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Home My WebLink About4990AGENDA BILL CITY OF BREMERTON CITY COUNCIL sm SUBJECT: Contract Modification Study Session Date: November 8, 2017 Agreement No. 3 with Parametrix for COUNCIL MEETING Date: November 15, 2017 Groundwater Monitoring at the former Department: Public Works & Utilities Chevron Property Remediation Presenter: Tom Knuckey Phone: (360) 473-2376 SUMMARY: Parametrix has been performing groundwater monitoring and reporting to the Department of Ecology for the former Chevron Property since remediation was completed in 2012. Contract Modification No. 1 provided scope and budget to complete all monitoring and reporting through 2017; over $73,000 of that budget still remains. Contract Modification No. 2 was a schedule extension with no modification to the scope or budget. This Contract Modification No. 3 supplements the existing contract to continue groundwater monitoring and reporting until 2022 when the site is expected to meet cleanup levels in compliance with Department of Ecology regulations. n ATTACHMENTS: 1) Contract Modification No. 3 2) Scope of Work FISCAL IMPACTS (Include Budgeted Amount): No fiscal impact to 2017`Budget' "'$17,000 is x: ,:_included,in.the.proposed 2018 Budget.:. STUDY SESSION AGENDA: N No Presentation ❑ Full Presentation STUDY SESSION ACTION: . N Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION: Move to approve Contract Modification Agreement No. 3 between the City of Bremerton and Parametrix for the former Chevron Property Remediation; and authorize the Mayor to finalize and execute the agreement with substantially the same terms and conditions as presented. COUNCIL ACTION: ZApprove ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 01/07/15 CONTRACT MODIFICATION AGREEMENT NO.3 BETWEEN THE CITY OF BREMERTON AND PARAMETRIX PROJECT Former Chevron Property Remediation CONSULTANT Parametrix, Inc. DATE October 13, 2017 THIS CONTRACT MODIFICATION AGREEMENT SPECIFICALLY AMENDS THE FORMER CHEVRON PROPERTY REMEDIATION AGREEMENT (the "Contract") entered into between the City of Bremerton and Parametrix on January 27, 2011 All provisions in the Contract shall remain in full force and effect 'except as expressly modified by this document. For valuable consideration and by mutual consent. of the parties, the modifications to the Contract are as follows: I. Section I. Scope , is modified as follows: the project scope is supplemented by the attached Exhibit A. Section - II. Term , is modified as follows: The Consultant shall complete. the work per Exhibit B by December 30, 2022. Section IIL Compensation is modified as follows: The original contract amount was $123,786.00. Contract Modification No. 1 amended the contract amount to $349,042.00. Contract Modification No. 2 was a no cost contract extension. This Contract Modification No. 3 increases the budget by $52,692:63 for a new contract total amount of $401`,735.13. II. Consultant accepts all requirements ;of this Contract Modification by endorsing below. Consultant further agrees that this Contract Modification constitutes full and final settlement of all of the Consultant's claims for contract time and for all. costs of any kind, including without limitation, costs of delays related to any work either covered or affected by this Contract Modification, claims related to on-site or home office overhead, or lost profits. This Contract Modification does not limit the City's right to bring a claim for past performance. The undersigned consultant approves the foregoing Contract Modification as to the changes,. if any, in the contract price specified for each item, including any and all supervision costs and. -W CONTRACT MODIFICATION Project Number: 61104 other miscellaneous costs relating to the change in work, and as to. the extension of time allowed, if any, for completion of the entire work due to said Contract Modification. This document will become a supplement of the contract and all provisions will apply hereto.. It is` understood that this Contract Modification shall be effective when approved by the City of Bremerton. The parties whose names appear bellow warrant that they are authorized to enter into a contract modification that is binding on the parties of this contract. In addition, Consultant warrants that it has or will inform the surety of�this change, and shall take appropriate action to modify any bonds required under the contract to address this change. IN WITNESS WHEREOF, the parties have executed this Contract .Modification on the day and :year first written above. City Engineer / Public Works Director approved to proces - 5 -7 r Initials and Date CONSULTANT- B\ DATE: I/ //S- / ;7 APPROVED AS TO FORM: Bremerton &Jty Attorney NOTICES TO BE SENT TO: Dave Dinkuhn Senior Engineer Parametrix, Inc. 60 Washington Ave., Suite 390 Bremerton, WA 98337 360-377-0014 THE CITY OF BREMERTON By Patt nt Its May DATE: IZ-/,f ' - 11*7 ATTEST: City Clerk NOTICES TO BE SENT TO: Tom Knuckey, PE. City Engineer City of Bremerton Engineering Department 3027 Olympus Drive Bremerton WA, 98312 .360-473-2376 C:\Users\johnsjean\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\ZOZVQLEIU71012_ContractModitication3.doc CONTRACT MODIFICATION Project Number: 61104 Parametrix ENGINEERING. PLANNING. ENVIRONMENTAL SCIENCES EXHIBIT A SCOPE OF WORK City of Bremerton. Former Chevron Property Remediation Amendment No. 3 INTRODUCTION This Scope of Work (SOW) describes Parametrix's proposal for additional services,to be performed under our existing contract for Long -Term Monitoring (LTM) at the Former Chevron Property. The work will be performed under Amendment No. 3 to our Professional Services Agreement dated January 27, 2011. Additional services consist of 5 additional years of groundwater monitoring and an update to the project's LTM plan. The new completion date for the project is October 31, 2022 (see Exhibit B — Schedule). The original project budget included a total of 12 groundwater sampling events to be completed within 5 years. This schedule assured that groundwater concentrations at the, site would attenuate and reach cleanup levels within that time frame. Since cleanup levels have not been met, the monitoring schedule is to be extended an additional 5 years. A total of nine sampling events have been conducted to date, leaving a surplus of three events under the existing budget. It is projected that a total of eight rounds of groundwater samples will be collected under Amendment No. 3. The budget request for this amendment reflects an additional five sampling events and an update to the site's LTM plan (if requested by Ecology_). The table below presents a summary of the Amendment No. 3 budget request. Budget Phase Cost Moving Forward Budget Remaining (as of 09/30/17) Amendment No. 03 Budget Request 01 Project Management $14,817.96 -$1,657.02 $16,474.98 02 Work Plans $2,522.85 $2086:51 $436.34 03 LTM Activities $95,327.86 $64,824.99 $30,502.87 04 Five Year LTM Report $8,471.14 $6,128.05 $2,343.09 Allocated Expenses $4,870.01 $1,934.66 $2,935.35 Total $126,009.82 $73;317.19 $52,692.63 Task 1 — F'roject Management and Administration Goal To provide for continued overview and direction of task activities in a manner that allows for the delivery of the project'in accordance with the scope, schedule, and budget. City of Bremerton 233=1896107 Former Chevron Property Remediation Amendment No. 3 1 October 2017 SCOPE OF WORK (continued) Approach Specific work elements will include: • A,.combination of in-house reviews and monthly progress reports to deliver elements of work described in. this Scope of Work. U Weekly calls or meetings with the City's project manager to update progress. U Subcontractor management. Deliverables Parametrix anticipates the following work products for this task: routine correspondence, schedule and budget updates, and status reports on progress.of work. Assumptions The task budget is based on the following assumptions: o Project management and administration tasks will be performed through the project period, which will end on October 31, 2022. s Monthly project update calls will be attended by the project manager.. Task 2 —Work Flans Goal Prepare an update to the LTM pian to reflect the new schedule of work (if requested by Ecology). Approach The following activities will be performed: 0 Update to the LTM Sampling, and Analysis Plan to reflect the program: changes. Deliverables Draft and Final work plan updates will be the deliverables under this task. Assumptions The task budget is based on the following assumptions: 0 Draft work,plans will be submitted electronically in PDF format. 0 Two hardcopiesof final plans will be submitted to Ecology and one hardcopy will be submitted to the City. 0 Final hardcopy submittals will'include a CD with electronic copies in.PDF format. City of Bremerton 233-1896.107 Former Chevron Property Remediation Amendment No. 3 2 October 2017 SCOPE OF WORK (continued) Task s — LTM Field Work and Reporting Goal To continue annual groundwater sampling at the site for 4 years followed by four quarterly sampling events conducted in year 5.. Approach The following activities will be performed: • One round ofgroundwater samples will be collected per year for 4. years (fromten monitoring wells). Following the initial 4 -year monitoring period,1 year of quarterly groundwater samples f fourfield events) will be collected from the same ten wells. • Following each LTM sampling effort, the results will be presented in a technical memorandum with. supporting tables and figures as appropriate. Deliverables Technical memoranda will be submitted following each monitoring event. Asgumpticins The task budget is based on the following assumptions: • Each sampling event can be accomplished by one field staff in three 10 -hour days. • Purge water from the wells will continue to be disposed of at.the City's wastewater treatment plant. • The LTM sampling results memoranda will be prepared within 6 weeks of completion of each groundwater monitoring event for City review and submittal to Ecology. • The draft results memoranda will be submitted electronically in PDF format to the City for review. • Two hardcopies of the final documents will be submitted to Ecology and one hardcopy will be submitted to the City. • Final hardcopy submittals will include a CD with an electronic copy of the final documents in PDF format. TASK 4 -- 5 -Year Summary Monitoring Report Goal To compile and report the results of the groundwater monitoring program at the site. The ultimate goal of the monitoring program is to demonstrate that cleanup levels have been met at the site. Since the monitoring program is extending beyond 5 years, the report will be titled "Summary Monitoring Report". Approach The. following activities will be performed: Preparation of a summary report describing the results of the LTM program, including supporting figures and tables and any proposed changes to,the monitoring, program. City of Bremerton 233-1896-107 Former Chevron Property Remediation Amendment No. 3 3 October 2017 SCOPE OF WORK (continued) Deliverables Draft and final summary monitoring reports wilVb'e submitted under this task. Assumptions: The task budget is based on the following assumptions: • One face-to-face 4 -hour meeting will be held with Ecology and/or the City to discuss and finalize the summary monitoring report. • A single round of comments each from the City and Ecology will be required to finalize the report. • Draft and final reports will be submitted electronically in PDF format. • Two hardcopies of the final documents will be submitted to Ecology and one hardcopy will be submitted to the City. • Final hardcopy submittals will include a CD with an electronic copy of the final documents in PDF format. City of Bremerton 233-1896-107 Former Chevron Property Remediation Amendment No. 3 4 October 2017 Parametrix ENGINEERING.: PLANNING . ENVIRONMENTAL 5CIENCES EXHIBIT B SCHEDULE Schedule Work Element Completed By Notice to Proceed October 31, 2017 Draft Work Plan Update January 1, 2018 Final Work Plan Update March 1, 2018 10th Groundwater Sampling Event.(annual) July 2018 11th Groundwater Sampling Event (annual) July 2019 12th Groundwater Sampling Event (annual) July 2020 13th Groundwater Sampling Event (annual) July 2021 14th Groundwater Sampling Event (quarterly) October 2021 15th Groundwater Sampling Event (quarterly) January 2022 16th Groundwater Sampling Event (quarterly) April 2022 17th Groundwater Sampling Event July 2022 Draft Summary Monitoring Report August 2022 Final Summary Monitoring Report September 2022 Project Close Out October 31, 2022 City of Bremerton 233-1896-107 Former Chevron Property Remediation Amendment No. 3 1 October 2017 Contract Number 4990 Vendor. PARAMETRIX, INC Subject Former Chevron Property Remediation Department Engineering File Class. LEG 12-1 Begin Date: 1/21/2011 End Date: 12/31/2017 Review Date- 12/31/2016 Vault Date Comments- CO #1 12/27/12 CONTRACT MODIFICATION AGREEMENT NO. 1 BETWEEN THE CITY OF EREMERTON AND I'' ,, " ' •. ►Illi i 1 1 ,. PROTECT Former Chevron Property Remediation CONSULTANT Parametrix, Inc DATE December 5, 2012 THIS CONTRACT MODIFICATION AGREEMENT SPECIFICALLY AMENDS THE FORMER CHEVRON PROPERTY REMEDIATION AGREEMENT (the "Contract") entered into between the City of Bremerton and Parametrix on January 27, 2011 All provisions in the Contract shall remain in full force and effect except as expressly modified by this document For valuable consideration and by mutual consent of the parties, the modifications to the Contract are as follows I. Section I. Scope , is modified as follows See Amended Scope of Work attached as Exhibit A) Section II. Term , is modified as follows The Consultant shall complete the work described in this Contract Modification Agreement by December, 2017 , as set out in Exhibit B Section III. Compensation , is modified as follows The original contract amount was One Hundred Twenty Three Thousand Seven Hundred Eighty -Six Dollars ($123,786.00) The City shall pay the Consultant fol the additional work described above, based on time and materials, an amount not to exceed Two Hundred 'Twenty Five Thousand Two Hundred Fifty -Six Dollars ($225,256.00), as set out in the Exhibit C, for a total amended contract amount of Three Hundred Fortv Nine Thousand Fortv-Two Dollars ($349,042.00), including this Contract Modification II. Consultant accepts all requirements of this Contract Modification by endorsing below. Consultant further agrees that this Contract Modification constitutes full and final settlement of all of the Consultant's claims for contract time and for all costs of any kind, including without limitation, costs of delays related to any work either covered or affected by this Contract Modification, claims related to on-site or home office overhead, or lost profits. This Contract Modification does not limit the City's right to bring a claim for past performance. CONTRACT MODIFICATION Project Number The undersigned consultant approves the foregoing Contract Modification as to the changes, if any, in the contract price specified for each item, including any and all supervision costs and other miscellaneous costs relating to the change in work, and as to the extension of time allowed, if any, for completion of the entire work due to said Contract Modification. This document will become a supplement of the contract and all provisions will apply hereto. It is understood that this Contract Modification shall be effective when approved by the City of Bremerton. The parties whose names appear below warrant that they are authorized to enter into a contract modification that is binding on the parties of this contract. In addition, Consultant warrants that it has or will inform the surety of this change, and shall take appropriate action to modify any bonds required under the contract to address this change. IN WITNESS WHEREOF, the parties have executed this Contract Modification on the day and year first written above. City Engmeei / Public Works Director approved to proces Z`� 1 Z� �%/ Initials and Date CONSULTANT. By Itsec— DATE— APPROVED AS TO FORM[: UV *q/ 4� Bremerton City Attorney NOTICES TO BE SENT TO: Dave Dmkuhn Senior Engineer Parametrix 4660 Kttsap Way, Suite A Bremerton, WA 98312 360-377-0014 R TEGAUContractsTORMS\Contract Modification (2003) doe CONTRACT MODIFICATION Project Number THE CITY OF BREMERTON � �a 4� �':: �'- � /— By P ent it hmor DATE ATTEST: Nv--J�- City Clerk NOTICES TO BE SENT TO: Tom Knuckey, PE City Engineer City of Bremerton Engineering Department 3027 Olympus Drive Bremerton WA, 98312 360-473-2376 EXHIBIT A — SCOPE OF WORK City of Bremerton Professional Services Agreement for Former Chevron Property Remediation Amendment No. 01 - Long Term Monitoring INTRODUCTION This Scope of Work (SOW) describes Parametrix's proposal for five years of Long -Term Monitoring (LTM) at the Former Chevron Property The work will be performed under Amendment No 01 to our existing Professional Services Agreement dated January 27, 2011 The tasks described here are part of the selected cleanup action described in the Draft Cleanup Action Plan (DCAP) developed for the site in coordination with the Washington State Department of Ecology (Ecology) The LTM activities include preparation of work plans, installation and development of a new groundwater monitoring well, four years of semi-annual groundwater sampling, and one year of quarterly groundwater sampling conducted during the fifth year Following each sampling effort, a summary technical memorandum will be prepared, a final Summary Report will be prepared at the end of the five-year monitoring period that will summarize the results of all monitoring events We anticipate that a portion of the work described here will be funded by a Remedial Action Grant from Ecology The grant funded work will include work plan preparation and long term monitoring for the first year The grant application is being developed concurrently with this SOW Parametrix shall not initiate work until the grant is approved by Ecology If the grant is not approved, the City of Bremerton (City) shall retain right to terminate any Professional Services Agreement executed based on this SOW TASK 1 — PROJECT MANAGEMENT AND ADMINISTRATION Goal To provide for overview and direction of task activities in a manner that allows for the delivery of the project in accordance with the scope, schedule, and budget Approach Specific work elements will include • A combination of in-house reviews and monthly progress reports will be used to deliver elements of work described in this Scope of Work • Weekly calls or meetings with the City's project manager to update progress • Management of subcontractors Deliverables City of Bremerton 233-1896-098 Scope of Work 1 October 2012 Former Chevron Property Remediation Amendment No 01 Parametrix anticipates the following work products for this task • Routine correspondence, schedule and budget updates, and status reports on progress of work Assumptions The task budget is based on the following assumptions • Project management and administration tasks will be performed through the project period, which will end on October 31, 2017 • Monthly project update calls will be attended by the project manager TASK 2 — WORK PLANS Goal Prepare project work plans as required by Ecology under the site's Agreed Order Approach The following activities will be performed • The required work plans that will be prepared for the project include Long -Term Monitoring Sampling and Analysis Plan Describes well installation procedures, sampling methods, analytical program, and QA/QC procedures for long-term monitoring Updated Public Participation and Health and Safety Plans Updates to these existing project plans will be prepared as appropriate > Institutional Controls Plan Describes procedures to be implemented to protect human health and the environment at the site Includes an Environmental Covenant to be recorded with the property title Final Cleanup Action Plan We will finalize the existing Draft Cleanup Action Plan (DCAP) Following public comment, the three protect plans listed above will be incorporated into the DCAP and a Final Cleanup Action Plan will be prepared Deliverables The following deliverables will be submitted under this task • Draft and Final Work Plans as described above Assumptions The task budget is based on the following assumptions City of Bremerton 233-1896-098 Scope of Work 2 October 2012 Former Chevron Property Remediation Amendment No 01 • Sampling will be conducted in all eleven Lower Yard wells for all five years The Sampling and Analysis Plan will include a provision allowing the City to request a reduction in the number of wells sampled and/or a reduction in the number of analyses performed Such request would require justification based on the results of the preceding long-term monitoring results Up to two 2 -hour meetings will be held with the City and Ecology via telephone to discuss approaches and comments to the draft work plans • Draft work plans will be submitted electronically in PDF format Two hardcopies of final plans will be submitted to Ecology and one hardcopy will be submitted to the City Final hardcopy submittals will include a CD with electronic copies in PDF format TASK 3 — LTM FIELD WORK AND REPORTING Goal To complete the required LTM sampling and reporting in accordance with the Sampling and Analysis Plan Approach The following activities will be performed • Installation and development of a new monitoring well (MW20R) downgradient of existing well MW27 and cross gradient of MW09R The purpose of the new well will be to assess the extent of the contaminated groundwater plume in this area and will represent a conditional point of compliance Development will be accomplished by surging and over pumping 0 Collection of four years of semi-annual rounds (eight field events) of groundwater samples from eleven wells Following the initial four-year monitoring period, one year of quarterly groundwater samples (four field events) will be collected from the same eleven wells • Additional survey effort to map the elevation of the new well • Following each LTM sampling effort, the results will be presented in a technical memorandum with supporting tables and figures as appropriate Deliverables The following deliverables will be submitted under this task • Technical memoranda following each monitoring event Assumptions The task budget is based on the following assumptions • Well installation and development can be accomplished by one field staff in two 8 -hour days City of Bremerton 233-1896-098 Scope of Work 3 October 2012 Former Chevron Property Remediation, Amendment No 01 • Each sampling effort can be accomplished by one field staff in three 10 -hour days • Development and purge water from the wells will be disposed of at the City's WWTP using a City vactor truck • The LTM sampling results memoranda will be prepared within six weeks of completion of each groundwater monitoring event for City review and submittal to Ecology • The draft results memoranda will be submitted electronically in PDF format to the City for review Two hardcopies of the final documents will be submitted to Ecology and one hardcopy will be submitted to the City Final hardcopy submittals will include a CD with an electronic copy of the final documents in PDF format Laboratory Data will be provided to Ecology in Environmental Information Management (EIM) format TASK 4 — FIVE-YEAR SUMMARY MONITORING REPORT Goal To compile and report the results of the five-year monitoring program and verify that natural attenuation continues to occur at the site or to demonstrate that cleanup levels have been met Approach The following activities will be performed • Preparation of a summary report describing the results of the first five years of the LTM program, including supporting figures and tables and any proposed changes to the monitoring program Deliverables The following deliverables will be submitted under this task • Draft and Final Five -Year Summary Report Assumptions The task budget is based on the following assumptions • One face-to-face 4 -hour meeting will be held with Ecology and/or the City to discuss and finalize the Five -Year Summary Report • A single round of comments each from the City and Ecology will be required to finalize the Five - Year Summary Report • The Five -Year Summary Report will be submitted electronically in PDF format Two hardcoples of the final documents will be submitted to Ecology and one hardcopy will be submitted to the City Final hardcopy submittals will include a CD with an electronic copy of the final documents in PDF format Laboratory Data will be provided to Ecology in EIM format City of Bremerton 233-1896-098 Scope of Work 4 October 2012 Former Chevron Property Remediation Amendment No 01 EXHIBIT B Schedule Work Element Completed By Notice to Proceed December 17, 2012 Draft Work Plans December 31, 2012 Final Work Plans January 2013 1St Semi -Annual Groundwater Sampling Event January 2013 2nd Semi -Annual Groundwater Sampling Event July 2013 3rd Semi -Annual Groundwater Sampling Event January 2014 4th Semi -Annual Groundwater Sampling Event July 2014 5th Semi -Annual Groundwater Sampling Event January 2015 6th Semi -Annual Groundwater Sampling Event July 2015 7th Semi -Annual Groundwater Sampling Event January 2016 8th Semi -Annual Groundwater Sampling Event July 2016 1 st Quarterly Groundwater Sampling Event October 2016 2nd Quarterly Groundwater Sampling Event January 2017 3rd Quarterly Groundwater Sampling Event April 2017 4th Quarterly Groundwater Sampling Event July 2017 Draft 5 -Year Summary Monitoring Report August 2017 Final 5 -Year Summary Monitoring Report September 2017 Project Close Out October 2017 City of Bremerton 233-1896-098 Scope of Work / October 2012 Former Chevron Property Long -Term Monitoring EXHIBIT C Budget Task 1 Project Management and Administration $9,296 Task 2 Work Plans $18,692 Task 3 Long -Term Monitoring Activities $186,656 Task 4 Five -Year Summary Monitoring Report $10,612 TOTAL................................................................................................................. $225,256 NOTES: The estimated fees shown above were determined on a cost plus multiplier basis, these fees shall not be exceeded without prior written approval by the City Personnel hourly rates shall be determined as follows Direct salary x 3 1 not to exceed $150 00 Subconsultants, sampling supplies, and equipment rental shall be subject to a 5 percent markup Total estimated costs reflect an anticipated 3 percent annual escalation A breakdown of costs is provided in the attached budget spreadsheet City of Bremerton 233-1896-098 Scope of Work / October 2012 Former Chevron Property Long -Term Monitoring Client City of Bremerton Project Former Chevron Prop - Long Term Monitoring Burdened Rates BUDGET DETAIL S15000 S13683 S9297 S6677 59734 S6200 S16740 S8215 Phase Task Description Labor Dollars Labor Hours $12,385 $309 $1,817 $8,328 $695 $555 $364 $0 $318 Labor Totals $129,471 01 tf Project Management $8,771 T N Subconsultant Name Amount Description a o m W O 68 8 30 Color 11 x 17 $52 Applied Professional Services, Inc 30 Z a u ate. v O o n 3 p �' O m rco h C m 'C Vt 2 i+ C C o 4 o E" i' Update PPP & HASP $3,683 E 3 CL 'o U w = 4 Q > d?: Institutional Control Plans u U u 34 28 m vii C.S 2 m U 04 S15000 S13683 S9297 S6677 59734 S6200 S16740 S8215 Phase Task Description Labor Dollars Labor Hours $12,385 $309 $1,817 $8,328 $695 $555 $364 $0 $318 Labor Totals $129,471 01 $7,372 $6,201 $4,456 $1,004 $2,782 Project Management $8,771 68 8 30 Subconsultant Name Amount Description 30 ESN Northwest 01 PM $8,771 68 8 30 Color 11 x 17 $52 Applied Professional Services, Inc 30 02 $74 Work Plans $17,504 176 48 76 16 14 22 01 Long Term Mon Plan $4,797 50 8 28 4 6 4 02 Update PPP & HASP $3,683 40 4 24 4 4 4 03 Institutional Control Plans $4,283 34 28 2 2 2 04 Final Cleanup Action Plan $4,741 52 8 24 6 2 12 03 LTM Activities $93,328 892 62 676 76 36 36 6 01 Install 1 New Well & Develop $4,148 40 2 28 4 6 02 LTM Groundwater Sampling $89,180 852 60 648 72 36 36 04 Five Year LTM Report $9,868 88 8 12 44 B. 8 8 01 Report $9,868 88 8 121 441 81 81 8 lHour Totals $2,079 1,224 16 152 796 100 58 66 6 30 Escalation Amt $12,385 $309 $1,817 $8,328 $695 $555 $364 $0 $318 Labor Totals $129,471 $2,709 $22,615 $82,332 $7,372 $6,201 $4,456 $1,004 $2,782 SUBCONSULTANTS $3,969 DIRECT EXPENSES $210 Subconsultant Name Amount Description Amount ESN Northwest $2,100 B& W 8 5 x 11 $299 OnSite Environmental, Inc $71,443 Color 11 x 17 $52 Applied Professional Services, Inc $179 55 Gallon Drums $74 Subconsultant Total $73,722 Allocated Expenses (6% of Labor) $7,768 Project Total $225,25di March 19, 2012 Filters $2,079 Genarator Rental $105 Honba Rental $2,993 Peristaltic Pump Rental $2,835 PPE $420 Pump Tubing $1,260 Shipping $3,969 Waterra Rental $210 Expense Total $22,063 Contract Number 4990 Vendor PARAMETRIX Subject Former Chevron Property Remediation Department Engineering File Class LEG 12-1 Begin Date 1/21/2011 End Date 10/30/2011 Review Date 11/15/2011 Vault Date Comments JAN 2 5 2011 PROFESSIONAL SERVICES AG Former Chevron Property Remediation The City of Bremerton ("City") and Parametnx ("Consultant"), referred to collectively as the "Parties," enter into the following Agreement for professional services: I. Scope: The Consultant agrees to perform the services more specifically described in the Scope of Work, dated December 2010, including any attachments thereto, attached hereto as Exhibit A, which is incorporated by reference herein The Scope of Work may be modified only pursuant to Section VII G of this Agreement. If the Scope of Work provides for unspecified additional services such services shall only be performed upon the express written request of the City Consultant further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices in effect at the time such services are performed. H. Term: The City and the Consultant agree that work will begin on the tasks described in Exhibit A immediately upon execution of this Agreement. The parties agree that the work described in Exhibit A is to be completed as provided for in the work schedule attached hereto in Exhibit B; provided however, that additional time shall be granted by the City for excusable delays or extra work as provided for in section IX (A) of this agreement. III. Compensation: In consideration of the services provided pursuant to this Agreement, the City shall pay Consultant in an amount not to exceed $123,786. Consultant's charges and bills shall conform to the fee schedule attached hereto as Exhibit C and incorporated herein by this reference. The Consultant shall submit regular billing statements detailing work performed and amount charged on each task or portion thereof The descriptions shall conform to and fall within the categories set out in the Scope of Work and/or Fee Schedule Upon receipt of a conforming billing statement, the City shall promptly process payment. PROVIDED, HOWEVER, the City reserves the right to prioritize scoped work and accelerate and/or delay work tasks under the time frame set forth in Section II herein. The Consultant's labor rates and billing fees shall be as delineated in Exhibit C. Consultant shall not perform work beyond the Scope of Work, nor shall be compensated for such work, unless the Scope of Work or amount of compensation is modified pursuant to this Agreement Consultant shall only be compensated for additional services if requested pursuant to Section I and, if not otherwise provided, such compensation shall be in accordance with Exhibit C. If a billing statement does not conform to this Agreement, the City may withhold payment until the statement is brought into compliance. Such withholding does not relieve Consultant of its obligations under this Agreement Bremerton/Parametrix Former Chevron Property Remediation Page 1 of 6 IV. Relationship of Parties: Consultant represents that it is skilled in the matters addressed in the Scope of Work and is performing independent functions and responsibilities within its field of expertise Consultant and its personnel are independent Consultants and not employees of the City Consultant and its personnel have no authority to bind the City or to control the City's employees and other Consultants. None of the benefits provided by the City to its employees, including, but not limited to, compensation, insurance, and unemployment insurance are available from the City to the employees, agents, representatives, or sub -Consultants of the Consultant Consultant will be solely and entirely responsible for its acts and for the acts of Consultant's agents, employees, representatives and sub -Consultants during the performance of this Agreement The City may, during the term of this Agreement, engage other independent Consultants to perform the same or similar work. As an independent Consultant, Consultant is responsible for its own management The City's administration and enforcement of this Agreement shall not be deemed an exercise of managerial control over Consultant or its personnel As an independent Consultant, Consultant is responsible for payment of all taxes and licensing fees necessary to perform its obligations under this Agreement These taxes and fees include but are not limited to State industrial insurance, Business & Occupation, State professional licensing, and City business licensing If any taxes or fees due the City have been declared delinquent, the City may withhold the delinquent amount, plus any additional charges arising from the delinquency, from any payments due Consultant V. Indemnification: Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, mluries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the performance of this Agreement, except for that portion of the injuries and damages caused by the City's sole negligence The City's review or acceptance of any of the work when completed shall not be grounds to avoid any of these covenants of indemnification Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's negligence IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER The provisions of this section shall survive the expiration or termination of this Agreement. Bremerton/Parametrix Former Chevron Property Remediation Page 2 of 6 VI. Insurance: The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for inlunes to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, its agents, representatives, employees, sub -consultants or sub -Consultants. Before beginning work on the project described in this Agreement, the Consultant shall provide a Certificate of Insurance evidencing: 1. Automobile Liability insurance with limits no less than $1,000,000 combined single limit per accident for bodily injury and property damage; and 2. Commercial General Liability insurance written on an occurrence basis with limits no less than $1,000,000 combined single limit per occurrence and general aggregate for personal injury, bodily injury and property damage Coverage shall include but not be limited to- blanket contractual, products/completed operationsibroad form property damage; explosion, collapse and underground (XCU) if applicable, and employer's liability, and 3. Excess Liability insurance with limits not less than 1,000,000 limit per occurrence and aggregate 4. Professional Liability insurance with limits no less than $1,000,000 limit per occurrence/claim Any payment of deductible or self insured retention shall be the sole responsibility of the Consultant. All required policies shall be provided on an "occurrence" basis except professional liability insurance (if required), which may be provided on a "claims -made" basis The City shall be named as an additional insured on the Commercial General Liability insurance policy, as respects work performed by or on behalf of the Consultant and a copy of an endorsement that is acceptable to the City, which names the City as an additional insured shall be attached to the Certificate of Insurance The City reserves the right to receive a certified copy of all the required insurance policies and endorsements. The City further reserves the right to reject any unacceptable policies and/or endorsements The Consultant's Commercial General Liability insurance shall contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. The Consultant's insurance shall be primary insurance as respects the City and the City shall be given thirty (30) days prior written notice by certified mail, return receipt requested, of any cancellation, suspension or material change in coverage. The City also reserves its unqualified right to require at any tune and for any reason, proof of coverage in the form of a duplicate of the insurance policy with all endorsements as evidence of coverage. Bremerton/Parametrix Former Chevron Property Remediation Page 3 of 6 VII. General Conditions: A. Reports and Information: When requested by the City, Consultant shall furnish periodic reports and documents on matters covered by this Agreement The reports and documents shall be furnished in the tune and form requested. Consultant shall maintain accounting records in accordance with Generally Accepted Accounting Principles (GAAP) to substantiate all billed amounts B. Ownership and Use of Records and Documents- Original documents, drawings, designs and reports, including those in electronic format, developed under this Agreement are the property of the City. All written information submitted by the City to the Consultant in connection with the services performed by the Consultant under this Agreement will be safeguarded by the Consultant to at least the same extent as the Consultant safeguards like information relating to its own business If such information is publicly available or is already in Consultant's possession or known to it, or is rightfully obtained by the Consultant from third parties, Consultant shall bear no responsibility for its disclosure, inadvertent or otherwise All data, documents and files created by Consultant under this Agreement may be stored at Consultant's office in Bremerton, Washington. Consultant shall make such data, documents, and files available to the City upon its request at all reasonable tunes for the purpose of editmg, modifying and updating as necessary until such time as the City is capable of storing such information in the City's offices. Duplicate copies of this information shall be provided to the City upon its request, and at reasonable cost. All documents, including all reports, drawings, specifications, computer software or other items prepared or furnished by Consultant pursuant to this Agreement, are instruments of service with respect to the project and are the property of the City Any reuse by the City for other than the specific purpose intended will be at City's sole risk C Work Performed at Consultant's Risk Consultant shall take all precautions necessary and shall be responsible for the safety of its employees, agents, and sub -consultants in the performance of the work hereunder and shall utilize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. D. Place of Work The Consultant shall perform the work authorized under this Agreement at its offices in Bremerton, Washington Meetings with the City staff as described in Exhibit A, Scope of Work, shall take place at the City's offices, or at locations mutually agreed upon by the parties. E Entire Agreement. This Agreement and its Exhibits constitutes the entire agreement between the Parties, and the Parties acknowledge that there are no other agreements, written or oral, that have not been set forth in the text of this Agreement Bremerton/Parametrix Former Chevron Property Remediation Page 4 of 6 F. Severability Should any part of this Agreement be found void, the balance of the Agreement shall remain in full force and effect. G. Modification: This Agreement may only be modified by written instrument signed by both Parties. H Written Notices. All communications regarding this Agreement shall be sent to the parties at the addresses listed below by registered or 1 st class mail, or by personal service, 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. City Address 345 5U' Street Bremerton, WA 98337 Consultant Address 4660 Kitsap Way Suite A Bremerton, WA 98312 I Waiver. Failure to enforce any provision of this Agreement shall not be deemed a waiver of that provision. Waiver of any right or power arising out of this Agreement shall not be deemed waiver of any other right or power J. Non -Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained herein, or to exercise any option herein conferred in one or more instances shall not be construed to be a waiver or relinquishment of said covenants, agreements or options, and the same shall be and remain in full force and effect K Compliance with Laws Consultant shall comply with all applicable Federal, State, and local laws in performing its obligations under this Agreement. L. Choice of Law and Venue- This Agreement shall be interpreted according to the laws of the State of Washington Any judicial action to resolve disputes arising out of this Agreement shall be brought in Kitsap County Superior Court. M. Attorneys' Fees In the event of litigation to enforce any of the terms or provisions herein, each party shall pay all its own costs and attorney's fees N Assigninent. Any assignment of this agreement by the Contractor without the written consent of the City shall be void VIII. Nondiscrimination: Consultant shall not discriminate in employment or services to the public on the basis of race, color, national origin, sex, religion, age, marital status, disability, or sexual orientation except for employment actions based on bona fide occupational qualification IX. Termination: This Agreement shall remain in force until completion and acceptance of the services, terminated by written instrument upon mutual consent, or by the City of Bremerton for convenience. This Agreement may be immediately terminated for cause by a Party if the other Party substantially fails to perform through no fault of the terminating Party, and the non- performing Party does not commence correction of the failure of performance within thirty (30) Bremerton/Parametnx Former Chevron Property Remediation Page 5 of 6 days of the terminating Party's sending notice to the non-performing Party Any Notice by Consultant shall include a report showing the status of all items listed in the Scope of Work current through the termination date If the City receives reimbursement by any federal, state, or other source for work described in Section I herein, and that funding is withdrawn, reduced or limited in any way, or the project is cancelled or substantially reduced after the execution date of this Agreement and prior to the completion of the work, the City may summarily terminate this Agreement A Excusable Delays: The right of Consultant to proceed shall not be terminated nor shall Consultant be charged with liquidated damages for any delays in the completion of the work due to. 1) any acts of the federal government in controlling, restricting, or requisitioning materials, equipment, tools, or labor by reason of war, national defense, or other national emergency, 2) any acts of the City, its consultants, or other public agencies causing such delay, and 3) causes not reasonably foreseeable by the parties at the time of the execution of the Agreement that are beyond the control and without the fault or negligence of the Consultant, including, but not restricted to, acts of God, fires, floods, strikes, or weather of unusual seventy PROVIDED, HOWEVER, that the Consultant must promptly notify the City within ten (10) calendar days in writing of the cause of the delay If, on the basis of the facts and the terns of this Agreement, the delay is properly excusable, the City shall, in writing, extend the time for completing the work for a period of time commensurate with the period of excusable delay B Rights Upon Termination In the event of termination, the City shall pay for all services performed by the Consultant to the effective date of termination, as described on a final invoice submitted to the City After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project which may be used by the City without restriction Any such use not related to the project which Consultant was contracted to perform shall be without liability or legal exposure to the Consultant CITY OF BREMERTON r,5 � 'P'X,2 2 z-; , � / By• Pa e t its Maw Date D/ Approved as to form merton City orney R \LEGAL\Contracts\FORMS\Profe stonal Serv.ces Agreement Form (2003) doc Bremerton/Parametnx Former Chevron Property Remediation Page 6 of 6 CONSULTANT <i�>- By l.� its Pr, -- Date- ?c-, jew EXHIBIT A — SCOPE OF WORK City of Bremerton Professional Services Agreement for Former Chevron Property Remedial Investigation, Feasibility Study and Interim Action Completion INTRODUCTION This scope of work (SOW) describes Parametrix's tasks for completion of the remedial investigation/feasibility study (RDFS) and Interim Action (IA) activities at the Former Chevron Property The tasks described here supplement work performed previously at the site under separate contract The supplemental work was requested by the Washington State Department of Ecology (Ecology) during a December 2, 2010 project meeting Ecology will provide 90 percent matching funds for the work under their Remedial Action Grant program The tasks described in this SOW are intended to complete the required RI/FS and IA activities at the site Additional RI and IA activities include installation of a new well, redevelopment of all existing wells, air sampling, infection of oxygen release compound (ORC) into several "hot spots," and a single round of groundwater sampling Following these activities, the existing draft RDFS Report will be finalized and a Draft Cleanup Action Plan (DCAP) will be prepared TASK 1 — PROJECT MANAGEMENT AND ADMINISTRATION Goal To provide for overview and direction of task activities in a manner that allows for the delivery of the project in accordance with the scope, schedule, and budget Approach Specific work elements will include a A combination of in-house reviews and monthly progress reports will be used to deliver elements of work described in this scope of work • Weekly calls or meetings with the City's protect manager to update progress • Management of subcontractors Deliverables Parametria anticipates the following work products for this task • Routine correspondence, schedule and budget updates, status reports on progress of work Assumptions City of Bremerton 255-1896-063 Scope of Work 1 December 2010 The task budget is based on the following assumptions • Project management and administration tasks will be performed through the project period, which will end upon termination of funding from Ecology • Monthly project update calls will be attended by the project manager. • Up to six, 2 -hour face-to-face meetings or conference calls with Ecology will be required under this task TASK 2 — SUPPLEMENTAL REMEDIAL INVESTIGATION/FEASIBILITY STUDY WORK PLAN Goa/ Prepare a Work Plan for the additional RI and IA activities to be performed Approach The following activities will be performed Preparation of a streamlined Work Plan for the additional RDFS and lA activities The Work Plan will consist of a technical memorandum with supporting tables and figures as appropriate Deliverables The following deliverables will be submitted under this task • Draft and Final Work Plan Assumptions The task budget is based on the following assumptions • Up to two 2 -hour meetings will be held with the City and Ecology via telephone to discuss approaches and comments to the Draft Work Plan • The Draft Work Plan will be submitted electronically in PDF format Two hard copies of the final plan will be submitted to Ecology and one hard copy will be submitted to the City Final hard copy submittals will include a CD with an electronic copy of the Final Work Plan in PDF format City of Bremerton 255-1896-063 Scope of Work 2 December 2010 TASK 3 — ADDITIONAL RI/FS FIELD WORK Goa! To complete the required additional RDFS site investigations Approach The following activities will be performed • Installation of a new monitoring well downgradient of existing well MW09 The purpose of the new well is to assess the downgradient extent of the contaminated groundwater plume in this area, which currently extends beyond MW09 • Development of the twelve existing wells to reduce the amount of suspended sediment in samples collected from the wells Development will be accomplished by surgmg and over pumping • Collection of five air samples at the site to assess potential park user exposure to volatile organic compounds (VOCs) in air A total of five samples will be collected using colornmetrnc tubes and a photoiomzation detector • Collection of one round of groundwater samples from thirteen wells • Additional survey effort to map the elevation of the new well and any existing well that is raised to accommodate filling activities at the site Deliverables Deliverables for this task will be provided under Task 5 below Assumptions The task budget is based on the following assumptions • Well development can be accomplished within five field days by a single staff geologist • Development water from the wells will be disposed of at the City's WWTP using a City vactor truck • Air sampling can be accomplished during one field day by a staff geologist The results of the air sampling will be reported under Task 5 below TASK 4 — INTERIM ACTION DESIGN AND CONSTRUCTION OVERSIGHT Goal To design the IA, oversee the IA contractor during construction, and aid the City in the execution and management of the protect City of Bremerton 255-1896-063 Scope of Work 3 December 2010 Approach The following activities will be performed • Preparation of plans (2 sheets maximum), specifications (WSDOT format, Divisions 01 and 02), and cost estimate Design review shall be streamlined and submittals shall consist of a 90% and for -construction Bid Set • General bid support, review of Contractor submittals and response to Contractor requests for information • Survey staking of mjection locations • On-site observation of Contractor during performance of the IA • Reporting of IA activities under Task 5 including a record drawing Deliverables The following deliverables will be submitted under this task • 90% and Bid Set PS&E • Request for information responses • IA activities description and record drawing (to be included in deliverables under Task 5) Assumptions The task budget is based on the following assumptions • The record drawing will consist of a hand -prepared "redline" of the construction plan sheet sealed by a professional engineer • Staffing for IA oversight is assumed to require one person onsite full tune for up to 12 working days • Up to sic face-to-face 2 -hour meetings and/or site visits will be attended by the project manager for the following purposes design review, preconstruction site walk, bid opening, and site visits during construction TASK 5 — RUFS REPORT, DCAP, AND NEGOTIATE 2ND AGREED ORDER Goal To integrate the results of the additional RI and IA activities into the existing Draft R1/FS Report, prepare a DCAP, and support the City during negotiations for the site's 2nd Agreed Order City of Bremerton 255-1896-063 Scope of Work 4 December 2010 Approach The following activities will be performed • Completion of the existing Draft RDFS Report to include descriptions of the additional RDFS and IA activities performed under this SOW • Preparation of a DCAP describing the selected cleanup approach for the site and an appropriate long-term groundwater monitoring program Deliverables The following deliverables will be submitted under this task • Draft and Final RDFS Report • Draft Cleanup Action Plan (DCAP) Assumptions The task budget is based on the following assumptions • Up to four face-to-face 4 -hour meetings will be held with Ecology and/or the City to discuss the RDFS Report and DCAP • A single round of comments each from the City and Ecology will be required to finalize the RDFS Report and the DCAP • The Draft RDFS Report and DCAP will be submitted electronically in PDF format Two hard copies of the final documents will be submitted to Ecology and one hard copy will be submitted to the City Final hard copy submittals will include a CD with an electronic copy of the final documents in PDF format Laboratory Data will be provided to Ecology in Environmental Information Management (EIM) format City of Bremerton 255-1896-063 Scope of Work 5 December 2010 L. n EXHIBIT B Schedule Work Element Completed or Submitted By Notice to Proceed February 1, 2011 Draft RI/FS Work Plan and 90% PS&E Well installation/development, final Work Plan, Bid Set PS&E, advertise contract Groundwater sampling round Draft RI/FS Report Award Infection Project ORC infection and preliminary DCAP Final RI/FS Report Final Draft Cleanup Action Plan February 15, 2011 March 1, 2011 April 15, 2011 May 15, 2011 May 1, 2011 June 1, 2011 June 15, 2011 June 30, 2011 Project Close Out September 30, 2011 City of Bremerton 255-1896-063 Scope of Work 1 December 2010 4 9 EXHIBIT C Budget Task 1 Protect Management and Administration $11,192 Task 2 Supplemental RDFS Work Plan $8,980 Task 3 Additional RDFS Field Work $31,754 Task 4 IA Design and Construction Oversight $28,536 Task 5 RDFS Report, DCAP, and Negotiate 2nd Agreed Order $37,122 Allocated Expenses (6% of Labor) . $6202 TOTAL.......................................................................................................................$123,786 NOTES: The estimated fees shown above were determined on a cost plus multiplier basis, these fees shall not be exceeded without prior written approval by the City Personnel hourly rates shall be determined as follows Direct salary x 3 1 not to exceed $150 00 Subconsultants, sampling supplies, and equipment rental shall be subject to a 5% markup A breakdown of costs is provided in the attached budget spreadsheet City of Bremerton 255-1896-063 Scope of Work 1 December 2010 C'arriracc1-- #�jD CONTRACT MODIFICATION AGREEMENT NO.2 BETWEEN THE CITY OF BREMERTON AND PARAMETRIX PROJECT Former Chevron Property Remediation CONSULTANT Parametrix, Inc. DATE October 10, 2017 THIS CONTRACT MODIFICATION AGREEMENT SPECIFICALLY AMENDS THE FORMER CHEVRON PROPERTY REMEDIATION AGREEMENT (the "Contract") entered into between the City of Bremerton and Parametria on January 27, 2011 All provisions in the Contract shall remain in full force and effect except as expressly modified by this document. For valuable consideration and by mutual consent of the parties, the modifications to the Contract are as follows: I. Section I. Scope , is modified as follows: NIA this is a contract extension only. Section II. Term , is modified as follows: The Consultant shall complete Jhe work described in this Contract Modification Agreement by December -30, 2022. Section III. Compensation , is modified as follows: The original contract amount was One Hundred Twenty Three Thousand Seven Hundred Eighty -Six Dollars ($123,786.00). Contract Modification No. 1 amended the contract amount to Three Hundred Forty Nine Thousand Forty -Two Dollars ($349,042.00). This Contract Modification No. 2 does not revise the contract amount. II. Consultant accepts all requirements of this Contract Modification by endorsing below. Consultant further agrees that this Contract Modification constitutes full and final settlement of all of the Consultant's claims for contract time and for all costs of any kind, including without limitation, costs of delays related to any work either covered or affected by this Contract Modification, claims related to on-site or home office overhead, or lost profits. This Contract Modification does not limit the City's right to bring a claim for past performance. The undersigned consultant approves the foregoing Contract Modification as to the changes, if any, in the contract price specified for each item, including any and all supervision costs and CONTRACT MODIFICATION Project Number: other miscellaneous costs relating to the change in work, and as to the extension of time allowed, if any, for completion of the entire work due to said Contract :Modification. This document will become a supplement of the contract and all provisions will apply hereto. It is understood that this Contract Modification shall be effective when approved by the City of Bremerton. The parties whose names appear below warrant that they are authorized to enter into a contract modification that is binding on the parties of this contract. an addition, Consultant warrants that it has or will inform the surety of this change, and shall take appropriate action to modify any bonds required under the contract to address this change. IN WITNESS WHEREOF, the parties have executed this Contract Modification on the day and year first written above. City Engineer / Public Works Director approved to process DATE: - 10' - (l- k1 APPROVED AS TO FORM: 1 I' Bremerton Citytto ey NOTICES TO BE SENT TO: Dave Dinkuhn Senior Engineer Parametrix 4660 Kitsap Way, Suite A Bremerton, WA 98312 360-377-0014 Initials and Date THE CITY OF BREIMERTON By P L nt Its NL4r DATE: ATTEST: i J City Clerk NOTICES TO BE SENT TO: Tom Knuckey, PE City Engineer City of Bremerton Engineering Department 3027 Olympus Drive Bremerton WA, 98312 360-473-2376 C:\Usen\dinkudav\AppData\L,ocal\Microsoft\Windows\Tempormy Internet Files\Content. Outlook\IJDFARIU\121018 CondactModitication2.doc CONTRACT MODIFICATION Project Number: Client City of Bremerton Project Chevron Property RI/FS IA Completion Project No 235-1896-OXX Labor Task/Subconsultant Amount Task 03 - APS (locates) ° Task 03 - ESN Northwest (drilling) 0 Parametrix0 c v a) cog _ Jg U o N W ED Q m >+ E Z rn CO x N in U m` CO CL v CO i T Labor Burdened Rates: $133 00 $67081 $8761 $15000 $16740 $9359 $81 13 Phase Task Description Total Hours Mult. 01 RI/FS and IA Completion $103,361 973 3.1 302 80 434 78 11 60 8 01 PM ect Management, $11,191 90 3.1 48 18 24 02 RI/FS & A Work Plan ,980 76 3 1 44 12 8 12 03 RIMS I✓ield Work $17,531 183 31 26 10 140 2 5 04 IA Qesi nand CM $28,536 276 31 62 _16 148 20 6 24 05 RI/FS Report and DCAP $37,122 348 3.1 -122 24 146 24 24 _ 8 06 Allocated I=x ehsds _ _ $0 - 01 061 0 Labor Totals: SUBCONSULTANTS Task/Subconsultant Amount Task 03 - APS (locates) $35700 Task 03 - ESN Northwest (drilling) $2,10000 Task 03 - OnSite Env (laboratory) $6,82605 Subconsultant Total: $9,283 DIRECT EXPENSES: Task/Description Amount Task 03 - Expenses (Supplies /Rental) $4,94000 Task 06 - Allocated Expenses (6% of Labor) $6,20200 Expense Total: $11,142 Project Total: 123,786 973 302 80 434 78 11 60 8 EXHIBIT C J__ - If DATE(MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 10/24/2024 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 have ADDITIONAL INSURED provisions or 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 NAME: Jennifer Aguirre AssuredPartners Design Professionals Insurance Services, LLC PHONE FAX 3697 Mt. Diablo Blvd Suite 230 (A/c,No,Ext): (510)465-3090 (A/C,No): Lafayette CA 94549 ADODRESS: DesignProCerts@AssuredPartners.com INSURER(S)AFFORDING COVERAGE NAIC# License#:6003745 INSURERA: Continental Insurance Company 35289 INSURED PARAINC-01 INSURER B:XL Specialty Insurance Co. 37885 Parametrix, Inc. 1019 39th Ave. SE Suite 100 INSURERC: Valley Forge Insurance Company 20508 Puyallup, WA 98374 INSURER D: National Fire Insurance of Hartford 20478 (253)604-6600 INSURERE: Continental Casualty Company 20443 INSURER F: COVERAGES CERTIFICATE NUMBER:1221154965 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 TYPE OF INSURANCE ADDL INSD sUBR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MM/DD/YYYY) D X COMMERCIAL GENERAL LIABILITY Y Y 6050531366 11/1/2024 11/1/2025 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $1,000,000 X Contractual Liab MED EXP(Any one person) $10,000 X XCU Included PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X 'ECT LOC PRODUCTS-COMP/OP AGG $2,000,000 X OTHER: WA Stop Gap/EL WA Stop Gap $1,000,000 E AUTOMOBILE LIABILITY Y Y 6050531352 11/1/2024 11/1/2025 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) A X UMBRELLA LIAB X OCCUR Y Y 6050531433 11/1/2024 11/1/2025 EACH OCCURRENCE $15,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $15,000,000 DED X RETENTION$n $ G WORKERS COMPENSATION Y 6050531383 11/1/2024 11/1/2025 X D AND EMPLOYERS'LIABILITY Y/N 6050531402 11/1/2024 11/1/2025 STATUTE ER WA Stop Gap ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Professional Liability DPR5035932 11/1/2024 11/1/2025 Per Claim $1,000,000 Claims Made Annual Aggregate $1,000,000 Pollution Liability Included Y Retroactive Date: 01/01/1969 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Umbrella Liability policy is a follow-form to underlying General Liability/Auto Liability/Employers Liability. Project Number/Name: #233-1896-107/Long Term Monitoring Former Chevron Property, Bremerton,WA-- The City of Bremerton is named as Additional Insured on General Liability and Auto Liability,per policy forms,with respect to the operations of the Named Insured as required by written contract or agreement. General Liability is Primary/Non-Contributory and severability of interests per policy form wording. Insurance coverage includes waiver of subrogation per attached. CERTIFICATE HOLDER CANCELLATION 30 Days Notice of Cancellation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Bremerton ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Noreen Bolo 345 6th Street, Ste 100 AUTHORIZED REPRESENTATIVE Bremerton WA 98310 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions, or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations subject to such written contract; or B. in the performance of your work subject to such written contract, but only with respect to 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. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition, or 10-01 edition of CG2010, or under the 10- 01 edition of CG2037; or B. additional insured coverage with "arising out of" language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I. above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: M M 0 A. coverage broader than required by the written contract; or 0 B. a higher limit of insurance than required by the written contract. 0 N IV. The insurancegranted bythis endorsement to the additional insured does not apply to bodilyinjury, property pp Y � J rY� p p Y 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. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance is amended to add the following,which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part: CNA75079XX(10-16) Policy No: 6050531366 Page 1 of 2 Endorsement No: 15 Nat' 1 Fire Ins Co of Hartford Insured Name: PARAMETRIX, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage Endorsement Primary and Noncontributory Insurance With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured; or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above, this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self-insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement, the section entitled 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: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. 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. CNA75079XX(10-16) Policy No: 6050531366 Page 2 of 2 Endorsement No: 15 Nat' 1 Fire Ins Co of Hartford Insured Name: PARAMETRIX, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. CNA CNA PARAMOUNT Waiver of Transfer of Rights of Recovery Against Others to the Insurer Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION WHOM THE NAMED INSURED HAS AGREED IN WRITING IN A CONTRACT OR AGREEMENT TO WAIVE SUCH RIGHTS OF RECOVERY, BUT ONLY IF SUCH CONTRACT OR AGREEMENT: 1. IS IN EFFECT OR BECOMES EFFECTIVE DURING THE TERM OF THIS COVERAGE PART; AND 2. WAS EXECUTED PRIOR TO THE BODILY INJURY, PROPERTY DAMAGE OR PERSONAL AND ADVERTISING INJURY GIVING RISE TO THE CLAIM. (Information required to complete this Schedule, if not shown above,will be shown in the Declarations.) Under COMMERCIAL GENERAL LIABILITY CONDITIONS, it is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: With respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named Insured's ongoing operations or your work included in the products-completed operations hazard. All other terms and conditions of the Policy remain unchanged. 0 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, Fg o and expires concurrently with said Policy. (0 (0 (0 0 0 N O O EEE = CNA75008XX(1O-16) Policy No: 6050531366 Page 1 of 1 Endorsement No: 17 Nat'l Fire Ins Co of Hartford Insured Name: PARAMETRIX, INC. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. CNA Business Auto Policy Policy Endorsement CONTRACTORS EXTENDED COVERAGE ENDORSEMENT - BUSINESS AUTO PLUS THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. LIABILITY COVERAGE A. Who Is An Insured The following is added to Section II, Paragraph A.1., Who Is An Insured: 1. a. Any incorporated entity of which the Named Insured owns a majority of the voting stock on the date of inception of this Coverage Form; provided that, b. The insurance afforded by this provision A.1. does not apply to any such entity that is an insured under any other liability "policy" providing auto coverage. 2. Any organization you newly acquire or form, other than a limited liability company, partnership or joint venture, and over which you maintain majority ownership interest. The insurance afforded by this provision A.2.: a. Is effective on the acquisition or formation date, and is afforded only until the end of the policy period of this Coverage Form, or the next anniversary of its inception date, whichever is earlier. b. Does not apply to: (1) Bodily injury or property damage caused by an accident that occurred before you acquired or formed the organization; or (2) Any such organization that is an insured under any other liability "policy" providing auto coverage. 3. Any person or organization that you are required by a written contract to name as an additional insured is an insured but only with respect to their legal liability for acts or omissions of a person, who qualifies as an insured under SECTION II — WHO IS AN INSURED and for whom Liability Coverage is afforded under this policy. If required by written contract, this insurance will be primary and non-contributory to insurance on which the additional insured is a Named Insured. 4. An employee of yours is an insured while operating an auto hired or rented under a contract or agreement in that employee's name, with your permission, while performing duties related to the conduct of your business. "Policy", as used in this provision A. Who Is An Insured, includes those policies that were in force on the inception date of this Coverage Form but: 1. Which are no longer in force; or 2. Whose limits have been exhausted. B. Bail Bonds and Loss of Earnings Section II, Paragraphs A.2. (2) and A.2. (4) are revised as follows: 1. In a.(2), the limit for the cost of bail bonds is changed from $2,000 to $5,000; and 2. In a.(4), the limit for the loss of earnings is changed from $250 to $500 a day. Form No: CNA63359XX (04-2012) Policy No: 6050531352 Page: 1 of 4 Policy Effective Date: 11/01/2024 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 °Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission. CNA Business Auto Policy Policy Endorsement C. Fellow Employee Section II, Paragraph B.5 does not apply. Such coverage as is afforded by this provision C. is excess over any other collectible insurance. II. PHYSICAL DAMAGE COVERAGE A. Glass Breakage - Hitting A Bird Or Animal - Falling Objects Or Missiles The following is added to Section III, Paragraph A.3.: With respect to any covered auto, any deductible shown in the Declarations will not apply to glass breakage if such glass is repaired, in a manner acceptable to us, rather than replaced. B. Transportation Expenses Section III, Paragraph A.4.a. is revised, with respect to transportation expense incurred by you, to provide: a. $60 per day, in lieu of $20; subject to b. $1,800 maximum, in lieu of $600. C. Loss of Use Expenses Section III, Paragraph A.4.b. is revised, with respect to loss of use expenses incurred by you, to provide: a. $1,000 maximum, in lieu of $600. D. Hired "Autos" The following is added to Section III. Paragraph A.: 5. Hired "Autos" If Physical Damage coverage is provided under this policy, and such coverage does not extend to Hired Autos, then Physical Damage coverage is extended to: a. Any covered auto you lease, hire, rent or borrow without a driver; and b. Any covered auto hired or rented by your employee without a driver, under a contract in that individual employee's name, with your permission, while performing duties related to the conduct of your business. c. The most we will pay for any one accident or loss is the actual cash value, cost of repair, cost of replacement or $75,000, whichever is less, minus a $500 deductible for each covered auto. No deductible applies to loss caused by fire or lightning. d. The physical damage coverage as is provided by this provision is equal to the physical damage coverage(s) provided on your owned autos. e. Such physical damage coverage for hired autos will: (1) Include loss of use, provided it is the consequence of an accident for which the Named Insured is legally liable, and as a result of which a monetary loss is sustained by the leasing or rental concern. (2) Such coverage as is provided by this provision will be subject to a limit of $750 per accident. E. Airbag Coverage The following is added to Section III, Paragraph B.3.: The accidental discharge of an airbag shall not be considered mechanical breakdown. Form No: CNA63359XX (04-2012) Policy No: 6050531352 Page: 2 of 4 Policy Effective Date: 11/01/2024 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 °Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission. CNA Business Auto Policy Policy Endorsement F. Electronic Equipment Section III, Paragraphs B.4.c and B.4.d. are deleted and replaced by the following: c. Physical Damage Coverage on a covered auto also applies to loss to any permanently installed electronic equipment including its antennas and other accessories d. A $100 per occurrence deductible applies to the coverage provided by this provision. G. Diminution In Value The following is added to Section III, Paragraph B.6.: Subject to the following, the diminution in value exclusion does not apply to: a. Any covered auto of the private passenger type you lease, hire, rent or borrow, without a driver for a period of 30 days or less, while performing duties related to the conduct of your business; and b. Any covered auto of the private passenger type hired or rented by your employee without a driver for a period of 30 days or less, under a contract in that individual employee's name, with your permission, while performing duties related to the conduct of your business. c. Such coverage as is provided by this provision is limited to a diminution in value loss arising directly out of accidental damage and not as a result of the failure to make repairs; faulty or incomplete maintenance or repairs; or the installation of substandard parts. d. The most we will pay for loss to a covered auto in any one accident is the lesser of: (1) $5,000; or (2) 20% of the auto's actual cash value (ACV). III. Drive Other Car Coverage — Executive Officers The following is added to Sections II and III: 1. Any auto you don't own, hire or borrow is a covered auto for Liability Coverage while being used by, and for Physical Damage Coverage while in the care, custody or control of, any of your "executive officers", except: a. An auto owned by that "executive officer" or a member of that person's household; or b. An auto used by that "executive officer" while working in a business of selling, servicing, repairing or parking autos. Such Liability and/or Physical Damage Coverage as is afforded by this provision. (1) Equal to the greatest of those coverages afforded any covered auto; and (2) Excess over any other collectible insurance. 2. For purposes of this provision, "executive officer" means a person holding any of the officer positions created by your charter, constitution, by-laws or any other similar governing document, and, while a resident of the same household, includes that person's spouse. Such "executive officers" are insureds while using a covered auto described in this provision. IV. BUSINESS AUTO CONDITIONS A. Duties In The Event Of Accident, Claim, Suit Or Loss The following is added to Section IV, Paragraph A.2.a.: Form No: CNA63359XX (04-2012) Policy No:6050531352 Page: 3 of 4 Policy Effective Date: 11/01/2024 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 °Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission. CNA Business Auto Policy Policy Endorsement (4) Your employees may know of an accident or loss. This will not mean that you have such knowledge, unless such accident or loss is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager. The following is added to Section IV, Paragraph A.2.b.: (6) Your employees may know of documents received concerning a claim or suit. This will not mean that you have such knowledge, unless receipt of such documents is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager. B. Transfer Of Rights Of Recovery Against Others To Us The following is added to Section IV, Paragraph A.5. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have, because of payments we make for injury or damage, against any person or organization for whom or which you are required by written contract or agreement to obtain this waiver from us. This injury or damage must arise out of your activities under a contract with that person or organization. You must agree to that requirement prior to an accident or loss. C. Concealment, Misrepresentation or Fraud The following is added to Section IV, Paragraph B.2.: Your failure to disclose all hazards existing on the date of inception of this Coverage Form shall not prejudice you with respect to the coverage afforded provided such failure or omission is not intentional. D. Other Insurance The following is added to Section IV, Paragraph B.5.: Regardless of the provisions of Paragraphs 5.a. and 5.d. above, the coverage provided by this policy shall be on a primary non-contributory basis. This provision is applicable only when required by a written contract. That written contract must have been entered into prior to Accident or Loss. E. Policy Period, Coverage Territory Section IV, Paragraph B. 7.(5►.(a). is revised to provide: a. 45 days of coverage in lieu of 30 days. V. DEFINITIONS Section V. paragraph C. is deleted and replaced by the following: Bodily injury means bodily injury, sickness or disease sustained by a person, including mental anguish, mental injury or death resulting from any of these. Form No: CNA63359XX (04-2012) Policy No: 6050531352 Page: 4 of 4 Policy Effective Date: 11/01/2024 Underwriting Company: The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 °Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission. CNA Workers Compensation And Employers Liability Insurance Policy Endorsement WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any Person or Organization on whose behalf you are required to obtain this waiver of our right to recover from under a written contract or agreement. The premium charge for the endorsement is reflected in the Schedule of Operations. 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,1 takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: WC 00 03 13 (04-1984) Policy No: 6 50531402 Endorsement No: 3; Page: 1 of 1 Underwriting Company: American Casualty Company of Reading, Pennsylvania, 333 S Wabash Ave, Chicago, IL 60604 Copyright 1983 National Council on Compensation Insurance. CNA Workers Compensation And Employers Liability Insurance Policy Endorsement BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement changes the policy to which it is attached. It is agreed that Part One - Workers' Compensation Insurance G. Recovery From Others and Part Two - Employers' Liability Insurance H. Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE - Refer to the Schedule of Operations The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure. The amount is 2%. 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 Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: G-19160-B (11-1997) Policy No:WC 6 50531383 Policy Endorsement Effective Date: Endorsement Expiration Date: Endorsement No: 2; Page: 1 of 1 Underwriting Company: American Casualty Company of Reading, Pennsylvania, 151 N Franklin St, Chicago, IL 60606 °Copyright CNA All Rights Reserved.