2) $27,262.12 $24,203.47 $5,792.68 $29,996.35 $2,734.23 110% 2 Basemap Prep&Supplemental Survey $17,254.00 $16,402.95 $706.88 $17,109.83 $144.17 99% 3 Public Involvement $4,594.00 $364.43 $0.00 $364.43 $4,229.57 8% 4 Hydrologic/Hydraulic Modeling $15,956.00 $9,967.53 $2,119.31 $12,086.64 $3,669.16 76% 5 Final Geotechnical Report $3,357.00 $2,291.35 $0.00 $2,291.35 $1,065.65 68% 6 Permit Su rt $3,112.00 $1,639.93 $0.00 $1,639.93 $1,472.07 53% Final Design, Construction Docs&Cost Estimate and 7 Landscape Architecture-HBB(thru Amend 2) $118,567.88 $98,716.33 $30,578.41 $129,294.74 $10,726.86 109% 8 Services During Bidding & Construction $5,621.00 $0.00 $669.31 $669.31 $4,951.69 12% Total Tasks $196,724.00 $163,686.99 $39,866.79 $193,462.78 $2,271.22 98.8°� Ch24n* June 4th,2015 Hebe Bernardo City of Renton 1055 S. Grady Way Renton,WA 98057 Subject: Sunset Community Low Impact Development Retrofit Project- Sunset Terrace Regional Stormwater Facility Invoice No.8 Through May 29nd,2015 Dear Hebe: Enclosed is invoice No. 8 for the above captioned task. Please see the attached progress report and table summarizing the percent complete of each subtask. If you have any questions please give me a call at 206.612.8901. Sincerely, CH2M HILL Dustin Atchison,P.E. Project Manager r PROGRESS REPORT Through May29nd,2015 Status of Activities Current Invoiced to Budget Task Description Budget Invoice Date Remaining 01/01/2015 05/29/2015 1 Project Management $27,262.12 $5,792.88 $29,996.35 $2,734.23 Basemap Prep & 2 Supplimental Survey $17,254.00 $706.88 $17,109.83 $144.17 3 Public Involvement $4,594.00 $0.00 $364.43 $4,229.57 Hydrologic/Hydraulic 4 Modeling $15,956.00 $2,119.31 $12,086.84 $3,869.16 5 Final Geotechnical Report $3,357.00 $0.00 $2,291.35 $1,065.65 6 Permit Support $3,112.00 $0.00 $1,639.93 $1,472.07 Final Design, Construction 7 Docs& Cost Estimate $118,567.88 $30,578.41 $129,294.74 $10,726.86 Services During Bidding & 8 Construction $5,621.00 $669.31 $669.31 $4,951.69 Total Tasks $195,724.00 $39 866.79 $193 452.78 $2 271.22 Activities Performed During This Period: Task 1 -Project Management • Project administration. • Project Status reports and invoicing • Coordination with Sunset Terrace Park Plan Development. • Sub-consultant coordination • Processed Amendment 2-Irrigation system and contract extension. Task 2- Basemap Prep & Supplemental Survey • Updated basemap and existing utilities • Completed Task 3-Public Involvement • Completed Task 4-Hydrologic/Hydraulic Modeling • Performed existing pipe capacity analysis. • Updated the final Technical Information Report. 2 Task 5-Final Geotechnical Report • Completed Task 6-Permit Support • Completed Task 7-Final Design,Construction Docs &Cost Estimate • Prepared 90% Submittal-Drawings,Cost Estimate and Special Specifications. • Prepared one new drawings for the pre-demolition conditions. • Coordinate with the construction of Library for proposed storm drain and water line. • Added Library construction drawings in CAD background. • Prepared 100% Submittal-Drawings,Cost Estimate and Special Specifications (3/20). • Added one drawing for the relocation of the water line • Prepared 100% full size drawings Task 8-Services During Bidding&Construction • Accounting and administrative effort to transition to construction and close-out. Deliverables This Period: • Prepared 90% Submittal-Plans,Specifications,and cost estimate(1/23) • Added Irrigation Plans and Details(3 sheets). • Prepared 100% Submittal-Plans,Specifications,and cost estimate (3/5) • Prepared 100% Full size drawings(3/5). • Prepared the Final TIR(3/20) • Submitted AutoCAD Files (3/10) Scope,/Change Mana eg ment: • Consultant is withholding overruns on Task 7 to manage contract to net overall budget of Tasks 2 to 7 in recognition that some task budgets may be exceeded while others may be under-spent. • Per submittal of final plans,Tasks 2 through 7 are complete. Additional project management and invoicing has been expended under Task 1 due to extended contract duration. A net$2,217 remains for completion of Task 1 and 8 pending potential amendment to provide services during construction. • Amendment#2 for$4,104 signed and approved on March 4,2015 and is incorporated herein. 3 / FORM: ADD-2010 CAG-13-021 , Adden #2-15 ADDENDUM NO. 2 ENGINEERING CONSULTANT AGREEMENT FOR PROFESSIONAL SERVICES for Sunset Terrace Regional Stormwater Facility, CAG-13-021 u v, This Addendum is made and entered into this ( , day of �I�At��X by and between the City of Renton, hereinafter called the "City", and CH21VIHILL Engineers, Inc. whose address is 1100 1121h Ave NE Suite 500 Bellevue, WA 98004, hereinafter called the "Consultant". WITNESSETH THAT: WHEREAS, the City engaged the services of the consultant under Engineering Consultant Agreement CAG-13-021, dated January 31, 2013,to provide engineering services necessary for the Sunset Community Plan SSIP—Sunset Terrace Regional Stormwater Facility Project; and WHEREAS, the City desires to complete the work associated with the Sunset Community Plan SSIP— Harrington Avenue NE Green Connections Project, and the City does not have sufficient qualified engineering employees to perform the work within a reasonable time; and WHEREAS, the City and consultant have determined that additional services are required to complete the work items listed in Exhibit A Scope of Services under the original contract CAG-13-021, dated January 31, 2013; NOW, THEREFORE, in accordance with Section Vill Extra Work of the Master Agreement CAG-13-021, dated January 31, 2013, it is mutually agreed upon that Engineering Consultant Agreement CAG-13- 021, is amended to include the work and associated budget as follows: 1. The Scope of Work (Section I of the Master Agreement CAG-13-021) is modified to include the additional services on the attached Exhibit A. 2. The Payment (Section VI of the Master Agreement CAG-13-021) is modified to include payment for the additional work items defined in Exhibit A. The revised contract total payable for work on this contract addendum is increased from 191,620.00 to $195,724.00, making a difference of $4104.00. The maximum amount payable for the additional work items defined in Exhibit B of this contract addendum is $4,104.00, without prior authorization from the City. 3. The Time of Completion (Section V of the Master Agreement CAG-13-021)for the above referenced contract is extended until December 31, 2015. All other provisions of Consultant Agreement CAG-13-021 dated January 31, 2013 shall apply to this addendum. GO CH2MHILL ADDENDUM 2 to GAC-I2-OXX(2) EXECUTION IN WITNESS WHEREOF, the parties have executed this Addendum No. 2 to ENGINEERING CONSULTANT AGREEMENT CAG-13-021 as of the day and year first above written. CONSULTANT C OF RENTON ZD 2�0157 Sig ture Date Gregg Zi f7fn, dministrator bate J A ES G. Koff A Type or Print Name Ulm ��S ld ErVT_ Title GO CH2MHILL ADDENDUM 2 to GAC-I2-OXX(2) City of Renton Sunset Terrace Regional Facility -Amendment#2 Exhibit A: Scope of Work Updated:January 28, 2015 Project Description— The project description is supplemented os follows: Amendment#1 specifically addresses additional scope to provide landscape architecture services for an irrigation system, project management and quality. Scope of Work TASKS 2- 8 ARE NOT MODIFIED BY AMENDMENT#2 TASK 1A. PROJECT MANAGEMENT- SUPPLEMENT 1.1. Project Administration. CONSULTANT will extend project administrative services for subconsultant management and quality assurance for the additional landscape architecture services. TASK 9.—LANDSCAPE ARCHITECTURE - NEW TASK 9B DESIGN & CONSTRUCTION DOCUMENTS This task supplements Task 7 to constructed Final construction documents, specifications and cost estimating with landscape architecture services. • Attend one design team meetings (phone conference) regarding irrigation design of the rain gardens. • Includes the layout of the water service line for the irrigation system. • Prepare design drawings and details for 90% and 100% submittals. Submittals include irrigation plans, specifications, and estimate. • 100% submittal will be the final, bid-ready construction documents and will not be further revised prior to bid. Exhibit B Task Description LOE Labor Subs Expenses Price 1 Project Management 5 $ 571 $ 513 $ - $ 1,085 7 Final Design, Construction Documents, and Cost Estimate 3 $ 508 $ 2,462 $ 50 $ 3,020 8-1 01 0 $ - $ - $ 1 $ - Total 1 8 $ 1,079 1 $ 2,975 1 $ 50 1 $ 4,104 ADMINISTRATIVE SERVICES DEPT. D Q c;tyoe City Clerk Office M E M O R A N D U M DATE: March 6, 2015 RECEIVED TO: Hebe Bernardo, PW— Utility Systems MAR 0 9 2015 FROM: dy Moya, Records Management Specialist CITY OF RENTON 0 UTILITY SYSTEMS SUBJECT: CAG-13-021, Adden #2-15—CH2M Hill Engineers, Inc. The attached document has been fully executed and is being returned to you. Please transmit the original to the contractor and retain a copy for your file. The City Clerk has retained an original for the file. Thank you! h:Vecords specialist\correspondence & memos - cindy\contract - fully executed.doc ADMINISTRATIVE SERVICES DEPT. D Q c;cyaf City Clerk Office M E M O R A N D U M DATE: July 24, 2014 RECEIVED TO: Hebe Bernardo, PW- Utilities JUL 2 5 2014 CITY OF RENTON FROM: gndy Moya, Records Management Specialist UTILITY SYSTEMS SUBJECT. CAG-13-021,Adden#1-14—CH2MHILL, Engineers, Inc. The attached document has been fully executed and is being returned to you. Please transmit the original to the contractor and retain a copy for your file.The City Clerk has retained an original for the file. Thank you! h:\records specialist\correspondence &memos - cindy\contract- fully executed.doc PUBLIC WORKS DEPARTMENT D City of R �CE_ ---- DATE a�. 1 I y M E M O R A N D U N �I A,e.4 -L, It I DATE: June 26, 2014 ct TO: Gregg Zimmerman, Public Works Adr i dLV ,.._..t_c FROM: Lys Hornsby, Utility Systems Director STAFF CONTACT: Ron Straka, Surface Water Utility Engineering Manager, x7248 Hebe C. Bernardo, Surface Water Utility Engineer, x 7264 SUBJECT: Addendum #1 to CAG-13-021 for the Sunset Terrace Regional Stormwater Facility Project with CH2MHILL Engineers Please sign Addendum #1 to the Engineering Consultant Agreement with CH2MHILL Engineers, Inc. for final design of the Sunset Terrace Regional Stormwater Facility project, CAG-13-021, in the amount of$12,617. Under the original contract, the Consultant is providing design services for the design of the Regional Stormwater Facility located in the future Sunset Neighborhood Park to retrofit approximately three acres of roadway from Sunset Boulevard (a high-traffic major arterial), adjacent roads, and developments by providing flow control and enhanced basic water quality treatment prior to discharging into Johns Creek. The Sunset Terrace Regional Stormwater Facility Project will consist of rain gardens and an infiltration gallery. Amendment#1 is needed to address additional scope to provide landscape architecture services, project management, and quality control. The Sunset Terrace Regional Stormwater Facility Project will be funded ($983,000) by Ecology's FY 2012 Statewide Stormwater Grant Agreement No. G1200544 and the Surface Water Utility's Capital Improvement Program (CIP) for the Sunset Terrace Regional Stormwater Facility Project (427.475492). The approved 2013-2014 CIP budget for the project is $1,307,172, including$983,000 of grant funding approved in 2012. The remaining project budget is for City project management and construction cost. Attachments H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-8889 Sunset Regional SW Facility\1103 Contracts\Addenum 1\Addendum#1 CH2MHILL Memo to Gregg.doc\HBad PUBLIC WORKS DEPARTMENT D City of M E M O R A N D U M DATE: June 26, 2014 TO: Gregg Zimmerman, Public Works Administrator FROM: Lys Hornsby, Utility Systems Director STAFF CONTACT: Ron Straka, Surface Water Utility Engineering Manager, x7248 Hebe C. Bernardo, Surface Water Utility Engineer, x 7264 SUBJECT: Addendum #1 to CAG-13-021 for the Sunset Terrace Regional Stormwater Facility Project with CH2MHILL Engineers Please sign Addendum #1 to the Engineering Consultant Agreement with CH2MHILL Engineers, Inc. for final design of the Sunset Terrace Regional Stormwater Facility project, CAG-13-021, in the amount of$12,617. Under the original contract, the Consultant is providing design services for the design of the Regional Stormwater Facility located in the future Sunset Neighborhood Park to retrofit approximately three acres of roadway from Sunset Boulevard (a high-traffic major arterial), adjacent roads, and developments by providing flow control and enhanced basic water quality treatment prior to discharging into Johns Creek. The Sunset Terrace Regional Stormwater Facility Project will consist of rain gardens and an infiltration gallery. Amendment#1 is needed to address additional scope to provide landscape architecture services, project management, and quality control. The Sunset Terrace Regional Stormwater Facility Project will be funded ($983,000) by Ecology's FY 2012 Statewide Stormwater Grant Agreement No. G1200544 and the Surface Water Utility's Capital Improvement Program (CIP) for the Sunset Terrace Regional Stormwater Facility Project (427.475492). The approved 2013-2014 CIP budget for the project is $1,307,172, including $983,000 of grant funding approved in 2012. The remaining project budget is for City project management and construction cost. Attachments H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-8889 Sunset Regional SW Facility\1103 Contracts\Addenum 1\Addendum#1 CH2MHILL Memo to Gregg.doc\HBad City Clerk Number f• Checklist Select One: ❑X Contract ❑ Permit ❑ Lease ❑ Agreement Contract Type (assigned by City Clerk) Staff Name: Hebe C. Bernardo Extension: 7264 Department/Division: EDEN Public Works/Surface Water Utility Approval Queue: 05/007p Addendum Number: 1 to City Clerk Number: CAG-13-021 (if applicable). Contract Class: ❑ Receivable FX_j Payable ❑ Grant ❑ Misc. (no$) Expiration Date: 06/30/2015 Contractor Name: CH2MHILL Short Description: Sunset Terrace Regional Stormwater Facility, SWP 27-5295 Full or Additional Sunset Terrace Regional Stormwater Facility, SWP 27-5295, provide flow control and enhanced basic Description: water quality treatment prior to discharge to Johns Creek consisting of rain gardens and infiltration gallery. ❑X Legal Review (attach memorandum from City Attorney) Risk Management review for insurance (attach memorandum from Risk Management) 7 Insurance certificate and/or policy (attach original) ❑ Response to legal or Risk Management concerns (explain, in writing, how concerns have been met) ❑ Performance bond and verification memo from staff(for Public Works contracts only) ❑X Federal excluded parties list verification (Website. www.epls.gov; attach printout of search results) City business license number: Check EDEN or ask Finance Department. ❑ Accounts payable W-9 vendor form (obtain if not already on file with Finance Dept.) Submitted contracts are signed by contractor: ❑X Yes ❑ No If not, provide explanation below. Fiscal Impact: ❑X Expenditure or ❑ Revenue Amount Budgeted: Amount: $ 12,617 (line item;see below*): $ 1,307,172 Prior Council approval via agenda bill process required if: (see policies 250-02 and 800-12) ❑ Contract or addendum is$20,000 or over(non-Public Works)or$30,000 or over(Public Works). ❑ "Contract expenditure amount exceeds budgeted amount; fund transfer needed. ❑ Addendum is for the second and additional time extensions. ❑ Interlocal Agreement (most Interlocal Agreements require Resolutions) Date of Council Approval: Resolution Number: Contractor determined via: ❑ Phone Bid/Written Quote ❑ CFB Ad (if applicable) (if applicable) Consultant Roster RFP/SOQ Ad ❑ Application ❑ Sole Source Key words for City Clerk's electronic card file: r H2MHILL, Sunset Terrace, SR-900, Johns Creek, Department of Ecology FY-2012 Grant Agreement, LID, Stormwater trofit, Sunset Terrace Regional Stormwater Facility Print Form Revised 07/23/2008 HUMAN RESOURCES DI 007iq,of AND RISK MANAGEMENT M E M O R A N D U M DATE: April 17, 2014 TO: Hebe Bernardo FROM: Gary B. Lamb, Risk Manager SUBJECT: Insurance Review/CH2M Hill Engineers, Inc. Contract addendum to the Harrington Ave NE Stormwater Green Connections Improvement Project. I have reviewed the certificate of insurance for the above-mentioned entity. The insurance certificate meets the city's risk management requirements. \\rvfps-02\depts\pw\file sys\swp-surface water projects\swp-27-surface water projects(cip)\27-8889 sunset regional sw facility\1103 contracts\addenum 1\ch2mhill engineering_bernardo 2014.doc ® DATE(MMIDDIYYYY) AC40R o CERTIFICATE OF LIABILITY INSURANCE 04/22/2014 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 CONTACT MARSH USA INC. NAME' 122517TH STREET,SUITE 1300 PHONENo E : aC No): DENVER,CO 80202-5534 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# 15114-12345-5EX2P-14115 028600 CA INSURER A:Greenwich Insurance Compan y 22322 INSURED INSURER B:N/A N/A CH2M HILL ENGINEERS,INC. 1100 112TH AVE NE,SUITE 500 INSURER C:XL Insurance America,Inc. 24554 BELLEVUE,WA 98004 INSURER D:Zurich American Insurance Co 16535 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-002440387-04 REVISION NUMBER:2 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER Y EFF POLICY EXP LTR POLICY NUMBER MM/DDNYYY MM/DD/YYYY LIMITS GENERAL LIABILITY X EACH OCCURRENCE $ 1,500,000 A X COMMERCIAL GENERAL LIABILITY RGE500025503 05/01/2014 05/01/2015 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,500,000 CLAIMS-MADE Fq OCCUR MED EXP(Any one person) $ X $500,000 SIR PERSONAL&ADV INJURY $ 1,500,000 GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 5,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 21000,000 Ea accident A X ANY AUTO RAD500025403(ADS) 05101/2014 05/01/2015 BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED RAD500025603(MA) 05/01/2014 05101/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED I I RETENTION$ I$ WORKERS COMPENSATION X WC STATU- OH- AND EMPLOYERS'LIABILITY C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N RWD500025203(AIDS) 05/01/2014 05/01/2015 E.L.EACH ACCIDENT $ 1,000,000 G OFFICER/MEMBER EXCLUDED? a N/A RWR500025303 WI 05/01/2014 05/01/2015 1,000,000 (Mandatory in NH) ( ) E.L.DISEASE-EA EMPLOYE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D PROFESSIONAL LIABILITY' EOC3829621-12 05/0112014 05/01/2015 Each Claim&Aggregate $2,000,000 Each Policy Period DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) RE:SUNSET TERRACE COMMUNITY LID RETROFIT PROJECT-GREEN CONNECTION:HARRING TON AVE NE,PH 2 CITY OF RENTON IS INCLUDED AS AN ADDITIONAL INSURED ON THE GENERAL LIABILITY POLICY AS REQUIRED BY WRITTEN CONTRACTOR AGREEMENT. COVERAGE PROVIDED BY THE ABOVE GENERAL LIABILITY AND AUTO POLICIES SHALL BE PRIMARY AND NON-CONTRIBUTORY AND IS LIMITED TO THE LIABILITY RESULTING FROM THE NAMED INSURED'S OWNERSHIP AND/OR OPERATIONS. 'FOR PROFESSIONAL LIABILITY COVERAGE,THE AGGREGATE LIMIT IS THE TOTAL INSURANCE AVAILABLE FOR CLAIMS PRESENTED WITHIN THE POLICY PERIOD FOR ALL OPERATIONS OF THE INSURED.THE LIMIT WIL L BE REDUCED BY PAYMENTS OF INDEMNITY AND EXPENSE. CERTIFICATE HOLDER CANCELLATION CITY OF RENTON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN:HEBE BERNARDO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PUBLIC WORKS DEPT. ACCORDANCE WITH THE POLICY PROVISIONS. 1055 S GRADY WAY,5TH FLOOR RENTON,WA 98057 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Sharon A.Hammer ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ENDORSEMENT#006 This endorsement,effiective 12:01 a.m.,May 01,2014 forms a part of Policy No.RAD500026403 issued to CH2M HILL COMPANIES, LTD. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED—PRIMARY WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section 11 A. 1.WHO IS AN INSURED is amended to include: Any entity,person,or organization you are required or have agreed in a written contract, permit,access agreement and any other written agreement to provide insurance. This insurance is primary for the entity,person or organization, but only with respect to liability arising out of your work for that insured by or for you. Other insurance afforded to that insured will apply as excess and not contribute as primary to the insurance afforded by this endorsement. However, the insurance provided shall not exceed the scope of coverage and/or limits of this policy. Notwithstanding the foregoing sentence, in no event shall the insurance provided exceed the scope of coverage and/or limits required by said written contract, permit,access agreement.. (Authorized Representative) MANUS rj-D 2014 X.L.America, Inc. All Rights Reserved. May not be copied without permission. ENDORSEMENT#009 This endorsement, effective 12:01 a.m., May 01, 2014 forms a part of Policy No.RAD500025403 issued to CH2M HILL COMPANIES, LTD, by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled or non renewed for any statutorily permitted reason, other than nonpayment of premium, or if coverage is materially reduced, advanced written notice will be mailed or emailed to person(s)or entity(ies)according to the notification schedule shown below: _ - Number of Days Name of Person(s)or Entity(ies) Mailing Address: Advanced Notice of Cancellation: Per the most current schedule maintained by Marsh USA, Inc. and furnished to XL Insurance no less than 60 days 15 days prior to the 60 days of notice of cancellation, non-renewal or material reduction in coverage _ For the purpose of this endorsement,non-renewal shall mean solely ncn-renewal of the Policy and shall not include Notice of Conditional Renewal. Material reduction in coverage shall mean a decrease in the Policy limits,an increase in the deductible or self-insured retention or the application of a Policy exclusion not contemplated at Policy issuance. All other terms and conditions of the Policy remain unchanged. (Authorized Representative) MANUS ®2014 X.L. America;Inc. All Rights Reserved. May not be copied without permission. ENDORSEMENT#041 This endorsement,effective 12:01 a.m., May 01, 2014. forms a part of Policy No.RGE500025503 by Greenwich Insurance Company issued to CH2M HILL COMPANIES, LTD. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY AUTOMATIC ADDITIONAL INSURED'S PRIMARY COVERAGE This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Wth respect to coverage provided by this endorsement,the provisions of the Coverage Part apply unless modified by this endorsement. SCHEDULE Name Of Additional Insured Person(s)Or Organization Locations' of Covered Operations Any entity, person or organization you are required All Locations by any contract,permit,access agreement, executed prior to any loss to provide additional insured status under this Policy. A. Section II—Who is an Insured is amended to include as an additional insured the person(s)or Organization (s) shown in the schedule and any other person(s) or organization(s) you are required to add as an additional insured under the contract, permit or access agreement described in the schedule but only with respect to liability for "bodily injury" or "property damage"or"personal and advertising injury caused,in whole or in part by: 1. "Bodily Injury",'property damage` or"personal and advertising injury"caused by the your operations on the additional insured's premises or 2. "Your work"for the additional insured and included in the products-completed operations hazard';or 3. Your acts or omissions;or 4. The acts or omissions of those acting on your behalf. As resects 2,3, and 4 the following also applies in the performance of your ongoing operations for the additional insured(s)at the location(s)designated above. However: MANUS O 2014 X.L.America, Inc. All Rights Reserved. May not be copied without permission. 1.the insurance afforded to such additional insured(s) only applies to the extent permitted by law,and 2. If coverage provided to the additional insured(s)is required by a contract,permit or access agreement,the insurance afforded to such additional insured(s)will not be broader than that which you are required by the contract,permit or access agreement to provide for such additional insured(s) B. Only when required by a contract,permit or-access agreement this insurance applies to: 1. (a)All work on the project(other than service,maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the site of the covered operations has been completed;or(b)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. 2. 'Bodily Injury"or"Property Damage arising out of any act or omission of the additional insured(s) or any of their employees,other than the general supervision of work performed for the additional insured(s)by you. However: 3.The insurance afforded to such additional insured(s)only applies to the extent permitted by law and 4 If coverage provided to the additional insured(s)is required by a contract,permit or access agreement,the insurance afforded to such additional insured(s)will not be broader than that which you are required by the contract,permit or access agreement to provide for such additional insured(s). C. Any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured(s)whether primary,excess,contingent or on any other basis unless a contract specifically required that this insurance be primary, or you request that it apply on a primary basis.When this insurance applies on a primary basis for the additional insureds described above, it shall apply only to"bodily injury', `property damage" or "personal and advertising injury'caused by your work for that additional insured by or for you. Other insurance afforded to those additional insureds will apply as excess and not contribute as primary to the insurance afforded by this endorsement. The limits of, insurance with respect to each person,organization or entity shall not exceed the limits of liability of the named insured All insuring agreements, exclusions and conditions of this policy apply. In no event, shall the coverage or limits of insurance in this coverage form be increased by such contract, permit or access agreement. All other terms and conditions remain the same. Authorized Representative MANUS n 2014 X.L.America, Inc. All Rights Reserved. May not be copied without permission. ENDORSEMENT#027 This endorsement, effective 12:01 a.m„ May 01, 2014 forms a part of Policy No.RGE600025503 issued to CH2M HILL COMPANIES, LTD. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled or non renewed for any statutorily permitted reason or if coverage is materially reduced,or coverage is cancelled for non-payment of premium advanced written notice will be mailed or emailed to the person or entity according to the notification schedule shown below: Number of Days Name of Person or Entity Mailing Address: Advanced Notice of Cancellation: Per the most current schedule maintained by Marsh USA, Inc. and furnished to XL Insurance no less than 15 days prior to 60 days the 60 days of notice of cancellation, non- renewal or material reduction in coverage For the purpose of this endorsement, non-renewal shall mean solely non-renewal of the Policy and shall not include expiration or Notice of Conditional Renewal. Material reduction in coverage shall mean a decrease in the Policy limits,an increase in the deductible or self-insured retention or the application of a Policy exclusion not contemplated at Policy issuance, All other terms and conditions of the Policy remain unchanged. (Authorized Representative) MANUS O 2014 X.L. America, Inc. All Rights Reserved. May not be copied without permission. Endorsement;# i Notification to Others of Cancellation Electronic Schedule Z U R I C H Poticy Nu. EfE Uuta u(NA. Exp.Date of Pd. Eft.Data OfEai. Produarr Addl Prrm. Re ira Prun. kUC3V%21-12 0510r1?014 05.101.41015 0510V2014 2925300 -- Named Insured ant)Mailing Addrms: producer; CH2M Hill Companies,Ltd. Marsh USA, Inc. 9191 S Jamaica St 1225 17th St Ste#2100 Englewood CO 80112-5946 Denver CO 80202-5521 THIS ENDORSEN7TNT CHANGES THE POLICY. PLEASE READ 1T t.::S.RUFULLY. This endor-sement modifies insuranceprovided under the following: ' Architect;and Engineers Professional Lriabil[Uy Ltsurance Policy In crmsiderado n of Aic premium already charged.we agree with you,subject to all terms,exclusions,and coaditionns of the policy that. A. If we cancel this policy by written notiw to the first Named tnsun d for any reason other t'hati nonpayment of premium, wc; will mail or deliver a copy of such wT itten notice of Cancc1lUt.i0n: i. To the name and address cormsponding to each person or organiz-ation shown in the Schedule provided to us by the first "Named Insured". Such schedule; u. Must be initially provided to us N ithni 15 days: (1) After the beginning of the policy period shown in the Declarations;or (2) After this endorsement has been added w the policy; h. utntain the Haines and addresses of only the persons or organizations requiring notification that this Policy has bcc n Car]CIIed; i e. ktast be in an electronic format that is acceptable to i1.s;and d. Mast be accurate. Such Schedule unn,t be uprialctl and pnrvidcd to us,by the first "Named Tnsured", during the policy period. Sigh 141ild cd Schedule must Lomply with paragraphs It.,c.,and d.above. 2. At Icast thirty(30)days prior to the effective date of the cancellation,as advised in our notice to the first Named Insured, or the longer number of dam notice if indicated in the Schedule provided to us. B. Our notification, as descnbed in Paragraph A. of this endorsement, be based on the most recent Schedule provided to us by the first"Named Insured"as of the date the notice of cancellation is mailed. C. Proof of mailing will be sufficient proof that we have complied with I'aralaph A.of this endorsement. We are not responsible for the accuracy,integrity,timeliness and validity of information contained in the Schedule provide to us as described in Paragraphs A. of this endorsement. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Signed By: 5,'1;2014 Au prized Reptesmiu ve Date U-GL-t 13-A GW (4M) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 9906 57 (Ed. 12110) ENDORSEMENT#006 This endorsement,effective 12:01 a.m., May 01,2014 forms a part of Policy No. RWD500025203 issued to CH2M HILL COMPANIES, LTD. by XL Insurance America, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT This endorsement modifies insurance provided under the following: WORKERS'COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY In the event coverage is cancelled or non renewed for any statutorily permitted reason,other than nonpayment of premium,or if there is a material reduction in coverage, advanced written notice will be mailed or emailed to person(s) or entity(ies)according to the notification schedule shown below: Name of Person(s)or Entity(ies): Mailing Address: Number of Days Advanced Notice: Per the most current schedule maintained by Marsh USA,Inc. and furnished to XL Insurance no less 60 days than 15 days prior to the 60 days of notice of cancellation, non-renewal or material reduction in coverage. For the purpose of this endorsement, non-renewal shall mean solely non-renewal of the Policy and shall not include expiration or Notice of Conditional Renewal. Material reduction in coverage shall mean a decrease in the Policy limits,an increase in the deductible or self-insured retention or the application of a Policy exclusion not contemplated at Policy issuance. All other terms and conditions of the Policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective May 01,2014 Policy No. RWD500025203 Endorsement No. Insured:CH2M HILL COMPANIES, LTD. Premium: Included XL Insurance America. Inc. Countersigned by WC 99 06 57 Ed. 12110 D 2010 X.L.America,Inc.All Rights Reserved. May not be copied without permission. City off1 CITY ATTORNEY M E M O R A N D UM DATE: May 19, 2010 TO: Teresa Phelan, Administrative Secretary Public Works Department, Utilities Systems Division FROM: Lawrence J. Warren, City Attorney Staff Contact: Mark Barber, Senior Assistant City Attorney Telephone: (425) 430-6485 SUBJECT: Approval as to legal form of Template Addendum ADD-2010 Please be advised that I have reviewed the above-referenced Template Addendum ADD- 2010, and the same is approved as to legal form, and may be used in the future so long as there are no material changes or modifications to the standard form.. h:\02 mark\public works--contracts and agreements\2010-05-19 memo approving addendum template add-2010 with continuing approval.doc FORM: ADD-2010 ADDENDUM NO. 1 ENGINEERING CONSULTANT AGREEMENT FOR PROFESSIONAL SERVICES for Sunset Terrace Regional Stormwater Facility, CAG-13-021 This Addendum is made and entered into this , day of by and between the City of Renton, hereinafter called the "City", and CH2MHILL Engineers, Inc. whose address is 1100 1121h Ave NE Suite 500 Bellevue, WA 98004, , hereinafter called the "Consultant". WITNESSETH THAT: WHEREAS, the City engaged the services of the consultant under Engineering Consultant Agreement CAG-13-021, dated January 31, 2013, to provide engineering services necessary for the Sunset Community Plan SSIP—Sunset Terrace Regional Stormwater Facility Project; and WHEREAS, the City desires to complete the work associated with the Sunset Community Plan SSIP— Harrington Avenue NE Green Connections Project, and the City does not have sufficient qualified engineering employees to perform the work within a reasonable time; and WHEREAS, the City and consultant have determined that additional services are required to complete the work items listed in Exhibit A Scope of Services under the original contract CAG-13-021, dated January 31, 2013; NOW, THEREFORE, in accordance with Section VIII Extra Work of the Master Agreement CAG-13-021, dated January 31, 2013, it is mutually agreed upon that Engineering Consultant Agreement CAG-13- 021, is amended to include the work and associated budget as follows: 1. The Scope of Work (Section I of the Master Agreement CAG-13-021) is modified to include the additional services on the attached Exhibit A. 2. The Payment (Section VI of the Master Agreement CAG-13-021) is modified to include payment for the additional work items defined in Exhibit B. The revised contract total payable for work on this contract addendum is increased from $179,003.00, to 191,620.00, making a difference of $12,617.00. The maximum amount payable for the additional work items defined in Exhibit B of this contract addendum is $12,617.00, without prior authorization from the City. All other provisions of Consultant Agreement CAG-13-021 dated January 31, 2013 shall apply to this addendum. GO CH2MHILL ADDENDUM 1 to GAC-I2-OXX(2).doc EXECUTION IN WITNESS WHEREOF, the parties have executed this Addendum No. 1 to ENGINEERING CONSULTANT AGREEMENT CAG-13-021 as of the day and year first above written. CONSULTANT CITY OF RENTON tria Signature Date Gr Zi merman, Administrato bate Type or Print Name Title GO CH2MHILL ADDENDUM 1 to GAC-I2-OXX(2).doc City of Renton Sunset Terrace Regional Facility -Amendment#1 Exhibit A: Scope of Work Updated:June 17, 2014 I. Project Description—The project description is supplemented as follows: Amendment#1 specifically addresses additional scope to provide landscape architecture services, project management and quality. Scope of Work TASKS 2-8 ARE NOT MODIFIED BY AMENDMENT#1 TASK IA. PROJECT MANAGEMENT-SUPPLEMENT 1.1. Project Administration. CONSULTANT will extend project administrative services for subconsultant management and quality assurance for the additional landscape architecture services. TASK 9.—LANDSCAPE ARCHITECTURE - NEW TASK 9A DESIGN &CONSTRUCTION DOCUMENTS This task supplements Task 7 to constructed Final construction documents, specifications and cost estimating with landscape architecture services. • Attend three(3) design team meetings regarding planting design of the rain gardens. • Prepare design drawings and details for 30%, 60%,90%and 100%submittals. Submittals will include planting. Subsequent submittals after 30%will incorporate further design detail development, permitting agency comments, and client comments. • The 30%submittal will include:planting plan, plant schedule, and plant details.A 30% cost estimate will be provided.Special provisions will not be prepared for this submittal • The 60%submittal will include: planting plan, plant schedule, plant details, and soil preparation details.A 60%cost estimate will be provided. Information adequate for permit submittal. General special provisions to standard specifications will be provided. • The 90%submittal will include: planting plan, plant schedule, plant details, and soil preparation details. A 90%cost estimate will be provided.Special provisions to standard specifications will be provided. • 100%submittal will be the final, bid-ready construction documents and will not be further revised prior to bid. TASK 9B SERVICES DURING BIDDING This task supplements Task 8 to provide landscape architecture support during bidding. • Respond to contractor questions relating to the construction documents. Responses will be provided in writing. • Review of bidder-proposed substitution requests and submittals. • Prepare up to one (1) addendum that may be required to clarify the bid documents. City of Renton Sunset Area LID Retrofit - Sub-Regional Facility 6/17/14 Amendment 1 Budget Exhibit B Task Description LOE Labor Subs Expenses Price 1A Project Management 16 $ 2,163 $ 2,231 $ - $ 4,394 9A Final Design, Construction Documents, and Cost Estimate 0 $ - $ 7,189 $ - $ 7,189 9B Services During Bidding and Construction 0 $ - $ 1,034 $ - $ 1,034 Total 16 $ 2,163 $ 10,454 $ - $ 12,617 Denis Law City Of 1 Y U Mayor G t [ 6 » mas� r r =� o Public Works Department-Gregg Zimmerman,P.E.,Administrator July 1, 2014 Mr. Dustin Atchison CH2M Hill Engineers, Inc 1100 112th Ave N E, Ste 400 Bellevue, WA 98004 RE: SUNSET TERRACE REGIONAL STORMIWATER FACILITY, CAG-13-021 Dear Mr. Atchison: Enclosed please find the addendum to the existing CAG 13-021 contract. Please sign two originals, and return one original to the City. Please call me at 425-430-7264, if you have any questions. Sincerely, Hebe C. Bernardo Surface Water Utility Engineer Enclosure H:\File Sys\SWP-Su dace tiNater P-o ects\SVVP-27-Surface water Proiects(CIP)\27-8889 Sunset Regional SIN Facility\1103 Contracts\2014-07-01 Sign contract.doc\HCBah Renton City Hall • 1055 South Grady Way• Renton,Washington 98057 • rentonwa.gov City of CITY ATTORNEY M E M O R A N D UM DATE: May 19, 2010 TO: Teresa Phelan, Administrative Secretary Public Works Department, Utilities Systems Division FROM: Lawrence J. Warren, City Attorney Staff Contact: Mark Barber, Senior Assistant City Attorney Telephone: (425) 430-6485 SUBJECT: Approval as to legal form of Template Addendum ADD-2010 Please be advised that I have reviewed the above-referenced Template Addendum ADD- 2010, and the same is approved as to legal form, and may be used in the future so long as there are no material changes or modifications to the standard form.. hA02 mark\public works--contracts and agreements\2010-05-19 memo approving addendum template add-2010 with continuing approval.doc City Clerk Number Checklist Select One: [X—] Contract ❑ Permit ❑ Lease ❑ Agreement Contract Type (assigned by City Clerk) Staff Name: Hebe C. Bernardo Extension: 7264 Department/Division: EDEN Public Works/Surface Water Utility Approval Queue: 05/007p Addendum Number: 1 to City Clerk Number: CAG-13-021 (if applicable). Contract Class: ❑ Receivable ❑X Payable ❑ Grant ❑ Misc. (no $) Expiration Date: 06/30/2015 Contractor Name: CH2MHILL Short Description: Sunset Terrace Regional Stormwater Facility, SWP 27-5295 Full or Additional Sunset Terrace Regional Stormwater Facility, SWP 27-5295, provide flow control and enhanced basic Description: water quality treatment prior to discharge to Johns Creek consisting of rain gardens and infiltration gallery. ❑X Legal Review (attach memorandum from City Attorney) w OF RENT Risk Management review for insurance (attach memorandum from Risk Management) 0 Insurance certificate and/or policy (attach original) JUN 2014 ❑ Response to legal or Risk Management concerns (explain, in writing, how concerns have been Tyy R CE►V ERK'S p ICE ❑ Performance bond and verification memo from staff(for Public Works contracts only) ❑X Federal excluded parties list verification (Website: www.epls.gov, attach printout of search results) ❑X City business license number: Check EDEN or ask Finance Department. ❑ Accounts payable W-9 vendor form (obtain if not already on file with Finance Dept.) Submitted contracts are signed by contractor: ❑X Yes ❑ No If not, provide explanation below. Fiscal Impact: ❑X Expenditure or ❑ Revenue Amount Budgeted: Amount: $ 12,617 (line item,see below*): $ 1,307,172 Prior Council approval via agenda bill process required if: (see policies 250-02 and 800-12) ❑ Contract or addendum is $20,000 or over(non-Public Works)or$30,000 or over(Public Works). ❑ "Contract expenditure amount exceeds budgeted amount; fund transfer needed. ❑ Addendum is for the second and additional time extensions. ❑ Interlocal Agreement (most Interlocal Agreements require Resolutions) Date of Council Approval: Resolution Number: Contractor determined via: ❑ Phone Bid/Written Quote ❑] CFB Ad (if applicable) (if applicable) ❑X Consultant Roster RFP/SOQ Ad ❑ Application ❑ Sole Source Key words for City Clerk's electronic card file: rtro2MHILL, Sunset Terrace, SR-900, Johns Creek, Department of Ecology FY-2012 Grant Agreement, LID, Stormwater fit, Sunset Terrace Regional Stormwater Facility Print Form Revised 07/23/2008 PUBLIC WORKS DEPARTMENT ^Cmf�O� M E M O R A N D U M DATE: June 26, 2014 TO: Gregg Zimmerman, Public Works Administrator FROM: Lys Hornsby, Utility Systems Director STAFF CONTACT: Ron Straka, Surface Water Utility Engineering Manager, x7248 Hebe C. Bernardo, Surface Water Utility Engineer, x 7264 SUBJECT: Addendum #1 to CAG-13-021 for the Sunset Terrace Regional Stormwater Facility Project with CH2MHILL Engineers Please sign Addendum #1 to the Engineering Consultant Agreement with CH2MHILL Engineers, Inc. for final design of the Sunset Terrace Regional Stormwater Facility project, CAG-13-021, in the amount of$12,617. Under the original contract, the Consultant is providing design services for the design of the Regional Stormwater Facility located in the future Sunset Neighborhood Park to retrofit approximately three acres of roadway from Sunset Boulevard (a high-traffic major arterial), adjacent roads, and developments by providing flow control and enhanced basic water quality treatment prior to discharging into Johns Creek. The Sunset Terrace Regional Stormwater Facility Project will consist of rain gardens and an infiltration gallery. Amendment #1 is needed to address additional scope to provide landscape architecture services, project management, and quality control. The Sunset Terrace Regional Stormwater Facility Project will be funded ($983,000) by Ecology's FY 2012 Statewide Stormwater Grant Agreement No. G1200544 and the Surface Water Utility's Capital Improvement Program (CIP) for the Sunset Terrace Regional Stormwater Facility Project (427.475492). The approved 2013-2014 CIP budget for the project is $1,307,172, including$983,000 of grant funding approved in 2012. The remaining project budget is for City project management and construction cost. Attachments H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-8889 Sunset Regional SW Facility\1103 Contracts\Addenum 1\Addendum#1 CH2MHILL Memo to Gregg.doc\HBad HUMAN RESOURCES cityof AND RISK MANAGEMENT D ' �Oz M E M O R A N D U M DATE: April 17, 2014 TO: Hebe Bernardo FROM: Gary B. Lamb, Risk Manager SUBJECT: Insurance Review/CH2M Hill Engineers, Inc. Contract addendum to the Harrington Ave NE Stormwater Green Connections Improvement Project. I have reviewed the certificate of insurance for the above-mentioned entity. The insurance certificate meets the city's risk management requirements. \\rvfps-02\depts\pw\file sys\swp-surface water projects\swp-27-surface water projects(cip)\27-8889 sunset regional sw facility\1103 contracts\addenum 1\ch2mhill engineering_bernardo 2014.doc DATE(MWDD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE�,. oa/zvzol a 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(les)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 CONTACT MARSH USA INC. NAME' PHONE 122517TH STREET,SUITE 1300 A/C N t: A/C No: DENVER,CO 80202-5534 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# 15114-12345-5EX2P-14/15 028600 CA INSURER A:Greenwich Insurance Compan y 22322 INSURED INSURERS:WA N/A CH2M HILL ENGINEERS,INC. 1100112TH AVE NE,SUITE 500 INSURER C:XL Insurance America,Inc. 24554 BELLEVUE,WA 98004 INSURER D:Zurich American Insurance Cc 16535 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-002440387-04 REVISION NUMBER:2 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DDY EFF POLICY EXP LTR MM/DD/YYYY LIMITS LTR GENERAL LIABILITY X EACH OCCURRENCE $ 1,500,000 A X COMMERCIAL GENERAL LIABILITY RGE500025503 05I01I2014 05/01/2015 PREMISES Ea occurrence $ 1,500,000 CLAIMS-MADE M OCCUR IVIED EXP(Any one person) $ X $500,000 SIR PERSONAL&ADV INJURY $ 1,500,000 GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 5,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBED TIN GLE NGLE LIMIT 2,000,000 Ea accident A X ANY AUTO RAD500025403(ADS) 05/01/2014 05/01/2015 BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED RAD500025603(MA) 05/01/2014 05/01/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY t DAMAGE $ HIRED AUTOS AUTOS Per acciden UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DIED I I RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- CAND EMPLOYERS'LIABILITY N RWD500025203(ADS) 05/01I2014 05/01/2015 LIMITS I I ER 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ O OFFICER/MEMBEREXCLUC N N/A(Mandatory In NH) RWR500025303(WI) E.L.DISEASE-EA EMPLOYE $OSI01/2014 05I01/2015 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ D PROFESSIONAL LIABILITY' EOC3829621-12 05/01/2014 05/01/2015 Each Claim&Aggregate $2,000,000 Each Policy Period DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) RE:SUNSET TERRACE COMMUNITY LID RETROFIT PROJ ECT-GREEN CONNECTION:HARRING TON AVE NE,PH 2 CITY OF RENTON IS INCLUDED AS AN ADDITIONAL INSURED ON THE GENERAL LIABILITY POLICY AS REQUIRED BY WRITTEN CONTRACTOR AGREEMENT. COVERAGE PROVIDED BY THE ABOVE GENERAL LIABILITY AND AUTO POLICIES SHALL BE PRIMARY AND NON-CONTRIBUTORY AND IS LIMITED TO THE LIABILITY RESULTING FROM THE NAMED INSURED'S OWNERSHIP AND/OR OPERATIONS. 'FOR PROFESSIONAL LIABILITY COVERAGE,THE AGGREGATE LIMIT IS THE TOTAL INSURANCE AVAILABLE FOR CLAIMS PRESENTED WITHIN THE POLICY PERIOD FOR ALL OPERATIONS OF THE INSURED.THE LIMIT WIL L BE REDUCED BY PAYMENTS OF INDEMNITY AND EXPENSE. CERTIFICATE HOLDER CANCELLATION CITY OF RENTON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN:HEBE BERNARDO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PUBLIC WORKS DEPT. ACCORDANCE WITH THE POLICY PROVISIONS. 1055 S GRADY WAY,5TH FLOOR RENTON,WA 98057 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Sharon A.Hammer ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ENDORSEMEMT#008 This endorsement,effective 12lU a.m,May 01.2O14 forms m part o[ PuUuyNm.R8O50D0254U3 issued toCH2W HILL COMPANIES, LTD. hy Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |TCAREFULLY ADDITIONAL INSURED—PRIMARY WHERE REQUIRED UNDER CONTRACT ORAGREEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Section UA. 1.WHO|S AN INSURED isamended to include: Any entity,person,or organization you are required or have agreed in a written contract,permit,access agreement and any other written agreement tu provide insurance. This insurance is primary for the entity,person or organization, but only with respect tu liability arising out of your workfor that insured b m for you. Other insurance afforded to that insured will apply asexcess and not contribute on primary hu the insurance afforded by this endorsement. However, the insurance provided shall not exceed the scope of coverage and/or limits of this policy. Notwithstanding the foregoing wentenoe, in no event shall the insurance provided exceed the scope of coverage and/or limits required by said written contract,permit,access agreement.. (Authorized Representative� MANUS 2O14Xl.America, Inc. All Rights Reserved. EN0ORSEK0ENT#008 This endorsement, effective 12:O1a.m.. May U1. 2U14 forms a part vf Policy No.RAD500025403 issued to CH2KA HILL COMPANIES, LTD. bv Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |TCAREFULLY CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT |n the event coverage iu cancelled or non renewed for any statutorily permitted reason, other than nonpayment of premium, or if coverage is materially reduced, advanced written notice will be mailed or emailed to person(s)or entity(jes)according to the notification schedule shown below'. Number of Days. Name of Person(s)or Enfity(ies) Mailing Address: Advanced Notice of Per the most current schedule maintained by Marsh USA, Inc. and furnished to XL Insurance no less than 60 days 16 days prior to the 60 days of notice of cancellation, non-renewal or material reduction jp For the purpose of this endorsement,non-renewal shall mean solely non-renewal of the Polley and shall not include Notice of Conditional Renewal, Material reduction in coverage shall mean a decrease in the Policy ' limits,an increase in the deductible or self-insured retention or the application of a Policy exclusion not contemplated at Policy issuance. All other terms and conditions of the Policy remain unchanged. (Authorized Representative) MANUS 0 2U14 >iLAmmdcm�Inc. All Rights Reserved. May not be copied without permission. ENDORSEMENT#041 This endorsement,effective 12131e.m,May O1'2O14. forms a part nf Policy No.R8E5OUO25503 hy Greenwich Insurance Company issued tnCH2xx HILL COMPANIES, LTD. T HIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ [TCAREFULLY AUTOMATIC AoDfT)ONALUNSWREVS PRIMARY COVERAGE This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Wth respect to coverage provided by this endorsement,the provisions of the Coverage Part apply unless modified by this endorsement. SCHEDULE Name Of Additional Insured Person(s)Or Organization Location(s) of Covered Operations Any entity,person or organization you are required All Locations by any contract,permit,access agreement, !axecuted prior to any loss to provide additional insured status underthis Policy. A. Section U--Who is an Insured is amended to include as an additional insured the pmomn(c)o, Organization (s) wbcwvn in the schedule and any mherpe,00n(s) ormgamioamion(s) you are required to odd as an additional insured under the contract, permit or access agreement described in the schedule but only with respect to liability for "bodily injury' or "property damage"or"personal and advertising injury caused,in whole or in part by: 1. "Bodily Injury ,'property damage'or'personal and advertising injury'caused by the your operations on the additional ionmmd'wpremises or 2. "Your work'for the additional insured and included in the~pmductommmp|etedoperations hazard';or 3. Your acts m omissions;or 4. The acts o,omissions o[those acting om your behalf. As resects 2,3,and 4 the following also applies in the performance of your ongoing operations for the additional insured(s)at the location(s)designated above. However: M/UVUG (D2U14Xl.America, Inc. All Rights Reserved. May not be copied without permission. 1.the insurance afforded to such additional insured(s)only applies to the extent permitted by law;and 2. If coverage provided to the additional insured(s)is required by a contract,permit or access agreement,the insurance afforded to such additional insured(s)will not be broader than that which you are required by the contract,permit or access agreement to provide for such additional insured(s) B. Only when required by a contract,permit oreccess agreement this insurance applies to: 1. (a)All work on the project(other than service,maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the site of the covered operations has been completed;or(b)That potion of your wok 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. 2. "Bodily Injury"or"Property Damage arising out of any act or omission of the additional insured(s)or any of their employees,other than the general supervision of work performed for the additional insured(s)by you. However: 3.The insurance afforded to such additional insured(s)only applies to the extent permitted by law and 4 If coverage provided to the additional insured(s)is required by a contract,permit or access agreement,the insurance afforded to such additional insured(s)will not be broader than that which you are required by the contract,permit or access agreement to provide for such additional insured(s). C. Any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured(s)whether primary,excess,contingent or on any other basis unless a contract specifically required that this insurance be primary,or you request that it apply on a primary basis.When this insurance applies on a primary basis for the additional insureds described above, it shall apply only to"bodily injury",`property damage" or 'personal and advertising injury"caused by your wok for that additional insured by or for you. Other insurance afforded to those additional insureds will apply as excess and not contribute as primary to the insurance afforded by this endorsement. The limits of, insurance with respect to each person,organization or entity shall not exceed the limits of liability of the named insured ,All insuring agreements, exclusions and conditions of this policy apply. In no event, shall the coverage or limits of insurance in this coverage form be increased by such contract,permit or access agreement. All other terms and conditions remain the same. Authorized Representative MANUS r 2014 X.L.America, Inc. All Rights Reserved. May not be copied without permission. ENDORSEMENT#027 This endorsement, effective 12�D1a.m, May O1. QO14 forms a part of Po|icyNo.R(]E58O0256D3 isvedk` CH2k4 HILL COMPANIES, LTD. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ lTCAREFULLY CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled or non renewed for any statutorily permitted reason or if coverage is materially reduced,or coverage is cancelled for non-payment of premiumadvanced written notice will be mailed or emailed to the person or entity according to the notification schedule shown below: Number of Days Name of Person or Entity Mailing Address: Advanced Notice of Cancellation: Per the most current schedule maintained by Marsh USA, Inc. and furnished to XL I nsura nce no less tha n 15 days prior to 60 days the 60 days of notice of cancellation, non- renewal or material reduction in coverage For the purpose of this endorsement, non-renewal shall mean solely non-renewal of the Policy and shall not include expiration or Notice of Conditional Renewal. Material reduction in coverage shall mean a decrease m the Policy limits, an increase in the deductible or seflnsured retention or the app/icalioOufa Policy exclusion not contemplated at Policy issuance, All other terms and conditions of the Policy remain unchanged, ` (Authorized Representative) MANUS Kb2O14X.L America, Inc. All Rights Reserved. May not be copied without permission, Endon4ement T Notification to Others of Cancellation Electronic Schedule ZURICH Policy Nu- ) M LhtW c1Pu1, l xp-raatE of Pal. 6£f.Ciatr.(if raid- Producer Addl Prm Rxzttna Prctn k4.NC:3S' 9621-12 US1t11P?014 05101.+2(115 05?C1If_2014 2925300 Named Insured ant]Mailing Address: Producer: CH2M Hill Companies,Ltd. Marsh USA, Inc, 9191 S Jamaica St 1225 17n'St Ste#2100 Englewood CO 80112-5946 Denver CO 80202-5521 TICS ENDORSEKENT CHANGES THE POLICY. PLEASE Itk:.4J.1 IT CA RLP'U LLY. This t ndol>ement modifies inst.n-ance provided under the following: Architectix and Engiaccr.s Prol5cssionat Liability hisurance Policy In ctmsidi-Tudim of Lite prcrtriuin already charged,we agree with you,sub-ject to all terms,exclusions,and couditiorts of the policy that: A. If we cancel this policy by written notice to the first Narned Insun;d for arty reason other thatn noupayunent of pretniatri, wu: Nvill mail or deliver a copy of such writtcn notice of earIL6lril.ion: 1. To the name aril addreas eormsponding to each person or organization shown in the Schedule provided to us by the fast "Natricd Insured". Such schedule: a. Must be initially provided to us within 15 days: (1) After the beginning of the policy period shown in the Declarations;or {2) After this endorsement has been addr it to tic policy; h. 1~whust Contain the nutnc:s and addresses of only the persons or organizations requiring notification that this Policy has bcuti cancullc d; e. -N.-lust be in an electronic format that is acceptable to us;and d. Must be accurate. Such Schedule r_wo.be updakil and provided it) ua,by Lite first "Ndined Insured", during the policy peritul. Such ulydated. Schedule must comply with paragraphs It-c.,and d.above. 2. At least thirty{3t})days prior to the effective date of the cancellation,as advised iu our notice to the first Named lusured,or the longer number of days notice if indicated in the Schedule provided to us. B. Our notification,as described in Paragraph A-of this endorsement, will be based on the most recent Schedule provided to us bg- tha first"Named Insured"as of the date the notice of cancellation is mailed. C. Proof of mailing will be sufficient proof that we have complied with I'araMph A-of this endorsement. We we,not responsible for the accuracy,integrity,timeliness amd valitlity of information contained in the Schedule provide to ris as described in Paragraphs A. of this endorsement. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Signed B}: '� f �r% "�_ 511;20.1.4 Au orized Representative Date tI-GL-113-A CW (4F. ) WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 9906 57 (Ed. 12110) ENDORSEMENT#006 This endorsement,effective 12:01 a.m.,May 01,2014 forms a part of Policy No. RWD500025203 issued to CH2M HILL COMPANIES, LTD. by XL Insurance America, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT This endorsement modifies insurance provided under the following: WORKERS'COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY In the event coverage is cancelled or non renewed for any statutorily permitted reason, other than nonpayment of premium, or if there is a material reduction in coverage,advanced written notice will be mailed or emailed to person(s) or entity(ies)according to the notification schedule shown below: Name of Person(s)or Entity(ies): Mailing Address: Number of Days Advanced Notice: Per the most current schedule maintained by Marsh USA,Inc.and furnished to XL Insurance no less 60 days than 15 days prior to the 60 days of notice of cancellation, non-renewal or material reduction in coverage. For the purpose of this endorsement, non-renewal shall mean solely non-renewal of the Policy and shall not include expiration or Notice of Conditional Renewal. Material reduction in coverage shall mean a decrease in the Policy limits,an increase in the deductible or self-insured retention or the application of a Policy exclusion not contemplated at Policy issuance. All other terms and conditions of the Policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequerd to preparation of the policy.) Endorsement Effective May 01,2014 Policy No. RWD600025203 Endorsement No. Insured:CH2M HILL COMPANIES, LTD, Premium: Included XL Insurance America, Inc. Countersigned by WC 99 06 57 Ed. 12110 Q 2010 X.L.America.Inc.All Rights Reserved. May not be copied without permission. PUBLIC WORKS DEPARTMENT D o Ctyof �. M E M O R A N D U M coi�c%iRRENcE DAB 3 , r_.__...-. I I AUDA c n DATE: January 17, 2013 a _�------ TO: Randy Corman, Council President Members of the City Council VIA: Denis Law, Mayor ✓ "" �'' - _ FROM: Gregg Zimmerman, Administrator STAFF CONTACT: Ron Straka, Surface Water Utility Supervisor, x7248 Hebe C. Bernardo, Surface Water Utility Engineer, x7264 SUBJECT: Sunset Terrace Regional Stormwater Facility Project Engineering Consultant Agreement with CH2MHill ISSUE: Should Council approve the Engineering Consultant Agreement with CH2MHill for the final engineering design of the Sunset Terrace Regional Stormwater Facility Project, in the amount of$179,003? RECOMMENDATION: Authorize the Mayor and City Clerk to execute the Engineering Consultant Agreement with CH2MHill for the final engineering design of the Sunset Terrace Regional Stormwater Facility Project, in the amount of$179,003. BACKGROUND: The City of Renton completed and adopted the Sunset Community Plan and Planned Action Environmental Impact Statement which evaluated potential impacts of redevelopment in the Sunset Area and required infrastructure. As part of this effort the City developed and adopted the Sunset Area Surface Water Master Plan which identifies stormwater improvements to convey, treat, and infiltrate runoff from the existing and future land cover conditions. Recommended improvements included a regional storm water infiltration/flow control facility to be located within the proposed Sunset Park. Preliminary design work to collect data on subsurface conditions and update existing hydrologic and hydraulic analysis to refine sizing of the Sunset Terrace Regional Stormwater Facility has been completed by CH2MHill as part of the Engineering Consultant Agreement CAG-12-048, which was approved by Council on March 30, 2012. Mr.Corman,Council President Page 2 of 2 January 17,2013 The purpose of the Sunset Terrace Regional Stormwater Facility Project is to retrofit approximately three-acres of roadway from Sunset Boulevard (a high-traffic major arterial), adjacent roads, and developments by providing flow control and enhanced basic water quality treatment prior to discharging into Johns Creek (see attached Figure 1). The Sunset Terrace Regional Stormwater Facility Project will consist of rain gardens and an infiltration gallery. Work to be completed under the Engineering Consultant Agreement with CH2MHill will include data collection, survey and basemap preparation, permitting support, final design of the facility, preparation of construction plans and specifications, a technical information report, public outreach support, services during bidding, and project management. The project design is scheduled to start in 2013 and construction is planned to start in 2014. In accordance with the funding agreement with Washington State Department of Ecology (Ecology), the project construction and grant closeout must be completed by June 30, 2015. CH2MHill was selected from the approved 2013 Utility Systems Annual Consultant Roster based on their knowledge of the Sunset Area, their previous work on the Sunset Area Surface Water Master Plan, and their experience working with the City. The Sunset Terrace Regional Stormwater Facility Project will be funded ($983,000) by Ecology's FY 2012 Statewide Stormwater Grant Agreement No. G1200544 and the Surface Water Utility's Capital Improvement Program (CIP) for the Sunset Terrace Regional Stormwater Facility Project (427.475f92). The approved 2013-2014 CIP budget for the project is $1,307,172, including$983,000 of grant funding approved in 2012. The remaining project budget is for City project management and construction cost. CONCLUSION: The Sunset Terrace Regional Stormwater Facility Project will reduce the volume and peak rate of runoff from the area and improve the quality of the stormwater runoff. The Surface Water Utility recommends the City Council authorize the Mayor and City Clerk to execute the proposed Engineering Consultant Agreement, in the amount of $179,003, with CH2MHill for the final engineering design of the Sunset Terrace Regional Stormwater Facility Project. Attachment cc: Lys Hornsby,Utility Systems Director File H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-8889 Sunset Regional SW Facility\1103 Contracts\2012-12-6 Issue Paper-Sunset.doc\HCBah 4-� CITY OF RENTON COUNCIL AGENDA BILL Al #: Submitting Data: Public Works For Agenda of: Dept/Div/Board: Utility Systems Division/Surface January 28, 2013 Water Utility Staff Contact: Ron Straka, x7248 Agenda Status Hebe C. Bernardo, x7264 Consent............... X Subject: Public Hearing.... Sunset Terrace Regional Stormwater Facility Project Correspondence... Engineering Consultant Agreement with CH2MHill Ordinance............ Resolution............ Old Business........ Exhibits: New Business....... Issue Paper Study Sessions..... Contract Information........... Recommended Action: Approvals: Council Concur Legal Dept......... X Finance Dept...... X Other.................. Fiscal Impact: Expenditure Required... $179,003 Transfer/Amendment....... Amount Budgeted....... $1,307,172 Revenue Generated......... Total Project Budget $1,307,172 City Share Total Project.. SUMMARY OF ACTION: The purpose of the Sunset Terrace Regional Stormwater Facility Project is to retrofit approximately three acres of roadway from Sunset Boulevard, adjacent roads, and developments by providing flow control and enhanced basic water quality treatment prior to discharging into Johns Creek. The facility will consist of rain gardens and an infiltration gallery. Work to be completed under this engineering consultant agreement with CH2MHill, in the amount of$179,003, will include data collection, survey and basemap preparation, permitting support, final design of the facility, preparation of a technical information report, public outreach support, construction plans and specifications, services during bidding, and project management. In accordance with the funding agreement with the Washington State Department of Ecology (Ecology), the project construction and grant closeout must be completed by June 30, 2015. The Sunset Terrace Regional Stormwater Facility Project will be funded ($983,000) by Ecology's FY 2012 Statewide Stormwater Grant Agreement No. G1200544 and the Surface Water Utility's Capital Improvement Program (CIP) for the Sunset Terrace Regional Stormwater Facility Project (427.475492). The approved 2013-2014 CIP budget for the project is $1,307,172, including $983,000 of grant funding approved in 2012. The remaining project budget is for City project management and construction cost. STAFF RECOMMENDATION: Authorize the Mayor and City Clerk to execute the Engineering Consultant Agreement with CH2MHill for the final engineering design of the Sunset Terrace Regional Stormwater Facility Project, in the amount of$179,003. H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-8889 Sunset Regional SW Facility\1103 Contracts\Sunset Terrace Regioanl SW Fac Agenda Blll.doc\HCBah 00 PUBLIC WORKS DEPARTMENT city.f M E M O R A N D U M DATE: January 17, 2013 TO: Randy Corman, Council President Members of the City Council VIA: Denis Law, Mayoral FROM: Gregg Zimmermar�'4ministrator STAFF CONTACT: Ron Straka, Surface Water Utility Supervisor, x7248 Hebe C. Bernardo, Surface Water Utility Engineer, x7264 SUBJECT: Sunset Terrace Regional Stormwater Facility Project Engineering Consultant Agreement with CH2MHill ISSUE: Should Council approve the Engineering Consultant Agreement with CH2MHi11 for the final engineering design of the Sunset Terrace Regional Stormwater Facility Project, in the amount of$179,003? RECOMMENDATION: Authorize the Mayor and City Clerk to execute the Engineering Consultant Agreement with CH2MHill for the final engineering design of the Sunset Terrace Regional Stormwater Facility Project, in the amount of$179,003. BACKGROUND: The City of Renton completed and adopted the Sunset Community Plan and Planned Action Environmental Impact Statement which evaluated potential impacts of redevelopment in the Sunset Area and required infrastructure. As part of this effort the City developed and adopted the Sunset Area Surface Water Master Plan which identifies stormwater improvements to convey, treat, and infiltrate runoff from the existing and future land cover conditions. Recommended improvements included a regional storm water infiltration/flow control facility to be located within the proposed Sunset Park. Preliminary design work to collect data on subsurface conditions and update existing hydrologic and hydraulic analysis to refine sizing of the Sunset Terrace Regional Stormwater Facility has been completed by CH2MHill as part of the Engineering Consultant Agreement CAG-12-048, which was approved by Council on March 30, 2012. Mr. Corman,Council President Page 2 of 2 January 17,2013 The purpose of the Sunset Terrace Regional Stormwater Facility Project is to retrofit approximately three acres of roadway from Sunset Boulevard (a high-traffic major arterial), adjacent roads, and developments by providing flow control and enhanced basic water quality treatment prior to discharging into Johns Creek (see attached Figure 1). The Sunset Terrace Regional Stormwater Facility Project will consist of rain gardens and an infiltration gallery. Work to be completed under the Engineering Consultant Agreement with CH2MHill will include data collection, survey and basemap preparation, permitting support, final design of the facility, preparation of construction plans and specifications, a technical information report, public outreach support, services during bidding, and project management. The project design is scheduled to start in 2013 and construction is planned to start in 2014. In accordance with the funding agreement with Washington State Department of Ecology (Ecology), the project construction and grant closeout must be completed by June 30, 2015. CH2MHill was selected from the approved 2013 Utility Systems Annual Consultant Roster based on their knowledge of the Sunset Area, their previous work on the Sunset Area Surface Water Master Plan, and their experience working with the City. The Sunset Terrace Regional Stormwater Facility Project will be funded ($983,000) by Ecology's FY 2012 Statewide Stormwater Grant Agreement No. G1200544 and the Surface Water Utility's Capital Improvement Program (CIP) for the Sunset Terrace Regional Stormwater Facility Project (427.475492). The approved 2013-2014 CIP budget for the project is $1,307,172, including$983,000 of grant funding approved in 2012. The remaining project budget is for City project management and construction cost. CONCLUSION: The Sunset Terrace Regional Stormwater Facility Project will reduce the volume and peak rate of runoff from the area and improve the quality of the stormwater runoff. The Surface Water Utility recommends the City Council authorize the Mayor and City Clerk to execute the proposed Engineering Consultant Agreement, in the amount of $179,003, with CH2MHill for the final engineering design of the Sunset Terrace Regional Stormwater Facility Project. Attachment cc: Lys Hornsby,Utility Systems Director File H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-8889 Sunset Regional SW Facility\1103 Contracts\2012-12-6 Issue Paper-Sunset.doc\HCBah Uj U -- --- Z Z W J Connect 1 to Existing < :`• A, (` Storm Drain �ws/ � T � / Yf _ ! s Y # T 3 it. Connect to Existing �. ti I Storm Drain } \4 SUNSET'BLVD.(SR_SO�I� +, Connect l to Existing a _ i Storm Drain LEGEND ® Rain Garden Infiltration Gallery --�--r- Storm Drain FIGURE 1 Proposed Stormwater Sub-Regional Facility o ,00 200 300 Sunset Area LID Pre-Design North Approximate scale in feet October 2072 CH2MHILL. WBG101612144602.RSUDD 01 Site Plan E1-2012 ENGINEERING ANNUAL CONSULTANT AGREEMENT THIS AGREEMENT, made and entered into on this , day of by and between the CITY OF RENTON, WASHINGTON, A MUNICIPAL CORPORATION HEREINAFTER CALLED THE "CITY," and CH2MHILL Engineers, Inc. whose address is 1100 1121h Ave NE Suite 400 Bellevue, WA 98004, at which work will be available for inspection, hereinafter called the "CONSULTANT." PROJECT NAME:Sunset Terrace Regional Stormwater Facility WHEREAS,the City has not sufficient qualified engineering employees to provide the engineering within a reasonable time and the City deems it advisable and is desirous of engaging the professional services and assistance of a qualified professional consulting firm to do the necessary engineering work for the project, and WHEREAS,the Consultant has represented and by entering into this Agreement now represents,that it is in full compliance with the statutes of the State of Washington for registration of professional engineers, has a current valid corporate certificate from the State of Washington or has a valid assumed name filing with the Secretary of State and that all personnel to be assigned to the work required under this Agreement are fully qualified to perform the work to which they will be assigned in a competent and professional manner, and that sufficient qualified personnel are on staff or readily available to Consultant to staff this Agreement. WHEREAS,the Consultant has indicated that it desires to do the work set forth in the Agreement upon the terms and conditions set forth below. NOW THEREFORE, in consideration of the terms, conditions, covenants and performances contained herein below, the parties hereto agree as follows: I SCOPE OF WORK The Consultant shall furnish, and hereby warrants that it has,the necessary equipment, materials, and professionally trained and experienced personnel to facilitate completion of the work described in Exhibit A, Scope of Work, which is attached hereto and incorporated into this Agreement as though fully set forth herein. The Consultant shall perform all work described in this Agreement in accordance with the latest edition and amendments to local and state regulations, guidelines and policies. The Consultant shall prepare such information and studies as it may deem pertinent and necessary, in order to pass judgment in a sound engineering manner on the features of the work. The Consultant shall make such minor changes, amendments or revisions in the detail of the work as may be required by the City. This item does not constitute an "Extra Work" item as related in Section Vill of the Agreement. The work shall be verified for accuracy by a complete check by the Consultant. The Consultant will be held responsible for the accuracy of the work, even though the work has been accepted by the City. 11 DESIGN CRITERIA The City will designate the basic premises and criteria for the work needed. Reports and plans, to the extent feasible, shall be developed in accordance with the latest edition and amendments of local and State regulations, guidelines, and specifications, including, but not limited to the following: Page 1 of 25 Piazza/Data_Center/Forms/City/Contracts E1-2012 1. Washington State Department of Transportation/American Public Works Association (WSDOT/APWA), "Standard Specifications for Road, Bridge, and Municipal Construction," as amended by Renton Standard Specification. 2. WSDOT/APWA, "Standard Plans for Road, Bridge and Municipal Construction." 3. Washington State Department of Transportation, "Highway Design Manual." 4. American Association of State Highway and Transportation Officials, "Standard Specifications for Highway Bridges." 5. Washington State Department of Transportation, "Bridge Design Manual,Volumes 1 and 2." 6. Washington State Department of Transportation, "Manual of Highways Hydraulics," except hydrologic analysis as described in item 14. 7. Washington State Department of Transportation, "Materials Laboratory Outline." 8. Transportation Research Board, "Highway Capacity Manual." 9. U.S. Department of Transportation, Federal Highway Administration, "Manual on Uniform Traffic Control Devices for Streets and Highways." 10. Washington State Department of Transportation, "Construction Manual." 11. Washington State Department of Transportation, "Local Agency Guidelines." 12. Standard drawings prepared by the City and furnished to the Consultant shall be used as a guide in all cases where they fit design conditions. Renton Design Standards, and Renton Specifications shall be used as they pertain. 13. Metro Transit, design criteria. 14. King County Surface Water Design Manual, Sections 1.2 and 1.3 of Chapter 1, and Chapters 3, 4, and 5. 15. American Association of State Highway and Transportation Officials, "A Policy on Geometric Design of Highways and Streets." III ITEMS TO BE FURNISHED TO THE CONSULTANT BY THE CITY The City will furnish the Consultant copies of documents which are available to the City that will facilitate the preparation of the plans, studies, specifications, and estimates within the limits of the assigned work. All other records needed for the study must be obtained by the Consultant. The Consultant will coordinate with other available sources to obtain data or records available to those agencies. The Consultant shall be responsible for this and any other data collection to the extent provided for in the Scope of Work. City will provide to Consultant all data in City's possession relating to Consultants services on the project. Consultant will reasonably rely upon the accuracy, timeliness, and completeness of the information provided by the City. Should field studies be needed,the Consultant will perform such work to the extent provided for in the Scope of Work. The City will not be obligated to perform any such field studies. Page 2 of 25 Piazza/Data_Center/Forms/City/Contracts E1-2012 IV OWNERSHIP OF PRODUCTS AND DOCUMENTS TO BE FURNISHED BY THE CONSULTANT Documents, exhibits or other presentations for the work covered by this Agreement shall be furnished by the Consultant to the City upon completion of the various phases of the work. All such material, including working documents, notes, maps, drawings, photo, photographic negatives, etc. used in the project, shall become and remain the property of the City and may be used by it without restriction. Any use of such documents by the City not directly related to the project pursuant to which the documents were prepared by the Consultant shall be without any liability whatsoever to the Consultant. All written documents and products shall be printed on recycled paper when practicable. Use of the chasing-arrow symbol identifying the recycled content of the paper shall be used whenever practicable. All documents will be printed on both sides of the recycled paper, as feasible. All reports, drawings, specifications, documents, and other deliverables of Consultant, whether in hard copy or in electronic form, are instruments of service for this project, whether the project is completed or not. City agrees to indemnify Consultant and Consultant's officers, employees, subcontractors, and affiliated corporations from all claims, damages, losses, and costs, including, but not limited to, litigation expenses and attorney's fees arising out of or related to the unauthorized reuse, change or alteration of these project documents. V TIME OF BEGINNING AND COMPLETION The work detailed in the Scope of Work will be performed according to Exhibit B,Time Schedule of Completion, attached hereto and incorporated herein as though fully set forth. It is agreed that all the Consultant's services are to be completed and all products shall be delivered by the Consultant unless there are delays due to factors that are beyond the control of the Consultant. The Consultant shall not begin work under the terms of this Agreement until authorized in writing by the City. If, after receiving Notice to Proceed,the Consultant is delayed in the performance of its services by factors that are beyond its control, the Consultant shall notify the City of the delay and shall prepare a revised estimate of the time and cost needed to complete the Project and submit the revision to the City for its approval. Time schedules are subject to mutual agreement for any revision unless specifically described as otherwise herein. Delays attributable to or caused by one of the parties hereto amounting to 30 days or more affecting the completion of the work may be considered a cause for renegotiation or termination of this Agreement by the other party. VI PAYMENT The Consultant shall be paid by the City for completed work for services rendered under this Agreement as provided hereinafter as specified in Exhibit C, Cost Estimate. Such payment shall be full compensation for work performed or services rendered and for all labor, materials, supplies, equipment, and incidentals necessary to complete the work. All billings for compensation for work performed under this Agreement will list actual time (days and/or hours) and dates during which the work was performed and the compensation shall be figured using the rates in Exhibit C. Payment for this work shall not exceed $179,003 without a written amendment to this contract, agreed to and signed by both parties. Cost Plus Net Fee Payment for work accomplished shall be on the basis of the Consultant's actual cost plus a net fee. The actual cost includes direct salary cost, overhead, and direct non-salary cost. Page 3 of 25 Piazza/Data_Center/Form s/City/Contracts E1-2012 1. The direct salary cost is the salary expense for professional and technical personnel and principals for the time they are productively engaged in the work necessary to fulfill the terms of this Agreement. The direct salary costs are set forth in the attached Exhibit C and by this reference made a part of this Agreement. 2. The overhead costs as identified on Exhibit C are determined as 149.5 percent of the direct salary cost and by this reference made a part of this Agreement. The overhead cost rate is an estimate based on currently available accounting information and shall be used for all progress payments over the period of the contract. 3. The direct non-salary costs are those costs directly incurred in fulfilling the terms of this Agreement, including, but not limited to travel, reproduction,telephone, supplies, and fees of outside consultants. The direct non-salary costs are specified in Exhibit C, Cost Estimate. Billings for any direct non-salary costs shall be supported by copies of original bills or invoices. Reimbursement for outside consultants and services shall be on the basis of times the invoiced amount. 4. The net fee, which represents the Consultants profit shall be 20 percent of direct salary plus overhead costs. This fee is based on the Scope of Work and the estimated labor hours therein. In the event a supplemental agreement is entered into for additional work by the Consultant,the supplemental agreement will include provision for the added costs and an appropriate additional fee. The net fee will be prorated and paid monthly in proportion to the percentage of the project completed as estimated in the Consultant's monthly progress reports and approved by the City. Any portion of the net fee not previously paid in the monthly payments shall be included in the final payment, subject to the provisions of Section XI entitled TERMINATION OF AGREEMENT. 5. Progress payments may be claimed monthly for direct costs actually incurred to date as supported by detailed statements, for overhead costs and for a proportionate amount of the net fee payable to the Consultant based on the estimated percentage of the completion of the services to date. Final payment of any balance due the Consultant of the gross,amount earned will be made promptly upon its verification by the City after completion and acceptance by the City of the work under this Agreement. Acceptance, by the Consultant of final payment shall constitute full and final satisfaction of all amounts due or claimed to be due. Payment for extra work performed under this Agreement shall be paid as agreed to by the parties hereto in writing at the time extra work is authorized. (Section VIII "EXTRA WORK"). A short narrative progress report shall accompany each voucher for progress payment. The report shall include discussion of any problems and potential causes for delay. To provide a means of verifying the invoiced salary costs for consultant employees,the City may conduct employee interviews. Acceptance of such final payment by the Consultant shall constitute a release of all claims of any nature, related to this Agreement, which the Consultant may have against the City unless such claims are specifically reserved in writing and transmitted to the City by the Consultant prior to its acceptance. Said final payment shall not, however, be a bar to any claims that the City may have against the Consultant or to any remedies the City may pursue with respect to such claims. The Consultant and its subconsultants shall keep available for inspection, by the City, for a period of three years after final payment,the cost records and accounts pertaining to this Agreement and all items related to, or bearing upon, these records. If any litigation,claim or audit is started before the expiration of the three-year retention Page 4 of 25 Piazza/Data_Center/Forms/City/Contracts E1-2012 period, the records shall be retained until all litigation, claims or audit findings involving the records have been resolved. The three-year retention period starts when the Consultant receives final payment. VII CHANGES IN WORK The Consultant shall make all such revisions and changes in the completed work of this Agreement as are necessary to correct errors appearing therein, when required to do so by the City,without additional compensation. Should the City find it desirable for its own purposes to have previously satisfactorily completed work or parts thereof revised, the Consultant shall make such revisions, if requested and as directed by the City in writing. This work shall be considered as Extra Work and will be paid for as provided in Section VIII. VIII EXTRA WORK The City may desire to have the Consultant perform work or render services in connection with the Project in addition to or other than work provided for by the expressed intent of the Scope of Work. Such work will be considered as Extra Work and will be specified in a written supplement which will set forth the nature and scope thereof. Work under a supplement shall not proceed until authorized in writing by the City. Any dispute as to whether work is Extra Work or work already covered under this Agreement shall be resolved before the work is undertaken. Performance of the work by the Consultant prior to resolution of any such dispute shall waive any claim by the Consultant for compensation as Extra Work. IX EMPLOYMENT The Consultant warrants that it has not employed or retained any company or person, other than a bona fide employee working solely for the Consultant,to solicit or secure this contract and that he has not paid or agreed to pay any company or person, other than a bona fide employee working solely for the Consultant, any fee, commission, percentage, brokerage fee, gifts or any other consideration, contingent upon or resulting from the award or making of this contract. For breach or violation of this warranty, the City shall have the right to annul this Agreement without liability, or in its discretion to deduct from the Agreement price or consideration or otherwise recover,the full amount of such fee, commission, percentage, brokerage fee,gift or contingent fee. Any and all employees of the Consultant, while engaged in the performance of any work or services required by the Consultant under this Agreement, shall be considered employees of the Consultant only and not of the City and any and all claims that may or might 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. The Consultant shall not engage, on a full or part-time basis, or other basis, during the period of the contract, any professional or technical personnel who are, or have been at any time during the period of this contract, in the employ of the City except regularly retired employees, without written consent of the City. If during the time period of this Agreement, the Consultant finds it necessary to increase its professional,technical, or clerical staff as a result of this work,the Consultant will actively solicit minorities through their advertisement and interview process. Page 5 of 25 Pia zza/Data_Center/Forms/City/Contracts E 1-2012 X NONDISCRIMINATION The Consultant agrees not to discriminate against any client, employee or applicant for employment or for services because of race,creed, color, national origin, marital status, sexual orientation, sex, age or handicap except for a bona fide occupational qualification with regard to, but not limited to the following: employment upgrading; demotion or transfer; recruitment or any recruitment advertising; layoff or termination's; rates of pay or other forms of compensation; selection for training; rendition of services. The Consultant understands and agrees that if it violates this Non-Discrimination provision,this Agreement may be terminated by the City and further that the Consultant shall be barred from performing any services for the City now or in the future, unless a showing is made satisfactory to the City that discriminatory practices have terminated and that recurrence of such action is unlikely. XI TERMINATION OF AGREEMENT A. The City reserves the right to terminate this Agreement at any time upon not less than ten (10) days written notice to the Consultant, subject to the City's obligation to pay Consultant in accordance with subparagraphs C and D below. B. In the event of the death of a member, partner or officer of the Consultant, or any of its supervisory personnel assigned to the project, the surviving members of the Consultant hereby agree to complete the work under the terms of this Agreement, if requested to do so by the City. This section shall not be a bar to renegotiations of this Agreement between surviving members of the Consultant and the City, if the City so chooses. In the event of the death of any of the parties listed in the previous paragraph, should the surviving members of the Consultant, with the City's concurrence, desire to terminate this Agreement, payment shall be made as set forth in Subsection C of this section. C. In the event this Agreement is terminated by the City other than for fault on the part of the Consultant, a final payment shall be made to the Consultant for actual cost for the work complete at the time of termination of the Agreement, plus the following described portion of the net fee. The portion of the net fee for which the Consultant shall be paid shall be the same ratio to the total net fee as the work complete is to the total work required by the Agreement. In addition, the Consultant shall be paid on the same basis as above for any authorized extra work completed. No payment shall be made for any work completed after ten (10) days following receipt by the Consultant of the Notice to Terminate. If the accumulated payment made to the Consultant prior to Notice of Termination exceeds the total amount that would be due as set forth herein above, then no final payment shall be due and the Consultant shall immediately reimburse the City for any excess paid. D. In the event the services of the Consultant are terminated by the City for fault on the part of the Consultant,the above stated formula for payment shall not apply. In such an event the amount to be paid shall be determined by the City with consideration given to the actual costs incurred by the Consultant in performing the work to the date of termination, the amount of work originally required which was satisfactorily completed to date of termination, whether that work is in a form or of a type which is usable to the City at the time of termination,the cost to the City of employing another firm to complete the work required and the time which may be required to do so, and other factors which affect the value to the City of the work performed at the time of termination. Under no circumstances shall payment made under this subsection exceed the amount which would have been made if the formula set forth in subsection C above had been applied. Page 6 of 25 Piazza/Data_Ce me r/Form s/City/Co ntra cts E1-2012 E. In the event this Agreement is terminated prior to completion of the work,the original copies of all Engineering plans, reports and documents prepared by the Consultant prior to termination shall become the property of the City for its use without restriction. Such unrestricted use not occurring as a part of this project, shall be without liability or legal exposure to the Consultant. F. Payment for any part of the work by the City shall not constitute a waiver by the City of any remedies of any type it may have against the Consultant for any breach of this Agreement by the Consultant, or for failure of the Consultant to perform work required of it by the City. Forbearance of any rights under the Agreement will not constitute waiver of entitlement to exercise those rights with respect to any future act or omission by the Consultant. XII DISPUTES Any dispute concerning questions of facts in connection with work not disposed of by agreement between the Consultant and the City shall be referred for determination to the Public Works Administrator or his/her successors and delegees, whose decision in the matter shall be final and conclusive on the parties to this Agreement. In the event that either party is required to institute legal action or proceedings to enforce any of its rights in this Agreement, both parties agree that any such action shall be brought in the Superior Court of the State of Washington, situated in King County at the Maleng Regional Justice Center in Kent, Washington. XIII LEGAL RELATIONS The Consultant shall comply with all Federal Government, State and local laws and ordinances applicable to the work to be done under this Agreement. This contract shall be interpreted and construed in accordance with the laws of Washington. The Consultant agrees to indemnify, defend and hold the City and its officers and employees harmless from and shall process and defend at its own expense all claims, demands or suits at law or equity arising in whole or part from the Consultant's errors, omissions, or negligent acts under this Agreement provided that nothing herein shall require the Consultant to indemnify the City against and hold harmless the City from claims, demands or suits based upon the conduct of the City, its officers or employees and provided further that if the claims or suits are caused by or result from the concurrent negligence of(a)the Consultant's agents or employees and (b) the City, its agents, officers and employees, this provision with respect to claims or suits based upon such concurrent negligence shall be valid and enforceable only to the extent of the Consultant's negligence or the negligence of the Consultant's agents or employees. To the maximum extent permitted by law, Consultant's liability for City's damages will not, in the aggregate, exceed $1,000,000. This article takes precedence over any conflicting article of this AGREEMENT or any document incorporated into it or referenced by it. This limitation of liability will apply whether Consultant's liability arises under breach of contract or warranty;tort; including negligence; strict liability; statutory liability; or any other cause of action, and shall include Consultant's officers, affiliated corporations, employees, and subcontractors. Insurance Page 7 of 25 Pia zza/Data_Center/Form s/City/Contracts E1-2012 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, or employees. 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. 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. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. 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 Provision The Consultant's Automobile Liability and Commercial General Liability insurance policies are to contain, or be endorsed to contain that they shall be primary insurance as respect to the City. Any Insurance, self-insurance,or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANIL 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. Page 8 of 25 Piazza/Data_Center/Forms/City/Contracts E1-2012 F. Notice of Cancellation The Consultant shall provide the City with written notice of any policy cancellation, within two business days of their receipt of such notice. G. Failure to Maintain Insurance 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 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 therewith, 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. The limits of said insurance shall not, however, limit the liability of Consultant hereunder. The Consultant shall also submit copies of the declarations pages of relevant insurance policies to the City within 30 days of contract acceptance if requested. The Certification and Declaration page(s) shall be in a form as approved by the City. If the City's Risk Manager has the Declaration page(s) on file from a previous contract and no changes in insurance coverage has occurred, only the Certification Form will be required. The Consultant shall verify, when submitting first payment invoice and annually thereafter, possession of a current City of Renton business license while conducting work for the City. The Consultant shall require, and provide verification upon request, that all subconsultants participating in a City project possess a current City of Renton business license. The Consultant shall provide, and obtain City approval of, a traffic control plan prior to conducting work in City right-of-way. The Consultant's relation to the City shall be at all times as an independent contractor. It is further specifically and expressly understood that the indemnification provided herein constitute the Consultant's waiver of immunity under the Industrial Insurance Act, 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. XIV SUBLETTING OR ASSIGNING OF CONTRACTS The Consultant shall not sublet or assign any of the work covered by this Agreement without the express consent of the City. XV ENDORSEMENT OF PLANS The Consultant shall place their certification on all plans, specifications, estimates or any other engineering data furnished by them in accordance with RCW 18.43.070. XVI OPINIONS OF COST In providing opinions of cost, financial analyses, economic feasibility projections, and schedules for the project, the Consultant has no control over cost or price of labor and materials; unknown or latent conditions of existing equipment or structures that may affect operation or maintenance costs; competitive bidding procedures and market conditions; time or quality of performance by third parties; quality, type, management, or direction of operating personnel; and other economic and operational factors that may materially affect the ultimate project cost or schedule. Therefore, the Consultant makes no warranty that City's actual project costs, financial aspects, Page 9 of 25 Piazza/Data_Center/Forms/City/Contracts E1-2012 economic feasibility, or schedules will not vary from the Consultant's opinions, analyses, projections, or estimates. If the City wishes greater assurance as to any element of project cost, feasibility, or schedule, the City will employ an independent cost estimator, Consultant, or other appropriate advisor. XVII COMPLETE AGREEMENT This document and referenced attachments contain all covenants, stipulations, and provisions agreed upon by the parties. Any supplements to this Agreement will be in writing and executed and will become part of this Agreement. No agent, or representative of either party has authority to make, and the parties shall not be bound by or be liable for,any statement, representation, promise, or agreement not set forth herein. No changes, amendments, or modifications of the terms hereof shall be valid unless reduced to writing and signed by the parties as an amendment to this Agreement. The invalidity or unenforceability of any provision in this Agreement shall not affect the other provisions hereof, and this Agreement shall be construed in all respects as if such invalid or unenforceable provision were omitted. XVIII EXECUTION AND ACCEPTANCE This Agreement may be simultaneously executed in several counterparts, each of which shall be deemed to be an original having identical legal effect. The Consultant does hereby ratify and adopt all statements, representations, warranties, covenants, and agreements contained in the Request for Qualifications, and the supporting materials submitted by the Consultant, and does hereby accept the Agreement and agrees to all of the terms and conditions thereof. IN WITNESS WHEREOF,the parties hereto have executed this Agreement as of the day and year first above written. CONSULTANT CITY OF RENTON Signature Date Mayor Date type or print name ATTEST: Title Bonnie I.Walton, City Clerk Page 10 of 25 Piazza/Data_Center/Form s/City/Contracts E1-2012 EXHIBIT A City of Renton Sunset Community Low Impact Development Retrofit Project— Sunset Terrace Regional Stormwater Facility I. Background The City of Renton completed and adopted the Sunset Community Plan and Planned Action Environmental Impact Statement which evaluated potential impacts of redevelopment in the Sunset area and required infrastructure. As part of this effort the City developed and adopted the Sunset Area Surface Water Master Plan which identifies stormwater improvements to convey, treat and infiltrate runoff from the existing and future land cover conditions. Recommended improvements include the following: • New Storm Drainage mains. • Green Connections along Harrington Ave. NE between NE 16th St. and NE 10th St. at locations that fit with existing and planned future land use in the area to provide enhanced basic water quality treatment and flow control. within the right-of-way .The Harrington Ave NE Green Connections will consist of pervious sidewalks and rain gardens. • A regional storm water infiltration facility consisting construction of an infiltration/flow control facility for flow control mitigation and a rain garden for providing enhanced basic water quality treatment. This scope of work pertains to the design of the proposed Sunset Terrace Regional Stormwater facility which will retrofit approximately 3-acres of roadway from the Sunset Boulevard (a high-traffic major arterial) by providing flow control and enhanced and basic water quality treatment prior to discharging into Johns Creek. The regional facility will consist of rain gardens and an infiltration gallery with potential additional detention capacity for attenuation of high flows.The facility is co-located with a proposed new park in the Sunset Terrace area to compliment the park features and serve as a demonstration project to the public using low impact development to treat stormwater runoff. This scope will prepare construction documents (plans, specifications and construction cost estimate)for the Sunset Terrace Regional Stormwater Facility. Tasks included in this scope of work include data collection, survey and basemap preparation, permitting support,final design of the facility, preparation of a technical information report, public outreach support, services during bidding, and project management as defined in the tasks below. Services for during construction and construction management are not included in this scope of work and would be included in a separate amendment. II. DESIGN CRITERIA The City will designate the basic premises and criteria for the design. In addition, design reports and plans,to the extent feasible, shall be developed in accordance with the latest edition of the following documents: Washington State Department of Transportation/American Public Works Association (WSDOT/ APWA),Standard Specifications for Road, Bridge, and Municipal Construction 2010 edition 2. City of Renton Transportation Standard Specifications. Page 11 of 25 Piazza/Data_Center/Forms/City/Contracts E1-2012 3. 2009 King County Surface Water Design Manual (KCSWDM) and City of Renton Amendments to the 2009 KCSWDM. 2005 Low Impact Development Technical Guidance Manual for Puget Sound or current version as applicable. 4. Measurements will be in English units 5. Drafting Standards: City of Renton. o Vertical Datum: NA VD 88 o Horizontal Datum: NAD 83191 III. Compliance with the FY 2012 Statewide Stormwater Grant Program—Proviso Funding Agreement Design reports and plans, shall be developed in accordance with Task 2, design plans and specifications under Grant Agreement Number G1200544. Task 1. Project Management Perform project management, administration, and coordination of work effort involved in all phases and tasks. This task will continue throughout the duration of the project. It will include the work necessary to develop the project management plan, set up financial accounting including subconsultants, develop and implement quality management plan (QMP), overall project coordination with the CITY and project team, and project closeout. Invoices and progress reports will be provided to the CITY on a monthly basis. Monthly progress reports will include a summary of work performed by the CONSULTANT for that period and the work anticipated to be completed in the next period. This task includes a project kick-off meeting at the CITY with two (2) CONSULTANT attendees, assuming two (2) hours in length. QA/QC: Consultant shall conduct internal quality control regarding collection of data, surveying, basemap preparation and hydraulic modeling and all other tasks. Task 1 Deliverables • Monthly Invoices and progress reports • Bi-weekly phone call or email check-ins with the City project manager to report project status Task 1 Assumptions • Project duration is assumed to be a 16 month project duration with a 3-month inactive period where no invoices will be prepared. Project Schedule • Notice to Proceed -January 2013 • 30% Design -April 2013 • 60% Design—July 2013 • 90%design—October 2013 • 100% Design—November 2013 Page 12 of 25 Piazza/Data_Center/Forms/City/Contracts E1-2012 Task 2. Supplemental Survey The CONSULTANT will perform Survey as needed to supplement survey conducted under separate contract through Renton Housing Authority. Task 2.1 Supplemental Survey It is assumed that during the design phase, some level of supplemental survey may be necessary as the design progresses. The CONSULTANT will perform supplemental surveys as needed for purposes such as private property match/conforms, locating additional utility features and pothole locations, structures and elevations, or to obtain features requiring more definition for design purposes. For budgeting purposes this task item has been estimated not to exceed 10-field crew hours. Any costs for performing additional survey beyond 10-field crew hours,will require authorization by supplemental agreement. Task 2.2 Utility locations and potholing: The CONSULTANT will utilize a "One-Call Locate Service" to field locate all major utilities including but not limited to TV,gas, power,telephone, storm, water, sewer, fiber optic, and King County wastewater utilities identified in the street prior to field survey so that these locations can be picked up during the field survey. The CONSULTANT will compare available utility record drawings (As-Build's) against surface evidence of utilities obtained during the initial survey. Critical conflicts of identified utilities with proposed design improvements may require potholing to confirm the utility location and elevation. Potholing will be performed by a Sub-contractor(ADS). All utility potholes will be surveyed and a table of potholing results will be prepared. A field worksheet with location,type of utility,type of material, diameter of utility depth and measurements from fixed pointes will be provided. Photos of each utility will be included in the potholing information. The CONSULTANT has budgeted up to $5000 for utility potholing, which is assumed to occur within the paved road surface. In the event of unavoidable utility conflicts, the CONSULTANT will provide a list of conflicts to the CITY to notify the applicable utility agency to initiate the relocation of their utility prior to construction by the CITY. Coordination with the CITY and potholing Sub-contractor will be provided prior to the 60 percent plan submittal. Work by subcontractor will include right of way permitting, traffic control backfilling and resurfacing per City of Renton standards. Task 2 Deliverables 1. Updated 1" = 20' Design Basemapping in AutoCAD 2012 format. 2. Updated INROADS compatible Digital Terrain Model (DTM), saved in AutoCAD drawing (DWG) format. Task 2 Assumptions 1 Potholes will be backfilled with gravel (with 5/8-inch minus gravel compacted at 8 to 12-inch lifts) and the surface will be patched with like material. Depth of patch material shall match thickness of existing asphalt. One exception is that gas lines will initially be backfilled with 12 inches of sand then followed by gravel per PSE requirements. 2. Subcontractor will be responsible for requesting right of way permit. 3. Subcontractor will submit a traffic control plan to the City 4. One call utility locating service will be called - 5. Materials removed from potholing with be disposed of at a permitted diposal site. Also it is assumed that materials are contaminant free. Page 13 of 25 Piazza/Data_Center/Forms/City/Contracts E1-2012 Task 3. Public Involvement The CONSULTANT will provide support to the CITY for agency, stakeholder, and public consultation and coordination required during the design process. It is anticipated that the CITY will provide the lead in coordinating with stakeholders including RHA, and Parks; however,the following forums are anticipated in this scope: • Public Open House: It is anticipated to have an open house for the community to communicate the proposed project elements, goals and impacts to a broader audience. The CONSULTANT will support this effort by providing informational boards developed from products created under other tasks described in this scope of work and presentation by up to two staff members. Task 3 Deliverables • Two (2) 34x22-inch Boards for use at one (1) Public Open House. Assumed up to one (1) CONSULTANT Staff will attend the Public Open House. Task 3 Public lnvo/vment Assumptions • CITY will organize and host public meetings and provide notifications. CONSULTANT will participate in presentations and support preparation of presentation materials. • CITY will separately contract with a Landscape Architecture firm for design of the park and provide Landscape Architecture support for design of the regional facility. The LA firm will lead development of materials for the Public Open Houses and outreach. Task 4- Hydrologic/Hydraulic Modeling 4.1 Modeling of LID facilities 1. Size rain gardens needed for pre-treatment and to reduce pollution from SR 900 and adjacent streets and property.The consultant will delineate the sub basin areas tributary to the rain garden.The drainage area delineation will include tributary roadway as well as sidewalk, driveways, and pervious areas if applicable. 2. Rain Gardens will be sized per the 2005 DOE manual to filter a minimum of 91 percent of the runoff through bioretention media. 3. Conduct modeling in WWHM or approved equivalent models to size each individual rain garden. 4. Pervious sidewalk subgrade depth will be modeled to infiltrate 100 percent of rainfall. 4.2 Modeling of required conveyance improvements Determine the required pipe size to convey runoff to and from the rain gardens. These pipes will be designed at a minimum in accordance with the criteria specified in Section 1.2.4 of the 2009 King County Surface Water Design Manual to accommodate a 25-year storm event. 4.3 Drainage Technical Information Report CONSULTANT will prepare a Draft and Final Drainage Technical Information Report to reflect the hydrological and hydraulic conditions of the proposed LID improvements. Page 14 of 25 Piazza/Data_Center/Form s/City/Contracts E1-2012 Task 4 Deliverables 1- Electronic modeling files, including input and output parameters. 2. Documentation of sizing assumptions, methods, and results to be included in the drainage report 3. Brief memo summarizing model input and assumptions for City review to be submitted at the 30% design level. 4. One (1) hard copy (and electronic copy) of the Draft and Final Technical Information Report at the 60 and 90 percent submittals. Task 5—Finalize Geotechnical Report 1. Under Phase 1 a preliminary geotechnical report was prepared that evaluated the geotechnical considerations. Under Phase 2,geotechnical work includes updating the report to include recommendations for backfill and compaction for the new drainage system; In addition,the work will include consulting on various geotechnical considerations in design including a review of the design with respect to geotechnical considerations 2. Provide conclusions and geotechnical considerations for the following: a. Earthwork and site preparation. Include an evaluation of the site soils for use as structural (i.e., trench backfill) and gradation criteria for imported fill, as appropriate.This will include an evaluation of the effects of construction equipment on the site soils and mitigation of unsuitable soil conditions. b. Review risk and specifications for potential unintended discovery of underground utilities, abandoned septic tanks, fuel tanks or other hazards potentially remaining after RHA demolition of the site and encountered during construction. c. Comments on any anticipated construction difficulties identified from the results of our side studies Task 5 Deliverables Final Geotechnical Report including design conclusions and recommendations together with detailed site plans and supporting information. 2. Review of Plans and Specifications (in terms of geotechnical considerations) Task 5 Assumptions • Contractor will be responsible for developing shoring plan by an engineer for review by the City. • Final Geotechnical Report will also address recommendations and findings related to the Harrington Avenue NE Green Connections project under separate scope. • Contractor will be responsible for developing dewatering plan by an engineer for review by the City. Page 15 of 25 Piazza/Data_Center/Forms/City/Contracts E1-2012 Task 6 Permitting Support The CONSULTANT will provide support to the CITY to identify and provide supporting data for permit applications. The City will be responsible for completing the permit application and obtaining the permit.The CONSULTANT will provide up to 40 hours to support preparation of permit documents. In support of State Environmental Policy Act (SEPA) compliance, the Consultant will prepare an Environmental Checklist in support of a land use permit from the City.The checklist will include project information on background and environmental elements (earth, air, water, plants, animals, energy and natural resources, environmental health, land and shoreline use, housing, aesthetics, light and glare, recreation, historic and cultural preservation, transportation, public services, and utilities). Potential permits that may be required for the project are: a) SEPA Checklist, and b) Grading permit. Task 6 Assumptions • The project is covered under the Sunset Area Planned Action EIS and will not require a separate Environmental Impact Statement(EIS) • Completion of the Environmental Checklist will rely on information contained in other documents prepared for the project and project design elements (e.g.,temporary erosion and sedimentation control plan, traffic plan, storm water pollution prevention plan, etc.) • Some environmental elements will not apply to the project(e.g., housing, light and glare) • The City will sign the Environmental Checklist • The Environmental Checklist will be submitted to the City with the Land Use Permit Application Task 6 Deliverables • Draft SEPA Environmental Checklist for City review--electronic file in Adobe Acrobat (PDF) file format and one hard copy. • Final SEPA Environmental Checklist--electronic file in Adobe Acrobat(PDF) file format and one hard copy. Task 7. Final Design, Construction Documents and Cost Estimate Based on the result of the pre-design, the CONSULTANT will then prepare draft Construction Drawings,technical special provisions, and cost estimate representing approximately the 30 percent, 60 percent, 90 percent and 100 percent completion level for the selected improvement.The CONSULTANT will prepare the contract provisions at the 100 percent completion. Half-size (11"x17") drawings will be submitted to the CITY for review at the 30, 60, 90 and 100 percent stages.The 60 percent drawings can also be used by the CITY to prepare and submit permit packages. No additional drawings will be prepared by the CONSULTANT for use in permit applications. CONSULTANT will prepare a Draft and Final Technical Information Report to reflect the hydrological and hydraulic conditions of the proposed LID improvements. Page 16 of 25 Piazza/Data_Center/Forms/City/Contracts E1-2012 Task 7 Deliverables 1. Three (3) hard copy sets of half size (11"x17" sheets) draft construction drawings will be submitted to the CITY for review and comment at the 30 percent, 60 percent and 90 percent completion level. 2. Three (3) hard copy sets of half-size (11"x17" sheets) construction drawings will be submitted to the CITY at the 100 percent completion level. 3. Three (3) sets of engineer's cost estimate and technical specifications outline will be submitted to the CITY for the 30 percent submittal. 4. Three (3) sets of hard copy of specifications, and summary of quantities including an engineer's cost estimate for the construction documents will be submitted to the CITY for the 60, 90 and 100 percent submittals. 5. Electronic files AutoCAD 2012 format at the end of the project. 6. Submittal documents for compliance with the FY 2012 Statewide Stormwater Grant Program — Proviso Funding Agreement number G1200544. Task 7 Meetings • Two (2) meeting with two (2) CONSULTANT staff and with the CITY staff at the CITY offices to receive and discuss the 30 percent and 60 percent review comments. • One (1) meeting with two (2) CONSULTANT staff and with the CITY staff at the CITY offices to resolve and coordinate any outstanding issues prior to completion of the 100 percent completion construction documents. Task 7 Assumptions • The CONSULTANT will prepare the special provisions using the CITY's format. The CITY uses WSDOT 2012 Standard Specifications, and the 2012 Amendments to the 2012 Standard Specifications.The CITY will be responsible for development of general Div 00 and 01 specifications, supplements, bid form and preparing, printing and distributing to interested bidders the final bid document package. • 100 percent submittal will not require City review and resubmittal. • The CITY will provide review comments on the 30, percent, 60 percent and 90 percent submittal within two (2)weeks of receipt of submittal. • The CITY will provide to the CONSULTANT electronic versions of their standard CAD details. • CAD files will be delivered using AutoCAD in 2012 format. • The CITY will be responsible for printing and distributing final contract documents and addendums. • The CONSULTANT will use the Western Washington Hydrological Model, or equivalent, for the hydrologic modeling and facility sizing. Hydrology for conveyance system sizing will be using either the rational method or a single storm event models and utilize Manning's equation for capacity calculations. No tailwater analysis is assumed in this scope. • Two field visits with 2 consultant staff. • Four(4) meetings with two (2) CONSULTANT staff. Page 17 of 25 Piazza/Data_Center/Form s/City/Contracts E1-2012 • CITY will separately contract with a Landscape Architecture firm for design of the park and provide Landscape Architecture support for design of the regional facility and preparation of the Planting plans. . • The drawings for the improvements will use a horizontal scale of 1 inch = 20 feet. Drawings for the project will be full size 22"x 34" and will include the following: o Cover sheet,vicinity map, index(1) o Legend and notes (1) o Survey control and notes sheet (1) o Site Preparation and Erosion and sediment control plan (2) o Erosion control details (1) o Civil design plan sheets (3) o Civil design and Low Impact Development details (2) o Grading plan sheets(2) o Grading cross sections and drainage profiles (2) o Roadway Sections (1) Task 8. Services during Bidding This task provides for the following support services by the CONSULTANT: • Assist CITY in answering bidder questions during bid period as requested by the CITY. • Prepare and provide addenda to CITY for distribution to bidders as requested by the CITY. • Services during construction will be scoped and provided under a contract amendment. Task 8 Services During Bidding • CITY will make all notifications for bid advertisements; CITY will field all calls from bidders with questions during the bidding process. Answering bidder questions, as requested by the CITY, will be limited to the hour estimate identified in Exhibit A2: Budget. Any effort required beyond the hour estimate in the budget shall be paid on a time and material basis unless effort required is due to error or omission by CONSULTANT. Services under this Task are limited to 40 hours by CONSULTANT staff Basis of Scope The following general and task specific assumptions have been made in developing the Scope of Work and Budget for the project.They are listed below. General Assumptions • The AGREEMENT has an anticipated start date of January 2013 and is expected to be completed by March 31st, 2014, with an anticipated period of inactivity between final construction documents and bid support of 3 months • The standard of care applicable to CONSULTANT's Services will be the degree of skill and diligence normally employed by professional engineers or consultants performing the same or similar Services at the time said services are performed. CONSULTANT will reperform any services not meeting this standard without additional compensation. Page 18 of 25 Pia zza/Data_Center/Forms/City/Contracts E1-2012 • The CONSULTANT can reasonably rely on the timeliness, accuracy and completeness of the underground utility locates and any other data necessary to accomplish these tasks in a timely fashion. • The CITY will provide consolidated review comments to draft deliverables. The CONSULTANT will provide a written comment response and summary to the client. • Consultant's deliverables, including record drawings, are limited to the sealed and signed hard copies. Computer-generated drawing files furnished by CONSULTANT are for CITY or others' convenience.Any conclusions or information derived or obtained from these files will be at user's sole risk. • The CONSULTANT's ability to meet the schedule is contingent upon timely receipt of survey and any other information from the CITY and or third parties. • This project will be performed in conjunction with the Harrington Avenue NE Green Connection project. • The NE loth Street frontage improvements outside the future King County Library will be designed and constructed by the library project.The CONSULTANT will coordinate with that project for storm drain locations, and the continuity of the frontage improvements along NE loth Street. • Services during construction is not included in this scope of work. Page 19 of 25 Piazza/Data_Center/Form s/City/Contracts E1-2012 Exhibit B -Time Schedule of Completion Sunset Terrace Regional Stormwater Facility-Project Schedule Notice to Proceed January 2013 30% Design April 2013 60% Design July 2013 90%design October 2013 100% Design November 2013 Page 20 of 25 Piazza/Data_Center/Form s/City/Contracts E1-2012 EXHIBIT C—Cost Estimate Task t3ess rik tse r> LOE Labor Subs Expenses, Price 1 Rrc+ ct Management + rot 162 S 23,433 2 6asema,Preparation and Supplemental Survey € 115 S 12,057 S S 6,198 7,21 3 Public Invoiven nt 30 S '494 S5 tfl0 $ 4,594 ;, !tidro ic,P'Hydra0 Modeling 124 S 15,9%b S S 5.95 5 Pinali al Report 26 S 3,357 S S 4< 3 3a,7 b Permit Support 20 S 3,112 S - S 3,,112 7 Fin i l Desin,Corstruction Documents,and Cost Estimate 3?1:1 S 10-S.378 S - S 21'? 105,620 20 8 Ser°ices D nng Bidding and _ Construction 40 S 4 >1 S s - s S 21 . _ Total 1345 S 173,4t 2 - 5,5 i 179.003 Page 21 of 25 Piazza/Data_Ce me r/Form s/City/Co ntra cts E1-2012 EXHIBIT C COST PLUS NET FEE DETERMINATION DIRECT SALARY COST: Hourly Rates of Pay Personnel Principal Engineer Chief Engineer Engineer Surveyor Surveyor Planner Bookkeeper Executive Secretary CADD Operator/Drafter Clerical Net Fee 20%of direct salary cost plus overhead DIRECT NON-SALARY COST: Travel and Per Diem Mileage @ IRS reimbursement rate, currently$.565/mile Per Diem Office and Equipment Reproduction Expenses @ $ Jcopy .............................................................$ Health &Safety ........................................................................................................$ 1.75/hour for applicable staff Page 22 of 25 Pia zza/Data_Cemer/Forms/City/Contra Us E1-2012 EXHIBIT C(cont.) SUMMARY OF FEE FOR ENGINEERING SERVICES BREAKDOWN OF OVERHEAD COST See attached Exhibit C Addendum SUMMARY OF COSTS Project No. Name of Project DirectSalary Cost......................................................................................................................$ Overhead Cost (including payrolladditives........................................................................... % $ Sub-Total $ $Net Fee.............................................................................................................. /o Direct Non-Salary Costs: a. Travel and per diem................................................$ b. Reproduction expenses..........................................$ C. Computer expense.................................................$ d. Outside consultants................................................$ e. Other(specify)........................................................$ Total $ Sub Total $ GRAND TOTAL $ Page 23 of 25 Piazza/Data_Center/Forms/City/Contracts CITY OF RENTON SUMMARY OF FAIR PRACTICES POLICY ADOPTED BY RESOLUTION NO. 4085 It is the policy of the City of Renton to promote and provide equal treatment and service to all citizens and to ensure equal employment opportunity to all persons without regard to their race; religion/creed; national origin; ancestry; sex; age over 40; sexual orientation or gender identity; pregnancy; HIV/AIDS and Hepatitis C status; use of a guide dog/service animal; marital status; parental/family status; military status; or veteran's status, or the presence of a physical, sensory, or mental disability, when the City of Renton can reasonably accommodate the disability, of employees and applicants for employment and fair, non-discriminatory treatment to all citizens. All departments of the City of Renton shall adhere to the following guidelines: (1) EMPLOYMENT PRACTICES - The City of Renton will ensure all employment related activities included recruitment, selection, promotion, demotion, training, retention and separation are conducted in a manner which is based on job-related criteria which does not discriminate against women, minorities and other protected classes. Human resources decisions will be in accordance with individual performance, staffing requirements, governing civil service rules, and labor contract agreements. (2) COOPERATION WITH HUMAN RIGHTS ORGANIZATIONS - The City of Renton will cooperate fully with all organizations and commissions organized to promote fair practices and equal opportunity in employment. (3) CONTRACTORS' OBLIGATIONS - Contractors, sub-contractors, consultants and suppliers conducting business with the City of Renton shall affirm and subscribe to the Fair Practices and Non-discrimination policies set forth by the law and by City policy. Copies of this policy shall be distributed to all City employees, shall appear in all operational documentation of the City, including bid calls, and shall be prominently displayed in appropriate city facilities. CONCURRED IN by the City Council of the City of Renton, Washington, this 7th day of March 2011 CITY RENTON RENTON CITY COUNCIL i Denis Law, Mayor until Pr ident Attest: 56e r Bonnie I.Walton, City Clerk ' 5 AL ��Dfltl,'t!lHIUIli1i11111t1��\ Page 24 of 25 Piazza/Da ta_Center/Forms/City/Contracts E1-2012 CITY OF RENTON FAIR PRACTICES POLICY AFFIDAVIT OF COMPLIANCE hereby confirms and declares that: (Name of contractor/subcontractor/consultant) I. It is the policy of the above-named contractor/subcontractor/consultant, to offer equal opportunity to all qualified employees and applicants for employment without regard to their race; religion/creed; national origin; ancestry; sex; the presence of a physical, sensory, or mental disability; age over 40; sexual orientation or gender identity; pregnancy; HIV/AIDS and Hepatitis C status; use of a guide dog/service animal; marital status; parental/family status; military status; or veteran's status. II. The above-named contractor/subcontractor/consultant complies with all applicable federal, state and local laws governing non-discrimination in employment. III. When applicable, the above-named contractor/subcontractor/consultant will seek out and negotiate with minority and women contractors for the award of subcontracts. Print Agent/Representative's Name Print Agent/Representative's Title Agent/Representative's Signature Date Signed Instructions: This document MUST be completed by each contractor, subcontractor, consultant and/or supplier. Include or attach this documents) with the contract. Page 25 of 25 Piazza/Data_Center/Form s/City/Contracts Hebe Bernardo From: Mark Barber Sent: Thursday, December 20, 2012 8:33 AM To: Hebe Bernardo Subject: RE: legal review - CH2MHILL proposed edits to standard contract language - Sunset Regional Stormwater Facility Hello Hebe, I have reviewed the attached revised contract and it is approved as to legal form. Mark Barber Senior Assistant City Attorney Renton City Attorney 100S2ndSt P.O. Box 626 Renton,WA 98057 Direct line: 425-430-6485 E-mail: mbarber@rentonwa.gov From: Hebe Bernardo Sent: Thursday, December 20, 2012 7:53 AM To: Mark Barber Cc: Ronald Straka; Stephanie Rary Subject: RE: legal review-CH21VIHILL proposed edits to standard contract language-Sunset Regional Stormwater Facility Ups, sorry about that. Please see file attached. Best regards, Hebe C. Bernardo Civil Engineer II City of Renton I Public Works Department I Surface Water Utility 1055 S. Grady Way 15th Floor I Renton, WA 98057 1: Direct Office 425.430.7264 •: Direct Fax 425. 430.7241 D: hbernardo@rentonwa.gov -----Original Message----- From: Mark Barber Sent:Thursday, December 20, 2012 7:49 AM To: Hebe Bernardo Subject: RE: legal review-CH21VIHILL proposed edits to standard contract language-Sunset Regional Stormwater Facility Hello Hebe, When I opened the attachment it only contained a memo from Gary Lamb about insurance. Mark Barber 1 AAS - City Clerk City Clerk Number A yT Checklist Select One: [X—] Contract ❑ Permit ❑ Lease ❑ Agreement Contract Type (assigned by City Clerk) Staff Name: Hebe C. Bernardo Extension: 7264 Department/Division: Public Works/Surface Water Utility EDEN Approval Queue: 05/007p Addendum Number: to City Clerk Number: (if applicable). Contract Class: ❑ Receivable ❑X Payable ❑ Grant ❑ Misc. (no$) Expiration Date: 06/30/2015 Contractor Name: CH2MHILL Short Description: Sunset Terrace Regional Stormwater Facility, SWP 27-5295 Full or Additional provide flow control and enhanced basic water quality treatment prior to discharging into Johns Creek. Description: The Sunset Terrace Regional Stormwater Facility will consist of rain garden and infiltration galleries U Legal Review(attach memorandum from City Attorney) Risk Management review for insurance (attach memorandum from Risk Management) 0 Insurance certificate and/or policy (attach original) N ❑ Response to legal or Risk Management concerns (explain, in writing, how concerns have been met) ❑ Performance bond and verification memo from staff(for Public Works contracts only) ❑X Federal excluded parties list verification (Website: www.epls.gov, attach printout of search results) ❑X City business license number: Check EDEN or ask Finance Department. X Accounts payable W-9 vendor form (obtain if not already on file with Finance Dept.) Submitted contracts are signed by contractor: ❑X Yes ❑ No /f not, provide explanation below. Fiscal Impact. ❑X Expenditure or ❑ Revenue Amount Budgeted: Amount: $ 179,003 (line item;see below*): $ 1,307,172 Prior Council approval via agenda bill process required if: (see policies 250-02 and 800-12) ❑X Contract or addendum is$20,000 or over(non-Public Works)or$30,000 or over(Public Works). ❑ * Contract expenditure amount exceeds budgeted amount; fund transfer needed. ❑ Addendum is for the second and additional time extensions. ❑ Interlocal Agreement(most Interlocal Agreements require Resolutions) Date of Council Approval: Resolution Number: Contractor determined via: ❑ Phone Bid/Written Quote ❑ CFB Ad (if applicable) (if applicable) ❑X Consultant Roster RFP/SOQ Ad ❑ Application ❑ Sole Source Key words for City Clerk's electronic card file: CH2MHILL, Sunset Terrace, SR-900, Johns Creek, Department of Ecology FY-2012 Grant Agreement, LID, Stormwater retrofit, Sunset Terrace Regional Stormwater Facility Print FOrrn Revised 07/23/2008 _V Human Resources & Risk Management M E M O R A N D U M DATE: November 13, 2012 TO: Hebe Bernardo FROM: Gary B. Lamb, Risk Manager SUBJECT: Insurance Review/CH2M Hill Engineers, Inc. Sunset Regional Facility and the Harrington Green Connection Project Contract. I have reviewed the certificate of insurance documents for the above-named Agreement. The insurance coverage provided for this Agreement meets the City's risk management requirements. H:\Risk\Certificates\Specic Memo\CH2M Hill Engineers—Hebe Bernardo 2012 Memo.doc CERTIFICATE OF LIABILITY INSURANCE DATE/2012 /YYYY) ACORD DATE 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 CONTACT MARSH USA INC. NAME' 122517TH STREET,SUITE 2100 PHONE ac No): DENVER,CO 80202-5534 E-MAIL ADDRESS: INSURE S AFFORDING COVERAGE NAIC# 15114-01245-SG2PL-12/13 SEA BK INSURER A..Greenwich Insurance Compan y 22322 INSURED CH2M HILL ENGINEERS,INC. INSURER B:XL Specialty Insurance Co. 37885 1100 112TH AVE NE,SUITE 400 INSURER C:Zurich American Insurance Co 16535 BELLEVUE,WA 98004 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: SEA-002309508-07 REVISION NUMBER:12 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE D L SUER POLICY NUMBER MMIDDPOLICY/YYYY M EFF O/DDY EXP LTR LIMITS GENERAL LIABILITY X EACH OCCURRENCE $ 1,500,000 A X RGE500025501 05/0112012 05/01/2013 1,500,000 COMMERCIAL GENERAL LIABILITY PREMISES E occurrence) $ CLAIMS-MADE M OCCUR MED EXP(My one person) $ X $500,000 SIR I PERSONAL&ADV INJURY $ 1,500,000 GENERAL AGGREGATE $ 5,000.000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 5,000,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED ccid nt SINGLE LIMIT 2,000,000 Ea a A X ANY AUTO RAD500025401(AOS) 05/0112012 05/01/2013 BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED RAD500025601(MA) 05/01/2012 05/01/2013 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per ac'd nt Is UMBRELLA LIAB I OCCUR I I EACH OCCURRENCE_ __I EXCESS LIAB CLAIMS-MADE AGGREGATE is DED I I RETENTION$ I Is WORKERS COMPENSATION WC STATU- OTH' AND EMPLOYERS'LIABILITY B ANY PROPRIETOR,'PARTNERIEXECUTI' YIN RWD500025201 05/0112012 105/01/2013 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? LNJ NIA STOP GAP LIABILITY' 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under 'ONLY' 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C PROFESSIONAL LIABILITY' EOC3829621-10 /11/112012 �0111112013 Each Claim&Total For $2,000,000 All Claims. DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE:SUNSET TERRACE CO MMUNITY LID RETROFIT PROJ ECT-GREEN CONNECTION:HARRNG TON AVE NE. CITY OF RENTON AND RENTON HOUSING AUTHORITY A RE INCLUDED AS AN ADDITIONA.L INSURED ON THE GENERAL LIABILITY POLICY AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT. COVERAGE PROVIDED BY THE ABOVE GENERAL LIABILITY AND AUTO POLICIES SHALL BE PRIMARY AND NON-CONTRIBUTORY AND IS LIMITED TO THE LIABILITY RESUL T ING FROM THE NAMED INSURED'S OWNERSHIP AND/OR OPERATIONS. 'FOR PROFESSIONAL UA&LITY COVERAGE;THE AGGREGATE LIMIT IS THE TOTAL INSURANCE AVAILABLE FOR CLAIMS PRESENTED WITHIN THE POLICY PERIOD FOR ALL OPERATION;OF INSURED THE LI6'!T`N!LL°=REDUCED BY PAYMENTQ OF INDEMNITY.AND EXPENSE. CERTIFICATE:HOLDER CANCELLATION 1 CITY OF RENTON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PUBLIC WORKS DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN:HEBE BERNARD ACCORDANCE WITH THE POLICY PROVISIONS. 1055 S GRADY'WAY,5TH FLOOR RENTON,WA 98057 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. I I Sharon A.Hammer t i ©1988-2010 ACORD CORPORATION. Ali rights reserved. ACORD 25(2010105) The ACGR::name and ioo-O are registered marks of ACORD ENDORSEMENT#009 This endorsement, effective 12:01 a.m., May 01,2012 forms a part of Policy No.RAD500025401 Issued to CH2M HILL COMPANIES, LTD. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled or non renewed for any statutorily permitted reason,other than nonpayment of premium,or if coverage Is materially reduced,advanced written notice will be mailed or emailed to person(s)or entity(ies)according to the notification schedule shown below: Number of Days Name of Person(s)or Entity(ies) Mailing Address: Advanced Notice of Cancellation: Per the most current schedule maintained by Marsh USA, Inc.and furnished to XL Insurance no less than 60 days 15 days prior to the 60 days of notice of cancellation, non-renewal or material reduction In coverage For the purpose of this endorsement, non-renewal shall mean solely non-renewal of the Policy and shall not Include Notice of Conditional Renewal. Material reduction In coverage shall mean a decrease in the Policy limits, an increase in the deductible or self-insured retention of greater than$250,000 or the application of a Policy exclusion not contemplated at Policy issuance. All other terms and conditions of the Policy remain unchanged. (Authorized Repres ntatl ) I MANUS O 2011 X.L.America, inc. All Rights Reserved. May not be copied without permission. ENDORSEMENT#021 This endorsement, effective 12:01 a.m.,May 1,2012 forms a part of Policy No.RGE600026601 issued to CH2M HILL COMPANIES, LTD. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ iT CAREFULLY AUTOMATIC ADDITIONAL INSURED'S PRIMARY COVERAGE This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART LIQUOR LIABILITY COVERAGE PART The following provision is added to Section II,Who is an Insured: I. A. Any entity, person, or organization you are required or have agreed In a written Insured contract, permit,access agreement and any other written agreement to name as an insured is an insured (hereinafter called additional Insured) but only with respect to liability arising out of your premises,your work for the additional insured, or acts or omissions of the additional insured in connection with the general supervision of your work to the extent set forth below: (1) The limits of, insurance with respect to each person, organization or entity shall not exceed the limits of liability of the named insured. (2) Aii insuring agreements, 6xCiuwvits and uviluw�.l3 vi uns NOJ^.y GpN.y, I (3) In no event shall the coverage or limits of insurance in this coverage iorm be increased by such contract. B. Except when required otherwise by insured centract, this Insurance dons not apply to: (1) (a)All work on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional Insured(s)at the site of the covered operations has been completed; or(b)That portion of your work out of which the injury or damage arlses has been p:it to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. (2) Bodily Injury or Property Damage arising out of any act or omission of the additionai insureds)or i any of their employees, other than the general sueervisi^^of work perfo-,m ed for the additional insured(s) � by you. i i M;;NUS G 2011 X,L.America, Inc, F,ii Rights Reseeded. May not be copled`Y,'Ihaut permissio;1. i I � I C. Any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured(s)whether primary, excess, contingent or on any other basis unless a contract specifically required that this insurance be primary, or you request that it apply on a primary basis. When this insurance applies on a primary basis for the additional insureds described above, it shall apply only with respect to liability arising out of your work for that additional insured by or for you. Other insurance afforded to those additional insureds will apply as excess and not contribute as primary to the insurance afforded by this endorsement. All other terms and conditions remain the same. (Authorized Rep es tative) i MANUS ©2011 X.L. America, Inc. All Rights Reserved. May not be copied without permission. ENDORSEMENT#027 This endorsement, effective 12:01 a,m,, May 01,2012 forms a part of Policy No.RGE600025501 Issued to CH2M HILL COMPANIES, LTD. by Greenwich Insurance Company THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled or non renewed for any statutorily permitted reason or if coverage Is materially reduced, or coverage is cancelled for non-payment of premium advanced written notice will be mailed to the person or entity according to the notification schedule shown below: Number of Days Name of Person or Entity Mailing Address: Advanced Notice of Cancellation: Per the most current schedule maintained by Marsh USA, Inc. and furnished to XL Insurance no less than 15 days prior to 60 days the 60 days of notice of cancellation, non- renewal or material reduction in coverage For the purpose of this endorsement,non-renewal shall mean solely non-renewal of the Policy and shall not include expiration or Notice of Conditional Renewal, Material reduction In coverage shall mean a decrease in the Policy limits,an Increase In the deduotibie or self-Insured retention or the application of a Policy exclusion not contemplated at Policy issuance. All other terms and conditions of the Policy remain unci"i-an -.J (Authorizecgi0resentative) MANUS ©2011 X.L. America, ino. Ali Rights Reserved, N4ay not be copied without permission. � 1 Endorsement#52 Notification to Others of Cancellation . Electronic Schedule ZURICH Policy No. Eff.Date of Pol. Exp.Date of Pol. Eff.Date of End Producer Add'i Prem. I Return Prem. EOC3829621-10 5/l/2012 5/1/2013 5/t/2012 29253000 ----- ----- Insured Name and Mailing Address: Producer: C112M Hill Companies,Ltd. Marsh USA,Inc. 9191 S Jamaica Street 1225 17"St Ste 2100 Englewood,CO 80112-5946 Denver,CO 80202-5521 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: Architects and Engineers Professional Liability Policy—Claims Made and Reported Coverage In consideration of the premium already charged,we agree with you, subject to all terms, exclusions, and conditions of the policy that: A. If we cancel this policy by written notice to the first"Named Insured:for any reason other than nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation: 1. To the name and address corresponding to each person or organization shown in the Schedule provided to us by the first"Named Insured". Such Schedule: a. Must be initially provided to us within 15 days: i, After the beginning of the policy period shown in the Declarations; or ii. .After this endorsement has been added to the policy; b. Must contain the names and addresses of only the persons or organizations requiring notification that this Policy has been cancelled; c. Must be in an electronic format that is acceptable to us; and d. Must be accurate. Such Schedule must be updated and provided to us, by the first`N'anied Insured", during the policy period. Such updated Schedule must comply with paragraphs b., c. and d. above. 2. At least thirty(30)days prior to the effective date of the cancellation, as advised in our notice to the first"Named Insured", or the longer number of days notice if indicated in the Schedule provided to us. U-GL-113-A CW (4/90) Pagel of 2 I I I If we cancel this Policy by written notice to the first"Named Insured"for non-payment of premium,we will mail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or organization shown in the Schedule provided to us by the first"Named Insured"at least 10 days prior to the effective date of such cancellation. Such schedule shall meet the requirements outlined in item A.1. B. Our notification, as described in Paragraph A. or B. of this endorsement,will be based on the most recent Schedule provided to us by the first"Named Insured"as of the date the notice of cancellation is mailed. C. Proof of mailing will be sufficient proof that we have complied with Paragraph A. or B. of this endorsement. D. We are not responsible for the accuracy, integrity,timeliness and validity of information contained in the Schedule provided to us as described in Paragraph A. of this endorsement. All other terms and conditions of this policy remain unchanged. Signed By: ,i7' �, � "'V 4/25/2012 Authorized Representative Date U-GL-113-A CW (4/90) Page 2 of 2 i System for Award Management Page 1 of 1 Search Results Current Search Terms:ch2mhill* No records found for current seardi. SAM I Systemfor Award Management 1.o IBM v1.513.20121222-2220 0 a —. Note to all Users:This is a Federal Government computer system.Use of this -us;1. ._ system constitutes consent to monitoring at all times. https://www.sam.gov/portal/public/SAM/?portal:componentld=66fdb602-77f6-4ba0-914a-0... 1/8/2013 Excluded Parties List System Page 1 of 1 Excluded Parties List Svsten Er Search-Current Exclusions EPLS Search Resources Results >Advanced Search >Search Help >Multiple Names Search Results for Parties >Advanced Search Tips >Exact Name and SSN/TIN Excluded by >Public User's Manual >MyEPLS Firm, Entity,or Vessel :CH2MHILL >FAQ >Recent Updates As of 25-Oct-2012 6:37 PM EDT >Acronyms •Browse All Records Save to MyEPLS >Privacy Act Provisions >News View Cause and Treatment Code >System for Award Management Descriptions Your search returned no results. (SAM) >Reciprocal Codes Back New Search Printer-Friendly Reports >Procurement Codes >Nonprocurement Codes >Advanced Reports >Recent Updates Agency&Acronym Information >Dashboard >Agency Contacts Archive Search-Past Exclusions >Agency Descriptions >State/Country Code Descriptions >Advanced Archive Search >Multiple Names OFFICIAL GOVERNMENT USE ONLY >Recent Updates >Browse All Records •Debar Maintenance •Administration Contact Information >Upload Login >For Help: Federal Service Desk https://www.epls.gov/epls/search.do 10/25/2012 Teresa Phelan From: Teresa Phelan Sent: Friday, January 18, 2013 10:16 AM To: Ronald Straka; Gregg A. Zimmerman Cc: Hebe Bernardo; JoAnn Wykpisz; Linda Moschetti Subject: RE: Agenda Bill - Sunset Terrace Agreement with CH2MHill Hi Everyone, I made the changes to the agenda bill and issue paper and will give you new hardcopies. I also went into ICompass and changed the electronic versions. It looks like it is still at Iwen's level for approval. Thanks, Teresa From: Ronald Straka Sent: Friday, January 18, 2013 10:05 AM To: Gregg A. Zimmerman Cc: Teresa Phelan; Hebe Bernardo Subject: RE: Agenda Bill - Sunset Terrace Agreement with CH2MHill Ok, we will fix the agenda bill and issue paper. From: Gregg A. Zimmerman Sent: Friday, January 18, 2013 9:57 AM To: Ronald Straka Subject: FW: Agenda Bill - Sunset Terrace Agreement with CH2MHill Ron, FYI, account number issue on Sunset Terrace Agreement with CH21VIHilI Agenda Bill. Gregg Zimmerman, P.E. Public Works Administrator City of Renton Phone: (425)430-7311 Fax: (425)430-7241 E-mail: gzimmerman@rentonwa.gov From: JoAnn Wykpisz Sent: Friday, January 18, 2013 9:50 AM To: Gregg A. Zimmerman; Lys L. Hornsby Cc: Teresa Phelan; Linda Moschetti Subject: FW: Agenda Bill - Sunset Terrace Agreement with CH2MHill I concur with the budget amounts listed on the agenda bill and memorandum. However, the project number on page 2 of the memorandum should be 427.475492, and not 427.475292. JoAnn Wykpisz Public Works-Administration (425)430-7393 (Please note new phone number) From: Linda Moschetti Sent: Thursday, January 17, 2013 1:17 PM To: JoAnn Wykpisz Cc: Gregg A. Zimmerman; Lys L. Hornsby; Teresa Phelan Subject: Agenda Bill - Sunset Terrace Agreement with CH21VIHiI1 Hi JoAnn! Since you were out ill today and Gregg is out Friday at noon, we had a rush agenda bill for a consultant agreement with CH2MHill for the Sunset Terrace Stormwater Facility Project. We thought it would be better to move it forward and have Gregg approve today and you approve it afterward due to the holiday on Monday. So, will you please review the attached agenda bill and just send a reply all e-mail that you concur with the budget portion of the project? If you see the need for any changes, please see Teresa on Friday. Thanks! Linda Moschetti Administrative Assistant Public Works Department City of Renton 1055 South Grady Way Renton, Washington 98057 Phone: (425) 430-7394 Fax: (425) 430-7241 E-mail: Imoschetti@rentonwa.gov Ot"t of " ) r c WA .,. ,F . 2 y JtN W NORTHWEST CASCADE, INC. P.O. BOX 73399, PUYALLUP, WA 98373 TACOMA(253)848-2371 /SEATTLE(206)838-2359 NORTHCI148BG i I p pF REN UCj R�CE�VE�FFICE �m4m �o. GRAB' WAY ►�►� iRC��C�'. �u��-�D��u✓i� I�'u�.Irn��-c�- /J��e��n� �4E�O�F�r s�G��cw�-rt� �Rt� C�n►� cn��v $)►0 DP JT-: - TW 5, J]A r)_L IL), pU 14- ..�i'�11�i t : 3: 3r� R ►� BOND TO THE CITY OF RENTON Bond No. 09163755 KNOW ALL MEN BY THESE PRESENTS: That we,the undersigned Northwest Cascade, Inc. as principal, and Fidelity and Deposit Company of Maryland corporation organized and existing under the laws of the State of Maryland _ as a surety corporation, and qualified under the laws of the State of Washington to become surety upon bonds of contractors with municipal corporations, as surety are jointly and severally held and firmly bound to the City of Renton in the penal sum of $1,101,142.55 for the payment of which sum on demand we bind ourselves and our successors,heirs,administrators or person representatives,as the case may be. This obligation is entered into in pursuance of the statutes of the State of Washington, the Ordinance of the City of Renton. Dated at ,Washington,this day of .20i Nevertheless,the conditions of the above obligation are such that: WHEREAS,under and pursuant to Public Works Construction Contract CA+G-14-079 providing for construction of Sunset Community Low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington Ave NE Water Main Replacement Project SWP-27- 3635. WTR-27-3635 the principal is required to furnish a bond for the faithful performance of the contract;and WHEREAS, the principal has accepted, or is about to accept, the contract, and undertake to perform the work therein provided for in the manner and within the time set forth; NOW, THEREFORE, if the principal shall faithfully perform all of the provisions of said contract in the manner and within the time therein set forth,or within such extensions of time as may be granted under said contract, and shall pay all laborers, mechanics, subcontractors and materialmen, and all persons who shall supply said principal or subcontractors with provisions and supplies for the carrying on of said work, and shall hold said City of Renton harmless from any loss or damage occasioned to any person or property by reason of any carelessness or negligence on the part of said principal, or any subcontractor in the performance of said work,and shall indcmnify and hold the City of Renton harmless from any damage or expense by reason of failure of performance as specified in the contract or from defects appearing or developing in the material or workmanship provided or performed under the contract within a period of one year after its acceptance thereof by the City of Renton,then and in that event this obligation shall be void; but otherwise it shall be and remain in full force and effect. Northwest Cascade, Inc. Fidelity and Deposit Company of Maryland Principal Surety Signature 0 Signature L`1)�/1�5 j Karen Swanson,Attorney-in-Fact Title Title Client#: 12831 NORTCASCI DATE(MM/DDlYYYY) ACORD- CERTIFICATE OF LIABILITY INSURANCE TE(M.DDN 9/24/2014 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 CON NAMTA E: _ Debbie Henderson __-- Propel Insurance AICO"N,EXt);800 499-0933 (arc-No): 866.577.1326 Tacoma Commercial Insurance E MAIL ADDRESS: drh@propolinsurance.com p 1201 Pacific Ave,Suite 1000 ..__._ Tacoma,WA 98402 � INSURER(S)AFFORDING COVERAGE NAIC 0 _ INSURER A:Zurich American Insurance Co. INSURED Northwest Cascade Inc. INSURER B:Starr Surplus Lines Insurance C DBA: Honey Buckets,Inc; DBA FloHawks INSURER C P.O.Box 7399 INSURERD: Puyallup,WA 98373 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - - - ADDLSUBR - - POUCYEFF POLICYEXP LTR TYPE OF INSURANCE INSR WVQ POLICY NUMBER MM/DDNYYY (MMIDDNYYYl 1 LIMITS A GENERAL LIABILITY X X GLA013642400 10/01./2014 10/01/201 ElAct2cCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY q�,�A� RENTED RREMIS ST currenca) 000,000 CLAIMS-MADE C OCCUR `EDED EXP(Any one person)_ $101000_ X PD Ded:5,000 PERSONAL&AOV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY FXI PRO- LOCJECT $ A AUTOMOBILE LIABILITY X X GLA013642400 0/01/2014 10/01/201 COMBINED SINGLE LIMIT 1,000000 Ea accident) ..£.._...._...._L....._._... X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED "'-- AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS 1 Peraccident $ S B UMBRELLA LIAR X OCCUR X '1000021236 10/01/2014 10/01/2016 EACH OCCURRENCE _ $5 00O 000 _ EXCESS LIAB r �^ X X CLAIMS-MAD �AGGREG_A_TE $5 OOO OOO DED X RETENTION$Q _ $ A WORKERS COMPENSATION 1 10/01/2014 10/01/20 5 X WC STATU- X OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE WA Stop Gap E.L.EACH ACCIDENT S1 OQO 000 OFFICER/MEMBER EXCLUDED? N N I A A (Mandatory In NH) j GLA013642400 10/01/2014 10/01/201 E.L.DISEASE-EA EMPLOYEEI$1 000 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 _ A L/R Equip X CPP013642700 0101/2014 10/01/201 $420K Limit Rental Reimb. i $5,000 ded $1,000 Per Da DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space Is required) RE: SWP-27-3635 and WTR-27-3635/Sunset Commuity Low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington Ave NE Water Main Replacement Project. The City of Renton is additional insured per the attached endorsements. CERTIFICATE HOLDER CANCELLATION City of Renton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ty THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1055 South Grady Way ACCORDANCE WITH THE POLICY PROVISIONS. Renton,WA 98057 AUTHORIZED REPRESENTATIVE f A. `Jl ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1523278/M1517148 KTR00 This page has been left blank intentionally. COMMERCIAL AUTO CA 20 01 10 01 POLICY NUMBER: GLA013642400 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR - ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGEFORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Countersigned By, Named Insured:Northwest Cascade Inc. (Authorized Representative) SCHEDULE Insurance Company Zurich American Insurance Co. Policy Number GLA013642400 Effective Date 10/01/2014 Expiration Date 10/01/2015 Named Insured Northwest Cascade Inc. Address Additional Insured (Lessor)City of Renton Address 1055 South Grady Way Renton,WA 98057 Designation or Description of "Leased Autos' RE:SWP-27-3635 and WTR-27-3635/Sunset Comr 0 ISO Properties, Inc., 2000 Satew o and the Wow No are trademarks of Sateco Cwpomtlon, CA 20 01 10 01 Page 1 of 2 EP Coverages Limit of Insurance Liability $ Each "Accident Personal Injury Protection (or equivalent no-fault coverage) Comprehensive ACTUAL CASH VALUE OR COST OF REPAIR WHICHEVER IS LESS; MINUS: $ For Each Covered "Leased Auto" Collision ACTUAL CASH VALUE OR COST OF REPAIR WHICHEVER IS LESS; MINUS: $ For Each Covered "Leased Auto" Specified Causes of loss. ACTUAL CASH VALUE OR COST OF REPAIR WHICHEVER IS LESS MINUS: $ For Each Covered "Leased Auto" (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Coverage 3. If we make any payment to the lessor, we will 1. Any "leased auto"designated or described in the obtain his or her rights against any other party. Schedule will be considered a covered "auto"you C. Cancellation own and not a covered "auto"you hire or borrow. 1. If we cancel the policy, we will mail notice to the For a covered auto that is a 'leased auto" Who lessor in accordance with the Cancellation Is An Insured is changed to include as an Common Policy Condition, "insured"the lessor named in the Schedule. 2. If you cancel the policy, we will mail notice to the 2. The coverages provided under this endorsement lessor, apply to any "leased auto" described in the 3. Cancellation ends this agreement. Schedule until the expiration date shown in the D. The lessor is not liable for payment of your premiums. Schedule, or when the lessor or his or her agent E. Additional Definition takes possession of the 'leased auto', whichever occurs first. As used in this endorsement: 6, Loss Payable Clause "Leased auto' means an "auto' leased or rented to 1. We will pay, as interest may appear, you and the you, including ary substitute, replacement or extra lessor named in this endorsement for "loss^to a "auto" needed to meet seasonal or other needs, under "leased auto". a leasing or rental agreement that requires you to 2. The insurance covers the interest of the lessor provide direct primary insurance for the lessor. unless the loss" results from fraudulent acts or omissions on your part. Page 2 of 2 AYAISrER OF TRANSFER OF RIGHTS OIL RECOVERY AGAINST OTHERS TO US THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. POLICY NO. EFF.DATE OF POL. I EXP.DATE OF POL. EFF.DATE OF END. AGENCY NO. I ADD L,PREM. RETURN PREPL GLA013642400 10/01/2014 10/01/2015 10101/2014 Named Insured Northwest Cascade Inc. DBk Honey Buckets,Inc;DBA FloHawks Address(including ZIP Code) P.O.Box 7399 Puyallup,WA 98373 This endorsement modifies insurance provided by the following: Business Auto Coverage Part Truckers Coverage Part Garage Coverage Part SCHEDULE Name of Person or Organization: ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO WAIVE RIGHTS OF SUBROGATION OR RECOVERY BUT ONLY IF SUCH WRITTEN CONTRACT OR AGREEMENT IS ENTERED INTO (NOT BACKDATED) AND PUT IN EFFECT PRIOR TO LOSS BY YOU OR ANY OTHER PERSON, ENTITY OR ORGANIZATION FOR WHOM YOU -ARE LEGALLY RESPONSIBLE We waive any right of recovery we may have against the designated person or organization shown in the schedule because of payments we make for injury or damage caused by an"accident"or"loss"resulting from the ownership,maintenance.or use of a covered "auto' for which a Waiver of Subrogation is required in conjunction with work performed by you for the designated person or organization.The%waiver applies only to the designated person or organization shown in the schedule. Countersigned Authorized Representative U-CA-320-A(CW) (4/92) Msured Copy This page has been left blank intentionally. Coverage Extension Endorsement Z U RIC H Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff.Date of End. Producer No. Add'I.Prem Return Prem. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section 11—Covered Autos Liability Coverage: The following are also"insureds": a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any "employee" of yours is also an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission,while performing duties related to the conduct of your business. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an "auto"referenced in Paragraphs A.1.a.and A.11. in this endorsement. d. Where and to the extent permitted by law, any person(s)or organization(s)where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations,whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance—Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured"will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form. B. Amendment—Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II — Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident"we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. U-CA-424-F CW(04-14) Page 1 of 6 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. C. Fellow Employee Coverage The Fellow Employee Exclusion contained in Section II—Covered Autos Liability Coverage does not apply. D. Driver Safety Program Liability and Physical Damage Coverage 1. The following is added to the Racing Exclusion in Section II—Covered Autos Liability Coverage: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. 2. The following is added to Paragraph 2. in the Exclusions of Section III — Physical Damage Coverage of the Business Auto Coverage Form and Paragraph 2.b. in the Exclusions of Section IV — Physical Damage Coverage of the Motor Carrier Coverage Form: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. E. Lease or Loan Gap Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Lease Or Loan Gap Coverage In the event of a total 'loss"to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered "auto",less: a. Any amount paid under the Physical Damage Coverage Section of the Coverage Form; and b. Any: (1) Overdue lease or loan payments at the time of the'loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties,credit life insurance, health, accident or disability insurance purchased with the loan or lease; and (5) Carry-over balances from previous leases or loans. F. Towing and Labor Paragraph A.2.of the Physical Damage Coverage Section is replaced by the following: We will pay up to$75 for towing and labor costs incurred each time a covered "auto" of the private passenger type is disabled. However,the labor must be performed at the place of disablement. G. Extended Glass Coverage The following is added to Paragraph A.3.a.of the Physical Damage Coverage Section: If glass must be replaced, the deductible shown in the Declarations will apply. However, if glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. H. Hired Auto Physical Damage—Increased Loss of Use Expenses The Coverage Extension for Loss Of Use Expenses in the Physical Damage Coverage Section is replaced by the following: Loss Of Use Expenses For Hired Auto Physical Damage,we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We will pay for loss of use expenses if caused by: U-CA-424-F CW(04-14) Page 2 of 6 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered"auto'; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However,the most we will pay for any expenses for loss of use is$100 per day,to a maximum of$3000. I. Personal Effects Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Personal Effects Coverage a. We will pay up to$750 for"loss"to personal effects which are: (1) Personal property owned by an "insured";and (2) In or on a covered "auto". b. Subject to Paragraph a.above, the amount to be paid for"loss"to personal effects will be based on the lesser of: (1) The reasonable cost to replace; or (2) The actual cash value. c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered "auto". No deductible applies to this coverage. However, we will not pay for "loss"to personal effects of any of the following: (1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other documents of value. (2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious or semi-precious stones. (3) Paintings,statuary and other works of art. (4) Contraband or property in the course of illegal transportation or trade. (5) Tapes, records, discs or other similar devices used with audio,visual or data electronic equipment. Any coverage provided by this Provision is excess over any other insurance coverage available for the same'loss". J. Tapes, Records and Discs Coverage 1. The Exclusion in Paragraph 13.4.a. of Section III — Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph B.2.c. of Section IV — Physical Damage Coverage in the Motor Carrier Coverage Form does not apply. 2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section: We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records,discs or other similar audio, visual or data electronic devices: (a) Are the property of an "insured"; and (b) Are in a covered "auto"at the time of"loss". The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical Damage Coverage Deductible Provision does not apply to such 'loss". U-CA-424-F CW(04-14) Page 3 of 6 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. K. Airbag Coverage The Exclusion in Paragraph B.3.a.of Section III—Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph B.4.a. of Section IV— Physical Damage Coverage in the Motor Carrier Coverage Form does not apply to the accidental discharge of an airbag. L. Two or More Deductibles The following is added to the Deductible Provision of the Physical Damage Coverage Section: If an accident is covered both by this policy or Coverage Form and by another policy or Coverage Form issued to you by us,the following applies for each covered"auto"on a per vehicle basis: 1. If the deductible on this policy or Coverage Form is the smaller(or smallest)deductible, it will be waived; or 2. If the deductible on this policy or Coverage Form is not the smaller (or smallest)deductible, it will be reduced by the amount of the smaller(or smallest)deductible. M. Physical Damage—Comprehensive Coverage—Deductible The following is added to the Deductible Provision of the Physical Damage Coverage Section: Regardless of the number of covered "autos"damaged or stolen,the maximum deductible that will be applied to Comprehensive Coverage for all "loss"from any one cause is$5,000 or the deductible shown in the Declarations, whichever is greater. N. Temporary Substitute Autos—Physical Damage 1. The following is added to Section I—Covered Autos: Temporary Substitute Autos—Physical Damage If Physical Damage Coverage is provided by this Coverage Form on your owned covered "autos", the following types of vehicles are also covered "autos"for Physical Damage Coverage: Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered "auto"you do own but is out of service because of its: 1. Breakdown,- 2. Repair; 3. Servicing; 4. "Loss';or 5. Destruction. 2. The following is added to the Paragraph A.Coverage Provision of the Physical Damage Coverage Section: Temporary Substitute Autos—Physical Damage We will pay the owner for"loss"to the temporary substitute "auto"unless the"loss"results from fraudulent acts or omissions on your part. If we make any payment to the owner, we will obtain the owner's rights against any other party. The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it replaces. O. Amended Duties In The Event Of Accident, Claim,Suit Or Loss Paragraph a.of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following: a. In the event of"accident", claim, "suit" or"loss", you must give us or our authorized representative prompt notice of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or "loss" is known to you (if you are an individual), a partner(if you are a partnership), a member(if you are a limited liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any U-CA-424-F CW(04-14) Page 4 of 6 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. agent, servant or employee of the "insured"to notify us of any "accident", claim, "suit"or"loss" shall not invalidate the insurance afforded by this policy. Include,as soon as practicable: (1) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice of the claim or"suit"including, but not limited to, the date and details of such claim or"suit"; (2) The"insured's" name and address; and (3) To the extent possible,the names and addresses of any injured persons and witnesses. If you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you. P. Waiver of Transfer Of Rights Of Recovery Against Others To Us The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or "loss", provided that the "accident"or"loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract. Q. Employee Hired Autos-Physical Damage Paragraph b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f. of the Other Insurance-Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage,the following are deemed to be covered "autos"you own: (1) Any covered"auto"you lease, hire, rent or borrow; and (2) Any covered"auto"hired or rented under a written contract or written agreement entered into by an "employee"or elected or appointed official with your permission while being operated within the course and scope of that "employee's"employment by you or that elected or appointed official's duties as respect their obligations to you. However, any"auto"that is leased, hired, rented or borrowed with a driver is not a covered "auto". R. Unintentional Failure to Disclose Hazards The following is added to the Concealment, Misrepresentation Or Fraud Condition: However,we will not deny coverage under this Coverage Form if you unintentionally: (1) Fail to disclose any hazards existing at the inception date of this Coverage Form;or (2) Make an error, omission, improper description of"autos"or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to the acceptance of this policy. S. Hired Auto-World Wide Coverage Paragraph 7a.(5)of the Policy Period, Coverage Territory Condition is replaced by the following: (5) Anywhere in the world if a covered "auto"is leased, hired, rented or borrowed for a period of 60 days or less, T. Bodily Injury Redefined The definition of"bodily injury"in the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. U-CA-424-F CW(04-14) Page 5 of 6 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. U. Expected Or Intended Injury The Expected Or Intended Injury Exclusion in Paragraph B. Exclusions under Section 11—Covered Auto Liability Coverage is replaced by the following: Expected Or Intended Injury "Bodily injury" or"property damage" expected or intended from the standpoint of the "insured". This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. V. Physical Damage—Additional Temporary Transportation Expense Coverage Paragraph AA.a.of Section III—Physical Damage Coverage is replaced by the following: 4. Coverage Extensions a. Transportation Expenses We will pay up to $50 per day to a maximum of$1,000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". W. Replacement of a Private Passenger Auto with a Hybrid or Alternative Fuel Source Auto The following is added to Paragraph A. Coverage of the Physical Damage Coverage Section: In the event of a total "loss" to a covered "auto" of the private passenger type that is replaced with a hybrid "auto" or "auto" powered by an alternative fuel source of the private passenger type, we will pay an additional 10% of the cost of the replacement "auto", excluding tax, title, license, other fees and any aftermarket vehicle upgrades, up to a maximum of$2500. The covered "auto" must be replaced by a hybrid "auto" or an "auto" powered by an alternative fuel source within 60 calendar days of the payment of the "loss" and evidenced by a bill of sale or new vehicle lease agreement. To qualify as a hybrid "auto", the "auto" must be powered by a conventional gasoline engine and another source of propulsion power. The other source of propulsion power must be electric, hydrogen, propane, solar or natural gas, either compressed or liquefied. To qualify as an "auto" powered by an alternative fuel source, the "auto" must be powered by a source of propulsion power other than a conventional gasoline engine. An "auto" solely propelled by biofuel, gasoline or diesel fuel or any blend thereof is not an "auto" powered by an alternative fuel source. X. Return of Stolen Automobile The following is added to the Coverage Extension Provision of the Physical Damage Coverage Section: If a covered "auto" is stolen and recovered, we will pay the cost of transport to return the "auto"to you. We will pay only for those covered "autos"for which you carry either Comprehensive or Specified Causes of Loss Coverage. All other terms, conditions, provisions and exclusions of this policy remain the same. U-CA-424-F CW(04-14) Page 6 of 6 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Waiver Of Subrogation (Blanket) Endorsement ZURICH Policy No. Eff. Date of Pot. Exp. Date of Pol. Eff.Date of End. Producer AddT Prem Return Prent. GLA013642400 10101/2014 10/01f2015 10/01/2014 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: If you are required by a written contract or agreement,which is executed before a loss,to waive your rights of recovery from oth- ers,we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. U-GL-925-B Cw(12/00 Page 1 of 1 This page has been left blank intentionally. GLA013642400 Additional Insured —Automatic — Owners, Lessees Or ZURICH Contractors Policy No. Eff. Date of Pol. I Exp. Date of Pol. Eff.Date of End. Producer No, AWL Pre, Return Prem. 10101/2014 10/01/2015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: Northwest cascade Inc. Address(including ZIP Code): This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section II—Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement. Such person or organization is an additional insured only with respect to liability for"bodily injury", "property damage" or"personal and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations or "your work" as included in the "products-completed operations hazard",which is the subject of the written contract or written agreement. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds,the following additional exclusion applies: This insurance does not apply to: "Bodily injury", "property damage" or"personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders,change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the 'occurrence"which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural,engineering or surveying services. U-GL-1175-F CW(04/13) Page 1 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. GLA013642400 C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV— Commercial General Liability Conditions: The additional insured must see to it that: 1. We are notified as soon as practicable of an'occurrence"or offense that may result in a claim; 2. We receive written notice of a claim or"suit'as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit' will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D. For the purposes of the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section IV — Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV—Commercial General Liability Conditions: This insurance is excess over. Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same'occurrence", offense, claim or"suit'. This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section III—Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the written contract or written agreement referenced in Paragraph A.of this endorsement; or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. U-GL-1175-F Cw(04113) Page 2 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Northwest Cascade Inc. POLICY NUMBER:GLA013642400 COMMERCIAL GENERAL LIABILITY CG 20 28 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- LESSOR OF LEASED EQUIPMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Persons Or Organization(s) ANY PERSON OR ORGANIZATION TO WHOM OR TO WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO THE LOSS EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. Information required to complete this Schedule, if not shown above, will be shown In the Declarations. A. Section II --Who Is An Insured is amended to B. With respect to the insurance afforded to these Include as an additional insured the person(s) or additional insureds, this insurance does not apply organization(s) shown in the Schedule, but only to any 'occurrence" which takes place after the with respect to liability for"bodily injury", "property equipment lease expires, damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s)or organization(s). GG 20 28 07 04 ©ISO Properties, Inc.,2004 Page 1 of 1 13 This page has been➢eft blank intentionally. wlent*.- ILBJ I NUK I�,ASGT /DD/YYY1�(MM DATE ACORM CERTIFICATE OF LIABILITY INSURANCE DA TE(MM014 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 Inet I NAME: Debbie Henderson Propel Insurance k ��`0'�3 AlpN Ef:800 499-0933 N ; 866.577.1326 Tacoma Commercial Insurance ��G 3 E-MAIL SS: drh@propelinsurance.com 1201 Pacific Ave,Suite 1000 INSURER(S)AFFORDING COVERAGE NAIC# Tacoma,WA 98402 INSURER A:National Fire ins Co of Hartfor INSURED Northwest Cascade Inc. INSURER B:Starr Surplus Lines Insurance C 13604 DBA: Honey Buckets,Inc; DBA FloHawks INSURER C:Continental Casualty Company 20443 P.O. Box 7399 INSURER D:American Casualty Co of Reading Puyallup,WA 98373 INSURER E ..INSURER F COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE O U9 POLICY EFF POLICY FXP LTR POLICY NUMBER MM/DD/YY MM/DDIYYYY. LIMITS A GENERAL LIABILITY X X 2053866352 0/01/2013 10/0112014 EACH OCCURRENCE $1 OOO 000 RNGE TO RENTED Xa COMMERCIAL GENERAL MIAS S Ea occurrence �- $10O 0OO CLAIMS-MADE t..^.a OCCUR MED EXP(Any one person) $5,000 X PD Ded:5,000 PERSONAL BADVINJURY $1 000000 GENERALAGGREGATE $2 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: .PRODUCTS-COMP/OP AGG ,$2,000 OOO POLICY X PRO LOC $ D AUTOMOBILE LIABILITY X X 2053866318 0101/2013 10/01/2014 COMBINED$tNGLELlMIT Ea accident 9,OOQ000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PfONERTYOAMi1GE $ AUTOS Per accident B UMBRELLALIAB X OCCUR 1000020409 0/01/2013 10101/2014 EACH OCCURRENCE $5 000 000 X EXCESS LIAB X I CLAIMS-MADE AGGREGATE $5.000 000 DED X RETENTION$0 $ C WORKERS COMPENSATION 2093635362 0/01/2013 10/0112014 X WC8TATu- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N WA Stop Gap E.L.EACH ACCIDENT $1 000 000 OFFICER/MEMBER EXCLUDED? � NIA -s• A (Mandatory in NH) 2099313067 0/01/2013' 10/01/201 E.L.DISEASE-EA EMPLOYEE'_$1 000 000 If yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $1„000,000 C 'Leased/Rented Eq 2071939959 0/01/2013 10/01120' $420K Lmt/$100K to Othr Deductbls,$2,500 dedl$5k for MTC C Motor Truck Caro 2071939959 0/0112013' 1 O/01/201 $100k per Veh/$200k Agg DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) RE:SWP-27-3635 and WTR-27-3635/Sunset Commuity Low Impact Development Retrofit Stormwater Green Connection:Harrington Ave NE and Harrington Ave NE Water Main Replacement Project. The City of Renton is additional insured per the attached endorsements. CERTIFICATE HOLDER CANCELLATION City Of Renton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1055 South Grady Way ACCORDANCE WITH THE POLICY PROVISIONS. Renton,WA 98057 AUTHORIZED REPRESENTATIVE ' A• '-4*- ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S1437756IM1375169 KTR00 S p 00 — 006 �mI C,iG,rS n � � LiA"vY 3e� Cow rvormwesr�,ascaae inc. G-140331-D NA2053866352 {Ed.01/13} BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows: SCHEDULE(OPTIONAL) Name of Additional Insured Persons Or Organizations (As required by"written contract" per Paragraph A. below.) Locations of Covered Operations (As per the "written contract," provided the location is within the "coverage territory"of this Coverage Part.) A. Section II -Who Is An Insured is amended to include as an additional insured: 1. Any person or organization whom you are required by "written contract" to add as an additional insured on this Coverage Part; and 2. The particular person or organization, if any, scheduled above. B. The insurance provided to the additional insured is limited as follows: 1. The person or organization is an additional insured only with respect to liability for "bodily injury," "property damage,"or"personal and advertising injury"caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations specified in the "written contract"; or b. "Your work" that is specified in the "written contract" but only for "bodily injury" or "property damage" included in the "products-completed operations hazard,"and only if: (1) The"written contract" requires you to provide the additional insured such coverage; and (2) This Coverage Part provides such coverage. 2. If the "written contract"specifically requires you to provide additional insurance coverage via the 10/01 edition of CG2010 (aka CG 20 10 10 01), or via the 10/01 edition of CG2037 (aka CG 20 37 10 01), or via the 11185 edition of CG2010 (aka CG 20 10 11 85),then in paragraph B.1. above, the words 'caused in whole or in part by' are replaced by the words'arising out of. 3. We will not provide the additional insured any broader coverage or any higher limit of insurance than: a. The maximum permitted by law; b. That required by the "written contract'; c. That described in B.1. above; or d. That afforded to you under this policy, whichever is less. 4. Notwithstanding anything to the contrary in Condition 4. Other Insurance (Section IV), this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or G-140331-D (Ed. 01/13) Page 1 of 2 Copyright,CNA All Rights Reserved. G-140331-D CNA (Ed.01/13) any other basis. But if required by the "written contract" to be primary and non-contributory, this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured. 5. The insurance provided to the additional insured does not apply to "bodily injury," "property damage," or "personal and advertising injury"arising out of: a. The rendering of, or the failure to render, any professional architectural, engineering, or surveying 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 (2) Supervisory, inspection, architectural or engineering activities; or b. Any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this Coverage Part. C. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. The Duties In The Event of Occurrence, Offense, Claim or Suit condition is amended to add the following additional conditions applicable to the additional insured: An additional insured under this endorsement will as soon as practicable: (1) Give us written notice of an "occurrence" or an offense which may result in a claim or "suit" under this insurance,and of any claim or"suit"that does result; (2) Except as provided in Paragraph B.4. of this endorsement, agree to make available any other insurance the additional insured has for a loss we cover under this Coverage Part; (3) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or"suit';and (4) Tender the defense and indemnity of any claim or"suit" to any other insurer or self insurer whose policy or program applies to a loss we cover under this Coverage Part. But if the"written contract"requires this insurance to be primary and non-contributory, this provision (4) does not apply to insurance on which the additional insured is a Named Insured. We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a claim or"suit." D. Only for the purpose of the insurance provided by this endorsement, SECTION V—DEFINITIONS is amended to add the following definition: "Written contract" means a written contract or written agreement that requires you to make a person or organization an additional insured on this Coverage Part, provided the contract or agreement: 1. Is currently in effect or becomes effective during the term of this policy; and 2. Was executed prior to: a. The"bodily injury"or"property damage"; or b. The offense that caused the"personal and advertising injury," for which the additional insured seeks coverage under this Coverage Part. All other terms and conditions of the Policy remain unchanged. Material used with permission of ISO Properties, Inc. G-140331-D (Ed. 01/13) Page 2 of 2 Copyright,CNA All Rights Reserved. DNA G 2053866352 (Edd..07"�7-12�) CONTRACTORS' GENERAL LIABILITY EXTENSION ENDORSEMENT It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. The changes this endorsement makes do not apply with respect to any coverage that has been excluded or amended by another endorsement attached to this policy. SCHEDULE Coverage is summarized below. For particulars and limitations affecting each coverage, please refer to the corresponding policy provisions in the body of this endorsement. 1. Additional Insureds Seven additional insured extensions. 2. Bodily Injury—Expanded Definition 3. Broad Knowledge of Occurrence/Notice of Occurrence 4. Broad Named Insured 5. Broadened Liability Coverage For Damage To"Your Product"And"Your Work" _Limit:$100,000. 6. Contractual Liability—Railroads Expanded definition of"insured contract." 7. Contractual Liability For Personal And Advertising Injury B. Electronic Data Liability Loss of Electronic Data Limit: $100,000. S. Expanded Personal And Advertising Injury-Discrimination Or Humiliation 10. Expected Or Intended Injury Reasonable force—"bodily injury"or"property damage." 11. General Aggregate Limits Of Insurance-Per Project 12. In Rem Actions 13. Incidental Health Care Malpractice Coverage 14. Joint Ventures/Partnership/Limited Liability Companies Coverage for your interest in such terminated or ended organizations. 15. Legal LiabilitylAlienated Premises/Borrowed Equipment Coverage Extended perils. Default limit increased to$500,000 for Damage to Premises Rented To You. $25,000 limit for"property damage"to borrowed tools or equipment at a jobsite. 16. Liberalization Clause 17. Liquor Liabitity Coverage Extension 18. Medical Payments Limits increased to$15,000. Reporting increased to three years from the date of accident. 19. Non-owned Aircraft Coverage 20. Non-owned Watercraft Increased to 75 feet. 21. Primary And Non-Contributory To Other Insurance 22. Property Damage-Elevators 23. Supplementary Payments Cost of bail bonds increased to$5,000. Daily loss of earnings increased to$1,000, 24. Unintentional Failure To Disclose Hazards 25. Waiver of Subrogation-Blanket Waiver of subrogation where required by written contract or written agreement. 26. Wrap-Up Extension G-18652-J (Ed. 07-12) Page 1 of 12 Copyright,CNA All Rights Reserved. 2053866352 (Ed.07-12) 1. ADDITIONAL INSURED 2. With respect to the insurance afforded to these additional insureds, this insurance SECTION II—WHO IS AN INSURED is amended to does not apply to any 'occurrence" which include as an insured any person or organization takes place after the equipment lease (called additional insured)described in paragraphs expires. A.through G.below whom you are required to add as an additional insured on this policy under a D. Lessor-Land written contract or written agreement, provided the An owner or other interest from whom land has written contractor written agreement: been leased by you but only with respect to i. Is currently in effect or becomes effective liability arising out of the ownership, during the term of this policy; and maintenance or use of that specific part of the land leased to you and subject to the following ii. Was executed prior to the "bodily injury;' additional exclusions: "property damage" or "personal injury and advertising injury" for which the additional This insurance does not apply to: insured seeks coverage. 1. Any 'occurrence" which takes place after However, we will not provide the additional you cease to lease that land; or insured any broader coverage or any higher limit 2. Structural alterations, new construction or of insurance than the least that is: demolition operations performed by or on a. The maximum permitted by law; behalf of such additional insured. b. Required in the written contract or written E. Lessor-Premises agreement; A manager or lessor of premises but only with c. Afforded to you under this policy; or respect to liability arising out of the ownership, maintenance or use of that specific part of the d. Described in the applicable paragraphs A. premises leased to you and subject to the through G.below. following additional exclusions: A. Controlling Interest This insurance does not apply to: Any persons or organizations with a controlling 1. Any 'occurrence" which takes place after interest in you but only with respect to their you cease to be a tenant in that premises; liability arising out of: or 1. Their financial control of you;or 2. Structural alterations, new construction or 2. Premises they own, maintain or control demolition operations performed by or on while you tease or occupy these premises. behalf of such additional insured. This insurance does not apply to structural F. Mortgagee,Assignee or Receiver alterations, new construction and demolition A mortgagee, assignee or receiver but only with operations performed by or for such additional respect to their liability as mortgagee, assignee, insured. or receiver and arising out of the ownership, B. Co-owner of Insured Premises maintenance, or use of a premises by you. A co-owner of a premises co-owned by you and This insurance does not apply to structural covered under this insurance but only with alterations, new construction or demolition respect to the co-owner's liability as co-owner of operations performed by or for such additional such premises. insured. C. Lessor-Equipment G. State or Governmental Agency or Subdivision or Political Subdivisions 1. Any person or organization from whom you lease equipment, but only with respect to A state or governmental agency or subdivision liability for"bodily injury... 'property damage" or political subdivision subject to the following or"personal and advertising injury" caused, provisions: in whole or in part, by your maintenance, 1. This insurance applies only with respect to operation or use of equipment leased to you the following hazards for which the state or by such person or organization. governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises G-18652-J (Ed. 07-12) Page 2 of 12 Copyright,CNA All Rights Reserved. G 2053866352 (Ed.d. 07-1 07-12) you own, rent, or control and to which this You must give us or our authorized insurance applies: representative notice of an "occurrence," a. The existence, maintenance, repair, offense, claim, or "suit" only when the construction, erection, or removal of occurrence,' offense, claim or suit is known advertising signs, awnings, canopies, to: cellar entrances, coal holes, driveways, (1) You, if you are an individual; manholes, marquees, hoistaway (2) A partner,if you are a partnership: openings, sidewalk vaults, street banners, or decorations and similar (3) An executive officer or the employee exposures; or designated by you to give such notice, if you b. The construction, erection, or removal are a corporation; or of elevators;or (4) A manager, if you are a limited liability c. The ownership, maintenance or use of company. any elevators covered by this insurance. B. NOTICE OF OCCURRENCE 2. This insurance applies only with respect to Your rights under this Coverage Part will not be operations performed by you or on your prejudiced if you fail to give us notice of an behalf for which the state or governmental "occurrence,"offense, claim or"suit"and that agency or subdivision or political subdivision failure is solely due to your reasonable belief has issued a permit or authorization. that the"bodily injury"or"property damage"is 3. This insurance does not apply to: not covered under this Coverage Part. However, you shall give written notice of this"occurrence," a. Bodily injury, property damage or offense,claim or suit to us as soon as you are "personal and advertising injury" arising aware`that this insurance may,apply to such out of operations performed for the "occurrence,"offense ciairn or"suit."` federal government, state or 4. BROAD NAMED INSURED municipality; or b. "Bodily injury" or "property damage" A. Any subsidiary or affiliate organization, other included within the "products-completed than a partnership, joint venture or limited operations hazard." liability company, in which a Named Insured specifically shown in the Declarations has A governmental permit which requires you to management control, directly or through one or add the governmental entity as an additional more subsidiary organizations, at the time of insured will trigger this Provision 1.as if the loss will qualify as a Named Insured but only if permit were a written contract. there is no other similar insurance available to 2. BODILY INJURY—EXPANDED DEFINITION such organization, nor similar insurance which would be available but for exhaustion of its SECTION V—DEFINITIONS, the definition of limits. For the purpose of this provision, similar "bodily injury"is changed to read: insurance means general liability or equivalent "Bodily injury"means bodily injury,sickness or insurance, no matter whether its coverage is disease sustained by a person, including death, broader or narrower than that provided by this insurance. But if the only other similar insurance humiliation, shock, mental anguish or mental injury is fora "consolidated (wrap-up) program," then by that person at any time which results as a a subsidiary that qualifies as a Named Insured consequence of the bodily injury, sickness or on such project-specific insurance can still disease. qualify as a Named insured on this insurance, 3. BROAD KNOWLEDGE OF OCCURRENCE/ but not for projects covered by the"consolidated NOTICE OF OCCURRENCE (wrap-up) program." Condition 2.Duties in The Event of Occurrence, [Please see Item 26.C.of this endorsement for Offense, Claim or Suit of SECTION IV— the definition of"consolidated (wrap-up) COMMERCIAL GENERAL LIABILITY program."] CONDITIONS is amended to add the following B. This endorsement does not apply to any provisions: organization for which coverage is excluded by A. BROAD KNOWLEDGE OF OCCURRENCE another endorsement attached to this policy. C. Only for the purpose of this endorsement: G-18652-J(Ed_ 07-12) Page 3 of 12 Copyright,CNA All Rights Reserved. CN! A Gd18652-) 2053866352 (Ed.07-12 1. Management control means: I. Damage to Your Work a. Ownership interest representing more "Property damage"to"your work"arising out of than 50 of the voting, appointment, or it, or any part of it and included in the"products- designation power for the subsidiary completed operations hazard." organization's governing body;or This exclusion does not apply: b. Having the right, pursuant to a written contract, or pursuant to the by-laws, (1) If the damaged work or the work out of charter, operating agreement, or similar which the damage arises was document of a specifically shown performed an your behalf by a Named Insured or controlled subsidiary subcontractor; or organization to select, appoint, or (2) If the cause of loss to the damaged designate a majority of the subsidiary work arises as a result of: organization's governing body. Such contract or document must have been (a} Fire; created prior to the time of loss;or (b) Smoke; c. Having the right, pursuant to a written (c) Collapse; or trust agreement, to protect, control the use of, encumber or transfer and sell (d) Explosion. property held byatrust. B. The following paragraph is added to SECTION 2. Governing body means the Board of III LIMITS OF INSURANCE: Directors of a corporation. Subject to 5.above, $100,000 is the most we 3. Loss means: will pay under Coverage A for the sum of damages arising out of any one "occurrence" a. The occurring of the "bodily injury" or because of"property damage"to"your product" "property damage';or and "your work"that is caused by fire, smoke, b. The committing of the offense that collapse or explosion and is included within the caused the "personal and advertising "product-completed operations hazard." This injury." sublimit does not apply to"property damage"to "your work"if the damaged work or the work out D. The insurance provided by this policy applies to of which the damage arises was performed on Named Insureds when trading under their own your behalf by a subcontractor. names, or under such trading names or doing- C. This Provision 5. Broadened Liability business-as (DBA) names as any should Coverage For Damage To "Your Produc choose to employ. And "Your Work" does not apply if an 5. BROADENED LIABILITY COVERAGE FOR endorsement of the same name is attached to DAMAGE TO "YOUR PRODUCT" AND "YOUR this policy. WORK" 6. CONTRACTUAL LIABILITY—RAILROADS A. Under SECTION I — COVERAGE A —BODILY INJURY AND PROPERTY DAMAGE With respect to operations performed within 50 feet LIABILITY,Paragraph 2. Exclusions is amended of railroad property,the definition of"insured to delete exclusions k. and I. and replace them contract in SECTION V—DEFINITIONS is with the following: replaced by the following: [This insurance does not apply to:] "Insured ContracC'means: k. Damage to Your Product a. A contract for a lease of premises. However, that portion of the contract for a lease of "Property damage"to"your product"arising premises that indemnifies any person or out of it, or any part of it except when organization for damage by fire to premises caused by or resulting from: while rented to you or temporarily occupied by (1) Fire; you with permission of the owner is not an "insured contract'; (2) Smoke; b. A sidetrack agreement; (3) Collapse; or c. Any easement or license agreement; (4) Explosion. G-18652-J (Ed. 07-12) Page 4 of 12 Copyright,CNA All Rights Reserved. CNA G 2053866352 (Ed.d. 07-12)07-12) d. An obligation, as required by ordinance, to Damages arising out of the loss of, loss of use indemnify a municipality, except in connection of, damage to, corruption of, inability to access, with work for a municipality; or inability to manipulate "electronic data" that does not result from physical injury to tangible e. An elevator maintenance agreement; property. f. That part of any other contract or agreement However, this exclusion does not apply to pertaining to your business (including an liability for damages because of"bodily injury." indemnification of a municipality in connection with work performed for a municipality) under B. The following paragraph is added to SECTION which you assume the tort liability of another Ill—LIMITS OF INSURANCE: party to pay for "bodily injury" or "property Subject to S.above, $100,000 is the most we damage" to a third person or organization. Tort will pay under Coverage A for all damages liability means a liability that would be imposed arising out of any one"occurrence"because of by law in the absence of any contract or "property damage"that results from physical agreement. injury to tangible property and arises out of Paragraph f.does not include that part of any "electronic data." contract or agreement: C. The following definition is added to the (1) That indemnifies an architect, engineer or SECTION V— DEFINITIONS: surveyor for injury or damage arising out of: "Electronic data"means information,facts or (a) Preparing, approving or failing to programs stored as or on,created or used on, prepare or approve maps, shop or transmitted to or from computer software drawings, opinions, reports, surveys, (including systems and applications software), field orders, change orders or drawings hard or floppy disks, CD-ROMS, tapes, drives, and specifications; or cells, data processing devices or any other (b) Giving directions or instructions, or media which are used with electronicallycontrolled equipment. failing to give them, if that is the primary cause of the injury or damage; D. For the purposes of the coverage provided by (2) Under which the insured, if an architect this endorsement, the definition of "property engineer or surveyor, assumes liability for damage" in SECTION V — DEFINITIONS is an injury or damage arising out of the replaced by the following: insured's rendering or failure to render 17. "Property damage" means: professional services, including those listed a. Physical injury to tangible property, in (1) above and supervisory, inspection, including all resulting loss of use of that architectural or engineering activities. property. All such loss of use shall be 7. CONTRACTUAL LIABILITY FOR PERSONAL deemed to occur at the time of the AND ADVERTISING INJURY physical injury that caused It; Under SECTION I—COVERAGE B—PERSONAL b. Loss of use of tangible property that is AND ADVERTISING INJURY LIABILITY, Paragraph not physically injured. All such loss of 2. Exclusions is amended to delete exclusion e. use shall be deemed to occur at the Contractual Liability. time of the "occurrence" that caused it; This provision 7. does not apply to any person or or organization who otherwise qualifies as an c. Loss of, loss of use of, damage to, additional insured on this Coverage Part. corruption of, inability to access, or 8. ELECTRONIC DATA LIABILITY inability to properly manipulate "electronic data resulting from physical A. Under SECTION I — COVERAGE A — BODILY injury to tangible property. All such loss INJURY AND PROPERTY DAMAGE, of "electronic data" shall be deemed to Paragraph 2. Exclusions is amended to delete occur at the time of the "occurrence" exclusion p. Electronic Data and replace it with that caused it the following: For the purposes of this insurance, [This insurance does not apply to:] "electronic data"is not tangible property. p. Electronic Data E. If Electronic Data Liability is provided at a higher limit by another endorsement attached to this G-18652-J (Ed. 07-12) Page 5 of 12 Copyright,CNA All Rights Reserved. G-18652-J C/I�q 2053866352 (Ed. 07-12) policy, then the $100,000 limit provided by this Intended Injury and replace it with the Provision 8. Electronic Data Liability is part of, following: and not in addition to, that higher limit. [This insurance does not apply to:] 9. EXPANDED PERSONAL AND ADVERTISING a. Expected or Intended Injury INJURY -DISCRIMINATION OR HUMILIATION A. SECTION V—DEFINITIONS is amended to add "Bodily injury"or"property damage" the following to the definition of "Personal and expected or intended from the standpoint of advertising injury": the insured. This exclusion does not apply to"bodily injury"or"property damage" h. Discrimination or humiliation that results in resulting from the use of reasonable force injury to the feelings or reputation of a to protect persons or property. natural person, but only if such 11. GENERAL AGGREGATE LIMITS OF discrimination or humiliation is: INSURANCE-PER PROJECT (1) Not done intentionally by or at the A. For each construction project away from direction of: premises you own or rent, a separate (a) The insured; or Construction Project General Aggregate Limit, equal to the amount of the General (b) Any "executive officer," director, Aggregate Limit, is the most we will pay for stockholder, partner, member or manager(if you are a limited liability the sum of: company) of the insured; and I. All damages under Coverage A, except damages because of "bodily injury" or (2) Not directly or indirectly related to the "property damage" included in the employment, prospective employment, "products-completed operations past employment or termination of hazard"; and employment of any person or persons by any insured. 2. All medical expenses under Coverage B. Under SECTION 1 -- COVERAGE B — C' PERSONAL AND ADVERTISING INJURY that arise from "occurrences" or LIABILITY, Paragraph 2. Exclusions is accidents which can be attributed solely amended to add the following additional to ongoing operations at that exclusions: construction project. Such payments [This insurance does not apply to:] shall not reduce the General Aggregate Limit shown in the Declarations, nor the Discrimination Relating To Room, Construction Project Aggregate Limit of Dwelling or Premises any other construction project. "Personal or advertising injury"caused by B. All: discrimination directly or indirectly related to 1. Damages under Coverage B, regardless of the sale, rental, lease or sub-lease or the number of locations or construction prospective sale, rental, lease or sub-lease projects involved; of any room, dwelling or premises by or at the direction of any insured. 2. Damages under Coverage A, caused by Fines Or Penalties occurrences which cannot be attributed solely to ongoing operations at a single Fines or penalties levied or imposed by a construction project, except damages governmental entity because of because of "bodily injury" or "property discrimination. damage" included in the "products- This provision 9.does not apply to any person completed operations hazard'; and or organization who otherwise qualifies as an 3. Medical expenses under Coverage C additional insured on this Coverage Part. caused by accidents which cannot be 10. EXPECTED OR INTENDED INJURY attributed solely to ongoing operations at a single construction project, Under SECTION I—COVERAGE A—BODILY will reduce the General Aggregate Limit shown INJURY AND PROPERTY DAMAGE in the Declarations. LIABILITY, Paragraph 2. Exclusions is amended to delete exclusion a. Expected or G-18652-J(Ed. 07-12) Page 6 of 12 Copyright,CNA All Rights Reserved. G-18652-J 2053866352 (Ed. n7-12) CIAVA C. The limits shown in the Declarations for Each (a) "Bodily injury" caused by a "health Occurrence, for Damage To Premises Rented care incident" will be considered To You and for Medical Expense continue to caused by an"occurrence'; and apply, but will be subject to either the Construction Project Aggregate Limit or the (b) All acts, errors or omissions that General Aggregate Limit, depending on whether are logically connected by any the "occurrence" can be attributed solely to common fact, circumstance, situation, transaction, event, advice ongoing operations at a particular construction ... project or decision will be considered to constitute a single"occurrence"; D. When coverage for liability arising out of the (2) The "bodily injury" occurs during the "products-completed operations hazard" is All "bodily injury" arising. period . policy . provided, any payments for damages because p „ of"bodily injury' or"property damage" included from an occurrence will be deemed to in the "products-completed operations hazard," have occurred at the time of the first regardless of the number of locations involved act, error, or omission that is part of the will reduce the Products-Completed Operations "occurrence'; and Aggregate Limit shown in the Declarations. B. With respect only to the insurance provided by E. If a single construction project away from this Provision 13., Exclusion 2.e. Employer's premises owned by or rented to the insured has Liability of SECTION I — COVERAGE A — been abandoned and then restarted, or if the BODILY INJURY AND PROPERTY DAMAGE, authorized contracting parties deviate from is amended to append the following: plans, blueprints, designs, specifications or Only for "bodily injury" not covered by other timetables, the project will still be deemed to be liability insurance (including state-sanctioned the same construction project. self insurance)available to the insured (or which F. The provisions of SECTION III — LIMITS OF would be available but for exhaustion of its INSURANCE not otherwise modified by this limits), this exclusion does not apply to "bodily endorsement shall continue to apply as injury"that arises out of a"health care incident." stipulated. C. SECTION V—DEFINITIONS is amended to add 12. IN REM ACTIONS the following new definition: Any action in rem against any vessel owned or "Health care incident" means a negligent act operated by or for you, or chartered by or for you will error or omission by your "employees" or be treated in the same manner as though the action "volunteer workers" working on your behalf in were in personam against you, the rendering of or failure to render professional health care services in any of the following In rem is a term used to designate actions instituted capacities, or the related furnishing of food, against the thing, as distinct from actions against beverages, medical supplies or appliances: the person,which are said to be in personam. a. Physician; 13. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE b. Nurse; A. With respect only to "bodily injury" that arises c. Emergency medical technician; out of a"health care incident," COVERAGE A— d. Paramedic; BODILY INJURY AND PROPERTY DAMAGE e. Chiropractor, LIABILITY OF SECTION I — COVERAGES is amended to replace Insuring Agreement f. Dentist; Paragraphs 1.b.(1) and 1.b.(2) with the following: 9. Athletic trainer; b. This insurance applies to"bodily injury" only h. Audiologist; if you are not in the business of providing I. Physical therapist; professional health care services, and only if: j. Psychologist; (1) The "bodily injury" is caused by an k. Speech therapist; "occurrence" that takes place in the 1. Other allied health professional; or "coverage territory." For the purpose of this insurance: G-18652-J (Ed. 07-12) Page 7of12 Copyright,CNAAII Rights Reserved. G-18652-J CNA2053866352 (Ed.07-12) m. Provider of first aid or Good Samaritan a. "bodily injury" to a co-"volunteer worker" services rendered in an emergency and for while performing duties related to the which no payment is demanded or received. conduct of your business; and D. SECTION I—COVERAGE A—BODILY INJURY b. "bodily injury" to an "employee" while in AND PROPERTY DAMAGE, Paragraph 2. the course of the "employee's" Exclusions is amended to add the following employment by you or while performing additional exclusions. These new exclusions duties related to the conduct of your apply only to this Incidental Health Care business; Malpractice Coverage: when such"bodily injury""arises out of a [This insurance does not apply to:] "health care incident" Dishonesty or Crime 3. Paragraphs 2.a. (1)(a), (b) and (c) of Any dishonest, criminal or malicious act, error or SECTION 11 — WHO IS AN INSURED do not apply to "bodily injury" for which omission. insurance is provided this Provision 13. Clinical Trials I Product Testing 4. Paragraph 2.a.(1)(d) of SECTION Il—WHO Acts, errors or omissions that occur in the IS AN INSURED is deleted. course of human clinical trials or product G. With respect to the insurance provided by this testing. Provision 13., the following is added to Medicare/Medicaid Fraud Paragraph 4.b.(1) of SECTION IV — COMMERCIAL GENERAL LIABILITY Medicare or Medicaid fraud or abuse. CONDITIONS: Services Excluded by Endorsement To the extent this insurance applies, it is excess Any "health care incident" for which coverage is over any of the other insurance (including excluded by endorsement qualified self insurance), whether primary, E. SECTION V—DEFINITIONS is amended to add excess, contingent or on any other basis, except the followingsubparagraph to Paragraph f. of for insurance purchased specifically by you to be excess of this policy. the definition of"insured contract": 14. JOINT VENTURES 1 PARTNERSHIP 1 LIMITED Paragraph L does not include that part of any LIABILITY COMPANIES contract or agreement: A. The following is added to SECTION 11 — WHO (4) Under which you assume another's tort IS AN INSURED: liability for "bodily injury" arising out of the rendering of or failure to render professional 4. You are an insured when you had an health care services. interest in a joint venture, partnership or limited liability company which terminated or F. SECTION Il — WHO IS AN INSURED is ended prior to or during this policy period, amended to add the following provisions: but only to the extent of your interest in such 1. Your"employees" are insureds with respect joint venture, partnership or limited liability to: company.This coverage does not apply: a. "bodily injury" to a co"employee" while a. Prior to the termination date of any joint in the course of the co='employeds" venture, partnership or limited liability employment by you or while performing company; duties related to the conduct of your b. If there is other valid and collectible business; and insurance purchased specifically to b. "bodily injury" to a "volunteer worker" insure the partnership, joint venture or while performing duties related to the limited liability company; or conduct of your business; c. To a joint venture, partnership or limited when such"bodily injury"arises out of a liability company which is or was "health care incident" insured under a"consolidated (wrap-up) 2. Your "volunteer workers" are insureds with insurance program:' respect to: G-18652-J(Ed.07-12) Page 8 of 12 Copyright,CNA All Rights Reserved. G-18652-J �� 2053666352 (Ed. 07-12) [Please see Item 26.C, of this endorsement Paragraphs (1), (3) and (4) of this exclusion for the definition of"consolidated (wrap-up) do not apply to "property damage" (other program."] than damage by fire) to premises rented to B. The last paragraph of SECTION II — WHO IS you or temporarily occupied by you with the AN INSURED is deleted and replaced by the permission of the owner, or to the contents following: of premises rented to you for a period of 7 or fewer consecutive days. A separate limit Except as provided under the Contractors' of insurance applies to Damage To General Liability Extension Endorsement or by Premises Rented To You as described in the attachment of another endorsement(if any), SECTION III—LIMITS OF INSURANCE. no person or organization is an insured with respect to the conduct of any current or past Paragraphs (3), (4), (5) and (fi) of this exclusion do not apply to liability assumed partnership, joint venture or limited liability company that is not shown as a Named Insured under a sidetrack agreement. in the Declarations. Paragraph (6) of this exclusion does not 15. LEGAL LlABILITYIALIENATED PREMISES! apply to "property damage" included in the " BORROWED EQUIPMENT products-completed operations hazard." A. Under SECTION I — COVERAGE A — BODILY B. Under SECTION I — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE, INJURY AND PROPERTY DAMAGE the last Paragraph 2. Exclusions is amended to delete paragraph of Paragraph 2. Exclusions is deleted exclusion j. Damage to Property in its entirety and replaced by the following. and replace it with the following: Exclusions c. through n. do not apply to [This insurance does not apply to:] damage by fire to premises while rented to you or temporarily occupied by you with permission j. Damage to Property of the owner nor to the contents of premises "Property damage"to: rented to you for a period of 7 or fewer consecutive days. (1) Property you own, rent, or occupy; A separate limit of insurance applies to this (2) Premises you sell, give away or coverage as described in SECTION III—LIMITS abandon, if the "property damage" OF INSURANCE. arises out of any part of those C. The following paragraph is added to SECTION premises; III—LIMITS OF INSURANCE: (3) Property loaned to you; Subject to 5.above, $25,000 is the most we will (4) Personal property in the care, custody pay under Coverage A for damages arising out or control of the insured; of any one "occurrence" because of "property damage"to tools or equipment loaned to you by (5) That particular part of real property on others that occurs while the equipment is being which you or any contractors or used to perform operations. subcontractors working directly or indirectly on your behalf are performing D. Paragraph 6. Damage To Premises Rented To operations, if the "property damage" You Limit of SECTION III — LIMITS OF arises out of those operations; or INSURANCE is replaced by the following: (6) That particular part of any property that 6. Subject to Paragraph 5. above, (the Each must be restored, repaired or replaced Occurrence Limit), the Damage To because "your work" was incorrectly Premises Rented To You Limit is the most performed on it. we will pay under SECTION — I — COVERAGE A for damages because of Paragraph (2) of this exclusion does not "property damage" to any one premises apply if the premises are"your work." while'rented to you or temporarily occupied Paragraphs (3) and (4) of this exclusion do by you with the permission of the owner, not apply to "property damage" to tools or including contents of such premises rented equipment loaned to you. A separate limit to you for a period of 7 or fewer consecutive of insurance applies to such tools or days. The Damage To Premises Rented To equipment that are damaged while being You Limit is the greater of: used in your operations, a. $500,000;or G-16652-J (Ed. 07-12) Page 9 of 12 Copyright,CNA All Rights Reserved. G-18652-J f'NA 2053866352 {Ed. 07-12) b. The Damage To Premises Rented To This paragraph B. does not apply to medical You Limit shown in the Declarations. expenses incurred in the state of Missouri. E. Paragraph 4.b.(1)(a)(H) of SECTION IV — 19. NON-OWNED AIRCRAFT COMMERCIAL GENERAL LIABILITY Under SECTION I—COVERAGE A—BODILY CONDITIONS is deleted and replaced by the INJURY AND PROPERTY DAMAGE LIABILITY. following: Paragraph 2.Exclusions is amended such that (ii) That is property Insurance for premises exclusion g.Aircraft,Auto or Watercraft does not rented to you, for premises temporarily apply to an aircraft you do not own, provided that: occupied by you with the permission of the 1. The pilot in command holds a currently effective owner, or for personal property of others in certificate issued by the duly constituted your care, custody or control; authority of the United States of America or F. This Provision 15. does not apply if Damage To Canada, designating that person as a Premises Rented To You Liability under commercial or airline transport pilot; SECTION — I — COVERAGE A is excluded by 2. The aircraft is rented to you with a trained, paid endorsement. crew; and 16. LIBERALIZATION CLAUSE 3. The aircraft does not transport persons or cargo If we adopt a change in our forms or rules which for a charge. would broaden coverage for contractors under this 20. NON-OWNED WATERCRAFT endorsement without an additional premium charge, your policy will automatically provide the additional Under SECTION I—COVERAGE A—BODILY coverage as of the date the revision is effective in INJURY AND PROPERTY DAMAGE LIABILITY, your state. Paragraph 2. Exclusions is amended to delete 17. LIQUOR LIABILITY subparagraph (2)of exclusion g.Aircraft,Auto or Watercraft and replace it with the following. Under SECTION I—COVERAGE A BODILY [This exclusion does not apply to:] INJURY AND PROPERTY DAMAGE, Paragraph 2. Exclusions is amended to delete exclusion c. (2) A watercraft you do not own that is: Liquor Liability. (a) Less than 75 feet long; and This provision 17.does not apply to any person or organization who otherwise qualifies as an (b) Not being used to carry persons or property additional insured on this Coverage Part for a charge. 18. MEDICAL PAYMENTS 21. PRIMARY AND NON-CONTRIBUTORY TO OTHERINSURANCE A. Paragraph 7. Medical Expense Limit, of With respect to any person or organization that is an SECTION III — LIMITS OF INSURANCE is additional insured under this Coverage Part the deleted and replaced by the following: following is added to Paragraph 4.of SECTION IV— 7. Subject to Paragraph S. above (the Each COMMERCIAL GENERAL LIABILITY Occurrence Limit), the Medical Expense CONDITIONS: Limit is the most we will pay under SECTION — [ — COVERAGE C for all If you have agreed in writing in a contract or medical expenses because of"bodily injury" agreement that this insurance is primary and non- sustained by any one person. The Medical contributory relative to an additional insured's own Expense Limit is the greater of: insurance,then this insurance is primary and we will not seek contribution from that other insurance. For (1) $15,000;or the purpose of this Provision 21., the additional (2) The amount shown in the Declarations insured's own insurance means insurance on which for Medical Expense Limit. the additional insured is a Named Insured. B. Paragraph 1.a.(3)(b) of SECTION I — This Provision 21. does not apply in situations COVERAGE C MEDICAL PAYMENTS, is where the endorsement on this policy affording replaced by the following: coverage to the additional insured specifies that this insurance is excess over any other insurance (b) The expenses are incurred and reported to available to that additional insured. us within three years of the date of the 22 PROPERTY DAMAGE—ELEVATORS accident; and G-18652-J(Ed. 07-12) Page 10 of 12 Copyright,CNA All Rights Reserved. CNA2053866352 (Ed. 07-12) A. Under SECTION I — COVERAGE A — BODILY However, this waiver applies only when you have INJURY AND PROPERTY DAMAGE, agreed in writing to waive such rights of recovery in Paragraph 2. Exclusions is amended such that a contract or agreement, and only if the contract or exclusion k. Damage to Your Product, and agreement: subparagraph (3), (4) and (6) of exclusion j. 1. Is in effect or becomes effective during the term Damage to Property do not apply "property damage"that results from the use of elevators. of this policy; and S. With respect only to the coverage provided by 2. Was executed prior to loss. this endorsement, Condition 4. Other 26. WRAP-UP EXTENSION: OWNER CONTROLLED Insurance in SECTION IV — COMMERCIAL INSURANCE PROGRAM, CONTRACTOR GENERAL LIABILITY CONDITIONS is CONTROLLED INSURANCE PROGRAM OR amended to add the following subparagraph CONSOLIDATED (WRAP-UP) INSURANCE b.(1)(a)(v): PROGRAMS 4. Other Insurance Note: The following provision does not apply to any b. Excess Insurance public construction project in the state of Oklahoma, nor to any construction project in the state of (1) This insurance is excess over. Alaska,that is not permitted to be insured under a (a) Any of the other insurance, "consolidated (wrap-up) insurance program"by whether primary, excess, applicable state statute or regulation: contingent or on any other If the endorsement EXCLUSION— basis: CONSTRUCTION WRAP-UP or another (v) That is Property insurance exclusionary endorsement pertaining to Owner covering property of others Controlled Insurance Programs(O.C.I.P.) or damaged from the use of Contractor Controlled Insurance Programs elevators. (C.C.I.P.) is attached to this policy, then the following changes apply: 23. SUPPLEMENTARY PAYMENTS A. The following wording is added to the A. Under Section I—Supplementary Payments— endorsement Coverages A and B, Paragraph 1.b.,the limit of With respect to a"consolidated (wrap-up) $250 shown for the cost of bail bonds is insurance program" project in which you are or replaced by$5,000: were involved, this exclusion does not apply to B. In Paragraph 1.d., the limit of $250 shown for those sums you become legally obligated to pay daily loss of earnings is replaced by$1,000. as damages because of: 24. UNINTENTIONAL FAILURE TO DISCLOSE 1. "Bodily injury," "property damage," or HAZARDS "personal or advertising injury" that occurs If unintentionally you should fail to disclose all during your ongoing operations at the existing hazards at the inception date of your policy, project, or during such operations of anyone we will not deny coverage under this Coverage Part acting on your behalf; nor because of such failure. 2. "Bodily injury" or "property damage" included within the "products-completed 25. WAIVER OF SUBGROGATION-BLANKET operations hazard" that arises out of those Under SECTION IV—COMMERCIAL GENERAL portions of the project that are not LIABILITY CONDITIONS,The Transfer Of Rights "residential structures." Of Recovery Against Others To Us Condition is B. SECTION IV — COMMERCIAL GENERAL amended by the addition of the following: LIABILITY CONDITIONS is amended to add the We waive any right of recovery we may have following subparagraph 4.b.(1)(c) to Condition against any person or organization because of 4. Other Insurance: payments we make for injury or damage arising out [This insurance is excess over] of: (c) Any of the other insurance whether primary, 1. Your ongoing operations; or excess, contingent or any other basis that is 2. "Your work" included in the"products completed insurance available to you as a result of operations hazard." your being a participant in a "consolidated (wrap-up) insurance program," but only as G-18652-J (Ed. 07-12) Page 11 of 12 Copyright,CNA All Rights Reserved. G-18652-J AMAL MAIL 2053866352 (Ed. 07-12) respects your involvement in that residency including but not limited to single or "consolidated (wrap-up) insurance multifamily housing, apartments, condominiums, program." townhouses, co-operatives or planned unit C. SECTION V—DEFINITIONS is amended to add developments and also includes their common the following definition_ areas and/or appurtenant structures(including pools, hot tubs, detached garages, guest "Consolidated(wrap-up) insurance program" houses or any similar structures).When there is means a construction, erection or demolition no individual ownership of units, residential project for which the prime contractor/project structure does not include military housing, manager or owner of the construction project collegeluniversity housing or dormitories, long has secured general liability insurance covering term care facilities, hotels,or motels. some or all of the contractors or subcontractors Residential structure also does not include Involved in the project, such as an Owner hospitals or prisons. Controlled Insurance Program (O.C.I.P.)or This provision 26.does not apply to any person Contractor Controlled Insurance Program or organization who otherwise qualifies as an (C.C.I.P.). additional insured on this Coverage Part "Residential structure"means any structure where 30 or more of the square foot area is used or is intended to be used for human All other terms and conditions of the Policy remain unchanged. This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. Material used with permission of ISO Properties, Inc G-18652-J(Ed. 07-12) Page 12 of 12 Copyright,CNA All Rights Reserved. POLICY NUMBER: 2053866318 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s)who are"insureds"under the Who Is An Insured Provision of the Coverage Form.This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Countersigned By: Named Insured:Northwest Cascade Inc. Authorized Representative SCHEDULE Name of Person(s) or Organization(s): ANY PERSON OR ORGANIZATION WHICH IS REQUIRED TO BE NAMED AS A RESULT OF A WRITTEN CONTRACT. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an"insured"for Liability Coverage,but only to the extent that person or organization qualifies as an"insured"under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 POLICY NUMBER: 2053866318 COMMERCIAL AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Northwest Cascade Inc. Endorsement Effective Date: 10/01/2013 SCHEDULE Name(s) Of Person(s)Or Organization(s): Any person or organization as required by written contract Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the "loss" under a contract with that person or organization. CA 04 44 0310 Copyright, Insurance Services Office, Inc., 2009 Page 1 of 1 o-h r' r.'F CNA National Utility Contractors Association General Liability - Occurrence Renewal Declaration POLICY NUMBER COVERAGE PROVIDED BY FROM - POLICY PERIOD - TO U 2053866352 VALLEY FORGE INSURANCE COMPANY 10/01/2013 10/01/2014 333 S. WABASH CHICAGO, IL. 60604 INSURED NAME AND ADDRESS NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 REFER TO ADDITIONAL NAMED INSUREDS SCHEDULE AGENCY NUMBER AGENCY NAME AND ADDRESS 065944 PROPEL INSURANCE 1201 PACIFIC AVE, #1 PO BOX 2940 (98401) TACOMA, WA 98402 Phone Number: (253)759-2200 BRANCH NUMBER BRANCH NAME AND ADDRESS 050 SEATTLE BRANCH 999 THIRD AVENUE, STE 2500 SEATTLE, WA 98104 Phone Number: (206)587-2600 This policy becomes effective and expires at 12:01 A.M. standard time at your mailing address on the dates shown above. The Named Insured is a Corporation. Your policy is composed of this Declarations, with the attached Common Policy Conditions, Coverage Forms, and Endorsements, if any. The Policy Forms and Endorsement Schedule shows all forms applicable to this policy at the time of policy issuance. The Estimated Policy Premium Is ' Audit Period is Not Auditable In return for the payment of the premium, and subject to all the terms and conditions contained here-in, we agree to provide the insurance as stated. INSURED Page 1 of 5 PubifA NUMBER 1NSUKr:U NAM ANL) AUVAEbb U 2053866352 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 LIMITS OF INSURANCE DESCRIPTION LIMIT Each Occurrence $1, 000,000 Personal & Advertising Injury $1, 000,000 Medical Expense - Any One Person $5,000 Damage To Premises Rented To You Limit $100,000 Products/Completed Operations Aggregate $2,000,000 General Aggregate $2,000,000 Employee Benefits Liability Coverage Each Employee $1, 000,000 Aggregate $2,000,000 Stop Gap Liability "Bodily Injury" by Accident - Each Accident $1,000,000 "Bodily Injury" by Disease - Aggregate Limit $1, 000,000 "Bodily Injury" by Disease - Each "Employee" $1,000,000 SCHEDULE OF COVERAGES PREMIUM ESTIMATED COVERAGE/HAZARD DESCRIPTION EXPOSURE BASIS RATE PREMIUM POLICY LEVEL COVERAGES Employee Benefits Liability INCL Each INCL INCL Employee Deductible Each Employee $1,000 Stop Gap Liability - Washington INCL INCL INCL INCL Stop GAP Liability - WA INCL Each INCLINCL $100 Total Payroll Contractors General Liability Extension INCL INCL INCL INCL Subcontractors Blanket Additional Insured INCL INCL INCL INCL Limited Pollution Liability Coverage INCL INCL COMPOSITE RATING Per $1,000 Gross Sales INSURED Page 2 of 5 POLICY NUMBER INSURED NAME AND ADDRESS U 2053866352 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 ADDITIONAL INSURED SCHEDULE LOCATION: 1 Additional Insured Name and Address: HOFFMAN CORPORATION PO BOX 73399 PUYALLUP, WA 98373 TYPE: Additional Insured ADDITIONAL NAMED INSUREDS SCHEDULE GOTTA GO PORTABLES MDP MERIDIAN LLC DRAINS PLUS NORTHWEST CASCADE 401(K) PROFIT SHARING PLAN, PLAN ID #B37 NWC#1 FLOHAWKS NWC #5 PARTNERSHIP, LLC NCS WASTEWATER SOLUTIONS CASCADE SYSTEM MANAGEMENT NORTHWEST CASCADE INC. DBA HONEY BUCKETS INSURED Page 4 of 5 POLICY NUMBER INSURED NAME AND ADDRESS U 2053866352 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 FORMS AND ENDORSEMENTS SCHEDULE Form Number Form Title G56015B 11/1991 G300415A ADDITIONAL INSURED SCHEDULED PERSON OR OR CG0001 12/2007 Commercial General Liability Coverage Form CGO068 05/2009 Rec And Distr Of Mat Or Info In Viol Of Law Excl CGO197 12/2007 WA Changes-Employment-Related Practices Exclusion CG2154 01/1996 Exclusion - Designated Ongoing Operations Covered CG2173 01/2008 Exclusion of Certified Acts Terrorism CG2279 07/1998 Exclusion - Contractors - Professional Liability CG2504 05/2009 Designated Location(s) General Aggregate Limit G114050A 02/1995 Stop Gap Liability Coverage Supplemental Schedule G132263B 11/2004 Amendatory Endorsement - Pollution Exclusion G132279C99 07/2005 Limited Pollution Coverage - Work Sites G133122B46 11/2004 WA Changes-Ltd Pollution Cov Worksite G136107A 03/2000 Exclusion - Construction Wrap-Up Program G140331D 01/2013 Blanket Addl Insd - Owner, Lessee Cntrctr - w/C-0 G140396A99 10/2001 Fungi/Mold/Mildew/Yeast/Microbe Exclusion G144291A 03/2003 Economic And Trade Sanctions Condition G145658A 11/2003 Exclusion - Silica CG0300 01/1996 Deductible Liability Insurance G15104A 10/1989 Employee Benefits Liability Supplemental Schedule G15115A 10/1989 Changes-Notice-Cancellation or Material Cov Change G18652J 07/2012 Contractors General Liability Extension Endt G22614A 12/1994 Stop Gap Liability Coverage Endorsement G300250A 02/2006 Exterior Finish System Prod/Comp Ops Exclusion G43316C 06/1998 Exclusion - Asbestos G43815C 08/2001 Employee Benefits Liability Coverage G55157B 02/1988 Premium Bases IL0003 09/2007 Calculation of Premium IL0146 08/2010 Common Policy Conditions IL0198 09/2000 Nuclear Energy Liability Excl Endt. (Broad Form) *** PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY *** Form Number Form Title G144246F 12/2007 Notice-Offer/Reject Terrorism Premium Disclosure G145041A 05/2003 IMP INF Economic And Trade Sanctions Condition G44128B 11/2004 Imp Info For Insureds Who Hire Subcontractors C C Countersignature .J Secretary Chairman of the Board P-55170-A (Ed. 01/86) INSURED Page 5 of 5 Ado CNA National Utility Contractors Association Business Auto Renewal Declaration POLICY NUMBER COVERAGE PROVIDED BY FROM - POLICY PERIOD - TO U 2053866318 AMERICAN CASUALTY CO OF READING,PA 10/01/2013 10/01/2014 333 S. WABASH CHICAGO, IL. 60604 INSURED NAME AND ADDRESS NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 REFER TO NAMED INSURED SCHEDULE AGENCY NUMBER AGENCY NAME AND ADDRESS 065944 PROPEL INSURANCE 1201 PACIFIC AVE, #1 PO BOX 2940 (98401) TACOMA, WA 98402 Phone Number: (253)759-2200 BRANCH NUMBER BRANCH NAME AND ADDRESS 050 SEATTLE BRANCH 999 THIRD AVENUE, STE 2500 SEATTLE, WA 98104 Phone Number: (206) 587-2600 This policy becomes effective and expires at 12:01 A.M. standard time at your mailing address on the dates shown above. The Named Insured is a Corporation. Your policy is composed of this Declarations, with the attached Common Policy Conditions, Coverage Forms, and Endorsements, if any. The Policy Forms and Endorsement Schedule shows all forms applicable to this policy at the time of policy issuance. The Estimated Policy Premium is Audit Period is Annual sss In return for the payment of the premium, and subject to all the terms and conditions contained here-in, we agree to provide the insurance as stated. INSURED Page 1 of 12 POLICY NUMBER INSURED NAME AND ADDRESS U 2053866318 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 ITEM TWO Schedule Of Coverages and Covered Autos This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those "autos" shown as covered "autos" . "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the Covered Auto Section of the Business Auto Coverage Form next to the name of the Coverage. COVERED COVERAGES AUTO SYMBOL LIMIT PREMIUM Liability 1 $1,000,000 $372,464 Personal Injury 5 Separately Stated In Each INCLUDED Protection (Or Personal Injury Protection Equivalent No-Fault Endorsement. Coverage) Added Personal Injury Separately Stated in Each Protection (Or Added Personal Injury Equivalent Added No-Fault Protection Endorsement. Coverage) Property Protection Separately Stated In The Insurance Property Protection (Michigan Only) Insurance Endorsement. Auto Medical Payments $5, 000 INCLUDED Included Medical Expense and Separately Stated in The Income Loss Benefits Medical Expense and Income (Virginia Only) Benefits Endorsement. Uninsured Motorists 2 See Endorsement INCLUDED Underinsured Motorists 2 See Endorsement INCLUDED (When Not Included In Uninsured Motorist Coverage) INSURED Page 2 of 12 POLICY NUMBER INSURED NAME AND ADDRESS U 2053866318 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 ITEM TWO Schedule Of Coverages and Covered Autos (Cont'd) COVERED COVERAGES AUTO SYMBOL LIMIT PREXXU K 3 Actual Cash Value or Cost Of $1,,932 Physical Damage Repair, Whichever is Less, Minus Comprehensive $500 Deductible for Coverage Each Covered Auto, But no Ded- uctible Applies to Loss Caused By Fire Or Lightning. See Item Four For Hired or Borrowed Autos. 4, 8 Actual Cash Value or Cost Of $5,523 Physical Damage Repair, Whichever is Less, Minus Specified Deductible for Causes of Loss Each Covered Auto For Loss Coverage Caused By Mischief Or Vandalism. See Item Four For Hired or Borrowed Autos. 3, 8 Actual Cash Value or Cost Of INCLUDED Physical Damage Repair, Whichever Is Less, Minus Collision $500 Deductible for Coverage Each Covered Auto. See Item Four For Hired or Borrowed Autos. Physical Damage For Each Disablement of Towing and Labor A Private Passenger Auto. Premium for Endorsement: Included Estimated Total Premium: INSURED Page 3 of 12 POLICY NUMBER INSURED NAME AND ADDRESS U 2053866318 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 ITEM FOUR: SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS LIABILITY COVERAGE - COST OF HIRE RATING BASIS (OTHER THAN MOBILE OR FARM EQUIPMENT) ESTIMATED COST LIABILITY OF HIRE FOR STATES COVERAGE ALL STATES PREMIUM WA Excess Coverage IF ANY Included Total Premium Included Cost of hire means the total amount you incur for the hire of "autos" you don't own (not including 'autos' you borrow or rent from your partners or "employees" or their family members) . Cost of hire does not include charges for services performed by motor carriers of property or passengers. INSURED Page 4 of 12 POLICY NUMBER INSURED NAME AND ADDRESS U 2053866318 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 NAMED INSURED SCHEDULE INCLUDES THE FOLLOWING ENTITIES NWC#1 FLOHAWKS NWC #5 PARTNERSHIP, LLC GOTTA GO PORTABLES MDP MERIDIAN LLC NCS WASTEWATER SOLUTIONS CASCADE SYSTEM MANAGEMENT DRAINS PLUS NORTHWEST CASCADE INC. DBA HONEY BUCKETS INSURED Page 10 of 12 POLICY NUMBER INSURED NAME AND ADDRESS U 2053866318 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 FORMS AND ENDORSEMENTS SCHEDULE FORM NUMBER FORM TITLE G56015B 11/1991 DESIGNATED INSURED CA2048 G56015B 11/1991 WAIVER OF SUBROGATION CA0440 G56015B 11/1991 MEDICAL PAYMENTS G56015B 11/1991 COMPOSITE RATE ENDORSEMENT CA0001 03/2010 Business Auto Coverage Form CA0051 12/2004 Changes in Coverage Forms - Mobile Equipment CA0118 11/2000 Idaho Changes CA0123 10/2011 South Dakota Changes CA0135 01/2008 Washington Changes CAO149 01/2010 Oregon Changes CA0159 03/2010 Utah Changes CA0240 03/2010 Suspension of Insurance CA0301 03/2010 Deductible Liability Coverage CA0302 03/2010 Deductible Liability Insurance CA0444 03/2010 Waiver of Transfer Rights of Recovery CA2001 03/2006 Additional Insured - Lessor CA2048 02/1999 Designated Insured CA2054 10/2001 Employee Hired Autos CA2105 01/2010 Oregon Uninsured Motorists Coverage-Bodily Injury CA2134 01/2008 Washington Underinsured Motorists Coverage CA2141 03/2006 South Dakota Uninsured Underinsured Motorists CA2162 10/2010 Utah Uninsured Motorists Coverage CA2236 01/2010 Oregon Personal Injury Protection CA2244 03/2006 Utah Personal Injury Protection CA2263 09/1994 Utah PIP - Exclusion of Loss of Income Benefits CA3106 10/2010 Utah Underinsured Motorists Coverage CA3115 03/2006 Idaho Uninsured Motorists Coverage CA3118 11/2011 Idaho Underinsured Motorists Coverage CA9903 03/2006 Auto Medical Payments Coverage CA9910 03/2010 Drive Other Car Broadened Coverage for Named Indiv CA9944 12/1993 Loss Payable Clause CA9989 05/2001 Washington Loss Payable Form Reg - 335 G144291A 03/2003 Economic And Trade Sanctions Condition G147207B 04/2006 Washington Named Driver Exclusion G21578B 05/2008 Broadened Pollution Liability Coverage G22454A 10/1994 Broadened Pollution Liability Schedule G89001E 05/2007 Composite Rate Endorsement IL0003 09/2007 Calculation of Premium IL0142 09/2008 Oregon Changes - Domestic Partnership IL0146 09/2007 Common Policy Conditions IL0198 09/2000 Nuclear Energy Liability Excl Endt. (Broad Form) *** PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY *** FORM NUMBER FORM TITLE G118177A 02/1996 Important Information-Idaho Uninsured/Underinsured G138878A 08/2000 Important Information =_ G142630A 05/2002 Imp. Info.- For Our Commercial Auto Policyholders G145041A 05/2003 IMP INF Economic And Trade Sanctions Condition INSURED Page 11 of 12 EVANSTON INSURANCE COMPANY MAKEr ENVIRONMENTAL COMMON POLICY DECLARATIONS THIS POLICY MAY PROVIDE CLAIMS-MADE COVERAGE. PLEASE READ THE ENTIRE POLICY CAREFULLY TO DETERMINE YOUR RIGHTS AND DUTIES AND WHAT IS AND IS NOT COVERED. POLICY NUMBER: 14CPLOWE00228 RENEWAL OF POLICY: NEW Named Insured and Mailing Address(No.,Street,Town or City,County,State,Zip Code) NORTHWEST CASCADE, INC. PO BOX 73399 PUYALLUP, WA 98373 Policy Period: From 01/27/2014 to 10/01/2014, at 12:01 A.M. Standard Time at your mailing address shown above. Form of Business: ❑ Individual ❑ Partnership ❑Joint Venture ❑Trust ❑ Limited Liability Company ® Organization, including Corporation (but not incl. Partnership, Joint Venture or LLC) IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. Coverage is provided for the following only if indicated with an X: Claims Made 11 Occurrence Premium Commercial General Liability NOT COVERED ❑ Products-Completed Operations Liability Monoline Coverage) ❑ ❑- NOT COVERED Contractor's Pollution Liability ❑ ® Included Professional Liability NOT AVAILABLE NOT COVERED Environmental Impairment Liability NOT AVAILABLE_ NOT COVERED Terrorism Risk Insurance Act RIA). EXCLUDED Advance And Deposit Premium: Other Charge (Specify): NOT APPLICABLE $0.00 Other Charge (Specify): NOT APPLICABLE $0.00 Inspection Fee (100% Fully Earned): $0.00 TOTAL(including all charges): Minimum Retained Premium: 25% Producer Number, Name and Mailing Address 65700 "This Contract is registered and delivered as a Worldwide Facilities, Inc. - Seattle surplus line coverage under the insurance code of the state of Washington, Title 48 RCW. It is not 601 Union Street Suite 1630 protected by any Washington state guaranty Seattle, WA 98101 association law." WORLDWIDE FACILITIES,INC.-WAOIC#116180 WA Surplus Lines Tau&Fees(Pol Eff 7/1/11+) Erik Lindquist Premium: Company Fee: $ MDEI 2004 05 13 Broker/Filing Fee: $ Page 1 of 2 Inspection Fee: $ _ 2%State Tax: $ .10%Stamping Fee: $ Combined General Aggregate Limit Of Insurance $1,000,000 The Amount shown in the schedule above is the most we will pay under any/all coverage parts attached to this policy Audit Period (Indicated by an X): ❑Annual ❑ Semi-Annual ❑Quarterly ❑ Monthly ❑ Other ® Flat Endorsements Forms and Endorsements applying to this Coverage Part and made part of this policy at time of issue: See Forms Schedule MDIL 1001 These declarations, together with the General Terms and Conditions, Coverage Form Declarations, Coverage Form(s), and any Endorsements(s) complete the above numbered policy. 02/20/2014 Countersigned By Countersignature Date MDEI 2004 05 13 Page 2 of 2 INTERLINE POLICY NUMBER: 14CPLOWE00228 I If MARKET EVANSTON INSURANCE COMPANY FORMS SCHEDULE Form Number Form Name MJIL 1000 08 10 Evanston Jacket MPEI 2000 06 12 Emergency Response Hotline MPGL 2001 01 14 Notice To Policyholders Potential Restr re TRIA MPIL 1007 04 10 Privacy Notice MDEI 2004 05 13 CA Environmental Common Policy Declaration MDIL 1001 08 11 Forms Schedule MEEI 2700 05 13 General Terms and Conditions Section MEIL 1225 10 11 Changes- Civil Union IL 12 01 11 85 Named Insured Endt MEEI 2206 04 11 Minimum Earned Prem&Minimum Retained Prem Endt MEEI 2210 08 10 Punitive Damages Exclusion Modification MEEI 2211 08 10 Waiver Of Transfer Of Rights Of Recovery MEEI 2274 05 11 Automatic Primary& NonContributory Insurance MEIL 1200 01 10 Service of Suit MEIL 1308 05 13 Exclusion Of Certified Acts Of Terrorism MEIL 1320 11 13 Application Warranty MEIL 1322 01 14 Conditional Exclusion Of Terrorism Re TRIA MDEI 2002 07 13 Contractors Pollution Liability Supplemental Dec MEEI 0002 06 12 Contractor's Pollution Liability Coverage Form MEEI 2221 09 13 Transp Pollution Liab (1st& 3rd Party Vehicles) MEEI 2244 08 10 Non-Owned Disposal Site - Blanket Basis- OCC Form MEEI 2271 07 11 Fungi, Mold, or Microbial Matter Coverage MDIL 1001 08 11 Page 1 of 1 CNA 333 S Wabash Chicago,Illinois 60604 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY INFORMATION PAGE - RENEWAL OF WC 2 93635362 Policy Number From Policy Period To Coverage Is Provided By Agency WC 2 93635362 110/01/13 10/01/14 CONTINENTAL CASUALTY CO 065944050 Named Insured And Address Agent ITEM NORTHWEST CASCADE INC. PROPEL INSURANCE 1. PO BOX 73399 1201 PACIFIC AVE, #1 PUYALLUP, WA PO BOX 2940 (98401) ACOMA- WA 98402 98373 FEIN NUMBER: 911002132 NCCI CARRIER CODE NO: 10243 INTERSTATE ID NO: 911002132 OTHER WORK PLACES NOT SHOWN ABOVE: SEE ATTACHED SCHEDULE(S) YOU ARE A - CORPORATION/S 2. POLICY PERIOD- 10/01/13 TO 10/01/14 12:01 AM STANDARD TIME AT THE INSUREDS MAILING ADDRESS. 3A. PART ONE OF THIS POLICY APPLIES TO THE WORKERS COMPENSATION LAW AND ANY OCCUPATIONAL DISEASE LAW OF EACH OF THE STATES LISTED HERE: AZ,GA, ID,IN,MD,MT,NV,OR,SC,UT,VA,AK. 3B. PART TWO OF THIS POLICY APPLIES TO EMPLOYERS LIABILITY INSURANCE FOR WORK IN EACH STATE LISTED IN ITEM 3A: THE LIMITS OF LIABILITY ARE: BODILY INJURY BY ACCIDENT $1,000,000 EACH ACCIDENT BODILY INJURY BY DISEASE $1,000,000 POLICY LIMIT BODILY IN,?URY BY DISEASE $1, 000,000 EACH EMPLOYEE 3C. PART THREE OF THIS POLICY APPLIES TO OTHER STATES, IF ANY, LISTED HERE: ALL STATES EXCEPT CA, ND, OH, WA, WY, AND STATES LISTED IN ITEM 3A OF THE INFORMATION PAGE 3D. THIS POLICY INCLUDES THESE ENDORSEMENTS AND SCHEDULES: SEE ATTACHED SCHEDULES 4. THE PREMIUM FOR THIS POLICY WILL BE DETERMINED BY OUR MANUAL OF RULES, CLASSIFICATIONS, RATES, AND RATING PLANS'. ALL INFORMATION REQUIRED BELOW IS SUBJECT TO VERIFICATION AND CHANGE BY AUDIT. ADJUSTMENT OF PREMIUM SHALL BE MADE: AT POLICY EXPIRATION CLASSIFICATION OF OPERATIONS EST ANNUAL PREMIUM SEE ATTACHED PREMIUM DISCOUNT EXPENSE CONSTANT TERRORISM PREMIUM CATASTROPHE (O/T CERT ACTS OF TERROR) 44'/ MINIMUM PREMIUM $1,120 TOTAL ESTIMATED ANNUAL PREMIUM TOTAL STATE TAXES/ASSESSMENTS/SURCHARGES TOTAL ESTIMATED COST DEPOSIT PREMIUM $141,275 ACCOUNT NUMBER: 3001802614 DATE OF ISSUE: 10/14/13 POLICY ISSUING OFFICE: SEATTLE COUNTERSIGNED BY DATE AUTHORIZED AGENT WC000001 P-33398-E (ED. 6/87) Ch,k-OV.8-d TTTCTTD Vr) C/1 fA 333 S Wabash Chicago.Illinois 60604 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY INFORMATION PAGE - RENEWAL OF WC 2 93635362 Policy Number From Policy Period To Coverage Is Provided By Agency WC 2 93635362 110/01/13 10/01/14 CONTINENTAL CASUALTY CO 1065944050 Named Insured And Address Agent NORTHWEST CASCADE INC. PROPEL INSURANCE PO BOX 73399 1201 PACIFIC AVE, #1 PUYALLUP, WA PO BOX 2940 (98401) ACOMA WA 98402 98373 ** ENDORSEMENT SCHEDULE ** SCHEDULE PAGE 1 NUM13ER DESCRIPTION EDITION DATE G124506A VIRGINIA ESTIMATED PREMIUM AUDITS 03/97 G35224B COVERAGE B - INCREASED LIMIT OF LIABILITY 03/84 QUICKREF TABLE OF CONTENTS 06/96 WC000000B COVERAGE PART 07/11 WC000106A LONGSHOREMEN'S AND HARBOR WORKERS ACT COVERAGE 04/92 WC000313 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS EMT. 04/84 WC000406A PREMIUM DISCOUNT ENDORSEMENT 08/95 WC000414 NOTIFICATION OF CHANGE IN OWNERSHIP ENDORSEMENT 07/90 WC000419 PREMIUM DUE DATE ENDORSEMENT 01/01 WC000421C CATASTROPHE (O/T CERT ACTS OF TERRORISM) PREM ENDT 09/08 WC000422A TERRORISM RISK INS PGM RE-AUTH ACT DISCLOSURE ENDT 09/08 WCO20601 ARIZONA CANCELLATION ENDORSEMENT 05/86 WC100402 GA NON-COOPERATION WITH PREMIUM AUDIT ENDT 01/13 WC100601A GEORGIA CANCELATION NONRENEWAL AND CHMGE ENDT 04/93 WC190401 MARYLAND CONSTRUCTION REDUCTION PROGRAM 07/93 WC190601E MLA CANCELLATION AND NONRENEWAL ENDORSEMENT 01/09 WC250305 MT INTENTIONAL INJURY EXCLUSION ENDORSEMENT 07/02 WC250601A MONTANA CANCELATION AND NON-RENEWAL ENDORSEMENT 10/03 WC250602 MONTANA SAFETY ENDORSEMENT 01/94 WC270601C NEVADA CANCELLATION AND NONRENEWAL ENDORSEMENT 10/08 WC360306 OREGON LIMITS OF LIABILITY ENDORSEMENT 01/02 WC360402 OREGON CONTRACTING CLASS PREMIUM ADJUSTMENT 01/91 WC360406 OREGON PREMIUM DUE DATE ENDORSEMENT 10/01 ..ram DATE OF ISSUE: 10/14/13 POLICY ISSUING OFFICE: SEATTLE maim WC000001 P-33398-E (ED. 6/87) TATCTTDP,Tl EXCESS LIABILITY DECLARATIONS Starr Surplus Lines Insurance Company Chicago, IL Administrative Office: 399 Park Avenue, 81h Floor, New York, NY 10022 POLICY NUMBER: 1000020409 RENEWAL OF: NEW PRODUCER NAME: Swett& Crawford Group ADDRESS: 515 South Figueroa Street, """�►- - - Los Angeles, CA 90017 o ITEM 1. NAMED INSURED: Northwest Cascade Inc. ADDRESS: PO Box 73399, Puyallup, WA 98373 ITEM 2: POLICY PERIOD: FROM 10/01/2013 TO 1 0101/201 4 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED INSURED SHOWN ABOVE. ITEM 3. COVERAGE: Commercial Excess Liability ITEM 4. LIMITS OF INSURANCE: The Limits of Insurance, subject to all the terms of this Policy, are: A. $5,000,000 Each Occurrence B. $5,000,000 Other Aggregate(s),Where Applicable C. $5,000,000 Products-Completed Operations Aggregate ITEM 5. "UNDERLYING INSURANCE" A. First Underlying Insurance Policy(ies) Insurer Policy No. Policy Period See attached Schedule of Underlying Insurance B. Additional Underlying Insurance Policy0es) Insurer Policy No. Policy Period ITEM 6. POLICY PREMIUM: Advanced Premium Minimum Premium Minimum Earned Premium AAA n- .,,.,, ,...... __.... N/A Estimated Exposure Rate Per Audit Period N/A N/A NIA This contract is registered and delivered as a surplus line coverage under the insurance code of the state of Washington,Title 48 RCW. It is not protected by any Washington state guaranty association law. SL -101 -D (10108) Name of Surplus Lines Broker: Michael Hamby Page 1 of 2 Copyright©C.V.Starr&Company and Starr Surplus Lines Insurance Company. All rights reserved. Includes copyrighted material of ISO Properties,Inc.,used with its permission. ITEM 7. NOTICES Send all Excess Casualty Loss Notices to; In the event of an accident, occurrence,wrongful act, claim or FARA suit,that is reasonably likely to involve 1625 West Causeway Approach this Policy,send all pertinent facts to: Mandeville, LA 70471 cla i mop en i nq(&fara.co m FAX: (877)297-9272 After hours emergency service call: (800)666-3439 ITEM 8. ENDORSEMENTS ATTACHED: Title Form Number Excess Liability Declarations SL 101 D 10 08 Excess Liability Policy Schedule Of Underlying Insurance SL 102 10 08 Excess Liability Policy Form SL 100 10 08 Continuing Or Progressively Deteriorating Damages Endorsement SL 134 10 08 EIFS Exclusion SL 149 10 08 Employment Related Practices Exclusion SL 154 10 08 Lead Exclusion SL 174 10 08 Pollution Exclusion (Total Exclusion) SL 198 10 08 Specified Operations Exclusion SL 222 10 08 Wrap-Up And Joint Venture Exclusion SL 236 10 08 Washington Changes-Conditions SL 301 WA 10 08 Washington-Auto Coverage Exclusion Of Terrorism SL 341 WA 10 08 Washington -Exclusion of Terrorism SL 346 WA 01 09 Service of Suit Endorsement(All States Except CA, IL, DE) SL 704 08 10 Starr Companies Excess Liability Program Claim Reporting Form SL CLAIMS NOTICE The foregoing discloses all hazards insured hereunder known to exist at the inception date of this Policy, unless otherwise stated herein by endorsement on this Policy. COUNTERSIGNED 10/04/2013 BY DATE AUTH ZED REPRESENTATIVE SL -101 -D(10108) Page 2 of 2 Copyright©C.V.Starr&Company and Starr Surplus Lines Insurance Company. All rights reserved. Includes copyrighted material of ISO Properties,Inc.,used with its permission. * Starr Surplus Lines Insurance Company Chicago, IL 1-646-227-6300 Excess Liability Policy Schedule of Underlying Insurance Policy Number: 1000020409 Effective Date:10/0112013 Named Insured:Northwest Cascade Inc. Issuing Company: Starr Surplus Lines Insurance Company The Declarations, Schedule(s), and all terms and conditions complete this insurance Policy. Type of Policy or Coverage and Insurer,Policy Number and Policy Period Limits of Insurance A. First Underlying Insurance Policy(ies) Carrier: National Fire Insurance of Hartford Policy No.: 2053866352 Limits: Coverage: GENERAL LIABILITY $1,000,000 Each Occurrence Limit Policy Period: 10/01/2013 to 10/01/2014 $2,000,000 General Aggregate Limit $2,000,000 Products/Comp.Ops.Aggregate Limit Carrier: American Casualty Company Of Reading, PA Policy No.: 2053866318 Limits: Coverage: AUTO LIABILITY $1,000,000 Combined Single Limit Policy Period: 10/01/2013 to 10/01/2014 SL-102(10/08) Page 4 of 2 Copyright O C.V.Starr&Company and Starr Surplus Lines Insurance Company. All rights reserved. Includes copyrighted material of ISO Properties,Inc.,used with its permission. NORTHWEST CASCADE INC Page 1 of 4 Washington State Department of " Labor & Industries NORTHWEST CASCADE INC Owner or tradesperson PO BOX 73399 Diklich,John Martin PUYALLUP, WA 98373-0399 253-848-2371 Principals PIERCE County Diklich, John Martin, PRESIDENT PERRY, MARK Roger, VICE PRESIDENT BARGER, STEPHEN Richard, VICE PRESIDENT mariani, gary e, DIRECTOR Gorski, Donald Joseph, DIRECTOR Jones, Harvey Norton, DIRECTOR WINGARD, WILLIAM B JR, SECRETARY (End: 09/16/2013) Doing business as NORTHWEST CASCADE INC WA UBI No. Business type 278 049 149 Corporation License Verify the contractor's active registration/license/certification (depending on trade)and any past violations. Construction Contractor Active. ................................................ ............ ... Meets current requirements. License specialties GENERAL License no. NORTHC1148BG Effective—expiration 01/07/1986—10/01/2015 Bond ................. Fidelity & Deposit Co of MD $12,000.00 Bond account no. 09090648 Received by L&I Effective date 09/17/2012 10/01/2012 Expiration date Until Canceled Bond history https:Hsecure.Ini.wa.gov/verify/Detail.aspx?UBI=278049149&LIC=NORTHCI148BG&SAW= 6/10/2014 NORTHWEST CASCADE INC Page 2 of 4 Insurance .............................. National Fire Ins of Hartford $1,000,000.00 Policy no. 2053866352 Received by L&I Effective date 09/27/2013 10101/2013 Expiration date 10101/2014 Insurance history Savings ......................... No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts .......................................... No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations ........................................................ No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 265,081-00 .-.........I................... Doing business as NORTHWEST CASCADE INC Estimated workers reported Quarter 1 of Year 2014 "Greater than 100 Workers" L&I account representative T1 /TYRONE COLEMAN (360)9024807 - Email: COT1235@lni.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Citation issue date 12/04/2012 No violations Inspection no. 316257575 Location 1-90, East of the Snoqualmie S Snoqualmie Pass, WA 98373 Citation issue date 12/18/2009 No violations Inspection no. 313888851 Location https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=278049149&LIC=NORTHCI148BG&SAW= 6/10/2014 NORTHWEST CASCADE INC Page 3 of 4 SE Tanner Rd North Bend, WA 98045 Citation issue date 09/04/2009 No violations Inspection no. 313574154 Location 8003 Lowell-Larimar Road Everett,WA 98208 Citation issue date 11/13/2008 No violations Inspection no. 312565625 Location 10412 Joe Bananola Way Puyallup, WA 98374 Citation issue date 10/30/2008 Under appeal. The results of the inspection are Inspection no. being challenged. 312130636 Date of appeal Location 01/05/2010 8th St and M St Tacoma, WA 98402 Citation issue date 09/09/2008 Violations Inspection no. 312111602 Location 1200 6th Ave Tacoma,WA 98405 Citation issue date 07/17/2008 No violations Inspection no. 312112089 Location Canyon Road Puyallup,WA 98371 Citation issue date https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=278049149&LIC=NORTHCII48BG&SAW= 6/10/2014 NORTHWEST CASCADE INC Page 4 of 4 06/16/2008 No violations Inspection no. 312111636 Location Main St and Hwy 410 Buckley,WA 98321 ©Washington State Dept.of Labor&Industries. Use of this site is subject to the laws of the state of Washington. Artie wasWt tt _ t:�tmae t-rxtnttuas R's 1t* https:Hsecure.Ini.wa.gov/verify/Detail.aspx?UBI=278049149&LIC=NORTHCII48BG&SAW= 6/10/2014 ` ^ CADMAN July 14, 2014 Northwest Cascade 1O412 John Banano|a Way E. Puyallup, V\AS8373 Project: Sunset Community Low Impact Development Subject: Aggregate Submittal F'aoheQe Dear Jeff, This letter certifies that the materials listed in the table below meet the specifications you have provided, for the above referenced project. You will also find multiple sources for many of the products to accommodate flexible transportation options. PRODUCT Redmond High Rock Sky River B. Diamond Issaquah Seattle North Bend Gold Bar Gravel Borrow X 5/8"Clear Crushed X Type 26 Please also find attached: • VV8DOT Aggregate Source Approval Report for each source • Sieve Analysis reports for each product from each source except SpaUnfkRip Rap ° Permit Information for disposal sites In the case that you find the need for additional products, or should any of the products listed above become available at additional locations, we will be happy to submit further data to meet your needs. Please feel free to contact mne directly with any questions. I can be reached through mny office at/425) 961-T38G. ormYcoUst (425) 804-0050. �4U Cad man 8inoen$|y. Mitch San Sebastian Sales Representative Aggregate Source Approval Report. Page I of I Washlinqon State Departmentl of Transportation WSDOT MATERIALS LAB 07/14/2014 Aggregate Source Approval Report Owner: Cadman,Inc. Aggregate Source: PS-A-511 Lessee: Cadman Inc. Known as: Black Diamond Pit Located in: S1/2 Section 24 T21N R6E County; King Remarks: Concrete Degradation Value=60...05/15/2012 SH Pit Run Materials: At the discretion of the Project Engineer,preliminary samples for Gradation and Sand Equivalent tests may be performed to determine if the material does in fact meet the specification for the intended use: Batkfill for Rock Mil Sackful for Sand Drains Bedding Material for Rigid Pipe Bedding Material for Thermoplastic Pipe Foundation Material for Classes A,8 or C Gravel Sackful for Drains and Drywells Gravel Sackful for Foundation Class 8 Gravel Sackful for Poe Zone Bedding Gravel Sackful W Walls Gravel Borrow Sand Drainage Blanket Select or Common Borrow No Preliminary Tests are required to be performed by the State Materials Lab Gravel Base: Test Date:02/20/2009 Expiration Date: 02/20/2014 Drainage:Free R Value:65 Swell Pressure.0 Contact the Regionat Materials Office to request PRELIMINARY SAMPLES be acquired.Evaluation and approval of this site as a source of GRAVEL BASE is required prior to use. Mineral Agg,and Surfacing: Test Date:04f30/2012 Expiration Date; 04130/2017 Absorption, Apparent Sp.G.: Bulk Sp.G.(SSD),2.72 Bulk Sp.G,: DeT 72 LA!13 Currently approved as a source of aggregate for: ATS Ballast BST Crushed Cover Stone BST Crushed Screenings Crushed Surfacing Base Course Crushed Surfacing Key Stone Crushed Surfacing Top Course Gravel Sackful for Foundation Class A HMA Other Courses HMA Wearing Course Maintenance Rock Permeable Ballast Acceptance tests need to be performed as necessary. Portland Cement Concrete Aggregates: Test Date;05110/2012 Expiration Date.05/1012017 ASR-14 Day:0294 ASR-One Year CCA Absorption:1,34 CCA Sp,G:2.698 FCA Absorption.1,98 FCA Organics.2 FCA Sp.G:2 LA:12 Mortar Strength: Petrographic Analysis: Currently approved for: Coarse Concrete Aggregates Fine Concrete Aggregates ASR MITIGATION MEASURES ARE REQUIRED PER WSDOT STD.SPEC.9-03.1(1),WHEN USING AGGREGATE FROM T-41S SOURCE FOR PORTLAND CEMENT CONCRETE. Acceptance tests need to be performed as necessary Riprap and Quarry Spells: Test Date: Expiration Date: Please see Remarks for Rlprap and Quarry Spalls results. Contact the Regional Materials Office to request PRELIMINARY SAMPLES be acquired.Evaluation and approval of this Site as a source or PIP RAP AND QUARRY SPALLS is required prior to use, Distribution:Physical Testing--Project Engineer......._Region Operations- Region Materials AggregateSource Approval System http://www.wsdot.wa_gov/bi7Jmats/asa/ASARe-port.cftn?prefix=A&t)it no=511 7/14100 11 CADMAN Gravel morrow Black Diamond 100.0 t tf2 1 5/8" 112" I 3/r t 1/�4" i #10 #40�-- #200 90.0 __4 l i 70.0 !i &0.0 ____,____ _ E , 3a j- Mo 10.0 _ F F 0.0 1 IT 100.0 10.0 1.0 0-1 0.0 GRAIN SIZE(mm) StI�+E Nii,FIUCSIEVE hC%€)at tiv➢' Nccum, , G.BORROTi' S.RG:iorTr.$.F SILc SIZE-Finn I<,ISF;hiti5f7 fPZ-Afi46E7 PASSING 9-03.13 T 4-G)3,D9.. DATE SAMPLED: 5/29/l4 4" 100.0 0.00 0.0 100.0 SOURCE: A511 75.0 0.00 O.tl L00.0 TESTED BY: Codey 2 1/2" 62.5 0.00 0.0 100.0 100 SAMPLED BY: Codey 2" 50.0 0.00 0.0 100.0 75-100 75-100 1 1/4" 1.a O.05 0.3 99.7 1" 25.0 1.45 10.0 90.0 3/ 19.0 3.10 21.5 78.5 3118" 9.5 6.75 46.7 53.3 Il4'r 6 s 6.90 47.8 i2.2 414 4.75 6.95 48,1 51.9 50-80 22w 100 16 1.18 206A 70.3 29.7 140 0.425 492.3 89.1 10.9 0-30 #100 0.150 581.9 96.6 3.4 'E"1"11200 0.075 608.1 98.8 1.2 0-7 SPLIT PAN w,r.= 622,9 SAMPLE WT 14.45 so min 30 Min S.E.= 74 GRAPH REPRESENTS SP-EC:IFICATR CADMAN Crushed Surtacl___ng,;8ase Cop a ......... _ Black Dramonti 100.0 11r4 1 W 10 w 114, 010 940 02WSao . ........_.�...._...>.... 1 80A 1 1 i - �- W € 1 T . ..__-._ _ 1 1 E.fi j30,0 - 1{ 20,0 10.0 •--f-' E •• I 100o 10.0 GRAIN SIZE(mm� SIE4'ii MEMRJCSIEVE ACCI,k,WE ACCUM.Y. ACCUM.'/a Me GB I'*Z=Bdd STYE SVE!-vo RETAINED RETAINED PASSWC. WSD4T RU3.4{3) WSDOT DATE SAMPLED: 619114 1 1/2" 37.5 0.00 0.0 100.0 100 SOURCE: A511 11/4" 31.5 0.00 0.0 100.0 99-100 TESTED Bl': Coley 1" 25.0 163.10 1.8 98.2 W100 75-100 SAMPLED 13Y: Coley 3/4" 19.0 1136.'70 12.6 87.4 5/8" 16.0 2128.00 23.5 76.5 50-80 50-100 1/2" 12.5 3134.00 34.7 65.3 3/8" 9.5 3834.80 42.4 57.6 1/4" 6.3 4535.80 50.2 49.8 #4 5.0 5128.50 56.7 43.3 2545 20-80 #10 2,0 4811 77.8 22.2 #40 0,425 819.7 92.6 7.4 3-18. 3-24. tET#200 0,075 96.6 3.4 0?,5 0-10 SPLIT PAN WT.= 487.3 SAMPLE WT 9043.10 40 Min. 3S Min. Graph represents results for speciCcotiom CADMAN Crushet_Surfal,ng Top Course E3tack D1,,,mond _,. 3 i 90.0 ` dF20Q i 80,0 __ _....... 1 I ; 700 ' i ..- WO 17-7 14 20,0 i t i ; i 1 l 4 T 1 Oa a ,a_a to GRAIN SIZE(mm) SIEVE htk7;ttt SfF;A'1i .4CGtF>i N.'I" ACt',[iK,.°�. ACGUS4 36 GSTC 4.t3. ' ZbdoSai S1713 �11.1J i,ntr,@I£SASKFU R6TAtNIiU PASSING v-o.5gaj 943.1'�(3j' r�ATE SAMPLED. 7na/1a 1112i. 37.5 ©.oa 0.0 100.0 99-1ao SOURCE: A511 1" 25.0 0.00 0.0 100.0 75-100 TESTED BY: Codey 3/4" 19.0 0.00 0.0 100.0 99_100 SAMPLED BY: Codey 5f8" 16.0 0.00 0.0 100.0 50-100 COMMENTS: 1/2" 12.5 185.90 1.6 98.4 so-10t) 3/8" 9.5 1436.00 12.5 87.5 1/4" 6,3 4281.14 37.3 62.7 f#4 5.0 5710.90 49.8 50.2 46-66 20-80 #10 2.0 456.6 71.8 28.2 i#40 0.425 807.9 88.8 11.2 8-24.T 1-24, WET#200 0.075 953.7 95.8 4.2 0-10 0.10 SPLIT PAN WT.= 1040.6 SAMPLE WT 11475,90 40Min 35 Min S.E.= 62 Graph represents resetlts for-specifications in first cola CADMAN 5/8" CLEAR CRUSHED- Type 22 Black Diamond 314" 1/2": I Mo nim, #4 #10 #40 80.0 70.0 z IT 60,0 7--7 Mo ui I L H 40.0 ui IL 30.0 . ............ -4-4- 20.0 10.0 0.0 17 IWO 10.0 1.0 0.1 0.0 GRAIN SIZE(mm) I).&SIEVE METRIC SIEVE ACCUM,%T. ACCUM.% ACCUM.% Typit M SIZE SIZE(nim) RETAINED RETAINrD PASSING City of SestOt DATE SAMPLED: 718/2014 3/4" 19.0 0.0 0.0 100.0 100 TIME: 5/8" 16.0 340.5 2.3 97.7 SOURCE: A511 1/214 12.5 6071.6 41.4 58.6 45-16-0 SAMPLED BY: Codey 3/8" 9.5 13437.1 91.6 8.4 TESTED BY: Codey 1/41t 6.3 1.4 5 04.9 98.9 1.1 COMMENTS: #4 5.0 14525.2 99.0 1.0 0-24 #10 2.0 14555.7 99.2 0.8 #40 0.425 14573.9 99.3 0.7 WET#200 1 0.075 14601.8 99.5 0.5 0-3 D"U'AL 14671.7 S.E. 0 RY wr. CADMAN Type#26 (Cit of Seattle Black Diamond 100.0 - 1"314" 1/2 3/8" #4 #8 #200 90.0 80.0 I% 70.0 ...... 60.0 60.0 z 40Z 30.0 20.0 0,0 100.0 10.0 1.0 0.1 0.0 GRAIN SIZE(mm) U.S.SIEVE Mlq'Rl( SlFVE MVUNI,WT ACCUM,% ACCUN&% SFI--'Ct Ij CA'HON SJZF SIZE(nifil) RFrAIN- 1-A) -RETAINUD PASSING S Typ�-,26 DATE SAMPLED: 12/19/2013 3/411 19.0 0.0 0.0 100.0 100 TIME: 1/2" 12.5 48.2 2.4 97.6 SOURCE: A511 1 Aff 6.25 917.1 44.9 55.1 SAMPLED BY: Ben J. #4 4.75 1182.0 57.8 42.2 28-56 TESTED BY: Ben J. #8 2.36 1407.4 68.8 31.2 20-50 CONMENTS: #50 0.30 1913.0 -93.6 6.4 1-12 #200 1 0.075 2034.0 1 99.5 0.5 0-1 1*4111AL 2044-6 -DRY WT. t ci±d aan' Inc, CADMAN July 14, 2014 Northwest Cascade 10412 John Bananola Way E. Puyallup, WA 98373 Project: Sunset Community Low Impact Development Subject: Aggregate Submittal Package Dear Jeff, This letter certifies that the materials listed in the table below meet the specifications you have provided, for the above referenced project. You will also find multiple sources for many of the products to accommodate flexible transportation options. Pit#1 Pit#2 Pit#3 Pit#4 Pit#5 Pit#6 Pit#9 Pit#11 PRODUCT Redmond High Rock Sky River B. Diamond Issaquah Seattle North Bend Gold Bar A-510/460 D-309/336 D-191/361 A-511/455 A-189 X-125 A-460 D-351 Gravel Borrow X CSBC X i CSTC X 5/8"Clear Crushed X Type 26 Please also find attached: • WSDOT Aggregate Source Approval Report for each source ■ Sieve Analysis reports for each product from each source except Spalls &Rip Rap • Permit Information for disposal sites In the case that you find the need for additional products, or should any of the products listed above become available at additional locations, we will be happy to submit further data to meet your needs_ Please feel free to contact me directly with any questions. I can be reached through my office at(425) 961-7386, or my cell at (425) 864-0050, All of us at Cadman thank you for your continued patronage. Sincerely, Mitch San Sebastian Sales Representative f Aggregate Source Approval Report Page I of I 411ftL — Washinitilan State v7AP Departntent at Transportation WSDOT MATERIALS LAB 07/14/2014 Aggregate Source Approval Report Owner: Cadman,Inc. Aggregate Source: PS-A-511 Lessee: Cadman Inc. Known as: Black Diamond Pit Located in; S1/2 Section 24 T21N k6f County: King Remarks: Concrete Degradation Value=60...05/15/2012 BH Pit Run Materials: At the discretion of the Project Engineer,preliminary samples for Gradation and Sand Equivalent tests may be performed to determine if the material does in fact meet the specification For the intended use: Backfill for Rock Wall Backlill for Sand Drains Bedding Material for Rigid Pipe Bedding Material for Thermoplastic Pipe Foundation Material for Classes A.8 or C Gravel Bac"ll for Drains and Drywells. Gravel Backfill for Foundation Class B Gravel Backfill for Pipe Zone Bedding Gravel Backfill for Walls Gravel Borrow Sand Drainage Blanket Select or Common Borrow No Preliminary Tests are required to be performed by the State Materials Lab Gravel Base: Test Date:02/20/2009 Expiration Date:0212012014 Drainage;Free R Valve:65 Swell Pressure:0 Contact the Regional Materials Office to request PRELIMINARY SAMPLES be acquired.Evaluation and approval of this site as a source of GRAVEL BASE is required prior to use. Mineral Agg.and Surfacing: Test Date.,04/30/2012 Expiration Date: 04130/2017 Absorption, Apparent Sp.G.: Bulk Sp,G.(SSD):Z72 Bulk Sp.G,: Deg,72 LA:13 Currently approved as a source of aggregate for: ATE Ballast EST Crushed Cover Stone BST Crushed Screenings Crushed Surfacing Base Course Crushed Surfacing Key Stone Crushed Surfacing Top Course Gravel Backfill for Foundation Class A HMA Other Courses HMA Wearing Course Maintenance Rock Permeable Ballast Acceptance tests need to be performed as necessary. Portland Cement Concrete Aggregates. Test Date:05/10/2012 Expiration Date;05/10/2017 ASR-14 Day:0 294 ASR-One Year CCAAbsorption:1.34 CCA Sp,G:2498 FCA Absorptiorv.1.98 FCA Otganics:2 FCA Sp.G:2 LA:12 Mortar Strength, Petrographic Anatys3 � Currently approved for: Coarse Concrete Aggregates Fine Concrete Aggregates ASR MITIGATION MEASURES ARE REQUIRED PER WSDOT STD.SPEC.9-03.1(1),WHEN USING AGGREGATE FROM THIS SOURCE FOR PORTLAND CEMENT CONCRETE. Acceptance tests need to be performed as necessary Riprap and Quarry Spalls: Test Date: Expiration Date; Please see Remarks for Riprap and Quarry Spalls results. Contact the Regional Materials office to request PRELIMINARY SAMPLES be acquired.Evaluation and approval of this Site as a source of RIP RAP AND QUARRY SPALLS is required prior to use. Distribution:Physical Testing_Project Engineer--,--Region Operations Region Materials_ Aggregate Source Approval System http://w-vvw.wsdot-wa.govlbi7Jmats/asa/ASAReport.cfm?i)refix=A&Dit no=511 7/1,4/Uld CADMAN Gravel Borrow...... _ ac iamond 100,0 11t2 1" 5/Ir 112" 3!6" 1/4" #10 #40 -, , #zo 90,0 70.0 4L, 3 f I € W 0400 a " I 3a.0 200 100 0.0 100.0 10,0 1.0 oA 00 GRAIN SIZE(mm) NIFI'Klf'Sltil%E Af`O'Nt il`E'. -lt('UM,'. ACCUM,l G.BORROW $.R On for Ty.BY 5[G SIZE i rn N IA11Ef5 k AAN-1-J PASSING 9a3.14 l 4t73.D9 DATE SAMPLED: 5/29/14 4 100.0 0.00 0.0 100.0 SOURCE: A511 3" 75.0 0.00 0.0 100.0 FEsTED BY: Code?` 2 1/12" 615 0.00 0.0 100.0 100 SAMPLED BY: Codex 2" 50.0 1 0.00 0.0 100.0 75-100 75-100 1 1/4" 1._1 0.0-5 0.3 99.7 Ill 25.0 1.45 1.0.0 90.0 3/4" 19.0 3.10 21.5 78.5 319" 9.5 6.75 4 7-53.3 1/4" 6.3 6.90 47.8 52.2 #4 4.75 6,95 48.1 51.9 50-80 22-100 #1 Ci L 15 266A 70. 29.7 1r40 0.425 492.3 89.1 10.9 0-30 #100 0.150 581.9 96.6 3.4 1�'11'12()0 0.075 608.1 98.8 1.2 0-7 0-10 SPLIT PAN W'C.= 622.9 SAMPLE WT 14.45 50 Min 30 Min. 5.E.= 74 IGRAPII REPRESENTS SPECIFICATIC CADMAN Crushed Suriacl Base Course $lack porno 11010 #+o om X0 _ ._, ao.a Tan.... Ba,a 1 i 1 30,0 20,0 t •. a as ! ...-----•- •v--.:. ._, .. _ _ I_.��, 1Io 0.1 ao GPAIN SIZE I i I . EVE ACCOM'AT. ACr4M s ACCVM% csoc c,6 top rwa ' ti SITE slEW u�.�Tvr sI SIZE(.W,) RE>TAINEO RETAINED F.i�SSING �VlSOAT%aam SVSmT DATE SAMPLED: 6/9/14 2" 375 0.00 0.0 100.0 100 SOURCE: A511 11/4" 31.5 0.00 0.0 100.d 99-10d TESTEU B Codey 1" SAC'LED 25,0 163.10 L8 98.2 80-100 75-100 Y: Cocky 3/4" 19.0 1136.70 12.6 87.4 5/8" 16.0 2128.00 23.5 76.5 50-80 50-100 1/2" 12.5 3134.00 34.7 65.3 3/8" 9.5 3834.80 42.4 57.6 I 1/4" 6.3 4535,80 %2 49.8 t#4 5.0 5128.50 56.7 43.3 25-45 20-80 #i0 2.0 482.1 77.8 22.2 #40 0,425 818.7 92.6 7.4 3-18. 3.24. N ET##200 0,075 909'8 96.6 3.4 0-7.5 0--10 r S1'LITPAN WT,= 987.3 SAMPLE)X'T t?043.10 40 Mice. 35;Min. S«F= 45 Graph represents results t`or specification: CADMAN Crushed Suriacn.Z To C'aurse .__.__._._.. _- ____ ..._ aa,a aaa 541" Me 3tW lr4' 010 Af Ialrian 0200 { 70,0 {f 4 ... .......... may. .a Co raft o 10.0 to a�Y 0.0 GRAIN SIZE;mm) Sitt'E %wi'1c s'itvi", ACCI..Ni Wl' ACt:UNI,^, Ai�CL�b4.°,> GST G.b_hpozono Bed ...) 517E SULbn'u) KF.TASFEU REfAtNFD PASW4r, DATE SAMPLED: 7/10/14 1 1/2" 37.5 0.00 0.0 100.0 99-100 SOURCE: A511 I,, 25.0 0.00 0.0 100.0 75-100 TESTED BY. Code 3l4" I9.0 0.00 0.0 100.0 99_100 SAMPLED BY: Codey 518" I6.0 0.00 0,0 100.0 50-100 COMMENTS; 1/2" 12.5 185.90 1.6 98 4 80.10() 31V 9.5 1436.00 12.5 87.5 63 4281.10 37.3 62.7 7t44 5.0 5710.90 49.8 50.2 46-fi6 20-80 #10 2.0 456.6 71.8 28.2 #/40 0.425 80T9 88.8 11.2 8-24: 3-24. WET9200 0.075953.7 _ 95.8 4.2 0-10 0-10 SPLIT PAN WT.= 1040.6 SAMPLE WT 11475.90 40 Min 35 Min S.E.= 62 Graph represents results for specincations in first cola CADMAN 5/8" CLEAR CRUSHED- Type 22 Black Diamond 3/4" 1/2"- #4 #10 IMO #40 *2on Mo - LH- 80.0 - 0 70.0 60.0 50.0 z ul 40.0 - ui 30.0 20.0 10.0 0.0 100,0 10.0 1.0 0.1 0.0 GRAIN SIZE(mm) U&SIEVE METRIC SIEVE ACCUM.WT. ACCUM ACCUM.% Type#21- SIZE SIZE(mm) RETAINED RETAWrl) PASSING City or se2ttlt DATE SAMPLED: 7/8/2014 3/411 19.0 0.0 0.0 100.0 100 TIME: 5/8ft 16.0 340.5 2.3 97.7 SOURCE: A511 1/2'1 12.5 6071.6 41.4 58.6 45-100 SAMPLED BY: Cooley 3/8#1 9.5 13437.1 91.6 8.4 TESTED BY: Codey 1/411 6.3 1,4504.9 98.9 1.1 COMMENTS: #4 5.0 14525.2 99.0 1.0 0-24 910 2.0 14555.7 99.2 0.8 #40 0.425 14573.9 99.3 0.7 WET#200 0.075 14601.8 99.5 0.5 0-3 DRY Wr, 14671.7j.......................S.E. 0 CADMAN Type#26 (Cit of Seattle Buck Diamond 100.0 - 123/4" 1/2 3/8" #4 #8 #200 90.0 80.0 70.0 ................ 60.0 50.0 z w 40.0 X0 20.0 ti 10.0 0.0 100.0 10.0 1.0 0.1 0.0 GRAIN SIZE(mm) (T,:s-,stL-vL- -11 rIRICS11-AT ACCLJ!VI.W['. A CUM,% ACCIAl 'SPHAVICATION SIZE WE(mm) R[JAINH) RETAINFI) PASSING 'I ypo 26 DATE SAMPLED: 12/19/2013 3/4ti 19.0 0.0 0.0 100.0 100 TIME: 1/2tf 12.5 48.2 2.4 97.6 SOURCE: A511 1 Aft 6.25 917.1 44.9 55.1 SAMPLED BY: Ben J. #4 4.75 1182.0 57.8 42.2 28-56 TESTED BY: Ben J. #8 2.36 1407.4 68.8 31.2 20-50 COMMENTS: #50 0.30 1913.0 93.6 6.4 1-12 #200 0.075 2034.0 99.5 0.5 0-1 INIIIAL 2044.6 -DRY WT. CNW NORTHWEST CASCADEINC July 14,2014 City of Renton Public Works Department 1055 South Grady Way Renton,WA 98057 Attention: Hebe Bernando,City of Renton Public Works Project Manager Subject: City of Renton,Sunset Community Low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington AVE NE Water Main Replacement Project The following are the key personnel for the above referenced project. Contact Title Phone No. Don Sigler Foreman/Erosion and (253)405-6468 Sediment Control Lead $lane Rody Foreman/Erosion and (253)405-3708 Sediment Control Lead Dave Honeywell Foreman/Erosion and (253)405-8241 Sediment Control Lead Mike Kivley Superintendent (253)255-7079 Jeff Collins Project Manager (253)414-4696 Eric Wright Traffic Control Supervisor (253)405-1355 In the event of an emergency, our office number of(253) 848-2371 is available 24 hours per day,seven days per week. If you call after normal business hours,the answering service is able to reach all company management personnel 24 hours per day. Resp,ectfallly, , J ff Collins Northwest Cascade,Inc. CNW NORTHWEST CASCADEINC July 14,2014 City of Renton Public Works Department 1055 South Grady Way Renton,WA 98057 Attention: Hebe Bernando,City of Renton Public Works Project Manager Re: Ivey Subcontractors and Suppliers for City of Renton, Sunset Community Low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington AVE NE Water Main Replacement Project The following are the key subcontractors and suppliers for the above referenced project. Subcontractor Location Phone No. Apply-A-Line Pacific,WA 253-299-1200 Buckley Nursery Sumner,WA 253-863-9563 C &P Fencing Enumclaw,WA 360-802-1059 Miles Resources Puyallup,WA 253-383-3585 Pelland Enterprises Puyallup,WA 253-435-7740 PLS,Inc. Issaquah,WA 425-313-9378 Tyee Concrete Fife,WA 253-507-8933 Supplier Location Phone No. Cadman Black Diamond, WA 425-961-7386 HD Fowler Pacific, WA 253-863-8600 Northwest Linings Kent,WA 253-872-0244 Olympic Foundry Seattle, WA 206-764-1200 Shope Concrete Products Puyallup,WA 253-848-1551 If there are any questions please contact us at 253-848-2371. 4;e effCollins Northwest Cascade,Inc. HOURLY LABOR RATES LATEST REVISION 07/12/2014 7.65% 0.60% $2.41000 5.84% UNION BENEFITS Total Workers Safety Perish Public Scale FICA FUTA Comp. UC Laborers Operators Teamsters Tests Supplies Hourly LABORERS Laborer Group 2A-Flaggers Regular: $ 25.79 1.97 0.15 2.41 1.51 10.44 0 0 $ 1.29 $ 1.29 $ 44.85 Overtime: $ 38.69 2.96 0.23 2.41 2.26 10.44 0 0 $ 1.93 $ 1.93 $ 60.85 Laborer Group 2B-TCS Regular: $ 28.30 2.16 0.17 2.41 1.65 10.44 0 0 $ 1.42 $ 1.42 $ 47.97 Overtime: $ 42.45 3.25 0.25 2.41 2.48 10.44 0 0 $ 2.12 $ 2.12 $ 65.53 Laborer Group 3-General Laborer Regular: $ 32.29 2.47 0.19 2.41 1.89 10.44 0 0 $ 1.61 $ 1.61 $ 52.92 Overtime: $ 48.44 3.71 0.29 2.41 2.83 10.44 0 0 $ 2.42 $ 2.42 $ 72.96 Laborer Group 4-Pipe Layer Regular: $ 33.08 2.53 0.20 2.41 1.93 10.44 0 0 $ 1.65 $ 1.65 $ 53.90 Overtime: $ 49.62 3.80 0.30 2.41 2.90 10.44 0 0 $ 2.48 $ 2.48 $ 74.42 Laborer Group 5-Grade Checker Regular: $ 33.62 2.57 0.20 2.41 1.96 10.44 0 0 $ 1.68 $ 1.68 $ 54.57 Overtime: $ 50.43 3.86 0.30 2.41 2.95 10.44 0 0 $ 2.52 $ 2.52 $ 75.43 Laborer Group X-Concrete Finisher Regular: $ 37.75 2.89 0.23 2.41 2.20 10.44 0 0 $ 1.89 $ 1.89 $ 59.69 Overtime: $ 56.63 4.33 0.34 2.41 3.31 10.44 0 0 $ 2.83 $ 2.83 $ 83.12 Laborer Foreman Regular: $ 34.29 2.62 0.21 2.41 2.00 10.44 0 0 $ 1.71 $ 1.71 $ 55.40 Overtime: $ 51.44 3.93 0.31 2.41 3.00 10.44 0 0 $ 2.57 $ 2.57 $ 76.68 OPERATORS Operator Group 1-Heavy/Ileavy Regular: $ 37.84 2.89 0.23 2.41 2.21 0 17.4 0 $ 1.89 $ 1.89 $ 66.77 Overtime: $ 56.76 4.34 0.34 2.41 3.31 0 17.4 0 $ 2.84 $ 2.84 $ 90.24 Operator Group 2-Heavy Regular: $ 37.35 2.86 0.22 2.41 2.18 0 17.4 0 $ 1.87 $ 1.87 $ 66.16 Overtime: $ 56.03 4.29 0.34 2.41 3.27 0 17.4 0 $ 2.80 $ 2.80 $ 89.33 Operator Group 3-Light Regular: $ 36.93 2.83 0.22 2.41 2.16 0 17.4 0 $ 1.85 $ 1.85 $ 65.64 Overtime: $ 55.40 4.24 0.33 2.41 3.2.4 0 17.4 0 $ 2.77 $ 2.77 $ 88.55 Operator Foreman Regular: $ 39.84 3.05 0.24 2.41 2.33 0 17.4 0 $ 1.99 $ 1.99 $ 69.25 Overtime: $ 59.76 4.57 0.36 2.41 3.49 0 17.4 0 $ 2.99 $ 2.99 $ 93.97 TEAMSTER Teamster Lowboy Driver Regular: $ 30.22 2.31 0.18 2.62 1.76 0 0 10.44 1.51 1.51 $ 50.56 Overtime: $ 45.33 3.47 0.27 2.62 2.65 0 0 10.44 2.27 2.27 $ 69.31 Revised 7/7/2014 Public Operating Standby No. Year MAKE MODEL DESCRIPTION Hourly Hourly Hourly Off-Highway Trucks Articulated Rear Dumps D191 2006 JOHN DEERE 350D ARTICULATED DUMP TRUCK $124.06 $62.95 $30.56 On-Highway Trucks-On Highway Truck Tractors Configuration 10,Diesel 6x4 50,000 LB,400 HP C115 1991 KENWORTH T800B LOWBOY TRACTOR $75.86 $55.15 $10.36 C358 2003 KENWORTH T800B LOWBOY TRACTOR $75.86 $55.15 $10.36 On-Highway Trucks-On Highway Truck Tractors Configuration 9,Diesel 6x4 75,000 LB,400 HP C552 2008 KENWORTH T800B LOWBOY TRACTOR $78.57 $56.30 $11.14 On-Highway Trucks-Rear Dumps Configuration 8,Diesel 6x4 50,000 LB 10 to 12 CY,400 HP C086 1989 INTERNATIONAL 9300 10 CY DUMP TRK $81.53 $60.85 $10.34 C104 1988 FORD LTL-9000 10 CY DUMP TRK $81.53 $60.85 $10.34 C548 1990 PETERBILT 378 10 CY DUMP TRK $81.53 $60.85 $10.34 On-Highway Trucks-On Highway Water Tankers Configuration 5,Diesel 3000 Gallon,190 HP C193 1997 INTERNATIONAL 4954 WATER TRUCK $40.73 $28.00 $6.37 C549 1994 FORD LNT8000 WATER TRUCK $40.73 $28.00 $6.37 K010 1974 INTERNATIONAL 4370 WATER TRUCK $40.73 $28.00 $6.37 On-Highway Trucks-On Highway Flatbed Trucks Configuration 9,Diesel 4x2 25,000 LB,200 HP C175 1996 INTERNATIONAL 4700 FLATBED TRUCK $30.74 $22.05 $4.35 C180 1996 INTERNATIONAL 4700 CONCRETE SAW TRUCK $30.74 $22.05 $4.35 C201 1997 GMC C711042 TRAFFIC CONTROL SIGN TRUCK $30.74 $22.05 $4.35 C296 2001 INTERNATIONAL 4700 SHOTCRETE TRUCK $30.74 $22.05 $4.35 Configuration 10,Diesel 6x4 40,000 LB,280 HP C078 1990 INTERNATIONAL 4900 RAMP TRUCK $44.43 $31.70 $6.37 C079 1990 INTERNATIONAL 4900 RAMP TRUCK $44.43 $31.70 $6.37 C080 1990 INTERNATIONAL 4900 RAMP TRUCK $44.43 $31.70 $6.37 C102 1990 FORD F800 RAMP TRUCK $44.43 $31.70 $6.37 C191 1993 FREIGHTLINER FLD11264ST RAMP TRUCK $44.43 $31.70 $6.37 C455 1998 KENWORTH T800 FLATBED $44.43 $31.70 $6.37 On-Highway Trucks-On Highway Flatbed Trucks Configuration 8,Diesel 4x2 30,000 LB,217 HP C467 2002 PETERBILT 330/1770 BOOM TRUCK $57.06 $32.45 $12.31 2002 MANITEX 1770C TELESCOPIC CRANES FOR TRUCK MOUNTI $21.93 $7.75 $7.09 On-Highway Light Duty Trucks Configuration 7,Gasoline Conventional 4x2 1/2 ton,143 HP C166 1995 FORD RANGER PICK UP $15.61 $12.20 $1.71 C351 2003 FORD RANGER PICK UP $15.61 $12.20 $1.71 C352 2003 FORD RANGER PICK UP $15.61 $12.20 $1.71 C353 2003 FORD RANGER PICK UP $15.61 $12.20 $1.71 C427 2005 FORD RANGER PICK UP $15.61 $12.20 $1.71 C519 2008 FORD RANGER PICK UP $15.61 $12.20 $1.71 C553 2007 FORD F150 PICK UP $15.61 $12.20 $1.71 C554 2007 FORD F150 PICK UP $15.61 $12.20 $1.71 C555 2007 FORD F150 PICK UP $15.61 $12.20 $1.71 Configuration 49,Gasoline Conventional 4x2 3/4 ton,285 HP C208 1998 DODGE RAM 1500 PICK UP $26.49 $22.80 $1.85 C256 1999 FORD F250 PICK UP $26.49 $22.80 $1.85 C521 2008 FORD F250 PICK UP $26.49 $22.80 $1.85 Configuration 50,Gasoline Crew 4x2 314 ton,285 HP C414 2004 FORD F250 EXT CAB PICK UP $27.48 $23.05 $2.22 C464 2006 FORD F250 EXT CAB PICK UP $27.48 $23.05 $2.22 C491 2007 FORD F250 EXT CAB PICK UP $27.48 $23.05 $2.22 C503 2007 FORD F250 EXT CAB PICK UP $27.48 $23.05 $2.22 C529 2008 FORD F250 EXT CAB PICK UP $27.48 $23.05_ $2.22 Configuration 45,Diesel Conventional 42 1 ton,340 HP C209 1997 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C255 1999 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C282 2000 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C310 2000 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C381 2000 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C385 1999 FORD F450 ONE TON FOREMAN $25.06` $20.15 $2.46 C388 2001 FORD F550 ONE TON FOREMAN $25.06 $20.15 $2.46 k C416 2004 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C435 2005 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C461 2006 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C465 2006 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C466 2006 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C469 1996 CHEVROLET 3500 ONE TON FOREMAN $25.06 $20.15 $2.46 C493 2007 GMC 3500 ONE TON FOREMAN $25.06 $20.15 $2.46 C524 2008 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C532 2008 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 C531 2008 FORD F350 ONE TON FOREMAN $25.06 $20.15 $2.46 Wheel Loaders D134 1994 JOHN DEERE 744E EROPS ARTICULATED WHEEL LOADER $80.96 $51.50 $14.73 D172 2002 JOHN DEERE 644H EROPS ARTICULATED WHEEL LOADER $66.67 $40.45 $13.11 D183 2006 JOHN DEERE 744J ARTICULATED WHEEL LOADER $109.76 $64.90 $22.43 D199 2008 JOHN DEERE 644J EROPS ARTICULATED WHEEL LOADER $73.65 $42.20 $15.73 D204 2005 CATERPILLAR 950G Series 2 ARTICULATED WHEEL LOADER $67.45 $40.40 $13.53 Graders D148 1998 JOHN DEERE 772CH EROPS ARTICULATED FRAME GRADERS $77.57 $44.30 $16.64 D182 2007 CATERPILLAR 140H EROPS ARTICULATED FRAME GRADERS $84.68 $46.70 $18.99 Excavators D140 1997 JOHN DEERE 892E LC CRAWLER MOUNTED HYDRAULIC EXCAVAI $119.80 $70.65 $24.58 D141 1997 JOHN DEERE 45OLC CRAWLER MOUNTED HYDRAULIC EXCAVAI $170.70 $95.90 $37.40 D142 1997 JOHN DEERE 200C LC CRAWLER MOUNTED HYDRAULIC EXCAVAI $86.40 $48.25 $19.08 D149 1999 CATERPILLAR 375L CRAWLER MOUNTED HYDRAULIC EXCAVAI $282.36 $160.40 $60.98 D159 2002 JOHN DEERE 200C LC CRAWLER MOUNTED HYDRAULIC EXCAVAI $86.40 $48.25 $19.08 D163 2004 JOHN DEERE 200C LC CRAWLER MOUNTED HYDRAULIC EXCAVAI $86.40 $48.25 $19.08 D164 2002 JOHN DEERE 450C LC CRAWLER MOUNTED HYDRAULIC EXCAVAI $180.68 $101.65 $39.52 D170 2005 JOHN DEERE 200C LC CRAWLER MOUNTED HYDRAULIC EXCAVAI $86.40 $48.25 $19.08 D175 2005 JOHN DEERE 370C CRAWLER MOUNTED HYDRAULIC EXCAVAI $140.62 $79.40 $30.61 D181 2006 JOHN DEERE 120C CRAWLER MOUNTED HYDRAULIC EXCAVAI $61.91 $31.85 $15.03 D184 2006 JOHN DEERE 240D LC CRAWLER MOUNTED HYDRAULIC EXCAVAI $115.68 $60.00 $27.84 D187 2007 HITACHI ZAXIS 20OLC CRAWLER MOUNTED HYDRAULIC EXCAVAI $88.10 $49.35 $19.38 D190 2007 JOHN DEERE 200C LC CRAWLER MOUNTED HYDRAULIC EXCAVAI $86.40 $48.25 $19.08 D215 2013 JOHN DEERE 450D LC CRAWLER MOUNTED HYDRAULIC EXCAVAI $211.19 $109.20 $51.00 Excavators-Crawler Mounted Compact Excavators D162 2003 JOHN DEERE 27C ZTS CRAWLER MOUNTED COMPACT EXCAVATC $16.12 $9.50 $3.31 D171 2004 HITACHI ZAXIS 27U CRAWLER MOUNTED COMPACT EXCAVATC $15.90 $9.45 $3.23 D186 2006 HITACHI ZAXIS 351.1-2 CRAWLER MOUNTED COMPACT EXCAVATC $18.12 $9.60 $4.26 D194 2005 CATERPILLAR 301.8 EROPS CRAWLER MOUNTED COMPACT EXCAVATC $13.63 $7.55 $3.04 D198 2007 JOHN DEERE 35D EROPS CRAWLER MOUNTED HYDRAULIC EXCAVAI $19.26 $9.60 $4.83 D206 2010 HITACHI ZAXIS 35U-2 CRAWLER MOUNTED HYDRAULIC EXCAVAI $18.12 $9.60 $4.26 D208 2012 JOHN DEERE 35D EROPS CRAWLER MOUNTED HYDRAULIC EXCAVAI $19.26 $9.60 $4.83 Scapers D079 1983 CATERPILLAR 623E EROPS SINGLE ENGINE ELEVATING SCRAPERS $284.72 $138.90 $72.91 D154 1989 CATERPILLAR 623E EROPS SINGLE ENGINE ELEVATING SCRAPERS $284.72 $138.90 $72.91 D174 2005 CATERPILLAR 623G EROPS SINGLE ENGINE ELEVATING SCRAPERS $284.72 $138.90 $72.91 Sweepers D127 1996 ROSCO RB48 PAVEMENT BROOM $34.05 $21.75 $6.15 Backhoes D151 2000 JOHN DEERE 310SE TRACTOR LOADER BACKHOE C-7 $36.07 $22.80 $6.64 D153 2000 JOHN DEERE 310SE TRACTOR LOADER BACKHOE C-7 $36.07 $22.80 $6.64 D169 2000 CASE 580L SERIES 2 TRACTOR LOADER BACKHOE C-7 $33.85 $21.95 $5.95 D160 2003 JOHN DEERE 31OSG TRACTOR LOADER BACKHOE C-7 $39.97 $24.15 $7.91 D161 2003 JOHN DEERE 31OSG TRACTOR LOADER BACKHOE C-7 $39.97 $24.15 $7.91 D167 2005 JOHN DEERE 31OSG TRACTOR LOADER BACKHOE C-7 $39.97 $24.15 $7.91 D168 2005 JOHN DEERE 31OSG TRACTOR LOADER BACKHOE C-7 $39.97 $24.15 $7.91 D178 2006 JOHN DEERE 31OSG TRACTOR LOADER BACKHOE C-8 $41.22 $24.60 $8.31 D179 2006 JOHN DEERE 31OSG TRACTOR LOADER BACKHOE C-7 $39.97 $24.15 $7.91 D180 2006 JOHN DEERE 31OSG TRACTOR LOADER BACKHOE C-7 $39.97 $24.15 $7.91 Dozers D126 1995 JOHN DEERE 750C EROPS CRAWLER DOZER $81.56 $47.55 $17.01 D137 1997 JOHN DEERE 450G ROPS CRAWLER DOZER $46.58 $27.55 $9.52 D158 2002 JOHN DEERE 450H ROP.S CRAWLER DOZER $46.72 $27.35 $9.69 D176 2000 CATERPILLAR 4C SERIES III ROPS CRAWLER DOZER $51.17 $30.35 $10.41 D192 2007 JOHN DEERE 450J LT ROPS CRAWLER DOZER $53.04 $29.15 $11.95 D196 2005 CATERPILLAR D7R SERIES II CRAWLER DOZER $134.21 $73.95 $30.13 Skid Steer Loader D197 2006 BOBCAT S160 BOBCAT $30.34 $17.10 $6.62 Rollers M020 1988 BOMAG BW 90 ADL ROLLER/COMPACTOR $13.61 $5.60 $4.01 M029 1989 BOMAG BW172D SMOOTH ROLLER/COMPACTOR $31.82 $19.75 $6.04 M082 1995 DYNAPAC CA251D ROLLER/COMPACTOR $60.58 $38.90 $10.84 M107 1998 DYNAPAC CA262D ROLLER/COMPACTOR $65.82 $40.20 $12.81 M194 2001 DYNAPAC CA152D SINGLE DRUM VIBRATORY COMPACTOR C- $53.12 $29.20 $11.96 M232 2005 WACKER RD15 TANDEM VIBRATORY COMPACTOR $16.64 $7.15 $4.75 Pulverizer M019 1988 BOMAG MPH-100R C2 RECLAIMER/STABILIZER $174.32 $96.65 $38.84 Hydraulic Compactors for Backhoe Mounting M022 1989 STANLEY HS6000 HYDRAULIC COMPACTOR FOR BACKHOE M $6.92 $2.80 $2.06 M035 1990 STANLEY HS6000 HYDRAULIC COMPACTOR FOR BACKHOE M $6.92 $2.80 $2.06 M037 1990 STANLEY HS6000 HYDRAULIC COMPACTOR FOR BACKHOE M $6.92 $2.80 $2.06 M050 1990 STANLEY HS11000 HYDRAULIC COMPACTOR FOR BACKHOE M $11.27 $4.85 $3.21 M140 2002 BTI TC301 H HYDRAULIC COMPACTOR FOR BACKHOE M $16.55 $6.10 $5.23 M174 2003 BTI TC301 H HYDRAULIC COMPACTOR FOR BACKHOE M $16.55 $6.10 $5.23 M192 2004 BTI TC301 H HYDRAULIC COMPACTOR FOR BACKHOE M $16.55 $6.10 $5.23 M246 2008 BTI TC301 H HYDRAULIC COMPACTOR FOR BACKHOE M $16.55 $6.10 $5.23 Hydraulic Impact Breaker M185 2000 TRAMAC V32 CONCRETE BREAKER $41.79 $15.20 $13.30 Portable Rotary Screw Air Compressors Configuration 9,Diesel,185CFM,125PSI,80HP T198 2004 SULLAIR 185DPQ PORTABLE ROTARY SCREW AIR COMPRES $19.40 $15.20 $2.10 T238 2001 SULLAIR 185DPO PORTABLE ROTARY SCREW AIR COMPRES $19.40 $15.20 $2.10 T239 2001 SULLAIR 185DPQ PORTABLE ROTARY SCREW AIR COMPRES $19.40 $15.20 $2.10 T304 2002 SULLAIR 185DPQ PORTABLE ROTARY SCREW AIR COMPRES $19.40 $15.20 $2.10 Pumps M187 2004 WACKER PT3A SELF PRIMING TRASH PUMP C-8 $19.95 $15.55 $2.20 Welders M144 2004 LINCOLN COMMANDER 500 PORTABLE WELDER C-28 $11.67 $9.65 $1.01 M191 2004 LINCOLN COMMANDER 500 PORTABLE WELDER C-28 $11.67 $9.65 $1.01 Line Pumps M197 1993 PUTZMEISTER TTS2040 TRAILER MOUNTED CONCRETE PUMP $35.86 $23.25 $6.31 M236 1999 SCHWING BPA 500X TRAILER MOUNTED CONCRETE PUMP $38.55 $23.55 $7.50 Concrete Saws M213 2006 TARGET PAC IV-20H CONCRETE SAW C8 $11.17 $8.10 $1.54 M230 2008 CLIPPER/DP CC3535-6-30 CONCRETE SAW C-4 $30.49 $22.85 $3.82 Double Deck Portable Screening Plants Configuration 37-Diesel,5'x10',36"x4o',68HP M053 1993 CEC ROADRUNNER SCREEN PLANT $46.20 $26.20 $10.00 M257 2010 CEC ROADRUNNER SCREEN PLANT $4620 $26.20 $10.00 2010 CEC ROADRUNNER GRIZZLY C-15 $29.24 $8.30 $10.47 WHEEL CUTTER M265 1992 VERMEER CC135T WHEEL TRENCHER $88.46 $46.90 $20.78 DEWATERING PUMPS M267 2011 GODWIN GSP900 HEAVY DUTY CENTRIFUGAL PUMPS C-22 $38.07 $22.30 $7.89 M268 2011 GODWIN GSP900 HEAVY DUTY CENTRIFUGAL PUMPS C-22 $38.07 $22.30 $7.89 GENERATORS M080 1990 N/A 25KW-ENCLOSED LARGE GENERATOR SET,CONFIGURATION $62.29 $52.40 $4.95 M081 1990 N/A 25KW-ENCLOSED LARGE GENERATOR SET,CONFIGURATION $62.29 $52.40 $4.95 M266 2006 CATERPILLAR 50KW-ENCLOSED LARGE GENERATOR SET,CONFIGURATION $74.84 $64.50 $5.17 SIGNAGE T295 2008 AABCO MESSAGE TRAILER MOUNTED CHANGEABLE MESSAG $7.50 $0.80 $3.35 T296 2008 AABCO MESSAGE TRAILER MOUNTED CHANGEABLE MESSAG $7.50 $0.80 $3.35 T302 2008 ALLMAND 2220/SE TRAILER MOUNTED ARROW BOARD C-1 $2.23 $0.55 $0.84 T305 2008 AABCO MESSAGE TRAILER MOUNTED CHANGEABLE MESSAC $7.50 $0.80 $3.35 T306 2008 AABCO MESSAGE TRAILER MOUNTED CHANGEABLE MESSAG $7.50 $0.80 $3.35 T366 2009 WANCO WTLMBS-LL(A)TRAILER MOUNTED CHANGEABLE MESSAG $7.50 $0.80 $3.35 T367 2009 WANCO WTLMBS-LL(A)TRAILER MOUNTED CHANGEABLE MESSAG $7.50 $0.80 $3.35 TRAILERS T012 1974 GARWOOD N/A ON-HIGHWAY REAR DUMP SEMI-TRAILER C $11.77 $4.90 $3.44 T027 1985 LOADKING 5030FP HYDRALIC REMOVABLE GOOSE NECK EQU $21.70 $8.55 $6.58 T199 2004 DROP DECK TRAILER TK70HT Fixed Gooseneck Equipment Trailers C12 $16.01 $7.15 $4.43 T292 2008 TRAIL KING TK70HT-483 Fixed Gooseneck Equipment Trailers C12 $16.01 $7.15 $4.43 T213 2003 GENIE TML-4000N TOWABLE LIGHT TOWER C-5 $9.92 $4.35 $2.79 T262 2000 WILLIAMS SCOTSMAN NBS-00241 8 X 24 OFFICE TRAILER C-3 $2.36 $1.00 $0.68 DRILL RIGS D146 1997 INTEROC AN109B HYDRAULIC DRILL RIG $132.27 $42.33 D147 1997 INTEROC DHR92A HYDRAULIC DRILL RIG $97.94 $44.07 D150 1998 KLEMM KR806-3 HYDRAULIC DRILL RIG $147.08 $51.48 D155 2000 KLEMM KR904 HYDRAULIC DRILL RIG D156 1997 KLEMM MR704D HYDRAULIC DRILL RIG D165 2004 BERETTA T45 HYDRAULIC DRILL RIG 0166 2004 BERETTA T45 HYDRAULIC DRILL RIG D177 2006 INTEROC AN109B HYDRAULIC DRILL RIG $132.27 $42.33 D185 2007 INTEROC AN109B HYDRAULIC DRILL RIG $132.27 $42.33 D189 2002 INTEROC AN109B HYDRAULIC DRILL RIG $132.27 $42.33 D200 1997 KLEMM KR806-3 HYDRAULIC DRILL RIG $147.08' $51.48 D201 INGERSOL RAND 4010 HYDRAULIC DRILL RIG D202 1995 KRUPP DHR-80 HYDRAULIC DRILL RIG $76.00 $33.44 D203 2009 YBM GI-50CII-JG JET GROUT RIG GROUT PLANT M110 2000 HIGH SHEAR 4/10 GROUT PLANT 16.48 $6.10 M112 1997 HIGH SHEAR 4/10 GROUT PLANT 16.48 $6.10 M113 1998 HIGH SHEAR 4/10 GROUT PLANT 16.48 $6.10 M118 2001 HIGH SHEAR 4/10 GROUT PLANT 16.48 $6.10 M125 2001 HIGH SHEAR 500E TRAILER MOUNTED GROUT PLANT M148 2002 HIGH SHEAR 7/14 GROUT PLANT $22.87 $8.92 M176 2004 HIGH SHEAR 7/14 GROUT PLANT $22.87 $8.92 M177 2004 HIGH SHEAR 7/14 GROUT PLANT $22.87 $8.92 M221 2005 HIGH SHEAR 7/14 GROUT PLANT $22.87 $8.92 HIGH AIR COMPRESSOR M111 2000 INGERSOL RAND 900/350 HIGH AIR COMPRESSOR $49.40 $14.82 M137 2001 SULLAIR 900/350 HIGH AIR COMPRESSOR $120.46 $16.86 M172 2004 SULLAIR 900/350 HIGH AIR COMPRESSOR $120.46 $16.86 M198 2004 SULLAIR 900XH HIGH AIR COMPRESSOR $120.46 $16.86 M203 2004 SULLAIR 900XH HIGH AIR COMPRESSOR $120.46 $16.86 M220 2005 SULLAIR 900XH HIGH AIR COMPRESSOR $120.46 $16.86 M228 2005 SULLAIR 900XH HIGH AIR COMPRESSOR $120.46 $16.86 FORKLIFT/TELEHANDLER M136 2001 CATERPILLAR TH103 TELEHANDLER $52.89 $27.80 $12.55 M186 2004 JCB 520 TELEHANDLER $31.58 $17.55 $7.02 M188 2003 CATERPILLAR TH103 TELEHANDLER $52.89 $27.80 $12.55 M195 1998 GEHL DL-61-TELEHANDLER $51.06 $26.80 $12.13 M204 2002 CATERPILLAR TH103 TELEHANDLER $52.89 $27.80 $12.55 M216 2000 CATERPILLAR TH103 TELEHANDLER $52.89 $27.80 $12.55 SWEEPER C551 2006 ELGIN/STERLING SC8000 SWEEPER $112.49 $66.55 $22.97 CITY OF RENTON FAIR PRACTICES POLICY AFFIDAVIT OF COMPLIANCE hereby confirms and declares that: (Name of contractor/subcontractor/consuhant) I. It is the policy of the above-named contractor/subcontractor/consultant, to offer equal opportunity to all qualified employees and applicants for employment without regard to their race; religion/creed; national origin;ancestry; sex;the presence of a physical, sensory, or mental disability; age over 40;sexual orientation or gender identity; pregnancy; HIV/AIDS and Hepatitis C status; use of a guide dog/service animal; marital status; parental/family status; military status; or veteran's status. 11. The above-named contractor/subcontractor/consultant complies with all applicable federal, state and local laws governing non-discrimination in employment. III. When applicable,the above-named contractor/subcontractor/consultant will seek out and negotiate with minority and women contractors for the award of subcontracts. l( 141,2� , 1G[ Print Agent/Representative's Name � Z. &Ilk � �II�(��bE - Print Agent/Representative's Title 1 Agent Rep sentati e's Signature Date Signed Instructions: This document MUST be completed by each contractor, subcontractor,consultant and/or supplier. Include or attach this document(s) with the contract. Page 34 Fair Practices Policy Affidavit of Compliance Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com-Always Verify Scale Award Date: CAG-I4-079 Awarded to: YY Bidding Requirements, City of Renton Forms, Contract Forms, Conditions of INA the Contract,PIans and Permits City of Renton. Sunset Community Low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington Ave NE Water Main Replacement Project SWP-27-36359 W TR-27-3635 City of Renton 1055 South Grady Way Renton WA 98057 Project Manager: I166 C.Bernardo, 425 430-72b4 Page 1 Cover Page Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com-Always Verify Scale INSTRUCTIONS TO BIDDERS 1. Sealed bids for this proposal will be received by the City of Renton at the office of the Renton City Clerk, Renton City Hall,until the time and date specified in the Call for Bids. At this time the bids will be publicly opened and read,after which the bids will be considered and the award made as early as practicable. No proposal may be changed or withdrawn after the time set for receiving bids. Proposals shall be submitted on the forms attached hereto. 2 Any omissions, discrepancies or need for interpretation should be brought, in writing, to the attention of the Project Engineer. Written addenda to clarify questions that arise may then be issued. No oral statements by Owner, Engineer, or other representative of the owner shall, in any way, modify the contract documents,whether made before or after letting the contract. 3 The work to be done is shown in the plans and /or specifications. Quantities are understood to be only approximate. Final payment will be based on actual quantities and at the unit price bid. The City reserves the right to add or to eliminate portions of that work as deemed necessary. 4. Plans may be examined and copies obtained at the Public Works Department Office. Bidders shall satisfy themselves as to the local conditions by inspection of the site. 5. The bid price for any item must include the performance of all work necessary for completion of that item as described in the specifications. 6. The bid price shall be stated in terms of the units indicated and as to a total amount. In the event of errors,the unit price bid will govern. Illegible figures will invalidate the bid. 7. The right is reserved to reject any and/or all bids and to waive informalities if it is deemed advantageous to the City to do so. 8. A certified check or satisfactory bid bond made payable without reservation to the Director of Finance of the City of Renton in an amount not less than 5% of the total amount of the bid shall accompany each bid proposal. Checks will be returned to unsuccessful bidders immediately following the decision as to award of contract. The check of the successful bidder will be returned provided he enters into a contract and furnishes a satisfactory performance bond covering the full amount of the work within ten days after receipt of notice of intention to award contract. Should he fail, or refuse to do so,the check shall be forfeited to the City of Renton as liquidated damage for such failure. 9. All bids must be self-explanatory. No opportunity will be offered for oral explanation except as the City may request further information on particular points. 10. The bidder shall, upon request, furnish information to the City as to his financial and practical ability to satisfactorily perform the work. 11. Payment for this work will be made in Cash Warrants. Page 9 Instructions to Bidders Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com-Always Verify Scale 12. The contractor shall obtain such construction insurance (e.g. fire and extended coverage, worker's compensation, public liability, and property damage as identified within Special Provisions, Specification Section 1-07.18"Public Liability and Property Damage Insurance". 13. The contractor, prior to the start of construction, shall provide the City of Renton a detailed bar chart type construction schedule for the project. 14 Before starting work under this contract, the Contractor is required to supply information to the City of Renton on all chemical hazards Contractor is bringing into the work place and potentially exposing City of Renton Employees. 15. Payment of retainage shall be done in accordance with Section 1-09.9(1) "Retainage". 16. It is anticipated that this project will be funded in part by the Washington State Department of Ecology's FY2012 Stormwater Retrofit and LID Competitive Grant Program. Neither the State of Washington nor any of its departments or employees are, or shall be, a party to any contract or any subcontract resulting from this solicitation for bids. 16. Basis For Approval The construction contract will be awarded by the City of Renton to the lowest, responsible, responsive bidder. The bidder shall bid on all bid schedules items of all schedules set forth in the bid forms to be considered responsive for award. The total price of all schedules will be used to determine the successful low responsive bidder. Partial bids will not be accepted. The owner reserves the right to award any or all schedules of the Bid to meet the needs of the City. The intent is to award to only one BIDDER. 17. Trench Excavation Safety Systems As required by RCW 39.04.180, on public works projects in which trench excavation will exceed a depth of four feet, any contract therefor shall require adequate safety systems for the trench excavation that meet the requirements of the Washington Industrial Safety and Health Act, Chapter 49.17 RCW. These requirements shall be included in the Bid Schedule as a separate item. The costs of trench safety systems shall not be considered as incidental to any other contract item and any attempt to include the trench safety systems as an incidental cost is prohibited. 18. Payment of Prevailing Wages In accordance with Revised Code of Washington Chapters 39.12 and 49.28 as amended or supplemented herein, there shall be paid to all laborers, workmen or mechanics employed on this contract the prevailing rate of wage for an hour's work in the same trade or occupation in the area of work regardless of any contractual relationship which may exist, or be alleged to exist, between the CONTRACTOR and any laborers, workmen,mechanics or subconsultants. The most recent issue of the prevailing wage rates are included within these specifications under section titled "Prevailing Minimum Hourly Wage Rates". The Contractor is Responsible for obtaining updated issues of the prevailing wage rate forms as they become available during the duration of the contract. The wage rates shall be included as part of any subcontracts the Contractor may enter into for work on this project. Page 10 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com-Always Verify Scale CITY OF RENTON CALL FOR BIDS Sunset Community Low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington Ave NE Water Main Replacement Project SWP-27-3635,WTR-27-3635 Sealed bids will be received until 3,30 p.m.,Tuesday,June 10,2014,at the City Clerk's office,71h floor, and will be opened and publicly read in Conference Room 511 on the S`h floor, Renton City Hall, 1055 South Grady Way, Renton WA 98057. The work to be performed within 90 working days from the date of commencement under this contract shall include,but not be limited to: Roadway,sidewalk,storm drainage and water improvements to Harrington Ave NE between NE 16`h Street and NE 10`h Street.Construction surveying,staking,and as-bunts,traffic control,installing and maintaining erosion control, installing the new storm system including approximately 1,800 feet of 12-inch and 18-inch CPEP pipe and 8-inch ductile iron pipe, 12 Type 2 catch basins and 12 Type 1 catch basins and 9 drain basin inlets, 9 water quality treatment bioretention stormwater facilities, temporary stormwater control, excavating existing roadway, removing and restoring asphalt pavement, removing and restoring concrete cub, gutter, sidewalk,and driveways, landscape and property restoration, placing geotextile, permeable base, permeable crushed surfacing, pervious concrete sidewalk, amended soils for rain gardens. Installation of approximately 895 linear feet of Class 52, 12- Inch and 8-inch Diameter Cement Lined Ductile Iron Water Pipe with Poly-wrap including fittings,valves, and fire hydrant assemblies, trench excavation, including removal of existing unsuitable material, stockpiling excavated material, and maintenance of existing utilities, removal and replacement of asphalt concrete pavement, asphalt overlay,concrete curbs,gutters,and driveways,testing,poly-pigging,disinfecting and flushing of water mains,and connecting to existing water mains, installing and maintaining adequate TESC measures and restoring all disturbed areas. It is anticipated that this project will be funded in part by the Washington State Department of Ecology's FY2012 stormwater Retrofit and LID Competitive Grant Program. Neither the State of Washington nor any of its departments or employees are, or shall be, a party to any contract or any subcontract resulting from this solicitation for bids. The estimated project cost is$1,250,000 to$1,450,000. The City reserves the right to reject any and/or all bids and to waive any and/or all informalities. Bid documents will be available May 20, 2014. Plans, specifications, addenda, and the plan holders list for this project are available on-line through Builders Exchange of Washington, Inc., at http://www.bxwa.com. Click on "bxwa.com"; "Posted Projects", "Public Works", "City of Renton", "Projects Bidding". (Note: Bidders are encouraged to"Register as a Bidder,"in order to receive automatic email notification of future addenda and to be placed on the"Bidders List.") Questions about the project shall be addressed to: Hebe C. Bernardo, Public Works Dept., 1055 South Grady Way, Fifth Floor,Renton,WA,98057,or 425-430-7264,or hbernardo@rentonwa.gov. A certified check or bid bond in the amount of five percent(5%)of the total of each bid must accompany each bid. The Ciity's Fair Practices,Non-Discrimination,and Americans with Disability Act Policies shall apply. Bonnie I.Walton,City Clerk Published: Daily Journal of Commerce May 20,2014 Daily Journal of Commerce May 27,2014 Daily Journal of Commerce June 3,2014 Page 13 Call for Bids Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com-Always Verify Scale Page 1 of 2 MINORITY BUSINESS/WOMEN BUSINESS ENTERPRISE SUBCONTRACTORS LIST Sunset Community Low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington Ave NE Water Main Replacement Project SWP-27- 3635, WTR-27-3635 All bidders are encouraged to utilize certified minority-owned and women-owned businesses to the extent possible in the performance of this contract. All prospective bidders or persons submitting qualifications should take the following steps, when possible. 1. Include qualified minority and women's businesses on solicitation lists. I 2. Assure that qualified minority and women's businesses are solicited whenever they are potential sources of service or supplies. 3. Divide the total requirements, when economically feasible, into smaller task or quantities to permit maximum participation by qualified minority and women's businesses. 4. Establish delivery schedules, where work requirements permit, which will encourage participation of qualified minority and women's businesses. 5. Use the services and assistance of the State Office of Minority and Women's Business Enterprise (OMWBE) and the Office of Minority Business Enterprise of the U.S. Department of Commerce, as appropriate. If the subcontractors names are not submitted with the bid, OR if two or more subcontractors are named to perform the same work, then the bid shall be considered nonresponsive and; therefore, void. Complete the following: � If awarded the contract, ti � � Q � �X C�S\11 will contract with the following minority- owned businesses and women businesses subcontractors for the performance of bid items associated with this contract: Bid Item (s) Subcontractor Name Address Phone No. State Contractor's License No. Bid Item(s) Subcontractor Name Address Phone No. State Contractor's License No. Bid Item(s) Subcontractor Name Address \\RVFPS-02\Depts\PW\Fite Svs\SWP-Surface Water Projects\SWP-27-Surface Water Project%(CIP)\27-3635 Sunset Community Plan SSIP\1600 Bid Package\i i-Subcontractor List-2006.doc Page 29 Minority Business/Women Business Enterprise Subcontractors List Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see wvvw.bxwa.com-Always Verify Scale Page 2 of 2 Phone No. State Contractor's License No. Bid Item(s) Subcontractor Name Address Phone No. State Contractor's License No. Bid Item(s) Subcontractor Name Address Phone No. State Contractor's License No. Bid Item(s) Subcontractor Name Address Phone No. State Contractor's License No. S natu of J orized Representative of Bidder N� Subscribed and sworn to be before me on this day of dune,, 200 1)4 Sonda Johnson Notary Public in and for Notary Public the State of Washington State of Washington \_ Notary (Print)gL-X\Lv&- My Comm. Expires 11 /22/20171 Residing at`6at'd'MOL My appointment expires: \\RVFPS-02\Dep1s\PW\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(C1P)\27-3635 Sunset Community Plan SSIP\1600 Bid Package\11-Subcontractor List-2006.doc Page 30 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com-Always Verify Scale N NORTHWEST CASCADE INC. POST OFFICE BOX 73399,PUYALLUP,WASHINGTON 98373/TOLL FREE 800 662-4442 EMERGENCY CON-FACT INFORMATION NORTHWEST CASCADE INC. 10412 JOHN BANANOLA WAY E. PUYALLUP,WA 98373 OFFICE: 253-848-2371 24 HOURS FAX: 253-848-2545 0.1 BUSINESS MANAGER: DOUGLAS J.WATT-CELL-253-606-2160 PROJECT SUPERINTENDENT: MIKE KIV LEY-CELL-253-255-7079 PROJECT MANAGER: CLINT MYERS-CELL-253-405-5063 ASST.PROJECT MANAGER JEFF COLLINS- CELL-253-414-4696 fi SAFETY DIRECTOR: ERIC WRIGHT-CELL-253-405-1355 1 i�Ice, Lo�iell> O •ter •. - •-'• ;i' D * arkaieat�f I l ot'0 tad Industries R ES3':.�ym _ .. CASCADENc �OBo `4s1450 4� � FVA'.98504-445fl 3- • — '`y r a CGCTHCIi4gBG A�L749, J I- } �� ded bylaw as 7 k`• =f�_ inn n Contactor t3RT Cs1SCADE C"d - � a�e�1711986 PITYALI,TjPA'983730399 -� fS 04. 1 i NORTHWEST CASCADE fNC Page 1 of 4 Washington State department of Labor & Industries NORTHWEST CASCADE INC Owner or tradesperson PO BOX 73399 Diklich, John Martin PUYALLUP, WA98373-0399 253-848-2371 Principals PIERCE County Diklich, John Martin, PRESIDENT PERRY, MARK Roger, VICE PRESIDENT BARGER, STEPHEN Richard, VICE PRESIDENT mariani, gary e, DIRECTOR Gorski, Donald Joseph, DIRECTOR Jones, Harvey Norton, DIRECTOR WINGARD, WILLIAM B JR, SECRETARY (End: 09/16/2013) Doing business as NORTHWEST CASCADE INC WA UBI No. Business type 278 049 149 Corporation License Verify the contractor's active registration / license/certification (depending on trade) and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. NORTHC1148BG Effective—expiration 01/07/1986— 10/01/2015 Bond ................. Fidelity & Deposit Co of MD $12,000.00 Bond account no. 09090648 Received by L&I Effective date 09/17/2012 10101/2012 Expiration date Until Canceled Bond history I---—//- -- 1_: __.- ,.,.-_.nr mr-1700nnl A v.T Tr—TTnnI'Trnr1 AOlDfl 9.0 n w- n7/1 1 /7n1 A NORTHWEST CASCADE fNC Page 2 of 4 Insurance .......................... National Fire Ins of Hartford $1,000,000.00 Policy no. 2053866352 Received by L&I Effective date 09/27/2013 10/01/2013 Expiration date 10/01/2014 Insurance history Savings ........... ..... No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations ........................................................ No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 265,081-00 -.................I............ Doing business as NORTHWEST CASCADE INC Estimated workers reported Quarter 1 of Year 2014 "Greater than 100 Workers" L&I account representative T1 /TYRONE COLEMAN (360)902-4807 - Email: COTI235@lni.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Citation issue date 12/04/2012 No violations Inspection no. 316257575 Location 1-90, East of the Snoqualmie S Snoqualmie Pass, WA 98373 Citation issue date 1211812009 No violations Inspection no. 313888851 Location httnc //cennre lni wa anv/vPrifv/T)etail asnx?TTRT=278049149k..T,TC=NORTNCTI4RRCT&SAW= 07/11/2014 NORTHWEST CASCADE INC Page 3 of 4 i SE Tanner Rd North Bend, WA 98045 f I ................................................_..............._.............._..............................._..........._............_...........................................................................__......_.......__........_...........................:__................................_...... Citation issue date 09/04/2009 No violations Inspection no. 313574154 Location 8003 Lowell-Larimar Road Everett, WA 98208 __.._......_ .... .... .... __... d Citation issue date 11/13/2008 No violations t Inspection no. 312565625 i Location 10412 Joe Bananola Way Puyallup, WA 98374 CCitation issue date 10/30/2008 Under appeal. The results of the inspection are t Inspection no. being challenged. • 't 312130636 Date of appeal Location 01/05/2010 i 8th St and M St Tacoma,WA 98402 i Citation issue date 09/09/2008 Violations Inspection no. 312111602 } Location 1200 6th Ave Tacoma, WA 98405 Citation issue date 07/17/2008 No violations Inspection no. 312112089 Location Canyon Road Puyallup, WA 98371 .. ......- ....... _. ....._ .._ ....... ......... i httns'//seciire.lni.wa.unv/verifv[De,tail a..nx?TTRT=97RO49144Rr.T.TC'.=NORT14C 114RRC'TkgAW= 07/11/9014 NORTHWEST CASCADE INC Page 4 of 4 ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. �s esti �t' tk�;n�tF�n j 9 I 5 i i j i s I I a a n i i A i https:Hsecure.Ini.wa.gov/verify/Detail.aspx?UBI=278049149&LIC=NORTHCI148BG&SAW= 07/11/2014 Business License ctty 3f,. 1055 South Grady Way Renton,WA 98057(425)430-6851 Fax(425)430-6983 License #: BL.000050 Expiration Date: 01/31/2015 Issued Date: 01/29/2014 NORTHWEST CASCADE INC PO BOX 73399 PUYALLUP, WA 98373-0399 Detach License and Post at business location listed below. CITY OF RENTON 1055 S Grady Way, Renton WA 98057(425)430-6851 Fax(425)430-6983 licensing@rentonwa.gov BUSINESS LICENSE NON-TRANSFERABLE Annual - Out of City License#: BL.000050 Expiration Date: 01/31/2015 Business Name: NORTHWEST CASCADE INC NAICS CODE: 238220 Business Location: 16207 MERIDIAN E ,A CitV Of --"" PUYALLUP, WA 98375-6201 Mayor Administrative 5 Administrator Licensee has applied for a City of Renton business license in accordance with Renton Municipal Code(the Code),Title V Business,Chapter 5 Business License.The Licensee agrees to comply with all requirements of the Code,as well as State laws and regulations applicable to the business activity llcensed. Post this License at the place of business. Ll This license does not allow licensee to operate a permanent physical location in Renton. BOND TO THE CITY OF RENTON Bond No.09163755 KNOW ALL MEN BY THESE PRESENTS: That we,the undersigned Northwest Cascade, Inc. as principal, and Fidelity and Deposit Company of Maryland corporation organized and existing under the laws of the State of Maryland as a surety corporation, and qualified under the laws of the State of Washington to become surety upon bonds of contractors with municipal corporations, as surety are jointly and severally held and firmly bound to the City of Renton in the penal sum of $1,101,142.55 for the payment of which sum on demand we bind ourselves and our successors,heirs,administrators or person representatives,as the case may be. This obligation is entered into in pursuance of the statutes of the State of Washington,the Ordinance of the City of Renton. Dated at ,Washington,this day of 20/ Nevertheless,the conditions of the above obligation are such that: WHEREAS,under and pursuant to Public Works Construction Contract CAG-14-079 providing for construction of Sunset Community Low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington Ave NE Water Main Replacement Project SWP-27- 3635,WTR-27-3635 the principal is required to furnish a bond for the faithful performance of the contract;and WHEREAS, the principal has accepted, or is about to accept, the contract, and undertake to perform the work therein provided for in the manner and within the time set forth; NOW, THEREFORE, if the principal shall faithfully perform all of the provisions of said contract in the manner and within the time therein set forth,or within such extensions of time as may be granted under said contract, and shall pay all laborers, mechanics, subcontractors and materialmen, and all persons who shall supply said principal or subcontractors with provisions and supplies for the carrying on of said work, and shall hold said City of Renton harmless from any loss or damage occasioned to any person or property by reason of any carelessness or negligence on the part of said principal, or any subcontractor in the performance of said work,and shall indemnify and hold the City of Renton harmless from any damage or expense by reason of failure of performance as specified in the contract or from defects appearing or developing in the material or workmanship provided or performed under the contract within a period of one year after its acceptance thereof by the City of Renton,then and in that event this obligation shall be void; but otherwise it shall be and remain in full force and effect. Northwest Cascade, Inc. Fidelity and Deposit Company of Maryland Princi 1 Surety Ira V Signatike U Signature &Q,��- Karen Swanson,Attorney-in-Fact Title Title i 1 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY 1 1 `- KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York,the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY,a corporation of the State of Maryland,and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by THOMAS O. MCCLELLAN, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies,which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate, constitute, and appoint Eric A. ZIMMERMAN, James B. BINDER, Karen SWANSON, Jennifer SNYDER, Julie R. TRUITT, Peggy A. FIRTH, Christopher KINYON, Jamie DIEMER, Carley ESPIRITU and Mandy KELTNER, all of Tacoma, Washington, EACH its true and lawful agent and Attomey-in-Fact,to make,execute,seal and deliver,for,and on its behalf as surety,and as its act and deed: any and all bonds and undertakings,and the execution of such bonds or undertakings in pursuance of these presents, ! shall be as binding upon said Companies,as fully and amply,to all intents and purposes,as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York,New York.,the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills,Maryland.,and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland.,in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF, the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 27th day of May,A.D.2014. ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND wi9tW�4 'wp DLIpf� .eG►Y).1-NSLy'�fy1 REAL `��_._° mi 1 tni a d+r. 7 itM �a s:,y t968 'a By y/o f j! 1 Assistant Secretary Vice President { Eric D.Barnes Thomas O.McClellan State of Maryland City of Baltimore On this 27th day of May,A.D.2014,before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,THOMAS O. MCCLELLAN,Vice President,and ERIC D.BARNES,Assistant Secretary,of the Companies,to me personally known to be the individuals and officers described in and who executed the preceding instrument,and acknowledged the execution of same,and being by me duly swom,deposeth and saith,that 4 he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said ( Corporations. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written. Maria D.Adamski,Notary Public My Commission Expires:July 8,2015 POA-F 180-2849C 9 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attorneys-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attomeys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attomey-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V,Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company,whether made heretofore or hereafter,wherever appearing upon a certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this day of 20 ti ��v � W�•'GO��t'•"OZ t ;o? 3 SEAL O Vaatj Geoffrey Delisio,Vice President RESOLUTION OF CORPORATE AUTHORITY OF NORTHWEST CASCADE,INC. Be it resolved that any of the four persons,CEO/Chairman Mark R.Perry,Chief Financial J Officer/Secretaryareasurer Gregory A.Potts.Vice President of Business Development Stephen R.Barber, 5 employee Douglas J.Watt,acting singly,shall be and hereby is authorized and empowered,on behalf of Northwest Cascade,Inc.,to execute contracts,letters,authorizations,commitments,proposals and other J � documents in the normal course of business relating to the following matters: 1. Contracts for work or materials to be furnished or supplied by the Corporation, Northwest Cascade,Inc. 2. Collection of amounts due for work or materials of Northwest Cascade,Inc. 3. Filing or release of liens,or claims against bonds or retained percentages;for work or materials furnished by Northwest Cascade,Inc. 4. Any and all matters related to any of the above and foregoing. This authority shall remain in effect until revoked by action of the Board of Directors. Dated this 25th day of September 2013. Secr arylTreasurer I certify that this is a true copy of the Resolution dated September 25,2013. /-( y 12-S"-/j 3 Ch CEO Date CONTRACTS OTHER THAN FEDERAL-AID FHWA THIS AGREEMENT, made and entered into this day of Q&ZSe , 2014, by and between THE CITY OF RENTON, Washington, a municipal cor orati(f of the State of Washington, hereinafter referred to as "CITY" and Northwest Cascade,Inc., hereinafter referred 1 to as "CONTRACTOR." WITNESSETH: 1) The Contractor shall within the time stipulated, (to-wit: within 90 working days from date of commencement hereof as required by the Contract, of which this agreement is a component part) perform all the work and services required to be performed, and provide and furnish all of the labor, materials, appliances, machines, tools, equipment, utility and transportation services necessary to perform the Contract, and shall complete the construction and installation work in a workmanlike manner, in connection with the City's Project (identified as No. SWP-27-3635 and WTR-27-3635 for improvement by construction and installation of: Sunset Community Low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington Ave NE Water Main Replacement Work as described in"Scope of Work"dated May 2014 , attached hereto. All the foregoing shall be timely performed, furnished, constructed, installed and completed 1 in strict conformity with the plans and specifications, including any and all addenda issued by the City and all other documents hereinafter enumerated, and in full compliance with all applicable codes, ordinances and regulations of the City of Renton and any other governmental authority having jurisdiction thereover. It is further agreed and stipulated that all of said labor, materials, appliances, machines, tools, equipment and services shall be furnished and the construction installation performed and completed to the satisfaction and the approval of the City's Public Works Director as being in such conformity with the plans, specifications and all requirements of or arising under the Contract. The Contractor agrees to use recycled materials whenever practicable. i 2) The aforesaid Contract, entered into by the acceptance of the Contractor's bid and signing of z this agreement, consists of the following documents, all of which are component parts of said Contract and as fully a part thereof as if herein set out in full, and if not attached, as if hereto attached. a) This Agreement b) Instruction to Bidders c) Bid Proposal d) Specifications e) Maps and Plans f) Bid g) Advertisement for Bids h) Special Provisions, if any i) Technical Specifications, if any 1 C 1-2009 3) If the Contractor refuses or fails to prosecute the work or any part thereof, with such diligence as will insure its completion within the time specified in this Contract, or any extension in writing thereof, or fails to complete said work with such time, or if the Contractor shall be adjudged a bankrupt, or if he should make a general assignment for the benefit of his creditors, or if a receiver shall be appointed on account of the Contractor's insolvency, or if he or any of his subcontractors should violate any of the provisions of this Contract, the City may then serve written notice upon him and his surety of its intention to terminate the Contract, and unless within ten(10) days after the serving of such notice, such violation or non-compliance of any provision of the Contract shall cease and satisfactory arrangement for the correction thereof be made, this Contract, shall, upon the expiration of said ten (10) day period, cease and terminate in every respect. In the event of any such termination, the City shall immediately serve written notice thereof upon the surety and the Contractor and the surety shall have the right to take over and perform the Contract, provided, however, that if the surety within fifteen (15) days after the serving upon it of such notice of termination does not perform the Contract or does not commence performance thereof, the City itself may take over the work under the Contract and prosecute the same to completion by Contract or by any other method it may deem advisable, for the account and at the expense of the Contractor, and his surety shall be liable to the City for any excess cost or other damages occasioned the City thereby. In such event, ( the City, if it so elects, may, without liability for so doing, take possession of and utilize in completing said Contract such materials, machinery, appliances, equipment, plants and other properties belonging to the Contractor as may be on site of the project and useful I therein. 4) The foregoing provisions are in addition to and not in limitation of any other rights or remedies available to the City. 5) Contractor agrees and covenants to hold and save the City, its officers, agents, representatives and employees harmless and to promptly indemnify same from and against any and all claims, actions, damages, liability of every type and nature including all costs and legal expenses incurred by reason of any work arising under or in connection with the I Contract to be performed hereunder, including loss of life, personal injury and/or damage to property arising from or out of any occurrence, omission or activity upon, on or about the premises worked upon or in any way relating to this Contract. This hold harmless and 3 indemnification provision shall likewise apply for or on account of any patented or unpatented invention, process, article or appliance manufactured for use in the performance of the Contract, including its use by the City, unless otherwise specifically provided for in this Contract. i The Contractor agrees to name the City as an additional insured on a noncontributory primary basis. In the event the City shall, without fault on its part, be made a party to any litigation commenced by or against Contractor, then Contractor shall proceed and hold the City harmless and he shall pay all costs,expenses and reasonable attorneys fees incurred or paid by the City in connection with such litigation. Furthermore, Contractor agrees to pay all costs, expenses and reasonable attorney's fees that may be incurred or paid by City in the enforcement of any of the covenants, provisions and agreements hereunder. Nothing herein shall require the Contractor to indemnify the City against and hold harmless the City, from claims, demands or suits based solely upon the conduct of the City, its officers or employees and provided further that if claims or suits are caused by or result from the concurrent negligence of(a)the Contractor's agents or employees and(b)the City, 2 C 1-2009 i fi a its agents, officers and employees, and involves those actions covered by RCW 4.24.115, this indemnity provision with respect to claims or suits based upon such concurrent y negligence shall be valid and enforceable only to the extent of the Contractor's negligence or the negligence of the Contractor's agents or employees. 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 contractor and the city, its officers, officials, employees and volunteers, the contractor's liability hereunder shall be only to the extent of the contractor's negligence. It is further specifically and expressly understood that the indemnification provided herein constitute the contractor's waiver of immunity under the Industrial Insurance Act, 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. 6) Any notice from one party to the other party under the Contract shall be in writing and shall be dated and signed by the party giving such notice or by its duly authorized representative of such party. Any such notice as heretofore specified shall be given by personal delivery thereof or by depositing same in the United States mail, postage prepaid, certified or registered mail. 7) The Contractor shall commence performance of the Contract no later than 10 calendar days after Contract final execution, and shall complete the full performance of the Contract not later than _90_ working days from the date of commencement. For each and every working day of delay after the established day of completion, it is hereby stipulated and agreed that the damages to the City occasioned by said delay will be the sum of per Section 1-08.9 of Standard Specifications as liquidated damages(and not as a penalty)for each such day, which shall be paid by the Contractor to the City. 8) Neither the final certificate of payment not any provision in the Contract nor partial or entire use of any installation provided for by this Contract shall relieve the Contractor of liability in respect to any warranties or responsibility for faulty materials or workmanship. The Contractor shall be under the duty to remedy any defects in the work and pay for any damage to other work resulting therefrom which shall appear within the period of one (1) iyear from the date of final acceptance of the work, unless a longer period is specified. The City will give notice of observed defects as heretofore specified with reasonable promptness after discovery thereof, and Contractor shall be obligated to take immediate steps to correct and remedy any such defect, fault or breach at the sole cost and expense of Contractor. Defective or Unauthorized Work. The City reserves its right to withhold payment from Contractor for any defective or unauthorized work. Defective or unauthorized work includes, without limitation: work and materials that do not conform to the requirements of this Agreement; and extra work and materials furnished without the City's written approval. If Contractor is unable, for any reason, to satisfactorily complete any portion of the work, the City may complete the work by contract or otherwise, and Contractor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Contract price specified above. The City further reserves its right to deduct the cost to complete the Contract work, including any Additional Costs, from any and all amounts due or to become due the Contractor. 3 C 1-2009 i t The Contractor agrees the above one year limitation shall not exclude or diminish the City's rights under any law to obtain damages and recover costs resulting from defective and unauthorized work discovered after one year but prior to the expiration of the legal time period set forth in RCW 4.16.040 limiting actions upon a contract in writing, or liability expressed or implied arising out of a written agreement. r Final Payment: Waiver of Claims. THE CONTRACTOR'S ACCEPTANCE OF FINAL PAYMENT (EXCLUDING WITHHELD RETAINAGE) SHALL CONSTITUTE A WAIVER OF CONTRACTOR'S CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY CONTRACTOR AS UNSETTLED AT THE TIME FINAL PAYMENT IS MADE AND ACCEPTED. I 9) The Contractor and each subcontractor, if any, shall submit to the City such schedules of 1 quantities and costs, progress schedules, payrolls, reports, estimates, records and miscellaneous data pertaining to the Contract as may be requested by the City from time to time. 10) The Contractor shall furnish a surety bond or bonds as security for the faithful performance of the Contract, including the payment of all persons and firms performing labor on the ! construction project under this Contract or furnishing materials in connection with this Contract; said bond to be in the full amount of the Contract price as specified in Paragraph 12. The surety or sureties on such bond or bonds must be duly licensed as a surety in the State of Washington. 11) The Contractor shall verify, when submitting first payment invoice and annually thereafter, possession of a current City of Renton business license while conducting work for the City. The Contractor shall require, and provide verification upon request, that all subcontractors participating in a City project possess a current City of Renton business license. The Contractor shall provide, and obtain City approval of, a traffic control plan prior to conducting work in City right-of-way. 12) The total amount of this contract is the sum of $1,101,142.55 numbers One million one hundred one thousand one hundred forty-two dollars and 551100 written words including Washington State Sales Tax. Payments will be made to Contractor as specified in the"Special Provisions" of this Contract. 13) INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor- Employer Relationship will be created by this Agreement and that the Contractor has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. 14) LIMITATION OF ACTIONS. CONTRACTOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK IS COMPLETE OR CONTRACTOR'S ABILITY TO FILE THAT CLAIM OR SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. 15) Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option 4 C 1-2009 conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. 16) Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three(3)business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. i 17) Assignment. Any assignment of this Agreement by either party without the written consent r of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. 18) Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative I of the city and Contractor. 19) Compliance with Laws. The Contractor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Contractor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. 20) Counterparts. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. 6 { IN WITNESS WHEREOF, the City has caused these presents to be signed by its Mayor and attested by its City Clerk and the Contractor has hereunto set his hand and seal the day and year first above-written. CONTRACTOR CITY O N I N u SEAL _ Pre ident/ ner/O,Zier Mayor Denis aw ATTEST /fill illN1� ecreKy Bonnie I . Walton, City Clerk dba // Q0 K�V� ST_ 10- l'1 ST tA—i �Q C Firm Name check one �-, ❑ Individual ❑ Partnership I'Corporation Incorporated in &_yCCCCA iA1, 104 5 C 1-2009 CITY OF RENTON Sunset Community low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington Ave NE Water Main Replacement Project SWP-27-3635, WTR-27-3635 RETAINAGE SELECTION Per Standard Specifications Section 1-09.9(1)Retainage, and RCW 60.28,a sum of 5-percent of the monies earned by the Contractor will be retained from progress estimates. The retainage will be used as a trust fund for the protection and payment of(1)the State with respect to taxes, and(2)the claims of any person arising under the Contract. Retainage shall be placed in a fund held by the City(non-interest bearing), unless the Contractor selects a one of the options listed below and completes all arrangements needed for that option to the satisfaction of the City. Other retainage fund options: _ 1. Deposited by the City in an escrow account(interest bearing) in a bank, mutual savings bank,or savings and loan association. Deposits will be in the name of the City and are not allowed to be withdrawn without the City's written authorization,or t _2. The City,at its' option, may accept a bond from the Contractor in lieu of retainage. If the Contractor selects option 1 or 2 it is fully responsible for selecting the bank or association to be r used, and for making all arrangements and paying all costs associated with that option. All arrangements and forms needed for option 1 or 2 shall be submitted to the City for review and approval. 1 i' { Release of the Retainage will be made 60 days following the Completion Date provided the conditions in Special Provisions Section 1-09.9(1), and applicable State Regulations,are met. SIGNED: PRINT NAME: ` COMPANY: IVGf\TUyESI 1� SC� � -- DATE: wient$: 7Loa-t PIUK I t.AJGI ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/25/2014 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 MIA CT NAMENAME:` Debbie Henderson NA .. Propel insurance PHONE 8O0 499-09331 FAX Al No, o Ext: Atc No): 866.577.1326 Tacoma Commercial Insurance E-MAIL ADDRESS: drh@propelinsurance.com 1201 Pacific Ave, Suite 1000. INSURERS)AFFORDING COVERAGE NAIC# Tacoma,WA 98402 INSURER A:National Fire Ins Co of HaFtfor INSURED INSURER B:Starr Surplus Lines Insurance C 13604 Northwest Cascade Inc. INSURER C:Continental Casualty Company 20443 DBA: Honey Buckets, Inc; DBA FloHawks INSURER D:American Casualty Co of Reading P.O. Box 7399 Puyallup,WA 98373 INSURER E: dNSURER F: COVERAGES CERTIFICATE NUMBER: 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 SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DDL UB POLICY EFP POLICY EXP LTR=-. i WV0 POLICY NUMBER MM/DD/YY MM/DD/YYYY LIMITS A GENERAL LIABILITY X X 2053866352 0/01/2013 10/01/2014 EACH OCCURRENCE $1 000 000 X-COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES.Ea-ocrt cuence $100 000 CLAIMS-MADE F x�OCCUR MED EXP(Any one person) s5,000 X PD Ded:5,000 PERSONAL&ADV INJURY $1 000 000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000 POLICY : X C7 n LOC $ p AUTOMOBILE LIABILITY X X 2053866318 0/01/2013 10/01/201 COMBINED SINGLE LIMIT Ea accldont 1,000,000 X ANY AUTO BODILY INJURY(Per person) .$ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED rHORER VY DAMAGE $ AUTOS Per accident B UMBRELLA LIAB X OCCUR 1000020409 0/01/2013 10/0112014 EACH OCCURRENCE $5 000 000 X EXCESS LIAB X CLAIMS-MADE AGGREGATE s5,000,000 DED X RETENTION$O $ C WORKERS COMPENSATION 2093635362 10/01/2013' 10/01/201 X wcs7A7u- oTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WA Stop Gap E.L.EACH ACCIDENT_ 10,000,000 OFFICER/MEMBEREXCLUDED? � N/A __ A (Mandatory in NH) 2099313067 0/01/20i3 1UfU1/LU1 E.L.DISEASE-EA EMPLOYEE]Si 000000 If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $1,000,000 C Leased/Rented Eq 2071939959 0/01/2013 10/01/201 $420K Lmt/$100K to Othr Deductbls $2,500 ded/$5k for MTC C Motor Truck Caro 2071939959 0/01/2013 10/01/201 $100k per Veh/$200k Agg DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) RE: SWP-27-3635 and WTR-27-3635/Sunset Commuity Low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington Ave NE Water Main Replacement Project. The City of Renton is additional insured per the attached endorsements. CERTIFICATE BOLDER CANCELLATION Cit Of Renton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF NO-RC=_ VO L BE DELIVERED IN 1055 South Grady Way ACCORDANCE W!TH THE POLICY PP.OVIS1O.h1S- Renton,WA 98057 AUTHORIZED REPRESENTATIVE I A- -a' ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1437756/M1375169 KTROO rvorinwesc�,ascace inc. G-140331-D 2053866352 (Ed. 01/13} CNA BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS- WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows: SCHEDULE(OPTIONAL) Name of Additional Insured Persons Or Organizations (As required by"written contract" per Paragraph A. below.) Locations of Covered Operations (As per the "written contract," provided the location is within the "coverage territory"of this Coverage Part.) A. Section II -Who Is An Insured is amended to include as an additional insured: 1. Any person or organization whom you are required by "written contract" to add as an additional insured on this Coverage Part; and 2. The particular person or organization, if any, scheduled above. B. The insurance provided to the additional insured is limited as follows: 1. The person or organization is an additional insured only with respect to liability for "bodily injury," "property damage,"or"personal and advertising injury"caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations specified in the "written contract";or b. "Your work" that is specified in the "written contract" but only for "bodily injury' or "property damage" included in the "products-completed operations hazard,"and only if: (1) The"written contract" requires you to provide the additional insured such coverage; and (2) This Coverage Part provides such coverage. 2. If the "written contract"specifically requires you to provide additional insurance coverage via the 10/01 edition of CG2010 (aka CG 20 10 10 01), or via the 10/01 edition of CG2037 (aka CG 20 37 10 01), or via the 11/85 edition of CG2010(aka CG 20 10 11 85),then in paragraph B.1. above, the words 'caused in whole or in part by'are replaced by the words'arising out of. 3. We will not provide the additional insured any broader coverage or any higher limit of insurance than: a. The maximum permitted by law; b. That required by the"written contract"; c. That described in B.I. above; or d. That afforded to you under this policy, whichever is less. 4. Notwithstanding anything to the contrary in Condition 4. Other Insurance (Section IV), this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or G-140331-D (Ed. 01(13) Page 1 of 2 Copyright,CNA All Rights Reserved. G-140331-D ��A (Ed. 01113) any other basis. But if required by the "written contract" to be primary and non-contributory, this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured. 5. The insurance provided to the additional insured does not apply to "bodily injury," "property damage," or "personal and advertising injury"arising out of: a. The rendering of, or the failure to render, any professional architectural, engineering, or surveying 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 (2) Supervisory, inspection, architectural or engineering activities; or b. Any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this Coverage Part. C. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. The Duties In The Event of Occurrence, Offense, Claim or Suit condition is amended to add the following additional conditions applicable to the additional insured: An additional insured under this endorsement will as soon as practicable: (1) Give us written notice of an "occurrence" or an offense which may result in a claim or "suit" under this insurance, and of any claim or"suit"that does result; (2) Except as provided in Paragraph B.4. of this endorsement, agree to make available any other insurance the additional insured has for a loss we cover under this Coverage Part; (3) Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or"suit";and (4) Tender the defense and indemnity of any claim or "suit' to any other insurer or self insurer whose policy or program applies to a loss we cover under this Coverage Part. But if the"written contract" requires this insurance to be primary and non-contributory, this provision (4) does not apply to insurance on which the additional insured is a Named Insured. We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a claim or"suit." D. Only for the purpose of the insurance provided by this endorsement, SECTION V—DEFINITIONS is amended to add the following definition: "Written contract" means a written contract or written agreement that requires you to make a person or organization an additional insured on this Coverage Part, provided the contract or agreement: 1. Is currently in effect or becomes effective during the term of this policy; and 2. Was executed prior to: a. The "bodily injury"or"property damage"; or b. The offense that caused the"personal and advertising injury," for which the additional insured seeks coverage under this Coverage Part. All other terms and conditions of the Policy remain unchanged. Material used with permission of ISO Properties, Inc. G-140331-D (Ed.01/13) Page 2 of 2 Copyright,CNA All Rights Reserved. G-18652-J HA2053a66352 (Ed. 07-12) CONTRACTORS'GENERAL LIABILITY EXTENSION ENDORSEMENT It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. The changes this endorsement makes do not apply with respect to any coverage that has been excluded or amended by another endorsement attached to this policy. SCHEDULE Coverage is summarized below. For particulars and limitations affecting each coverage, please refer to the corresponding policy provisions in the body of this endorsement. 1. Additional Insureds Seven additional insured extensions. 2. Bodily Injury—Expanded Definition 3. Broad Knowledge of Occurrence/Notice of Occurrence 4. Broad Named Insured 5. Broadened Liability Coverage For Damage To"Your Product"And"Your Work" Limit$100,000. 6. Contractual Liability—Railroads Expanded definition of"insured contract." 7. Contractual Liability For Personal And Advertising Injury B. Electronic Data Liability Loss of Electronic Data Limit: $100,000. 9. Expanded Personal And Advertising Injury-Discrimination Or Humiliation 10. Expected Or Intended Injury Reasonable force—"bodily injury"or"property damage" 11. General Aggregate Limits Of Insurance-Per Project 12. In Rem Actions 13. Incidental Health Care Malpractice Coverage 14. Joint Ventures/Partnership/Limited Liability Companies Coverage for your interest in such terminated or ended organizations. 15. Legal Liability/Alienated Premises/Borrowed Equipment Coverage Extended perils. Default limit increased to$500,000 for Damage to Premises Rented To You. $25,000 limit for"property damage"to borrowed tools or equipment at a jobsite. 16. Liberalization Clause 17. Liquor Liability Coverage Extension 18. Medical Payments Limits increased to$15,000. Reporting increased to three years from the date of accident 19. Non-owned Aircraft Coverage 20. Non-owned Watercraft Increased to 75 feet. 21. Primary And Non-Contributory To Other Insurance 22. Property Damage-Elevators 23. Supplementary Payments Cost of bail bonds increased to$5,000. Daily lass of earnings increased to$1,000. 24. Unintentional Failure To Disclose Hazards 25. Waiver of Subrogation-Blanket Waiver of subrargatton where required by written contract or written agreement 26. Wrap-Up Extension G-18652-J (Ed._07-12) Page 1 of 12 Copyright,CNA All Rights Reserved. G07-1 zosaassssz (Ed.d.07-12) 1. ADDITIONAL INSURED 2. With respect to the insurance afforded to SECTION if—WHO IS AN INSURED is amended to these additional insureds, this insurance does not apply to any "occurrence" which include as an insured any person or organization takes place after the equipment lease (called additional insured)described in paragraphs expires. A.through G. below whom you are required to add as an additional insured on this policy under a D. Lessor-Land written contract or written agreement, provided the An owner or other interest from whom land has written contractor written agreement: been leased by you but only with respect to i. Is currently in effect or becomes effective liability arising out of the ownership, during the term of this policy; and maintenance or use of that specific part of the land leased to you and subject to the following ii. Was executed prior to the "bodily injury," additional exclusions: "property damage" or "personal injury and advertising injury" for which the additional This insurance does not apply to: insured seeks coverage. 1. Any "occurrence" which takes place after However, we will not provide the additional you cease to lease that land; or insured any broader coverage or any higher limit 2. Structural alterations, new construction or of insurance than the least that is: demolition operations performed by or on a. The maximum permitted by law; behalf of such additional insured. b. Required in the written contract or written E. Lessor-Premises agreement; A manager or lessor of premises but only with c. Afforded to you under this policy; or respect to liability arising out of the ownership, maintenance or use of that specific part of the d. Described in the applicable paragraphs A. premises leased to you and subject to the through G. below. following additional exclusions: A_ Controlling Interest This insurance does not apply to: Any persons or organizations with a controlling 1. Any "occurrence" which takes place after interest in you but only with respect to their you cease to be a tenant in that premises; liability arising out of: or 1. Their financial control of you;or 2. Structural alterations, new construction or 2. Premises they own, maintain or control demolition operations performed by or on while you lease or occupy these premises. behalf of such additional insured. This insurance does not apply to structural F. Mortgagee,Assignee or Receiver alterations, new construction and demolition A mortgagee, assignee or receiver but only with operations performed by or for such additional rc^SpcCt to iiieir liability as mortgagee, assignee, insured. or receiver and arising out of the ownership, B. Co-owner of Insured Premises maintenance, or use of a premises by you. A co-owner of a premises co-owned by you and This insurance does not apply to structural covered under this insurance but only with alterations, new construction or demolition respect to the co-owner's liability as co-owner of operations performed by or for such additional such premises. insured. C. Lessor-Equipment G. State or Governmental Agency or Subdivision or Political Subdivisions 1. Any person or organization from whom you lease equipment, but only with respect to A state or governmental agency or subdivision liability for"bodily injury,""property damage" or political subdivision subject to the following or"personal and advertising injury" caused, provisions: in whole or in part, by your maintenance. 1. This insurance applies only with respect to operation or use of equipment leased to you the following hazards for which the state or by such person or organization. goven,;�,enta! agarir.J or subdivision or political subdivision has issued a permit or authorization in connection with premises G-!86-2-J (Ed. 07-12) Page 2 of 12 Copyright,CNA All Rights Reserved. G1 2053866352 (Ed.d. 07-07-12) rNA you own, rent, or control and to which this You must give us or our authorized insurance applies: representative notice of an "occurrence," offense, claim, or "suit' only when the a. The existence, maintenance, repair, "occurrence," offense, claim or "suit" is known construction, erection, or removal of to: advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, (1) You, if you are an individual; manholes, marquees, hoistaway (2) A partner, if you are a partnership; openings, sidewalk vaults, street banners, or decorations and similar (3) An executive officer or the employee exposures;or designated by you to give such notice, if you b. The construction, erection, or removal are a corporation; or of elevators;or (4) A manager, if you are a limited liability c. The ownership, maintenance or use of company. any elevators covered by this insurance. B. NOTICE OF OCCURRENCE 2. This insurance applies only with respect to Your rights under this Coverage Part will not be operations performed by you or on your prejudiced if you fail to give us notice of an behalf for which the state or governmental "occurrence,"offense, claim or"suit"and that agency or subdivision or political subdivision failure is solely due to your reasonable belief has issued a permit or authorization. that the"bodily injury"or"property damage"'is 3. This insurance does not apply to: not covered under this Coverage Part However, you shall give written notice of this"occurrence," a. "Bodily injury," "property damage" or offense,claim or"suit"to us as soon as you are "personal and advertising injury" arising aware that this insurance may apply to such out of operations performed for the "occurrence,"offense claim or"suit. federal government, state or 4. BROAD NAMED INSURED municipality; or b. "Bodily injury" or "property damage" A. Any subsidiary or affiliate organization, other included within the "products-completed than a partnership, joint venture or limited operations hazard." liability company, in which a Named Insured specifically shown in the Declarations has A governmental permit which requires you to management control, directly or through one or add the governmental entity as an additional more subsidiary organizations, at the time of insured will trigger this Provision 1.as if the loss will qualify as a Named Insured but only if permit were a written contract. there is no other similar insurance available to 2. BODILY INJURY—EXPANDED DEFINITION such organization, nor similar insurance which would be available but for exhaustion of its SECTION V—DEFINITIONS, the definition of limits. For the purpose of this provision, similar "bodily injury"is changed to read: insurance means general liability or equivalent "Bodily injury"means bodily injury, sicknessbroader or narrower than that provided by this or insurance, no matter whether its coverage >is ; disease sustained by a person, including death, insurance. But if the only other similar insurance humiliation, shock, mental anguish or mental injury is for "consolidated (wrap-up} program," then by that person at any time which results as a a subsidiary that qualifies as a Named Insured consequence of the bodily injury, sickness or on such project-specific insurance can still disease. qualify as a Named Insured on this insurance, 3. BROAD KNOWLEDGE OF OCCURRENCE/ but not for projects covered by the"consolidated NOTICE OF OCCURRENCE (wrap-up) program." Condition 2.Duties in The Event of Occurrence, [Please see Item 26.C.of this endorsement for Offense, Claim or Suit of SECTION IV— the definition of"consolidated(wrap-up) COMMERCIAL GENERAL LIABILITY program."] CONDITIONS is amended to add the following B. This endorsement does not apply to any provisions: organization for which coverage is excluded by A. BROAD KNOWLEDGE OF OCCURRENCE another endorsement attached to this policy. C. Only for the purpose of this endorsement: G-18552-J(Ed. 07-12) Page 3 of 12 Copyright,CNA All Rights Reserved. G-18652-J CNA2053866352 (Ed.07-12) 1. Management control means: 1. Damage to Your Work a. Ownership interest representing more "Property damage"to"your work"arising out of than 50 of the voting, appointment, or it, or any part of it and included in the"products- designation power for the subsidiary completed operations hazard." organization's governing body;or This exclusion does not apply: b. Having the right, pursuant to a written (1) If the damaged work or the work out of contract, or pursuant to the by-laws, charter, operating agreement, or similar which the damage arises was document of a specifically shown performed on your behalf by a Named Insured or controlled subsidiary subcontractor, or organization to select, appoint, or (2) If the cause of loss to the damaged designate a majority of the subsidiary work arises as a result of: organization's governing body. Such (a) Fire; contract or document must have been created prior to the time of loss;or (b) Smoke; c. Having the right, pursuant to a written (c) Collapse; or trust agreement, to protect, control the use of, encumber or transfer and sell (d) Explosion. property held by a trust. B. The following paragraph is added to SECTION 2. Governing body means the Board of Ill-LIMITS OF INSURANCE: Directors of a corporation. Subject to 5. above, $100,000 is the most we 3. Loss means: will pay under Coverage A for the sum of damages arising out of any one "occurrence" a. The occurring of the "bodily injury" or because of"property damage"to"your product" "property damage';or and "your work"that is caused by fire, smoke, b. The committing of the offense that collapse or explosion and is included within the caused the "personal and advertising "product-completed operations hazard_" This injury." sublimit does not apply to "property damage"to "your work" if the damaged work or the work out D. The insurance provided by this policy applies to of which the damage arises was performed on Named Insureds when trading under their own your behalf by a subcontractor. names, or under such trading names or doing- business-as (DBA) names as any should C. This Provision S. Broadened Liability choose to employ. Coverage For Damage To "Your Product" And "Your Work" does not apply if an 5. BROADENED LIABILITY COVERAGE FOR endorsement of the same name is attached to DAMAGE TO "YOUR PRODUCT" AND "YOUR this policy. WORK" 5. CONTRACTUAL LIABILITY-R;IL.RC.) S A. Under SECTION I - COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE With respect to operations performed within 50 feet LIABILITY, Paragraph 2. Exclusions is amended of railroad property, the definition of"insured to delete exclusions k. and 1. and replace them contract"in SECTION V-DEFINITIONS is with the following: replaced by the following: [This insurance does not apply to:] "Insured Contract" means: k. Damage to Your Product a. A contract for a lease of premises. However, that portion of the contract fora lease of "Property damage"to"your product"ansing premises that indemnifies any person, or out of it, or any part of it except when organization for damage by fire to premises caused by or resulting from: while rented to you or temporarily occupied by (1) Fire; you with permission of the owner is not an "insured contract (2) Smoke; b. A sidetrack agreement; (3) Collapse; or i.. Any easement-r iicef Ilse agreement; (4) Explosion. G-18552--J (Ed. 07-12) Page 4 of 12 Copyright.GNA All Rights Reserved. G-18652-J CA 2053866352 (Ed. 07-12) d_ An obligation, as required by ordinance, to Damages arising out of the loss of, loss of use indemnify a municipality, except in connection of, damage to, corruption of, inability to access, with work for a municipality; or inability to manipulate "electronic data" that e. An elevator maintenance agreement; does not result from physical injury to tangible property. f. That part of any other contract or agreement However, this exclusion does not apply to pertaining to your business (including an liability for damages because of"bodily injury." indemnification of a municipality in connection with work performed for a municipality) under B. The following paragraph is added to SECTION which you assume the tort liability of another Ill—LIMITS OF INSURANCE: party to pay for "bodily injury" or "property Subject to 5.above, $100,000 is the most we damage" to a third person or organization. Tort will pay under Coverage A for all damages liability means a liability that would be imposed arising out of any one"occurrence"because of by law in the absence of any contract or "property damage"that results from physical agreement. injury to tangible property and arises out of Paragraph L does not include that part of any "electronic data." contract or agreement: C. The following definition is added to the (1) That indemnifies an architect, engineer or SECTION V—DEFINITIONS: surveyor for injury or damage arising out of. "Electronic data" means information,facts or (a) Preparing, approving or failing to programs stored as or on,created or used on, prepare or approve maps, shop or transmitted to or from computer software drawings, opinions, reports, surveys, (including systems and applications software), field orders, change orders or drawings hard or floppy disks, CD-ROMS, tapes, drives, and specifications;or cells, data processing devices or any other (b) Giving directions or instructions, or media which are used with electronically failing to give them, if that is the primary controlled equipment cause of the injury or damage; D. For the purposes of the coverage provided by this endorsement, the definition of "property (2) Under which the insured, if an architect, damage" in SECTION V — DEFINITIONS is engineer or surveyor, assumes liability for replaced by the following: an injury or damage arising out of the insured's rendering or failure to render 17. "Property damage" means: professional services, including those listed a. Physical injury to tangible property, in (1) above and supervisory, inspection, including all resulting loss of use of that architectural or engineering activities. property. All such loss of use shall be 7. CONTRACTUAL LIABILITY FOR PERSONAL deemed to occur at the time of the AND ADVERTISING INJURY physical injury that caused it; Under SECTION I—COVERAGE B—PERSONAL b. Loss of use of tangible property that is AND ADVERTISING INJURY LIABILITY, Paragraph not physically injured. All such loss of 2. Exclusions is amended to delete exclusion e. use shall be deemed to occur at the Contractual Liability. time of the "occurrence" that caused it; This provision 7.does not apply to any person or or organization who otherwise qualifies as an c. Loss of, loss of use of, damage to, additional insured on this Coverage Part. corruption of, inability to access, or 8. ELECTRONIC DATA LIABILITY inability to properly manipulate "electronic data,"resulting from physical A. Under SECTION I — COVERAGE A — BODILY injury to tangible property. All such loss INJURY AND PROPERTY DAMAGE, of "electronic data" shall be deemed to Paragraph 2. Exclusions is amended to delete occur at the time of the "occurrence" exclusion p. Electronic Data and replace it with that caused it, the following: For the purposes of this insurance, [This insurance does not apply to:] "electronic data"is not tangible property. p. Electronic Data E. if Electronic Data Liability is provided at a higher limit by another endorsement attached to this G-18652-J (Ed. 07-12) Page 5 of 12 Copyright,CNA All Rights Reserved. 40,517AVA G 2053866352 (Ed,d. 07-12)07-12) policy, then the $100,000 limit provided by this Intended Injury and replace it with the Provision 8.'Electronic Data Liability is part of, following: and not in additidn to, that higher limit. [This insurance does not apply to:] 9, EXPANDED PERSONAL AND ADVERTISING a. Expected or Intended Injury INJURY -DISCRIMINATION OR HUMILIATION A. SECTION V—DEFINITIONS is amended to add "Bodily injury"or"property damage" the following to the definition of "Personal and expected or intended from the standpoint of advertising injury": the insured, This exclusion does not apply to"bodily injury'or"property damage" h. Discrimination or humiliation that results in resulting from the use of reasonable force injury to the feelings or reputation of a to protect persons or property. natural person, but only if such 11. GENERAL AGGREGATE LIMITS OF discrimination or humiliation is: INSURANCE-PER PROJECT (1) Not done intentionally by or at the A. For each construction project away from direction of: premises you own or rent, a separate (a) The insured; or Construction Project General Aggregate (b) Any "executive officer," director, Limit, equal to the amount of the General stockholder, partner, member or Aggregate Limit, is the most we will pay for manager(if you are a limited liability the sum of. company) of the insured; and 1. All damages under Coverage A, except (2) Not directly or indirectly related to the damages because of "bodily injury" or employment, prospective employment, property damage included in the "products-completed operations past employment or termination of hazard"; and employment of any person or persons by any insured. 2. All medical expenses under Coverage B. Under SECTION I -- COVERAGE B — C, PERSONAL AND ADVERTISING INJURY that arise from "occurrences" or LIABILITY, Paragraph 2. Exclusions is accidents which can be attributed solely amended to add the following additional to ongoing operations at that exclusions: construction project. Such payments shall not reduce the General Aggregate (This insurance does not apply to:] Limit shown in the Declarations, nor the Discrimination Relating To Room, Construction Project Aggregate Limit of Dwelling or Premises any other construction project. "Personal or advertising injury"caused by B. All: discrimination directly or indirectly related to 1. Damages under Coverage B, regardless of the sale, rental, lease or sub-lease or the number of locations or construction prospective sale, rental, lease or sub-lease projects involved; of any room, dwelling or premises by or at the direction of any insured. 2. Damages under Coverage A, caused by Fines Or Penalties "occurrences" which cannot be attributed solely to ongoing operations at a single Fines or penalties levied or imposed by a construction project, except damages governmental entty because of because of "bodily injury" or "property discrimination_ damage" included in the "products- This provision 9,does not apply to any person completed operations hazard"; and or organization who otherwise qualifies as an 3. Medical expenses under Coverage C additional insured on this Coverage Part. caused by accidents which cannot be 10. EXPECTED OR INTENDED INJURY attributed solely to ongoing operations at a single construction project, Under SECTION I—COVERAGE A—BODILY will reduce the General Aggregate Limit shown INJURY AND PROPERTY DAMAGE in the Decim-raUnns. LIABILITY, Paragraph I. Enciusi^"s is amended to delete exclusion a. Expected or G-18652-J (Ed_ 07-12) Page 6 of 12 Copyright,CNA All Rights Reserved. G-18652-J �lV� 2l)53866352 (Ed. 07-12) C. The limits shown in the Declarations for Each (a) "Bodily injury" caused by a "health Occurrence, for Damage To Premises Rented care incident' will be considered To You and for Medical Expense continue to caused by an"occurrence"; and apply, but will be subject to either the (b) All acts, errors or omissions that Construction Project Aggregate Limit or the General Aggregate Limit, depending on whether are logically connected by any the "occurrence" can be attributed solely to common fact, circumstance, ongoing operations at a particular construction situation, transaction, event,.advice projeck or decision will be considered to constitute a single"occurrence'; D. When coverage for liability arising out of the (2) The "bodily injury" occurs during the "products-completed operations hazard" is policy period. All "bodily injury" arising provided, any payments for damages because „ " of "bodily injury" or"property damage" included from an occurrence will be deemed to in the "products-completed operations hazard," have occurred at the time of the first regardless of the number of locations involved act, error, or omission that is part of the will reduce the Products-Completed Operations "occurrence"; and Aggregate Limit shown in the Declarations. B. With respect only to the insurance provided by E_ if a single construction project away from this Provision 13., Exclusion 2.e. Employer's premises owned by or rented to the insured has Liability of SECTION I — COVERAGE A — been abandoned and then restarted, or if the BODILY INJURY AND PROPERTY DAMAGE, authorized contracting parties deviate from is amended to append the following: plans, blueprints, designs, specifications or Only for "bodily injury" not covered by other timetables, the project will still be deemed to be liability insurance (including state-sanctioned the same construction project. self insurance)available to the insured (or which F. The provisions of SECTION III — LIMITS OF would be available but for exhaustion of its limits), this exclusion does not apply to "bodily INSURANCE not otherwise modified by this endorsement shall continue to apply as injury"that arises out of a"health care incident." stipulated. C. SECTION V—DEFINITIONS is amended to add 12. IN REM ACTIONS the following new definition: Any action in rem against any vessel owned or "Health care incident' means a negligent act, operated by or for you, or chartered by or for you will error or omission by your "employees" or "volunteer workers" working on your behalf in be treated in the same manner as though the action were in personam against you. the rendering of or failure to render professional health care services in any of the following In rem is a term used to designate actions instituted capacities, or the related furnishing of food, against the thing, as distinct from actions against beverages, medical supplies or appliances: the person,which are said to be in personam. a. Physician; 13. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE b. Nurse; A. With respect only to "bodily injury" that arises c. Emergency medical technician; out of a "health care incident," COVERAGE A— d. Paramedic; BODILY INJURY AND PROPERTY DAMAGE e. Chiropractor, LIABILITY OF SECTION I — COVERAGES is amended to replace Insuring Agreement f. Dentist, Paragraphs 1.b.(1) and 1.b.(2) with the g. Athletic trainer; following: b. This insurance applies to"bodily injury" only h. Audiologist; if you are not in the business of providing L Physical therapist; professional health care services, and only Y if. j• ps chologist; (1) The "bodily injury" is caused by an k. Speech therapist; "occurrence" that takes place in the 1. Other allied health professional; or "coverage territory," For the purpose of this insurance: G-18652_J (Ed. 07-12) Page 7 of 12 Copyright,CNA AA Rights Reserved. G-18652-J 2053866352 (Ed.07-12) m. Provider of first aid or Good Samaritan a. "bodily injury" to a co-"volunteer worker" services rendered in an emergency and for while performing duties related to the which no payment is demanded or received. conduct of your business; and D. SECTION I—COVERAGE A—BODILY INJURY b. "bodily injury" to an "employee" while in AND PROPERTY DAMAGE, Paragraph 2. the course of the "employee's" Exclusions is amended to add the following employment by you or while performing additional exclusions. These new exclusions duties related to the conduct of your apply only to this Incidental Health Care business; Malpractice Coverage: when such"bodily injury"inju "arises out of a [This insurance does not apply to:] "health care incident" Dishonesty or Crime 3. Paragraphs 2.a. (1)(a), (b) and (c) of Any dishonest criminal or malicious act error or SECTION 11 — WHO IS AN INSURED do not apply to "bodily injury" for which omission. not is provided this Provision 13. Clinical Trials!Product Testing 4. Paragraph 2.a.(1)(d) of SECTION Il—WHO Acts, errors or omissions that occur in the IS AN INSURED is deleted. course of human clinical trials or product G. With respect to the insurance provided by this testing. Provision 13., the following is added to Medicare/Medicaid Fraud Paragraph 4.b.(1) of SECTION IV — Medicare or Medicaid fraud or abuse. COMMERCIAL GENERAL LIABILITY CONDITIONS: Services Excluded by Endorsement To the extent this insurance applies, it is excess Any "health care incident" for which coverage is over any of the other insurance (including excluded by endorsement qualified self insurance), whether primary, excess, contingent or on any other basis, except E. SECTION V—DEFINITIONS is amended to add for insurance purchased specifically by you to the following subparagraph to Paragraph f. of be excess of this policy. the definition of"insured contract": 14. JOINT VENTURES / PARTNERSHIP 1 LIMITED Paragraph f. does not include that part of any LIABILITY COMPANIES contract or agreement: A. The following is added to SECTION 11 — WHO (4) Under which you assume another's tort IS AN INSURED: liability for "bodily injury" arising out of the rendering of or failure to render professional 4. You are an insured when you had an health care services, interest in a joint venture, partnership or limited liability company which terminated or F. SECTION U — WHO IS AN INSURED is ended prior to or during this policy period, amended to add the following provisions: but only to the extent of your interest in such 1. Your"employees" are insureds with respect joint venture, partnership or limited liability to: company.This coverage does not apply: a. "bodily injury" to a co-"employee" while a. Prior to the termination date of any joint in the course of the co-"employee's" venture, partnership or limited liability employment by you or while performing company; duties related to the conduct of your b. If there is other valid and collectible business;and insurance purchased specifically to b. "bodily injury" to a "volunteer worker` insure the partnership, joint venture or while performing duties related to the limited liability company; or conduct of your business; c. To a joint venture, partnership or limited when such"bodily injury"arises out of a liability company which is or was "health care incident." insured under a"consolidated (wrap-up) 2. Your "volunteer 74'orkers" are insureds with insurance program" respect to: G-18652-J (Ed. 01-1211 Page 8 of 12 Copyright,CNA All Rights Reserved. G-18652-J CA 2053866352 (Ed. 07-12) [Please see Item 26.C, of this endorsement Paragraphs (1), (3) and (4) of this exclusion for the definition of"consolidated (wrap-up) do not apply to "property damage" (other program."] than damage by fire) to premises rented to B. The last paragraph of SECTION 11 — WHO IS you or temporarily occupied by you with the AN INSURED is deleted and replaced by the permission of the owner, onto the contents following: of premises rented to you for a period of 7 or fewer consecutive days. A separate limit Except as provided under the Contractors' of insurance applies to Damage To General Liability Extension Endorsement or by Premises Rented To You as described in the attachment of another endorsement(if any), SECTION III—LIMITS OF INSURANCE. no person or organization is an insured with Paragraphs (3), (4), (5) and (6) of this respect to the conduct of any current or past exclusion do not apply to liability assumed partnership, joint venture or limited liability under a sidetrack agreement. company that is not shown as a Named Insured in the Declarations. Paragraph (6) of this exclusion does not 'I5. LEGAL LIABILITYIALlENATED PREMISES/ apply to "property damage" included in the BORROWED EQUIPMENT "products-completed operations hazard." A. Under SECTION I — COVERAGE A -BODILY B. Under SECTION 1 — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE, INJURY AND PROPERTY DAMAGE the last Paragraph 2. Exclusions is amended to delete paragraph of Paragraph 2. Exclusions is deleted exclusion j. Damage to Property in its entirety and replaced by the following. and replace it with the following: Exclusions c. through n. do not apply to [This insurance does not apply to:] damage by fire to premises while rented to you or temporarily occupied by you with permission j. Damage to Property of the owner nor to the contents of premises "Property damage"to: rented to you for a period of 7 or fewer p hY g consecutive days. (1) Property you own, rent, or occupy; A separate limit of insurance applies to this (2) Premises you sell, give away or coverage as described in SECTION III—LIMITS abandon, if the "property damage" OF INSURANCE. arises out of any part of those C. The following paragraph is added to SECTION premises; III—LIMITS OF INSURANCE: (3) Property loaned to you; Subject to 5. above, $25,000 is the most we will (4) Personal property in the care, custody pay under Coverage A for damages arising out or control of the insured; of any one "occurrence" because of "property damage"to tools or equipment loaned to you by (5) That particular part of real property on others that occurs while the equipment is being which you or any contractors or used to perform operations. subcontractors working directly or indirectly on your behalf are performing D. Paragraph 6. Damage To Premises Rented To operations, if the "property damage" You Limit of SECTION III — LIMITS OF arises out of those operations; or INSURANCE is replaced by the following: (6) That particular part of any property that 6. Subject to Paragraph 5. above, (the Each must be restored, repaired or replaced Occurrence Limit), the Damage To because "your work" was incorrectly Premises Rented To You Limit is the most performed on it. we will pay under SECTION — 1 — COVERAGE A for damages because of Paragraph (2) of this exclusion does not "property damage" to any one premises apply if the premises are"your work." while rented to you or temporarily occupied Paragraphs (3) and (4) of this exclusion do by you with the permission of the owner, not apply to "property damage" to tools or including contents of such premises rented equipment loaned to you. A separate limit to you for a period of 7 or fewer consecutive of insurance applies to such tools or days. The Damage To Premises Rented To equipment that are damaged while being You Limit is the greater of: used in your operations, a. $500,000; or G-16652-J (Ed. 07-12) Page 9 of 12 Copyright,CNA All Rights Reserved. G-18652-J C11AVA 2053866352 (Ed. 07_12) b. The Damage To Premises Rented To This paragraph B. does not apply to medical You Limit shown in the Declarations. expenses incurred in the state of Missouri. E. Paragraph 4.b.(1')(a)(ii) of SECTION IV — 19. NON-OWNED AIRCRAFT COMMERCIAL GENERAL LIABILITY Under SECTION I—COVERAGE A—BODILY CONDITIONS is deleted and replaced by the INJURY AND PROPERTY DAMAGE LIABILITY. following: Paragraph 2.Exclusions is amended such that (H) That is Property insurance for premises exclusion g.Aircraft,Auto or Watercraft does not rented to you, for premises temporarily apply to an aircraft you do not own, provided that: occupied by you with the permission of the 1. The pilot in command holds a currently effective owner, or for personal property of others in certificate issued by the duly constituted your care, custody or control; authority of the United States of America or F. This Provision 15. does not apply if Damage To Canada, designating that person as a Premises Rented To You Liability under commercial or airline transport pilot; SECTION - I — COVERAGE A is excluded by 2. The aircraft is rented to you with a trained, paid endorsement. crew; and 16. LIBERALIZATION CLAUSE 3. The aircraft does not transport persons or cargo If we adopt a change in our forms or rules which for a charge. would broaden coverage for contractors under this 20. NON-OWNED WATERCRAFT endorsement without an additional premium charge, your policy will automatically provide the additional Under SECTION I—COVERAGE A—BODILY coverage as of the date the revision is effective in INJURY AND PROPERTY DAMAGE LIABILITY, your state. Paragraph 2. Exclusions is amended to delete 17. LIQUOR LIABILITY subparagraph (2)of exclusion g.Aircraft,Auto or Watercraft and replace it with the following. Under SECTION I—COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE, Paragraph 2. (This exclusion does not apply to:] Exclusions is amended to delete exclusion c. (2) A watercraft you do not own that is: Liquor Liability. (a) Less than 75 feet long; and This provision 17.does not apply to any person or organization who otherwise qualifies as an (b) Not being used to cony persons or property additional insured on this Coverage Part_ for a charge. 18. MEDICAL PAYMENTS 21. PRIMARY AND NON-CONTRIBUTORY TO OTHERINSURANCE A. Paragraph 7. Medical Expense Limit, of SECTION III — LIMITS OF INSURANCE is With respect to any person or organization that is an deleted and replaced by the following: additional insured under this Coverage Part, the following is added to Paragraph 4. of SECTION IV— 7. Subject to Paragraph 5. above (the Each COMMERCIAL GENERAL LIABILITY Occurrence Limit), the Medical Expense CONDITIONS: Limit is the most we will pay under SECTION — I — COVERAGE C for all If you have agreed in writing in a contract or medical expenses because of"bodily injury" agreement that this insurance is primary and non- sustained by any one person. The Medics! contributory relative to an additional insured's own Expense Limit is the greater of: insurance, then this insurance is primary and we will not seek contribution from that other insurance. For (1) $15,000; or the purpose of this Provision 21., the additional (2) The amount shown in the Declarations insured's own insurance means insurance on which for Medical Expense Limit. the additional insured is a Named Insured. B. Paragraph 1.a.(3)(b) of SECTION I — This Provision 21. does not apply in situations COVERAGE C MEDICAL PAYMENTS is where the endorsement on this policy affording replaced by the fallowing: coverage to the additional insured specifies that this insurance is excess over any other insurance (b) The expenses are incurred and reported to available to that additional insured. us within three years of the date of twe 22. PROPERTY DAMAGE—ELEVATORS :TORS accident; and G-18652-J (Ed. 07-12) Page 10of12 Copyright,CNA All Rights Reserved. CNA G 2053666352 (Ed. 07-1 d7-12) A. Under SECTION 1 — COVERAGE A — BODILY However, this waiver applies only when you have INJURY AND PROPERTY DAMAGE, agreed in writing to waive such rights of recovery in Paragraph 2. Exclusions is amended such that a contract or agreement, and only if the contract or exclusion k. Damage to Your Product, and agreement: subparagraph (3), (4) and (6) of exclusion i. 1. Is in effect or becomes effective during the term Damage to Property do not apply "property damage"that results from the use of elevators. of this policy; and B. With respect only to the coverage provided by 2. Was executed prior to loss. this endorsement, Condition 4. Other 26. WRAP-UP EXTENSION: OWNER CONTROLLED Insurance in SECTION IV COMMERCIAL INSURANCE PROGRAM, CONTRACTOR GENERAL LIABILITY CONDITIONS is CONTROLLED INSURANCE PROGRAM OR amended to add the following subparagraph CONSOLIDATED (WRAP-UP) INSURANCE ba1)(a)(v): PROGRAMS 4. Other Insurance Note:The following provision does not apply to any b. Excess Insurance public construction project in the state of Oklahoma, nor to any construction project in the state of (1) This insurance is excess over. Alaska, that is not permitted to be insured under a (a) Any of the other insurance, "consolidated (wrap-up)insurance program"by whether primary, excess, applicable state statute or regulation: contingent or on any other If the endorsement EXCLUSION— basis: CONSTRUCTION WRAP-UP or another (v) That is Property insurance exclusionary endorsement pertaining to Owner covering property of others Controlled Insurance Programs(O.C.I.P.) or damaged from the use of Contractor Controlled Insurance Programs elevators. (C.C.I.P.) is attached to this policy, then the following changes apply: 23. SUPPLEMENTARY PAYMENTS A. The following wording is added to the A. Under Section I—Supplementary Payments— endorsement Coverages A and B, Paragraph 1.b.,the limit of With respect to a"consolidated (wrap-up) $250 shown for the cost of bail bonds is insurance program" project in which you are or replaced by$5,000: were involved, this exclusion does not apply to B. In Paragraph 1.d., the limit of $250 shown for those sums you become legally obligated to pay daily loss of earnings is replaced by$1,000. as damages because of 24. UNINTENTIONAL FAILURE TO DISCLOSE 1. "Bodily injury," "property damage," or HAZARDS "personal or advertising injury" that occurs If unintentionally you should fail to disclose all during your ongoing operations at the existing hazards at the inception date of your policy, project, or during such operations of anyone we will not deny coverage under this Coverage Part acting on your behalf; nor because of such failure. 2. "Bodily injury" or "property damage" 25. WAIVER OF SUBGROGATION-BLANKET included within the "products-completed operations hazard" that arises out of those Under SECTION IV—COMMERCIAL GENERAL portions of the project that are not LIABILITY CONDITIONS,The Transfer Of Rights "residential structures." Of Recovery Against Others To Us Condition is B. SECTION IV — COMMERCIAL GENERAL amended by the addition of the following: LIABILITY CONDITIONS is amended to add the We waive any right of recovery we may have following subparagraph 4.b.(1)(c) to Condition against any person or organization because of 4.Other Insurance: payments we make for injury or damage arising out [This insurance is excess over] of: 1. Your ongoing operations; or (c) Any of the other insurance whether primary, excess, contingent or any other basis that is 2. "Your work" included in the"products completed insurance available to you as a result of operations hazard." your being a participant in a "consolidated (wrap-up) insurance program," but only as G-18652-J (Ed. 07-12) Page 11 of 12 Copyright,CNA All Rights Reserved. G-1865 5VA 2053866352 (Ed. Q7-12)12) respects your involvement in that residency including but not limited to single,or "consolidated (wrap-up) insurance multifamily housing, apartments; condominiums, program." townhouses, co-operatives or planned unit C. SECTION V—DEFINITIONS is amended to add developments and also includes their common the following definition. areas and/or appurtenant structures(including pools, hot tubs, detached garages, guest "Consolidated(wrap-up) insurance program" houses or any similar structures).When there is means a construction, erection or demolition no individual ownership of units, residential project for which the prime contractor/project structure does not include military housing, manager or owner of the construction project college/university housing or dormitories, tong has secured general liability insurance covering term care facilities, hotels, or motels. some or all of the contractors or subcontractors Residential structure also does not include Involved in the project, such as an Owner hospitals or prisons. Controlled Insurance Program (O.C.I.P.)or This provision 26.does not apply to any person Contractor Controlled Insurance Program or organization who otherwise qualifies as an (C.C.I.P.), additional insured on this Coverage Part "Residential structure" means any structure where 30 or more of the square foot area is used or is intended to be used for human All other terms and conditions of the Policy remain unchanged. This endorsement,which farms a part of and Is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. Material used with permission of ISO Properties, Inc G-18652-J(Ed_ C7-12) Page 12 of 12 Copyright,CNA All Rights Reserved, POLICY NUMBER: 2053866318 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s)who are"insureds"under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: Countersigned By: Named Insured:Northwest Cascade Inc. Authorized Re resentative SCHEDULE Name of Person(s) or Organization(s): ANY PERSON OR ORGANIZATION WHICH IS REQUIRED TO BE NAMED AS A RESULT OF A WRITTEN CONTRACT. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured"for Liability Coverage,but only to the extent that person or organization qualifies as an "insured"under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page I of I POLICY NUMBER: 2053866318 COMMERCIAL.AUTO CA 04 44 03 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Northwest Cascade Inc. Endorsement Effective Date: 10/01/2013 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization as required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the 'loss" under a contract with that person or organization. CA 04 44 03 10 Copyright, Insurance Services Office, Inc_, 2009 Page 1 of 1 v -��rt-ems t'o 4 CNA y National Utility Contractors Association General Liability - Occurrence Renewal Declaration POLICY NUMBER COVERAGE PROVIDED BY FROM - POLICY PERIOD - TO U 2053866352 VALLEY FORGE INSURANCE COMPANY 10/01/2013 10/01/2014 333 S. WABASH CHICAGO, IL. 60604 INSURED NAME AND ADDRESS NORTHWEST CASCADE INC. PO BOX '73399 PUYALLUP, WA 98373 REFER TO ADDITIONAL NAMED INSUREDS SCHEDULE AGENCY NUMBER AGENCY NAME AND ADDRESS 065944 PROPEL INSURANCE 1201 PACIFIC AVE, #1 PO BOX 2940 (98401) TACOMA, WA 98402 Phone Number: (253) 759-2200 BRANCH NUMBER BRANCH NAME AND ADDRESS 050 SEATTLE BRANCH 999 THIRD AVENUE, STE 2500 SEATTLE, WA 98104 Phone Number: (206)587-2600 This policy becomes effective and expires at 12:01 A.M. standard time at your mailing address on the dates shown above. The Named Insured is a Corporation. Your policy is composed of this Declarations, with the attached Common Policy Conditions, Coverage Forms, and Endorsements, if any. The Policy Forms and Endorsement Schedule shows all forms applicable to this policy at the time of policy issuance. The Estimated Policy Premium Is Audit Period is Not Auditable In return for the payment of the premium, and subject to all the terms and conditions contained here-in, we agree to provide the insurance as stated. INSURED Page 1 of 5 U 2053866352 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 LIMITS OF INSURANCE DESCRIPTION LIMIT Each Occurrence $1, 000,000 Personal & Advertising Injury $1, 000,000 Medical Expense - Any One Person $5,000 Damage To Premises Rented To You Limit $100,000 Products/Completed Operations Aggregate $2, 000,000 General Aggregate $2, 000,000 Employee Benefits Liability Coverage Each Employee $1, 000,000 Aggregate $2, 000,000 Stop Gap Liability "Bodily Injury" by Accident - Each Accident $1, 000,000 "Bodily Injury" by Disease - Aggregate Limit $1, 000,000 "Bodily Injury" by Disease - Each "Employee" $1, 000,000 SCHEDULE OF COVERAGES PREMIUM ESTIMATED COVERAGE/HAZARD DESCRIPTION EXPOSURE BASIS RATE PREMIUM POLICY LEVEL COVERAGES Employee Benefits Liability INCL Each INCL INCL Employee Deductible Each Employee $1,000 Stop Gap Liability - Washington INCL INCL INCL INCL Stop GAP Liability - WA INCL Each INCLINCL $100 Total Payroll Contractors General Liability Extension INCL INCL INCL INCL Subcontractors Blanket Additional Insured INCL INCL INCL INCL Limited Pollution Liability Coverage INCL INCL COMPOSITE RATING Per $1,000 Gross Sales INSURED Page 2 of 5 ZV1J1.\.i "Ul•1D8iC 11VJUL<.QL 1V191.1L' t 14AJ � 00 U 2053866352 NORTHWEST CASCADE INC_ PO BOX 73399 PUYALLUP, WA 98373 ADDITIONAL INSURER._SCHEDULE LOCATION: 1 Additional Insured Name and Address: HOFFMAN CORPORATION PO BOX 73399 PUYALLUP, WA 98373 TYPE: Additional Insured ADDITIONAL NAMED INSUREDS SCHEDULE GOTTA GO PORTABLES MDP MERIDIAN LLC DRAINS PLUS NORTHWEST CASCADE 401(K) PROFIT SHARING PLAN, PLAN ID #B37 NWC#1 FLOHAWKS NWC #5 PARTNERSHIP, LLC NCS WASTEWATER SOLUTIONS CASCADE SYSTEM MANAGEMENT NORTHWEST CASCADE INC. DBA HONEY BUCKETS INSURED Page 4 of 5 POLICY NUMBER INSURED NAME AND ADDRESS U 2053866352 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 r FORMS AND. ENDORSEMENTS SCHEDULE Form Number Form Title G56015B 11/1991 G300415A ADDITIONAL INSURED SCHEDULED PERSON OR OR CG0001 12/2Oa7 Commercial General Liability Coverage Form CGO068 05/2009 Rec And D str Of Mat Or Info In Viol Of Law Excl CGO197 12/2.007 WA Changes-Employment-Related Practices Exclusion CG2154 01/1996 Exclusion - Designated Ongoing Operations Covered CG2173 01/2008 Exclusion of Certified Acts Terrorism CG2279 07/1998 Exclusion - Contractors - Professional Liability CG2504 05/2009 Designated Location(s) General Aggregate Limit G114050A 02/1995 Stop Gap Liability Coverage Supplemental Schedule C132263B 11/2004 Amendatory Endorsement - Pollution Exclusion G132279C99 07/2005 Limited Pollution Coverage - Work Sites G133122B46 11/2004 WA Changes-Ltd Pollution Cov Worksite G136107A 03/2000 Exclusion - Construction Wrap-Up Program G140331D 01/2013 Blanket Addl Insd - Owner, Lessee Cntrctr - w/C-O G140396A99 10/2001 Fungi/Mold/Mildew/Yeast/Microbe Exclusion G144291A 03/2003 Economic And Trade Sanctions Condition G145658A 11/2003 Exclusion - Silica i CG03;00 01/1996 Deductible Liability Insurance s G15104A 10/1989 Employee Benefits Liability Supplemental Schedule G15115A 10/1989 Changes-Notice-Cancellation or Material Cov Change G186.52J 07/2012 Contractors General Liability Extension Endt G22614A 12/1994 Stop Gap Liability Coverage Endorsement G300250A 02/2006 Exterior Finish System Prod/Comp Ops Exclusion G43316C 06/1998 Exclusion - Asbestos G43815C 08/2001 Employee Benefits Liability Coverage G55157B 02/1988 Premium Bases IL0003 09/2007 Calculation of Premium IL0146 08/2010 Common Policy Conditions IL0198 09/2000 Nuclear Energy Liability Excl Endt. (Broad Form) *** PLEASE READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY *** Form Number Form Title G144246F 12/2007 Notice-Offer/Reject Terrorism Premium Disclosure G145041A 05/2003 IMP INF Economic And Trade Sanctions Condition G44126B 11/2004 Imp Info For Insureds Who Hire Subcontractors 4 Countersignature lk.! • � .�/� SsctetarY Chairman of the Board P-55170-A (Ed. 01/86) INSURED Page 5 of 5 CNA National Utility Contractors Association Business Auto Renewal Declaration POLICY NUMBER COVERAGE PROVIDED BY FROM - POLICY PERIOD - TO U 2053866318 AMERICAN CASUALTY CO OF READING,PA 10/01/2013 10/01/2014 333 S. WABASH CHICAGO, IL. 60604 INSURED NAME AND ADDRESS NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 9 B 3 7 3 REFER TO NAMED INSURED SCHEDULE AGENCY NUMBER AGENCY NAME AND ADDRESS 065944 PROPEL INSURANCE 1201 PACIFIC AVE, #1 PO BOX 2940 (98401) TACOMA, WA 98402 Phone Number: (253) 759-2200 BRANCH NUMBER BRANCH NAME AND ADDRESS 050 SEATTLE BRANCH 999 THIRD AVENUE, STE 2500 SEATTLE, WA 98104 Phone Number: (206) 587-2600 This policy becomes effective and expires at 12:01 A.M. standard time at your mailing address on the dates shown above. The Named Insured is a Corporation. Your policy is composed of this Declarations, with the attached Common Policy Conditions, Coverage Forms, and Endorsements, if any. The Policy Forms and Endorsement Schedule shows all forms applicable to this policy at the time of policy issuance. The Estimated Policy Premium is Audit Period is Annual In return for the payment of the premium, and subject to all the terms and conditions contained here-in, we agree to provide the insurance as stated. INSURED Page 1 of 12 POLICY NUMBER INSURED NAME AND ADDRESS U 20S3866318 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 ITEM TWO Schedule Of Coverages and Covered Autos This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those "autos" shown as covered "autos" . "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the Covered Auto Section of the Business Auto Coverage Form next to the name of the Coverage. COVERED COVERAGES AUTO SYMBOL LIMIT PREMIUM Liability 1 $1, 000,000 $372,464 Personal Injury 5 Separately Stated In Each INCLUDED Protection (Or Personal Injury Protection Equivalent No-Fault Endorsement. Coverage) Added Personal Injury Separately Stated in Each Protection (Or Added Personal Injury Equivalent Added No-Fault Protection Endorsement. Coverage) Property Protection Separately Stated In The Insurance Property Protection (Michigan Only) Insurance Endorsement, Auto Medical Payments $5, 000 INCLUDED Included Medical Expense and Separately Stated in The Income Loss Benefits Medical Expense and Income (Virginia Only) Benefits Endorsement. Uninsured Motorists 2 See Endorsement INCLUDED Underinsured Motorists 2 See Endorsement INCLUDED (When Not Included In Uninsured Motorist Coverage) INSURED Page 2 of 12 POLICY NUMBER INSURED NAME AND ADDRESS U 2053866318 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 ITEM TWO Schedule Of Coverages and Covered Autos (Cont'd) COVERED COVERAGES AUTO SYMBOL LIMIT PREMIUM 3 Actual Cash Value or Cost Of $1,932 Physical Damage Repair, Whichever is Less, Minus Comprehensive $5OO Deductible for Coverage Each Covered Auto, But no Ded- uctible Applies to Loss Caused By Fire Or Lightning. See Item Four For Hired or Borrowed Autos. 4,, 8 Actual Cash Value or Cost Of $5,523 Physical Damage Repair, Whichever is Less, Minus Specified Deductible for Causes of Loss Each Covered Auto For Loss Coverage Caused By Mischief Or Vandalism. See Item Four For Hired or Borrowed Autos. 3, 8 Actual Cash Value or Cost Of INCLUDED Physical Damage Repair, Whichever Is Less, Minus Collision $500 Deductible for Coverage Each Covered Auto. See Item Four For Hired or Borrowed Autos. Physical Damage For Each Disablement of Towing and Labor A Private Passenger Auto. Premium for Endorsement: Included Estimated Total Premium: INSURED Page 3 of 12 POLICY NUMBER INSURED NAME AND ADDRESS U 2053866318 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 ITEM FOUR: SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMS LIABILITY COVERAGE —COST OF HIRE RATING BASIS (OTHER THAN MOBILE OR FARM EQUIPMENT) ESTIMATED COST LIABILITY OF HIRE FOR STATES COVERAGE ALL STATES PREMIUM WA Excess Coverage IF ANY Included Total Premium Included Cost of hire means the total amount you incur for the hire of "autos" you don't own (not including 'autos' you borrow or rent from your partners or "employees" or their family members) . Cost of hire does not include charges for services performed by motor carriers of property or passengers. INSURED Page 4 of 12 POLICY NUMBER INSURED NAME AND ADDRESS U 2053866318 NORTHWEST CASCADE INC. PO BOX 73399 PUYALLUP, WA 98373 NAMED INSURED SCHEDULE INCLUDES THE FOLLOWING_ENTITIES- NWC#1 FLOHAWKS NWC #5 PARTNERSHIP, LLC GOTTA GO PORTABLES MDP MERIDIAN LLC NCS WASTEWATER SOLUTIONS CASCADE SYSTEM MANAGEMENT DRAINS PLUS NORTHWEST CASCADE INC_ DBA HONEY BUCKETS INSURED Page 10 of 12 U 2053866318 NORTHWEST CASCADE INC..�r PO BOX 73399 PUYALLUP, WA 98373 FORMS AND ENDORSEMENTS SCHEDULE 4 i FORM NUMBER FORM TITLE G56015B 11/1991 DESIGNATED INSURED CA2048 G56015B 11/1991 WAIVER OF SUBROGATION CA0440 G560153 11/1991 MEDICAL PAYMENTS G56015B 11/1991 COMPOSITE RATE ENDORSEMENT CA0001 03/2`010 Business Auto Coverage Form CA0051 12/2004 Changes in Coverage Forms - Mobile Equipment CA0118 11/2000 Idaho Changes CA0123 10/2011 South Dakota Changes CA0135 01/2008 Washington Changes CA0149 01/2010 Oregon Changes CA0159 03/2010 Utah Changes CA0240 03/2010 Suspension of Insurance CA0301 03/2010 Deductible Liability Coverage CA0302 03/2010 Deductible Liability Insurance CA0444 03/2010 Waiver of Transfer Rights of Recovery CA2001 03/2006 Additional Insured - Lessor CA2048 02/1999 Designated Insured CA2054 10/2001 Employee Hired Autos CA2105 01/2010 Oregon Uninsured Motorists Coverage-Bodily Injury CA2134 01/2008 Washington Underinsured Motorists Coverage CA2141 03/2006 South Dakota Uninsured Underinsured Motorists CA2162 10/2010 Utah Uninsured Motorists Coverage CA2236 01/2010 Oregon Personal Injury Protection CA2244 03/2006 Utah Personal Injury Protection CA.2263 09/1994 Utah PIP - Exclusion of Loss of Income Benefits CA3106 10/2010 Utah Underinsured Motorists Coverage CA3115 03/2006 Idaho Uninsured Motorists Coverage CA3118 11/2011 Idaho Underinsured Motorists Coverage CA9903 03/2006 Auto Medical Payments Coverage CA9910 03/2010 Drive Other Car Broadened Coverage for Named Indiv CA9944 12/1993 Loss Payable Clause CA9989 05/2001 Washington Loss Payable Form Reg - 335 G144291A 03/2003 Economic And Trade Sanctions Condition G147207B 04/2006 Washington Named Driver Exclusion G21578B 05/2008 Broadened Pollution Liability Coverage G22454A 10/1994 Broadened Pollution Liability Schedule G89001E 05/2007 Composite Rate Endorsement IL0003 09/2007 Calculation of Premium IL0142 09/2008 Oregon Changes - Domestic Partnership IL0146 09/2001 Common Policy Conditions IL0198 09/2000 Nuclear Energy Liability Excl Endt. (Broad Form) { *** PLEASE. READ THE ENCLOSED IMPORTANT NOTICES CONCERNING YOUR POLICY *** FORM NUMBER FORM TITLE �-` G118177A 02/1996 Important Information-Idaho Uninsured/Underinsured G138878A 08/2000 Important Information G142630A 05/2002 Imp. Info.- For Our Commercial Auto Policyholders G145041A 05/2003 IMP INF Economic And Trade Sanctions Condition 5 INSURED Page 11 of 12 i i/D tl\ EVANSTON INSURANCE COMPANY MARKET ENVIRONMENTAL COMMON POLICY DECLARATIONS THIS POLICY MAY PROVIDE CLAIMS-MADE COVERAGE. PLEASE READ THE ENTIRE POLICY CAREFULLY TO DETERMINE YOUR RIGHTS AND DUTIES AND WHAT IS AND IS NOT COVERED. POLICY NUMBER: 14CPLOWE00228 RENEWAL OF POLICY: NEW Named Insured and Mailing Address(No.,Street,Town or City,County,state,Zip Code) NORTHWEST CASCADE, INC. PO BOX 73399 PUYALLUP,WA 98373 Policy Period: From 01/27/2014 to 10/01/2014, at 12:01 A.M. Standard Time at your mailing address shown above, Form of Business: ❑ Individual ❑ Partnership ❑Joint Venture ❑Trust ❑ Limited Liability Company ® Organization, including Corporation (but not incl. Partnership, Joint Venture or LLC) IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. Coverac le is provided for the following only if indicated with an X: Claims Made Occurrence Premium Commercial General Liability NOT COVERED Products-Completed Operations Liability ❑ Monoline Coverage) El ❑ NOT COVERED Contractor's Pollution Liability ❑ 0 Included ❑ Professional Liability NOT AVAILABLE NOT COVERED Environmental Impairment Liability NOT AVAILABLE NOT COVERED ❑ Terrorism Risk Insurance Act RIA): EXCLUDED Advance And Deposit Premium: Other Charge (Specify): NOT APPLICABLE $0.00 Other Charge (Specify): NOT APPLICABLE $0.00 Inspection Fee (100% Fully Earned): $0.00 TOTAL(including all charges): Minimum Retained.Premium: 1 25% Producer Number, Name and Mailing Address 65700 "This Contract is registered and delivered as a Worldwide Facilities, Inc. -Seattle surplus line coverage under the insurance code of the state of Washington, Title 48 RCW. It is not 601 Union Street Suite 1630 protected by any Washington state guaranty Seattle, WA 98101 association law." WORLDWIDE FACILITIES,INC.-WAOIC#116180 V S vpdu�s Lines Tar.&Fees(Pol Err 7/1/11+) Erik Lindquist Premium: Company Fee. MDEI 2004 05 13 Broker/Filing Fee: $ Page 1 of 2 Inspection Fee: $ _ 2%State Tax: $ + .10%Stamping Fee: $ Combined General Aggregate Limit Of Insurance $11 000,000 The Amount shown in the schedule above is the most we will pay under any/all coverage parts attached to this policy Audit Period (Indicated by an X): ❑Annual ❑ Semi-Annual ❑Quarterly ❑ Monthly ❑ Other Z Flat Endorsements Forms and Endorsements applying to this Coverage Part and made part ofthispolicy at time of issue: See Forms Schedule MDIL 1001 These declarations, together with the General Terms and Conditions, Coverage Form Declarations, Coverage Form(s), and any Endorsements(s) complete the above numbered policy. 02/20/2014 Countersigned By Countersignature Date MDEI 2004 05 13 Page 2 of 2 INTERLINE off POLICY NUMBER: 14CPLOM00228 MARKEC EVANSTON INSURANCE COMPANY FORMS SCHEDULE Form Number Form Name MJIL 1000 08 10 Evanston Jacket MDEI 2000 06 12 Emergency Response Hotline MPGL 2001 01 14 Notice To Policyholders Potential Restr re TRIA MPIL 1007 04 10 Privacy Notice MDEI 2004 05 13 CA Environmental Common Policy Declaration MDIL 1001 08 11 Forms Schedule MEEI 2700 05 13 General Terms and Conditions Section MEIL 1225 10 11 Changes-Civil Union IL 12 01 11 85 Named Insured Endt MEEI 2206 04 11 Minimum Earned Prem&Minimum Retained Prem Endt MEEI 2210 08 10 Punitive Damages Exclusion Modification MEEI 2211 08 10 Waiver Of Transfer Of Rights Of Recovery MEEI 2274 05 11 Automatic Primary& NonContributory Insurance MEIL 1200 01 10 Service of Suit MEIL 1308 05 13 Exclusion Of Certified Acts Of Terrorism MEIL 1320 11 13 Application Warranty MEIL 1322 01 14 Conditional Exclusion Of Terrorism Re TRIA MDEI 2002 07 13 Contractors Pollution Liability Supplemental Dec MEEI 0002 06 12 Contractor's Pollution Liability Coverage Form MEEI 2221 09 13 Transp Pollution Liab (1st&3rd Party Vehicles) MEEI 2244 08 10 Non-Owned Disposal Site - Blanket Basis- OCC Form MEEI 2271 07 11 Fungi, Mold,or Microbial Matter Coverage MDIL 1001 08 11 Page 1 of 1 CNA 333 S Wabash Chicago,Illinois 60604 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY INFORMATION PAGE - RENEWAL OF WC 2 93635362 Policy Number From Policy Period To Coverage Is Provided By Agency j WC 2 93635362 10/01/13 10/01/14 CONTINENTAL CASUALTY CO 1065944050 Named Insured And Address Agent ITEM NORTHWEST CASCADE INC'. PROPEL INSU32ANCE 1. PO BOX 73399 1201 PACIFIC AVE, #1 PUYALLUP, O: BOX '2940 (96401) QMi 98402 98373 FEIN NUMBER: 911002132 NCCI CARRIER CODE NO: 10243 INTERSTATE ID NO: 911002132 OTHER WORK PLACES NOT SHOWN ABOVE: SEE ATTACHED SCHEDULE(S) YOU ARE A - CORPORATION/S 2. POLICY PERIOD- 10/01/13 TO 10/01/14 12:01 AM STANDARD TIME AT THE INSUREDS MAILING ADDRESS. i 3A. PART ONE OF THIS POLICY APPLIES TO THE WORKERS COMPENSATION LAW AND ANY OCCUPATIONAL DISEASE LAW OF EACH OF THE STATES LISTED HERE: AZ,GA, I D,IN,MD,MT,NV,OR,SC,UT,VA,AK. 3B. PART TWO OF THIS POLICY -APPLIES TO ] NtPLOY8RS LIABILITY INSURANCE 00A 'WORK° IN EACH STATE LISTED IN ITEM 3A: THE LIMITS OF LIABILITY ARE: BODILY INJURY BY ACCIDENT $1,000,'D00 EACH ,ACCIDENT BODILY INJURY BY DISEASE $1,000,000 POLICY LIMIT BODILY INJURY BY DISEASE $1, 000,000 EACH EMPLOYEE 3C. PART THRE$ OF THIS POLICY APPLIES TO OTHER STATES, IF ANY, LISTED HERE: ALL STATES EXCEPT CA, ND, OH, WA, WY, f AND 'STATES LISTED IN ITEM 3A OF T'HE INFORMATION PAGB 3D. THIS POLICY INCLUDES THESE ENDORSEMENTS AND SCHEDULES: SEE ATTACHED SCHEDULES -_ - - _ -- ------------ --------------------------__ 4. THE PREMIUM FOR THIS POLICY WILL BE DETERMINED BY OUR MANUAL OF RULES, CLASSIFICATIONS, RATES, AND RATING 'iPLANS ALL INFORMATION R$QUIRED' BEwW IS SUBJECT TO VERIFICATION AND CHANGE BY AUDIT. ADJUSTMENT OF PREMIUM SHALL BE MADE: AT POLICY EXPIRATION CLASSIFICATION OF OPERATIONS EST ANNUAL PREMIUM SEE ATTACHED PREMIUM DISCOUNT EXPENSE CONSTANT TERRORISM PREMIUM CATASTROPHE (O/T CERT ACTS OF TERROR) Lei MINIMUM PREMIUM $1,120 TOTAL ESTIMATED ANNUAL PREMIUM TOTAL STATE tAXESfASSESSMENTS/SURd1ARGES TOTAL ESTIMATED COST i� DEPOSIT PREMIUM $141,275 ACCOUNT NUMBER: 3001802614 DATE OF ISSUE: 10/14/13 _ POLICY ISSUING OFFICE: SEATTLE COUNTERSIGNED BY DATE AUTHORIZED AGENT WC000001 P-33398-E (ED. 6/87) TINT CTTTJ t;n CNA 333 S Wabash Chicago, Illinois 60604 STANDARD WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY INFORMATION PAGE - RENEWAL OF WC 2 93635362 Policy Number From Policy Period To Coverage Is Provided By Agency WC 2 93635362 . 10/01/13 10/01/14 CONTINENTAL CASUALTY CO 1065944050 Named Insured And Address Agent NORTHWEST CASCADE INC. PROPEL INSURANCE PO BOX 73399 1201 PACIFIC AVE, #1 PUYALLUP, WA PO BOX 2940 (98401) ACOMA WA 98402 98373 ** E N D 0 R S E M E N T S C H E D U L E ** SCHEDULE PAGE 1 NUMBER DESCRIPTION EDITION DATE G124506A VIRGINIA ESTIMATED PREMIUM AUDITS 03/97 G35224B COVERAGE B - INCREASED LIMIT OF LIABILITY 03/84 QUICKREF TABLE OF CONTENTS 06/96 WC000000B COVERAGE PART 07/11 WC000106A IONGSHOREMENS AND HAR3OR WORKERS. ACT COVERAGE 04/92 WCGO0313 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDT. 04/84 WC000406A PREMIUM DISCOUNT ENDORSEMENT 08/95 WC000414 NOTIFICATION OF CHANGE IN OWNERSHIP ENDORSEMENT 07/90 WC000419 PREMIUM DUE DATE ENDORSEMENT 01/01 WC000421C CATASTROPHE (O/T CERT ACTS OF TERRORISM) PREM ENDT 09/08 WC000422A TERRORISM RISK INS PGM RE-AUTH ACT DISCLOSURE ENDT 09/08 WCO20601 ARIZONA CANCELLATION ENDORSEMENT 05/86 WC100402 GA NON-COOPERATION WITH PREMIUM AUDIT ENDT 01/13 WC100601A GEORGIA CANCELATION NONRENEWAL AND CHANGE ENDT 04/93 WC190401 MARYLAND CONSTRUCTION REDUCTION PROGRAM 07/93 WC190601F MD CANCELLATION AND NONRENEWAL ENDORSEMENT 01/09 WC250305 MT INTENTIONAL INJURY EXCLUSION ENDORSEMENT 07/02 WC250601A MONTANA CANCELATION AND NON-RENEWAL ENDORSEMENT 10/03 WC250602 MONTANA SAFETY ENDORSEMENT 01/94 WC270601C NEVADA CANCELLATION AND N€7NRENEWAL ENDORSEMENT 10/08 WC360306 OREGON LIMITS OF LIABILITY ENDORSEMENT 01/02 WC360402 OREGON CONTRACTING CLASS PREMIUM ADJUSTMENT 01/91 WC360406 OREGON PREMIUM DUE DATE ENDORSEMENT 10/01 DATE OF ISSUE: 10/14/13 POLICY ISSUING OFFICE: SEATTLE WC000001 P-33398-E (ED. 6/87) TTNTCTTD L'n EXCESS LIABILITY DECLARATIONS Starr Surplus Lines Insurance Company Chicago, IL Administrative Office` 399 Park Avenue, 8m Floor, New York, NY 10022 POLICY NUMBER: 1000020409 RENEWAL OF: NEW PRODUCER NAME: Swett&Crawford Group ADDRESS: 515 South Figueroa Street, Los Angeles, CA 90017 0 ITEM 1. NAMED INSURED: Northwest Cascade Inc. ADDRESS: PO Box 73399, Puyallup,WA 98373 ITEM 2: POLICY PERIOD: FROM 1010112013 TO 1 0101/201 4 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE NAMED INSURED SHOWN ABOVE. ITEM 3. COVERAGE: Commercial Excess Liability ITEM 4. LIMITS OF INSURANCE: The Limits of Insurance, subject to all the terms of this Policy, are: A. $5,000,000 Each Occurrence B. $5,000,000 Other Aggregate(s),Where Applicable C. $5,000,000 Products-Completed Operations Aggregate ITEM 5. "UNDERLYING INSURANCE" A. First Underlying Insurance Policy(ies) Insurer Policy No. Policy Period See attached Schedule of Underlying Insurance B. Additional Underlying Insurance Policy0es) Insurer Policy No. Policy Period ITEM 6. POLICY PREMIUM: Advanced PremiumMinimum Premium Minimum Earned Premium >. N/A Estimated Exposure Rate Per Audit Period N/A N/A N/A This contract is registered and delivered as a surplus line coverage under the insurance code of the state of Washington,Title 48 RCW. It is not protected by any Washington sate guaranty association la - SL - 101 -D (10108) Name of Surplus Lines Broker. Michael Hamby Page 1 of Copyright©C.V.Starr&Company and Starr Surplus Lines Insurance Company. All rights reserved. Includes copyrighted material of ISO Properties. Inc.,used with its permission. ITEM 7. NOTICES Send all Excess Casualty Loss Notices to. In the event of an accident, occurrence,wrongful act, claim or FARA suit, that is reasonably likely to involve 1625 West Causeway Approach this Policy, send all pertinent facts to: Mandeville, LA 70471 claimopening(cDfara.com FAX: (877)297-9272 After hours emergency service call: (800)666-3439 ITEM 8. ENDORSEMENTS ATTACHED: Title Form Number Excess Liability Declarations SL 101 D 10 08 Excess Liability Policy Schedule Of Underlying Insurance SL 102 10 08 Excess Liability Policy Form SL 100 10 08 Continuing Or Progressively Deteriorating Damages Endorsement SL 134 10 08 EIFS Exclusion SL 149 10 08 Employment Related Practices Exclusion SL 154 10 08 Lead Exclusion SL 174 10 08 Pollution Exclusion (Total Exclusion) SL 198 10 08 Specified Operations Exclusion SL 222 10 08 Wrap-Up And Joint Venture Exclusion SL 236 10 08 Washington Changes-Conditions SL 301 WA 10 08 Washington-Auto Coverage Exclusion Of Terrorism SL 341 WA 10 08 Washington - Exclusion of Terrorism SL 346 WA 01 09 Service of Suit Endorsement(All States Except CA, IL, DE) SL 704 08 10 Starr Companies Excess Liability Program Claim Reporting Form SL CLAIMS NOTICE The foregoing discloses all hazards insured hereunder known to exist at the inception date of this Policy, unless otherwise stated herein by endorsement on this Policy. COUNTERSIGNED 10/04/2013 BY ilAg DATE AUTH ZED REPRESENTATIVE SL -101 -D (10f08) Page 2 of 2 Copyright v C.V.Starr&Company and Starr Surplus Lines Insurance Company. All rights reserved. Includes copyrighted material of ISO Properties,Inc.,used with its permission. * Starr Surplus Lines Insurance Company Chicago, IL 1-646-227-6300 Excess Liability Policy Schedule of Underlying Insurance Policy Number. 1000020409 Effective Date:10/01/2013 Named Insured:Northwest Cascade Inc. Issuing Company: Starr Surplus Lines Insurance Company The Declarations, Schedule(s), and all terms and conditions complete this insurance Policy. Type of Policy or Coverage and Insurer,Policy Number and Policy Period Limits of Insurance A. First Underlying Insurance Policy(ies) Carrier: National Fire Insurance of Hartford Policy No.: 2053866352 Limits.- Coverage: GENERAL LIABILITY $1,000,000 Each Occurrence Limit Policy Period: 10/01/2013 to 1 010 1/20 1 4 $2,000,000 General Aggregate Limit $2,000,000 Products/Comp.Ops.Aggregate Limit Carrier: American Casualty Company Of Reading, PA Policy No.: 2053866318 Limits: Coverage: AUTO LIABILITY $1,000,000 Combined Single Limit Policy Period: 10/01/2013 to 10/01/2014 SL - 102(10/08) Page 1 of 2 Copyright©C.V.Starr&Company and Starr Surplus Lines Insurance Company. Ali rights reserved. Includes copyrighted material of ISO Properties,Inc.,used with its permission. LETTER OF TR ° UVSW( TALC CNW NORTHWEST CASCADE INC DATE June 30, 2014 P.O. BOX 73399, PUYALLUP.WA 98373 r a/ TACOMA(253)848-2371 /TOLL FREE 800-444-2371 RE Sunset Community LID TO NORTHC1148BG SWP-27-3635 and WTR-27-3635 City of Renton NWC # 3929 1055 S Grady Way Renton, WA 98057 RECEIVED WE ARE SENDING YOU Attached Under separate cover via the following items: .JUL O l 2014 Proposal and Contract copy of Letter Prints =Plans =Specifications Subcontract Change Order Sewage Disposal System"As Built" CITY OF RENTON Certificate of Insurance Check n UTILITY SYSTEMS EMS COPIES DATE NO. DESCRIPTION 2 Contracts - Signed 2 MBE/WBE Subcontractors List - Signed 2 Retainage Selection - Signed 2 Bond #09163755 - Signed 2 Affidavit of Compliance - Signed 2 Insurance Certificates THESE ARE TRANSMITTED as checked below: For Approval For Review and Comment =For Signature For Your Use Approved as Noted =Return Original 7As Requested Returned for Corrections Return copy(ies) n REMARKS COPY TO Thank you, SIGNED:If enclosures are not as noted,kindly notify us at once. Janet Preston x4406 Page 1 of 2 MINORITY BUSINESS/WOMEN BUSINESS ENTERPRISE SUBCONTRACTORS LIST Sunset Community Low Impact Development Retrofit Stormwater Green Connection: Harrington Ave NE and Harrington Ave NE Water Main Replacement Project SWP-27-3635, WTR-27-3635 All bidders are encouraged to utilize certified minority-owned and women-owned businesses to the extent possible in the performance of this contract. All prospective bidders or persons submitting qualifications should take the following steps, when possible. 1. Include qualified minority and women's businesses on solicitation lists. 2. Assure that qualified minority and women's businesses are solicited whenever they are potential sources of service or supplies. 3. Divide the total requirements, when economically feasible, into smaller task or quantities to permit maximum participation by qualified minority and women's businesses. 4. Establish delivery schedules, where work requirements permit, which will encourage participation of qualified minority and women's businesses. 5. Use the services and assistance of the State Office of Minority and Women's Business Enterprise (OMWBE) and the Office of Minority Business Enterprise of the U.S. Department of Commerce, as appropriate. If the subcontractors names are not submitted with the bid, OR if two or more subcontractors are named to perform the same work, then the bid shall be considered nonresponsive and; therefore, void. Complete the following: If awarded the contract,V�004MET Ohy,1 KE,JJC. will contract with the following minority- owned businesses and women businesses subcontractors for the performance of bid items associated with this contract: Bid Item (s) Subcontractor Name Address Phone No. State Contractor's License No. Bid Item (s) Subcontractor Name Address Phone No. State Contractor's License No. Bid Item (s) Subcontractor Name Address H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-3635 Sunset Community Plan SSIP\1600 Bid Package\11- Subcontractor List-2006.doc Page 2 of 2 Phone No. State Contractor's License No. Bid Item (s) Subcontractor Name Address Phone No. State Contractor's License No. Bid Item (s) Subcontractor Name Address Phone No. State Contractor's License No. Bid Item (s) Subcontractor Name Address Phone No. State Contractor's License No. igna of ut rized Representative of Bidder Subscribed and sworn to be before me on this day of 20] . Sonda Johnson Notary Public in and for Notary Public the State of Washington State of Washington Notary (Print) SOVO& \6y1,5M My Comm.Expires 11 /22/2017 Residing at �116ov►'l k My appointment expires: 2 H:\File Sys\SWP-Surface Water Projects\SWP-27-Surface Water Projects(CIP)\27-3635 Sunset Community Plan SSIP\1600 Bid Package\11- Subcontractor List-2006.doc