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HomeMy WebLinkAbout5562 �; � .� ��- �a P�tOFESSIONAL SERVICES AGREEMENT Pacific Forest Resources—Phase II The City of Bremerton ("City"} and Pacific Forest Resources ("Consultant"), referred to collectively as the"Parties,"enter into the foliowing Agreement for professional services: I. Scope: The Consultant agrees to perform the services more specifically described in the Scope of Work, dated April 3, 201b, 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.H of this Agreement. If the Scope of Work provides for unspecified additional services such services shall only be performed upon the express written reyuest of the City. Consultant further represents that the services furnished under this Ageement wili be performed in accordance with generally accepted professional pcactices in effect at the time such services are performed. II. 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. III. Compensation: In consideration of the services provided pursuant to this Agreement, the City shall pay Consultant in an amount not to exceed $15,0OO.OQ. Consultant's charges and bills shall confonn to the fee schedule as shown in the Scope of Work in Exhibit A 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 descciptions shall confonn to and fall within the categories set out in the Scope of Work and�or Eee 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 A. 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 A. if a billing statement does nat conform ta 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. IV. Relationship ot 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 Bremerton/Pacific Forest Resources Phase II —Fores Culvert Re lacement Rev 03-16 Page 1 of 7 i • 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 af mana�erial control over Consultant or its personnel. As an independent Consultant, Consultant is responsible for payment of all taxes and Iicensing 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. Indemnifecation: A. Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the perfom�ance of this Agreement, unless Consultant is conducting work pursuant to Subsection B below. The City's ceview or acceptance of any of the work when completed sha11 not be grounds to avoid any of Ehese covenants of indemnification. B. Architects, Eneineers and Anv Other Professional Listed [n and Performin� Services Defined in RCW 4.24.115. Should a court of competent jurisdiction determine that Consultant's services provided pursuank to 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 negli�ence of the Consuttant and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability hereunder shail be only to the extent of the Consuttant's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONS'TITUTES THE CONSULTANT'S WANER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, T'ITLE S I 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/Pacific Forest Resources Phase II—Fores Culvert Re lacement Rev 02-16 Page 2 of 7 VI. Insurance: The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons ar 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 Liabilitv insurance with limits no less than $1,000,000 combined single limit per accident for bodily injury and property damage; and 2. Commercia� General Leabelitv insurance written �n an occurrence basis with limits no less than $1,000,000 combined single limit per occurrence,and generaI aggregate for personal injury, bodily injury and property damage. Covera�e shall include but not be limited to: blanket contractual; productslcompleted operations/broad form property damage; explosion, collapse and underground(XCU) if appticable; and 3. Excess Liability insurance with limits not less than 1,000,000 limit per occurrence and aggregate. 4. Professional Liabilitv insurance with limits no less than $1,000,440 limit per occurrence,rclaim. 5. Workers Comaensation insurance as statutorily required by the [ndustrial Insurance Act of the State of Washington, Title 51, Revised Code of Washington and employer's liability with limits not less than$1,000,OQ0. 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. 1fie City shall be named as an additional insured on the Commercial General Liability insurance policy, as respects work perfocmed 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 endarsements. 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 separate[y to each insured against whom claim is made or suit is broughk, except with respects to the limits of the insurer's liability. The Consultant's insurance shall be primary insurance as respects the City and shall be an affirmative obligation upon Consultant to advise the City's Risk Manager by fax at (360) 473- 5161,or by certified mail, return receipt requested to City of Bremerton, attn: Risk Management, 345 6'� Street, Suite 600, Bremerton, WA 98337 within two days of the cancellation, suspension or substantive change of any insurance policy set out herein, and failure to do so shali be construed to be a breach of this Agreement. Bremerton/Pacific Forest Resources Phase II--Forestry Culvert Replacement Rev 02-16 Page 3 of 7 . d' The City also reserves its unqualified right to require at any time and for any reason, proaf of coverage in the form of a duplicate of the insurance policy with all endorsements as evidence of coverage. VII. Genera!Conditions: A. Reports and Information: When requested by the City, Consultant shall furnish periodic reports and documents on matters covered by this Ageement. The reports ar�d documents shall be furnished in the time and foRn requested. Consultant shall maintain accounting records in accordance with Generally Accepted Accounting Principles (GAAP) to substantiate all bitled amounts. B. Ownershin and Use of Records and Documents: Original documents, drawings, designs and reports, including those in electronic format, developed under this A�reement 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 wili be safegi�arded by the Consultant to at least the same extent as the Consultant safeguazds 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 rightfuity obtained by the Consultant from third parties, Consultant shall bear no responsibility for its disclosure, inadvertent or otherwise. All data, documents and fiIes created by Consultant under this Agreement may be stored at Cansultant's office in Enumclaw, Washington. Consultant shall make such data, documents, and files available to the City upon its request at all reasonable times for the purpose of editing, 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 alt reports, drawings,specifications, computer software or other items prepared or fumished 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. Use of Photo►raphs and Images. Consultant shalt not use or distribute photographs or images depicting City officials, persoruiel, property, or equipment whether prepared by Consultant or provided by City without prior written consent of the City. The City tivill not unreasonably withhold its consent. D. Work Performed at Consultant's Risk: Consultant shall take all precautions necessary and shall be responsible for the safety of its employees, agents, and suh-consultants in the performance af the work hereunder and shall utilize all protection necessary for that purpose. All work shaEl be done at Cansultant's own risk, and Consultant shall be responsible for any loss of ar damage to materials, tools, or other articles used or hetd for use in connection with the work. BremertonlPacific Forest Resources Phase II — Forestrv Culvert Reulacement Rev 02-t5 Page 4 of 7 E. Place of Work: The Consultant shal) perform the work authorized under this Agreement at its offices in Enumclaw, Washington. Meetings with the City staff as described in Exhibit A, Scope of Work, shall take place at the City's offices, ar at locations mutualty agreed upon by the parties. F. Entire A�reement: This Agreement and its Exhibits constitutes the entire agreement between the Parties, and the Parties acknowled�e that there are no other agreements, written or oral,that have not been set forth in the text of this Agreement. G. Severabilitv: Should any part of this Agreement be found void, the balance of the Agreement shall remain in full force and effect. H. Modification: This Agreement may only be modified by written instrument signed by both Parties. I. Written Notices: All communications regarding this Agreement shall be sent to ihe parties at the addresses listed below by registered or I st class mail, or by personal service, and shal] be deemed sufficienEly given if sen# to the addressee at the address stated in this Agreement or such other address as may be hereafter specifted in writing. City Address Consuitant Address � Pat Coxon Steve Fauikner, P.E. 1600 Oyster Bay Ave. S, PO Box 395; 29322 SE 374`�'St. Bremerton, WA 98312 Enumciaw, WA 98022 J. 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. K. 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, a��reements or options, and the same shall be and remain in full force and effect. L. Compliance with Laws: Consultant shall comply with all appiicable Federal, State, and local laws in perForming its obligations under this Agreement. M. Choice of Law and Venue: This Agreement shall be incerpreted accarding to ihe 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. N. Attornevs' Fees: In the event of litigation to enforce any of the terms or provisions herein, each party shatl pay att its own costs and attomey's fees. Bremerton/Pacific Forest Resources Phase II-�Forestry Culvert Re�lacement Rev o2-t6 Pa�e5af7 r �t O. Assignment: Any assignment uf this agreement by the Contractor without the written consent of the City shall be void. VI[I. Nondiscrimination: Consultant shall not disctiminate 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) days of the terminating Party's sending notice to the non-perforrning Party. Any Notice by Consultant shall include a report showing the status of alI 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 substantialiy 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 Dela s: 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 controiling, restricting, or requisitioning materials, eyuipment, 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 foreseeabte by the parties at the time of the execution of the Agreement that are beyond the control and without the fault or nebligence of the Consultant, including, but not restricted to, acts of God, fires, floods, strikes, or weather of unusual severity. PROVIDED, H�WEVER, that the Consultant must promptly notify the City within ten (10) catendar days in writing of the cause of the delay. If, on the basis of the facts and the terms of this Ageement, 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. Ri ts U on Tennination: In the event of terntination, the City shalt pay for all services perFormed by the Consultant to the effective date of termination, as described on a final invoice subrnitted to the City. After te�nination, 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 Cansultant. X. Suspension & Debarment. For contracts invoIving Federal funding, Consultant hereby certifies,by signing this agreement, that neither it nor its principals are presentIy debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. Consultant shall provide immediate written notice to the City if at any time it learns that it is or has become ineligible for Bremerton/Pacific Forest Resources Phase II— Forestrv Culvert Renlacement Rev 0?-�6 Page6of7 Cf.'Tt1�C3t1017. SI1011�C�I COtISli��ctillt eliYET 111td�Z',OVer�d�ransaction v+rith another fir3n. �onsultant agrees by signing this agr�em�nt that it`v�lI verify that the firm�uith`vhom it intends to cio bus�ness is not debarred, suspend�d,ineli�ibEe,excluded or disaualifieZ. C�T1'�F BRENERTOI�! COIVSULI'A�1'T . r �_.�,°�.._ �,�'���./�r �„~,,. __.... --.,__..���._._..�..,.,m,,...� `� d �}r: C3�a1 hlar#in, P.E. By: Steve F�1,ii�.�er, P.E. , its: �]irector�i P1, �&U it�: �'resident Late: ! .�.... _��.�..�� �..... . .... �ate: �1�1_r.6_._..._.�.. Apgror�ed as to �orr�: . est: �,_+����___._r.. .. _._. . ____.._ _ .�.1 m,__.. Bremertoa�City�.�tomey City Cler R Legal Lcga�Consra�ts FOR,4i5 Pn�f�ssiocwl Scrvicrs Agnti�anen�Fam f.20161 d�. Bremerton/Faeific Forest Resources Phase II�-Forestrv Culvert Re�lacement Rev u2-t6 Page 7 of 7 ; PF R Pacific Forest Resources, Inc. Engineeringatld ForestManagement City of Bremerton, Public works & Utilities April 3, 2016 Attn: Patric Coxon 1600 Oyster bay Ave S Bremerton, WA 98312 RE: Bremerton Watershed Bridge & Road Designs— Project Approach Outline & Cost Estimate The following is a brief description of the perceived engineering/design process required for potential road design(s) on steep slopes as requested, plus contract/construction administration for the 2000 Road and 3000 Road#2 bridge projects in the City of Bremerton Watershed along with an estimated cost to complete the process. Site Surveys & Preliminary Site Reviews Pacific Forest Resources (PFR) will provide the necessary site survey needed for the road design segments. It is anticipated that the City will provide at least one field assistant to PFR for the site survey to be completed (no provision is included by PFR for the field assistant). Initial field visit(s) to the road site will be made with the WDFW and WDNR to analyze potential options and. This meeting will also serve as the "pre-FP/HPA" review. Road design, Plan, FP/HPA Preparation & Cost Estimates Utilizing best engineering practices, PFR will develop "pernut-ready"plans and specifications needed to obtain the FP/HPA for the road construction. PFR will also prepare a complete Forest Practice Application package ready for the City's submittal to the WDNR. Following development of the preliminary plans, PFR will provide the City with a cost estimate for the completed project. Constr�ection Plans & Bid Specifications Pacific Forest Resources will prepare a"stand-alone" set of"construction-grade" plans for the 2000 Rd and the 3000 Rd#2 bridge projects as well as that portion of the road design(as required). In addition, PFR will provide construction plans for the road segments including such additional information/details as required by the FPA. The plans shall be stamped by a licensed engineer and will be suitable for construction and inclusion into the City's construction bid package. PFR will offer whatever assistance is needed to the City the in preparation and evaluation of the construction bid package/contractor selection and construction contract preparation. P.O.Box 395 Phone 360-825-2921 29322 SE 374�h St pacificforestresources@msn.com Cell 253-569-8244 Enumclaw,WA 98022 www.pacificforestresou►-ces.com Fax 360-825-8666 Breme�7on i�'ate�shec(Bridge Design P�-ujects Pi•oposcrl#1 4-3-3016 Page 2 Construction Staking It is recommended that the construction staking be completed at all sites prior to the construction bid site visit in order to reduce some of the potential contractor concerns. This work should be fairly straight-forward and could easily be accomplished by the City's forestry staff, however a separate item for that process is included under this proposal so that the"office design" can be verified in the field. A single site visit will be required to accomplish this item for the bridge projects and it is recommended that this site visit be combined with the construction pre-bid site meeting so the PFR can answer any potential contractor questions. Because the road design staking is a bit more complex, additional time is included in this line item. ' � � Construction Supervision It is expected that that some of the construction supervision will be done by the City's Forester, however, certain aspects of the bridge installation may require specialized knowledge and/or design revisions, therefore a provision is included for this item. Although probably not needed, if requested by the City, PFR will develop a set of As-Built plans for the projects that depict any significant deviations from the original construction plans. Estimated Engineering Costs Pacific Forest Resources(PFR) proposes to charge for professional services on a time and material basis as with similar municipal contracts. The basic engineering rate will be One Hundred Twenty Dollars ($120) per hour plus vehicle cost per the accepted IRS rate(currently Fifty Six Cents per mile for 2016). Direct expenses and/or materials will charged based on the actual cost incurred plus 10%. The cost estimate shown below should be somewhat conservative and also anticipates that much of the construction supervision is to be supplied by the City's Forester. Bremerton Watershed Briclge Design Projects Engineering Cost Estimate Iteaxi Estimated Time Estimated Cost Road Survey&Preliminary Site Review 3%zf days w/travel $3,SOOf Road Design, FPA &Cost Estimate 4f days $4,OOOf Road Construction Plans &Bid Specs 2� days $2,OOOf Construction Staking 2%Zf days w/travel $2,SOOf Construction Supervision 2`/zf days w/travel $2,SOOf As-Built plans 'hf day $SOOf Estimated Engineering Cost $15,OOOf � Bremerton b�uters{ted Bridge Desig�i Projec•ts Proposal#? 4-3-2016 Puge 3 As noted above, these costs are expected to be somewhat conservative, however all work is to be invoiced on an"actual time"basis, therefore if the project is simpler than expected or if more site work can be accomplished by the City, the final cost will obviously be reflective of that. Throughout the design process, status reports for the project will be coordinated with the City's contracting officer so that any decisions as to additions(or deletions) to the project scope may be made in a timely manner. Please feel free to contact me if you wish to discuss any of this in more detail. Respectfully submitted— � ' Steve Faulkner, PE President ACERTIFICATE OF LIABILITY INSURANCE i/26/2017 YI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Dianne Daines NAME: Totem Agencies, Inc PHONE 360-829-9400 FAX 360-829-9405 P 0 Box 1554 RECEIVED E,Ie IANC No.Ext): (A/C,No): E-MAIESS:d d a i n e s @ t o t e m a g e n c i e s.c o m ;AVE 4 INSURER(S)AFFORDING COVERAGE NAIC# Buckley WA 98321 JAN 30 Zoll INsuRERA:American States Insurance Co INSURED INSURER B: Pacific Forest Resources, Inc. City of BremertOn INSURER C: P. 0. Box 395Risk Management INSURER D: INSURER E: Enumclaw WA 98022 INSURER F: COVERAGES CERTIFICATE NUMBER:2017 liability 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR , ; .► a POLICY NUMBER MM/.D/YYYY M/DD/YY Y LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 200,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE X OCCUR 01CH746795-0 2/21/2017 2/21/2018 MED EXP(Any one person) $ 10,000 X Log Broad Form PD PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 X l POLICY n PR� LOC COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ p' ALL OWNED SCHEDULED 06CC084444-1 2/21/2017 2/21/2018 BODILY INJURY(Per accident) $ AUTOS _ AUTOS — NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _ AUTOS (Per accident) Underinsured motorist $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ 0180431582-3 2/21/2017 2/21/2018 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below ,,. E.L.DISEASE-POLICY LIMIT $_ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Certificate holder is named additional insured as respects operations of the named insured. Additional insured is primary per the attached endorsement CG7680-0396. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Bremerton 4 Attn: Risk Management 345 6th Street #600 AUTHORIZEDREPRESfNATIVE ( ` Bremerton, WA 98337 �.� L ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY POLICY NO: 01CH746795-0 CG 76 80 03 96 ADDITIONAL INSURED PRIMARY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any Person or Organization with whom the insured has agreed within a written contract provided such agreement is excuted prior to the loss. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement). WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule subject to the following provisions. 1. This insurance applies only with respect to liability: a. Arising out of your ongoing operations from that insured by or for you; or b. Arising from the general supervision of your ongoing operations by the person or organization shown in the schedule. 2. This insurance does not apply to "bodily injury" or"property damage" arising out Of the sole negligence or willful misconduct of, or for defects in design furnished by, the person or organization shown in the schedule. With respect to the insurance afforded the additional insured, paragraph 4 of COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV) is deleted and replaced by the following: 4. Other Insurance a. This insurance is primary and noncontributory, and our obligations are not affected by any other insurance carried by such additional insured whether primary, excess, contingent, or on any other basis. b. This additional provision applies only to the person or organization shown in the Schedule.