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HomeMy WebLinkAboutWTR2703604BID BOND FORM Herewith find deposit in the form of a certified check, cashier's check, cash, or bid bond in the amount of S which amount is not less than five percent of the total bid. Signature Know All Men by These Presents: That we, B&B utilities and Excavating, LLC as Principal, and Farmington Casualty Company as Surety, are held and firmly bound unto the City of Renton, as Obligee, in the penal sum of F_ve Percent (5%) of Total Amount Bid Dollars, for the payment of which the Principal and the Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, by these presents. The condition of this obligation is such that if the Obligee shall make any award to the Principal for SE 51h Street AC Water Main Replacement Project according to the terms of the proposal or bid made by the Principal therefor, and the Principal shall duly make and enter into a contract with the Obligee in accordance with the terms of said proposal or bid and award and shall give bond for the faithful performance thereof, with Surety or Sureties approved by the Obligee; or if the Principal shall, in case of failure to do so, pay and forfeit to the Obligee the penal amount of the deposit specified in the call for bids, then this obligation shall be null and void; otherwise it shall be and remain in full force and effect and the Surety shall forthwith pay and forfeit to the Obligee, as penalty and liquidated damages, the amount of this bond. SIGNED, SEALED AND DATED THIS 1st DAY OF May 20 B&B utilities and Excavating, LLC Principal /1 Farmington Casualty Company C '!/' �1/y� /►,_ Surety Theresa A. Lamb, Attorney -in -Fact Received return of deposit in the sum of S 3604_09_bidbd.dacl Page 12 Bid Bond Form Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER AW POWER OF ATTORNEY TRAVELERSJ Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company Attorney -In Fact No. 224156 Certificate No. 004608819 KNOW ALL MEN BY THESE PRESENTS: That St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company and St. Paul Mercury Insurance Company are corporations duly organized under the laws of the State of Minnesota, that Farmington Casualty Company, Travelers Casualty and Surety Company, and Travelers Casualty and Surety Company of America are corporations duly organized under the laws of the State of Connecticut, that United States Fidelity and Guaranty Company is a corporation duly organized under the laws of the State of Maryland, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Darlene Jakielski, Julie M. Glover, M.J. Cotton, Nancy J. Osborne, S.M. Scott, Steven K. Bush, Michael A. Murphy, Jim W. Doyle, Brandon K. Bush, Andy D. Prill, Jim S. Kuich, Chad M. Epple, Steve Wagner, Theresa A. Lamb, Brett N. Meier, and Ellen M. Bell of the City of Bothell , State of Washington , their true and lawful Attomey(s)-in-Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this day of October 2011 Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. St. Paul Fire and Marine Insurance Company St. Paul Guardian Insurance Company 26th St. Paul Mercury Insurance Company Travelers Casualty and Surety Company Travelers Casualty and Surety Company of America United States Fidelity and Guaranty Company G I. SnUnq �ytiTY ty ,IRE i iYt6�9V,Oy1p9P.•_8.Y2'�bY•JTLsc0 + 'i� i109p°a77*r� I4CjQ4PORA7r0G' !;iea iJs�,`RANCT•~` z Gf.sr�:m f 'lij�WJ4'J.cp i 1o•4 f �YY7 '8Y9'V6:1 CFD `�+;•..-.. '?+ �Yt ',•�� f • �� AtN State of Connecticut City of Hartford ss. By: Georg Thompson, nior Ice President On this the 26th day of October 2011 before me personally appeared George W. Thompson, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. In Witness Whereef. I hereunto set my hand and official seal.UOAlLirz— My Commission expires the 30th day of June, 2016. Marie C.Tetreault, Notary Public 58440-6-11 Printed in U.S.A. WARNING: THIS POWER OF ATTORNEY IS RED BORDER WARNING THIS POWER OF ATTORNEY IS INVALID WITHOUT This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary, of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which is in full force and effect and has not been revoked. .l IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this = 4 7 day of 20. Kevin E. Hughes, Assistant Sec tary 2 GASefUe.���` JyF\RE 64' C�T11• �MfG9 �/.+JpY.1NSU/J,'L 4 ,11 ANp S` �W'O EUgFIY �\Q Y C �f O �' ea • � 9 �' •.♦ fvi: .. A NCLCFgRktFD� i �t ����S�Tf m iW:'CApPORATf Cu a i $/Z 10M. 0NarrrwR�, ' ^^"T�h4/� � �' 1�g88°'m ji of CONN. %SSy 1951,,� SEALioIo:� 1 ,r� bra tip, �d 1� `~��n Ncc o �d�.........�a'�' o.'•... :�;a" W-,6 yec �f v'+"� �1 ,�+ Jr..� To verify the authenticity of this Power of Attorney, call 1-800-421-3880 or contact us at www.travelersbond.com. Please refer to the Attorney -In -Fact number, the above -named individuals and the details of the bond to which the power is attached. WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOLITTHE RED BORDER CITY OF RENTON PROPOSAL, COMBINED AFFIDAVITS, NON COLLUSION AFFIDAVIT, ASSIGNMENT OF ANTI-TRUST CLAIMS TO PURCHASER AND MINIMUM WAGE AFFIDAVIT & CERTIFICATION FORM SE 5th STREET AC WATER MAIN REPLACEMENT PROJECT NO. WTR-27-3604 TO THE CITY OF RENTON RENTON, WASHINGTON Ladies and/or Gentlemen: The undersigned hereby certify that the bidder has examined the site of the proposed work and have read and thoroughly understand the plans, specifications and contract governing the work embraced in this improvement, and the method by which payment will be made for said work, and hereby propose to undertake and complete the work embraced in this improvement, or as much thereof as can be completed with the money available, in accordance with the said plans, specifications and contract and the following schedule of rates and prices: Note: Unit prices for all items, all extensions, and total amount of bid should be shown. Show unit prices both in writing and in figures. The undersigned certifies and agrees to the following provisions: NON -COLLUSION AFFIDAVIT Being duly sworn, deposes and says, that he is the identical person who submitted the foregoing proposal or bid, and that such bid is genuine and not sham or collusive or made in the interest or on behalf of any person not therein named, and further, that the deponent has not directly induced or solicited any other Bidder on the foregoing work or equipment to put in a sham bid, or any other person or corporation to refrain from bidding, and that deponent has not in any manner sought by collusion to secure to himself or to any other person any advantage over other Bidder or Bidders. AND CERTIFICATION RE: ASSIGNMENT OF ANTI-TRUST CLAIMS TO PURCHASER Vendor and purchaser recognize that in actual economic practice overcharges resulting from anti- trust violations are in fact usually borne by the purchaser. Therefore, vendor hereby assigns to purchaser any and all claims for such over -charges as to goods and materials purchased in connection with this order or contract, except as to overcharges resulting from anti-trust violations commencing after the date of the bid, quotation, or other event establishing the price under this order or contract. In addition, vendor warrants and represents that such of his suppliers and subcontractors shall assign any and all such claims to purchaser, subject to the aforementioned exception. 0ZI7 3604_ 1 O_prop.doc\ Page 13 Proposal, Combined Affidavits, Non Collusion Affidavit, Assignment of Anti -Trust Claims to Purchaser and Minimum Wage Affidavit & Certification Form Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale MINIMUM WAGE AFFIDAVIT FORM I, the undersigned, having been duly sworn, deposed, say and certify that in connection with the performance of the work of this project, I will pay each classification of laborer, workman, or mechanic employed in the performance of such work; not less than the prevailing rate of wage or not less than the minimum rate of wages as specified in the principal contract: that I have read the above and foregoing statement and certificate, know the contents thereof and the substance as set forth therein is true to my knowledge and belief. FOR: PROPOSAL, NON COLLUSION AFFIDAVIT, ASSIGNMENT OF ANTI-TRUST CLAIMS TO PURCHASER AND MINIMUM WAGE AFFIDAVIT B & B Utilities and Excavating, LLC Name of Bidder's Firm Printed Name r_,l 1 �, �� �'. l.L �� (� L ( Signature Address: ' Names of Members of Partnership: OR Name of President of Corporation l_ �_. C Name of ySecretaiv of Corporation-r l E 1 Corporation Organized under the laws of ` \_ With Main Office in State of Washington at Subscribed and sworn to before me on this - day of , , 20 ; �. J�►�,r�5\ON �A otar ' Publicfor the State of Washington 40 �p�LaC gEotaryl(Print) �'��� .1 �,t t_'t i V- Lil '•9��`QF fps ��♦�� My appointment expires: 01111111111�1, 3604_10_prop.doc\ Page 14 Minimum Wage Affidavit Form Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale CITY OF RENTON PUBLIC WORKS DEPARTMENT SCHEDULE OF PRICES 2009 EARLINGTON WATER AND SEWER MAIN IMPROVEMENTS 'Note: Show price per unit in figures only. Figures written to the right of the dot (decimal) in the price per unit column shall be interpreted as cents. SEE SECTION 1-09.14 OF THE SPECIAL PROVISIONS FOR INFORMATION ON BID ITEMS. ITEM ITEM WITH UNIT PRICED BID APPROX. UNIT PRICE TOTAL AMOUNT NO. QUANTITY Dollars Cents Dollars Cents Mobilization, Demobilization, Site Preparation & Clean-up 1 May not be more than ten percent (10%) of the total amount of the bid. Lump Sum Per Lump Sum z c' Cxx:�) Cv 2 Traffic Control 1 3vC c% c Lump Sum Per Lump Sum ACC c'c' 3 Trench Excavation Safety Systems 1 ZvUv, W Lump Sum Per Lump Sum Z 0(__ U cam: 4 Construction Surveying and Staking 1 Z-c;cc; , c,c Lump Sum Per Lump Sum 2-OCC7 c� 5 As -Built Surveying for Progress Payments and Final As- 1 Z�'2C , C" Builts Lump Sum Per Lump Sum- G'o 6 Temporary Erosion and Sedimentation Control 1 "S0` L-47- Lump Sum Per Lump Sum 1-45 CD r G� 7 Site Specific Potholing 10 5 C - c Each Per Each 8 Furnish and Install 8" CI 52 DI Water Pipe & Fittings w/ (,-( � c"` Polywrap 1,760 c _7 3(-,C, Lineal Foot Per Lineal Foot 9 Furnish and Install 8" Gate Valve Assembly 5 1 cc' - C':% y c Each Per Each 10 Concrete for Thrust Blocking, Dead -Man Anchor Blocks 10 / cu , ('`' ( uc U _ u; Cubic Yard Per Cubic Yard 11 Furnish and Install 16"x8" Wet -Tap Tee & Gate Valve Assembly Each Per Each 12 Furnish and Install Fire Hydrant Assembly 2 �iC)L=L , c,- 0 C0 ; c �= Each Per Each 13 Relocate Existing Fire Hydrant Each Per Each 14 Furnish & Install 3/4" Water Service Connection 35 1 _Y; C: , c 0 y LL c Each Per Each 15 Connection to Existing Water Main 4 Each Per Each 16 Cut, Cap, and Block Existing Water Main 2 -� � Vic• Each I Per Each Page 15 Schedule of Prices Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale CITY OF RENTON PUBLIC WORKS DEPARTMENT SCHEDULE OF PRICES 2009 EARLINGTON WATER AND SEWER MAIN IMPROVEMENTS 'Note Show price per unit in figures only. Figures written to the right of the dot (decimal) in the price per unit column shall be interpreted as cents. SEE SECTION 1-09.14 OF THE SPECIAL PROVISIONS FOR INFORMATION ON BID ITEMS. ITEM ITEM WITH UNIT PRICED BID APPROX. UNIT PRICE TOTAL AMOUNT NO. I QUANTITY I Dollars Cents Dollars Cents 17 Removal and Replacement of Unsuitable Foundation 50 I . (%� Material v. cv Ton Per Ton 18 Select Imported Trench Backfill 800 c 10 Ton Per Ton 19 Crushed Surfacing Top Course and Crushed Rock Backfill 300 " I (-) L.Cv 3 Ton Per Ton 20 2" Temporary Cold Mix Asphalt Trench Patching 150 Ton Per Ton 21 H.M.A. Class Y2" PG 64-22 for Roadway Reconstruction 300 ( I C, C 0 including Crushed Surfacing Top Course Ton Per Ton 22 Removal and Replacement of Concrete Curb and Gutter 200 '? 2 `` /� —1 y�� Lineal Foot Per Lineal Foot 23 Concrete Driveway and/or Sidewalk Restoration 150Square-Yard Per Square -Yard 24 Property & Landscape Restoration 1 C L` ` r Lump Sum 1 Per Lump Sum Subtotal c-- c c 9.5% Sales Tax ZI� Total Page 16 Provided to Builders Exchange of WA, Inc. For usage Conditions Agreement see www.bxwa.com - Always Verify Scale CITY OF RENTON FAIR PRACTICES POLICY AFFIDAVIT OF COMPLIANCE B & B Utilities and Excavating, LLC hereby confirms and declares that: (Name of contractor/subcontractor/consultant) 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 C: t" n , IN/A_ Print Agent/Representative's Title A I _. Sig nature g n�eiii, PLerre..�..�.�� �tnatture S- Z 5 Date Signed instruction:: Ti his document i'vi[JS T1 be completed by each cciitractcr, Subwntraftor, Ceti .cnt and/or gUpot�Er. irc;L1dP or attach -his documetil si widl the contract. �.:1uv=iitT.uti5 uit��$i�iit�S�La'eJcyg'o iluiµ.iw, LQI:.^gS'LS ^r:. �j ,.... ...... ..Y � .....,..... �..-- .'H"4i.•.•v�•,hl1._5v�. _. __ r .�..r ri .Ai --ii r Department of Labor and Industries Certificate of Registration Name on Registration: ?�r� t FK Registration Number: t 1q"CC7 Expiration Date: �( - <<J i ' Note: A copy of the certificate will be requested as part of contract execution when project is awarded. 1:625-052-000 18/1>7) DEPARTMENT OF LABOR AND INDUSTRIES REGISTERED AS PROVIDED BY LAW AS CONST CONTR GENERAL REGIST. # EXP. DATE CC01 BBUTIUE948LN 6/15/2012 EFFECTIVE DATE 6/15/2006 B & B UTILITIES AND EXVTNG LLC PO BOX 293 BOTHELL WA 98041-0293 L-Dewch And Display Certificate f Business License Annual D City of V�Y o Expiration Date o O 01 /31 /2013 1055 South Grady Way Renton, WA 98057 (425) 430-6851 Business Location 23431 45TH AVE SE BOTHELL, WA 98021 B&B UTILITIES AND EXCAVATING LLC 23431 45TH AVE SE BOTHELL, WA 98021 Issued Date: License # 02/01/2012 BL.032377 Licensee has applied for a City of Renton business license in accordance with Renton Municipal Code (the Code), Title V Business, Chapter 5 Business Licenses. The Licensee agrees to comply with all requirements of the Code, as well as State laws and regulations applicable to the business activity licensed. Verify Workers' Comp Premium Status - Employer Liability Certificate Page 1 of 1 Washington State Department of Labor and Industries Department of Labor and Industries Employer Liability Certificate Date: 05/11/2012 UBI #: 602 619 105 Employer Liability Certificate Legal Business Name: B&B UTILITIES AND EXCAVATING LLC Account #: 114,557-00 'Doing Business As' Name: B&B UTILITIES AND EXCAVATING L Estimated Workers Reported: Quarter 1 of Year 2012 "1 to 3 Workers" (See Description Below) Workers' Comp Premium Status: Account is current. Firm has voluntarily reported and paid their premiums. Licensed Contractor? Yes License: BBUTIUE948LN Expire Date: 6/15/2012 Account Representative: T1 / JAN BENTLEY (360)902-4652 -Email: STRO235@lni.wa.gov What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RC 'A,' 51.11050 and 51.16.190). https:Hfortress.wa.gov/lni/crpsi/AcctInfoPrint.aspx?Accountld=l 1455700&AccountManag... 5/ 11 /2012 Kffl=0000010001Weli CITY OF RENTON FAIR PRACTICES POLICY AFFIDAVIT OF COMPLIANCE N�1;� I n5 e4I � nC hereby confirms and declares that: (Name of contra ctor/subcontractor/consv ant) 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; rellglon/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 fir►, 4a/fv Print Agent/Representative's Title ll � Asti.i M/Representative'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. c:\Uocunenu and Att;ngs%aweygandr,Locai Ser.ings\Temporary Internet NNA:. PUBLIC WORKS DEPARTMENT 111111111 1D 70citvof��0� M E M O R A N D U M DATE: June 5, 2012 TO: Colleen Shannon, Human Resources Systems Technician FROM: Andrew Weygandt, Water Utility Civil Engineer, x7208'k SUBJECT: Insurance Review for SE 5th Street AC Main Replacement Project, CAG-12-056 The Water Utility wants to enter into a construction contract with B&B Utilities and Excavating, LLC to construct the SE 5th Street AC Water Main Replacement Project. The contract amount is $296,821.65. Enclosed please find a copy of the Certificate of Liability Insurance with endorsement pages, and the Insurance Information Form with accompanying information submitted by B&B Utilities and Excavating, LLC. Also enclosed is a copy of the contract for your reference. The original of the Certificate of Liability Insurance will be submitted to the City Clerk, upon execution of the contract by the Mayor of the City of Renton. Please review these forms for Risk Management requirements. If you have any questions regarding the agreement or need additional information, please contact me. Thank you for your assistance. �, E Enclosures JUN 0 5 2012 HUMAN t3WAPEA RECEIVE® JUN 1 1 2012 CITY OF RENTON UTILITY SYSTEMS h:\file sys\wtr - drinking water utility\wtr-27 - water project files\wtr-27-3604 se 5th st ac main replacement\bid award and verification\wtr-27-3604 insurance review memo.doc\AWah OP ID: MA ,a►coRO` CERTIFICATE OF LIABILITY INSURANCE `--� DATEYY) 05/24/125/24/12 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 endorsements). PRODUCER 425-489-4500 NAME: CONTACT Hub International Northwest 425-489-4501 P. O. Box 3018 Bothell, WA 98041-3018 Chad Epple PHOAIC.NE Fax E-MAIL o Ext : ADDRESS: PRODUCER CUSTOMER ID #:B8,BUT-1 INSURERS AFFORDING COVERAGE NAIC # INSURED B & B Utilities And Excavating INSURERA:Ohio Security Insurance Co 24082 23431 45th Ave SE Bothell, WA 98021 INSURER B: INSURER C INSURER D : 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 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 LTR I TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR BKS 13 54999316 ( ) 03/23/12 03/23/13 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 X STOP GAP LIABILIT GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER. PRO LOC POLICY X jECT PRODUCTS - COMP/OP AGG $ 2,000,00 Emp Ben. $ 1,000,00 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BAS(13)54999316 03/23/12 03/23/13 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ UMBRELLA LIAB EXCESS LAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A BKS(13) 54999316 03/23/12 03/23/13 WC STATU- I X OTH- TORY LIMITS E, L. EACH ACCIDENT $ 1,000,00 j E L. DISEASE - EA EMPLOYEE $ 1,000,00 E L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ADDITIONAL INSURED(S)AS REQUIRED BY WRITTEN CONTRACT SUBJECT TO POLICY TERMS, CONDITIONS LIMITATIONS AND ATTACHED ENDORSEMENT: CITY OF RENTON. COVERAGE AFFORD9D IS PRIMARY AND NON-CONTRIBUTORY. RE: SE 5TH STREET AC WATER MAIN REPLACEMENT PROJECT; CAG-12-056. CFRTIFICATF HOLDER CANCELLATION CIRENTO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF RENTON THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1055 S. GRADY WAY RENTON, WA 98055 AUTHORIZED REPRESENTATIVE L.1fa.o� �/(• �� ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 85 83 10 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED CONTRACTORS - PRODUCTS/COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph 2, under Section II - Who Is An Insured Is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract or written agreement. Such person or organization Is an additional Insured but only with respect to liability for "bodily injury" or "property damage": 1. Caused by "your work" performed for that additional Insured that Is the subject of the written contract or written agreement; and 2. Included in the "products -completed operations hazard". The Insurance provided by this endorsement applies only if the written contract or written agreement Is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional Insured under this endorsement until we receive written notice of a "suit" by the additional Insured as required In Paragraph b. of Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Conditions. B. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This Insurance does not apply to: 1. "Bodily Injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. 2. "Bodily injury" or "property damage" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawing and specifications; and b. Supervisory, inspection, architectural or engineering activities. 02010 Liberty Mutual Insurance Company. All rights reserved. CG 85 83 10 09 Includes copyrighted material of Insurance Services Office, Inc., with its permission . Page 1 of 2 C. With respect to the insurance afforded by this endorsement, exclusion I. Damage To Your Work of Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability Is replaced by the following: 1. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products - completed operations hazard". D. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined In Section III - Limits Of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. E. With respect to the insurance afforded by this endorsement, Section IV - Commercial General Liability Conditions is amended as follows: 1. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claims Or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result In a claim or "suit" under this insurance to us; b. Tender the defense and Indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or Indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional Insured. 2. Paragraph 4. of Section IV -Commercial General Liability Conditions is amended as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making Its policy excess, and you have agreed In a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional Insured's policy for damages we cover. b. The following Is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit Issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non- contributory, this insurance is excess over any other Insurance for which the additional Insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insur- ance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. "10 Liberty Mutual Insurance Company. All rights reserved. CG 85 83 10 09 Includes copyrighted materiel of Insurance Services office, Inc., with its permission . Page 2 of 2 COMMERCIAL GENERAL UABILITY CG 88 10 10 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT NON -OWNED AIRCRAFT PAGE 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY — ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS — COVERAGES A AND B 3 ADDITIONAL INSUREDS — BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 6 ADDITIONAL INSUREDS- EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED — INCIDENTAL MEDICAL ERRORSIMALPRACTICE AND WHO IS AN INSURED — 6 FELLOW EMPLOYEE EXTENSION — MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 6 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 7 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU C2010 Llherty Mutual Insurance Company. All rights reserved. CG 88 1010 09 Includes copyrighted material or Insurance Services Office, Inc., with Its permission. Page 1 of 7 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Sectlon I — Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge, However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I —Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to cant' persons or property for a charge. C. PROPERTY DAMAGE LIABILITY — ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A — Bodily Injury And Property Damage Liability, Subparagraphs (3), (4) and (6) of exclusion J. Damage To Property do not apply if such 'property damage' results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV — Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenants Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion J. Damage To Property is replaced by the following: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (1) Premises rented to you for a period of 7 or fewer consecutive days; or (II) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of Insurance applies to this coverage as described in Section III — Limits of Insurance. C2010 Liberty Mutual Insurance Company. AU rights reserved. CG 88 10 10 09 Includes copyrighted material of Insurance Services Office, Inc., with Its permisslon. Page 2 of 7 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III — Limits Of Insurance. 2. Paragraph 6. under Section III — Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 6. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection systems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I — Coverage C — Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS —COVERAGES A AND B 1. Under Supplementary Payments — Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit', including actual loss of earnings up to $500 a day because of time off from work. G. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II — Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit Such person or organization is an additional insured but 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 on going operations for the additional insured that are the subject of the written contract or written agreement provided that the `bodily irrjury' or 'property damage" occurs, or the 'personal and advertising injury' is committed, subsequent to the signing of such written contract or written agreement; or 02010 Liberty Mutual Insurance Company. All rights reserved. CG 88 10 10 09 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 b. Premises or facilities rented by you or used by you; or C. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to 'bodily injury','property damage', or 'personal and advertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to 'bodily injury' or 'property damage' included within the "completed operations hazard'. (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any 'occurrence' which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage'' We have no duty to defend an additional insured under this endorsement until we receive written notice of a 'suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV — Commercial General Liability Conditions, 2. With respect to the Insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. 'Bodily injury' or "property damage' arising from the sole negligence of the additional insured. b. 'Bodily injury' or "property damage* that occurs prior to you commencing operations at the location where such 'bodily injury' or'property damage' occurs. C. 'Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: 02010 Uberty Mutual Insurance Company. All rights reserved. CG 88 10 10 09 Includes copyrighted material of Insurance Services Office, Inc., with Its permisslon. Page 1 of 7 (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. d. "Bodily injury' or "property damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such worts, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its Intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement issued by us and made a part of this policy. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional Insured under any form or endorsement under this policy. Condition 4.Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this Insurance is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other Insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional Insured on other policies. ADDITIONAL INSUREDS- EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or 'suit' under this insurance to us; b Tender the defense and indemnity of any claim or 'suit' to all insurers whom also have insurance available to the additional insured; and C. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. 02010 Liberty Mutual Insurance Company. All rights reserved. CG 88 10 10 09 Includes copyrighted material of Insurance Services Office, Inc_ with Its permission. Page 6 of 7 d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III — Llmlts of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. WHO IS AN INSURED- INCIDENTAL MEDICAL ERRORS / MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION- MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II - Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker' as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing professional health care personnel to others, or if coverage for providing professional health care services is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to 'bodily injury' or 'personal and advertising injury' caused by an "employee' who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other 'employees' of yours. However, none of these 'employees" are insureds for'bodily injury' or "personal and advertising injury' arising out of their willful conduct, which is defined as the purposeful or willful intent to cause 'bodily injury' or "personal and advertising injury', or caused in whole or in part by their intoxication by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your 'employee'. K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II - Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority Interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury' or "property damage" that occurred before you acquired or formed the organization; and C. Coverage B does not apply to "personal and advertising injury' arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. 02+2010 Marty Mutual Insurance Company. All rights reserved. CG 88 10 10 09 Includes copyrighted material of Insurance Services Office, Inc., with its permisslon. Page 6 of 7 L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV — Commercial General Liability Conditions, the following is added to Condition 6. Representations: Your failure to disclose all hazards or prior "occurrences' existing as of the Inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior 'occurrences' is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV — Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an 'occurrence', offense, claim or 'suit' by an agent, servant or "employee' of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II — Who Is An Insured or a person who has been designated by them to receive reports of "occurrences', offenses, claims or 'suits* shall have received such notice from the agent, servant or "employee*. N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V — Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury' means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease. P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. 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. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US — WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV — Commercial General Liability Conditions, the following is added to Condition 8. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agreement. 02010 Liberty Mutual Insurance Company. All rights reserved. CG 88 10 1009 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 Of 7 CONTRACTS OTHER THAN FEDERAL -AID FHWA THIS AGREEMENT, made and entered into this day of , 2012, by and between THE CITY OF RENTON, Washington, a municipal corporation of the State of Washington, hereinafter referred to as "CITY" and B B LJORM: And Excava: n"LC hereinafter referred to as "CONTRACTOR." WTTNESSETH: 1) The Contractor shall within the time stipulated, (to -wit: within 80 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. CAG-12-056) for improvement by construction and installation of: SE 5`" Street AC Water Main Replacement Project, VVTR-27-3604 per the "Scope of Work" included therein. All the foregoing shall be timely performed, furnished, constructed, installed and completed 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. 2) The aforesaid Contract, entered into by the acceptance of the Contractor's bid and signing of 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 e► Advertisement for Bids h) Special Provisions, if any i) Technical Specifications, if any j) Addenda, if any 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 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 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 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. 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 attorney's 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 concurent negligence of (a) the Contractor's agents or employees and (b) the City. 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 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 80 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) year 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. 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. 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. 9) The Contractor and each subcontractor, if any, shall submit to the City such schedules of 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 off / ��l i plus Washington State Sales Tax. Payments "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 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. -- 17) Assignment. Any assignment of this Agreement by either party without the written consent 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 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. 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 eff ZvoL%&A AVI/�L_ e Secretary dba B & B Utilities and Excavating, LLC Mayor CITY OF RENTON ATTEST Firni Name q (� 0 Indi-, idual ❑ Partnership P Corporation incorporated in City Clerk Attention: If business is a CORPORATION, name of the corporation should be listed in full and both President and Secretary must sign the contract, OR if one signature is permitted by corporation by-laws, a copy of the by-laws shall be furnished to the City and made a part of the contract document. If business is a PARTNERSHIP, full name of each partner should be listed followed by d/b/a (doing business as) and firm or trade name; any one partner may sign the contract. If business is an INDIVIDUAL PROPRIETORSHIP, the name of the owner should appear followed by d/b/a and name of the company.