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HomeMy WebLinkAbout5710AGENDA BILL CITY OF BREMERTON CITY COUNCIL SUBJECT: Professional Services Agreement with Parametrix for Engineering Services for the Manette Park Renovation Project 7F Study Session Date: July 26, 2017 COUNCIL MEETING Date: August 2, 2017 Department: Parks & Recreation Presenter: Jeff Elevado Phone: (360) 473-5428 SUMMARY: A Request for Qualifications (RFQ) was advertised on June 5, 2017 for the engineering consultant selection for the Manette Park Renovation Project. One submittal was received. ATTACHMENTS: 1) Professional Services Agreement 2) Exhibits A, B, and C; and Project Graphics FISCAL IMPACTS (Include Budgeted Amount): Budget Adjustment to increase the 2017 Parks Capital Construction Fund by $70,000 for engineering services and permitting. Funds transferred from the General Government Capital Improvement Fund (REET). STUDY SESSION AGENDA: 0 No Presentation ❑ Full Presentation STUDY SESSION ACTION: ® Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION: Move to approve the Professional Services Agreement between the City of Bremerton and Parametrix in an amount not to exceed $56,558.00; authorize the Mayor to finalize and execute the agreement with the same terms and conditions as presented; and authorize a Budget Adjustment to transfer $70,000 from the General Government Capital Improvement Fund and increase the 2017 Parks Capital Construction Fund Revenue and Expenditure Budgets by $70,000 respectively. COUNCIL ACTION: [Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 01/07/15 PROFESSIONAL SERVICES AGREEMENT Engineering Services for Manette Park Renovation Project The City of Bremerton ("City") and Parametrix ("Consultant"), referred to collectively as the "Parties," enter into the following Agreementf p ofessional services: I. Scope: The Consultant agrees to perform the services more specifically described in the Scope of Work, dated July 11, 2017, 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 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. 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 attached hereto as 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 $56,558.00. 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 Rev. 8/15 Engineering Services for Manette Park Renovation Project Page 1 of 7 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: 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 performance of this Agreement except for that portion of the injuries and damages caused by the - City's sole negligence, unless Consultant'is conducting 46ikilifsuant to Subsection B below. 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. B. Architects, Engineers and Any Other Professional Listed In and Performing Services Defined in RCW 4.24.115. Should a court of competent jurisdiction determine that Consultant's services provided pursuant 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 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 Bremerton/Parametrix Rev. 8/15 Engineering Services for Manette Park Renovation Project Page 2 of 7 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. VI. Insurance: The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, its agents, representatives, 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 Liabili 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 operations/broad 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 it shall be an affirmative obligation upon Consultant to advise the City's Risk Manager by fax at (360) 473- Bremerton/Parametrix Rev. 8/15 Engineering Services for Manette Park Renovation Proiect Page 3 of 7 5161, or by certified mail, return receipt requested to City of Bremerton, attn: Risk Management, 345 6`h 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 shall be construed to be a breach of this Agreement. The City also reserves its unqualified right to require at any time and for any reason, proof of coverage in the form of a duplicate of the insurance policy with all endorsements as evidence of coverage. 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 time 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 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 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. Use of Photographs and Images. Consultant shall,not use or distribute photographs or images depicting City officials, personnel, property, or equipment whether prepared by Consultant or provided by City without prior written consent of the City. The City will 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 sub -consultants in the performance of the work hereunder and shall utilize all protection necessary for that purpose. Bremerton/Parametrix Rev. 8/15 Engineering Services for Manette Park Renovation Project Page 4of7 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. E. 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. F. 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. G. Severability: 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 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 Consultant Address 680 Lebo Blvd. 60 Washington Ave. #390 Bremerton, WA. Bremerton, WA. 98310 98337 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, agreements or options, and the same shall be and remain in full force and effect. L. Compliance with Laws: Consultant shall comply with all applicable Federal, State, and local laws in performing its obligations under this Agreement. M. 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. Bremerton/Parametrix Rev. 8/15 En 'neering Services for Manette Park Renovation Project Page 5 of 7 N. 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. O. Assignment: 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) 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 severity. 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 terms 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. Bremerton/Parametrix Rev. 8/15 Engineering Services for Manette Park Renovation Project Page 6of7 X. Suspension & Debarment. For contracts involving Federal funding, Consultant hereby certifies, by signing this agreement, that neither it nor its principals are presently 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 certification. Should Consultant enter into a covered transaction with another firm, Consultant agrees by signing this agreement that it will verify that the firm with whom it intends to do business is not debarred, suspended, ineligible, excluded or disqualified. CITY OF BREMERTON • . FiRU . "!/�� ,, . Approved as to form: Att t: i Bremerto C' Attorkey City Clerk R:\Legal\Legal\Contracts\FORMS\Professional Services Agreement Form (2015)-2.doc Bremerton/Parametrix Rev. 8/15 Engineering Services for Manette Park Renovation Project Page 7 of 7 EXHIBIT A — SCOPE OF WORK City of Bremerton Manette Park Renovation INTRODUCTION This exhibit presents Parametrix's proposed scope of work (SOW) for preparation of construction plans, specifications, and engineers estimate (PS&E) for the Manette Park Renovation project. The work will consist mainly of developing the City's existing 30% design into bid set construction documents. A proposed schedule for the work is provided in Exhibit B and our proposed budget is attached as Exhibit C. The following tasks are associated with this SOW: Task 1 — Project Management and Meetings , Objective Obtain project data; monitor and manage scope, schedule, and budget; and periodically meet with the City and other members of the design team to review project status. Activities The following activities are associated with this task: • Schedule, prepare for, attend, and document up to two project meetings that will include the Consultant and City staff. • Manage and direct the project technical team. • Provide routine project management and communications (scope, schedule, budget, invoicing, etc.). • Prepare monthly progress reports and progress billings and submit to the City for approval and payment. The monthly report will include: A narrative of the work performed and the tasks to be performed in the next reporting period and, if necessary, explanation of delays, problems, responsive action requirements by the Consultant and the City, and other project needs. Deliverables The following deliverables will be prepared: • Routine correspondence and monthly progress reports. • Meeting agendas and notes. Assumptions The following assumptions apply to this task: • Design deliverables review meetings will be attended by the Parametrix project manager. City of Bremerton 234-1896-870 Manette Park Renovation 1 July 11. 2017 Scope of Work • Project duration will be 13 months (August 2017 through September 2018). Task 2 — 30 Cost Estimate and 60% Plans, Specifications and Estimates (PS&E) Objective Prepare 30% cost estimate, and 60 % PS&E for the project. Activities The following activities would be performed as part of this task: • Develop 30% cost estimate using City's 30% design to vet cost assumptions and evaluate budget. • Prepare 60% design plans. • Prepare a 60% cost estimate. • Prepare 60% special provisions. Deliverables The following deliverables are associated with this task: • 60% - the proposed plan sheets to be delivered for this task are listed in the budget spreadsheet in Exhibit C. • 30% and 60% cost estimates. • 60% special provisions. • Two hard copies and one PDF set of all plans (on 11 "x 17"), special provisions, and cost estimates at each design stage. • AutoCAD and PDF files of all drawings and documents provided on CD. Assumptions The following assumptions are associated with this task: • The total number of plan sheets for the design is 15 as shown in Appendix C. • Structural designs for the Romtec restroom, Redi-Rock retaining walls, and sports field lighting (Musco Lighting) will be provided by each respective vendor, including plans stamped by a Washington State licensed professional engineer. Parametrix will provide layout plan and profile plans for the Redi-Rock retaining walls. • Landscape and irrigation design will be by the City. • Special provisions and all drawings will follow WSDOT format • Bid schedule will be structured to provide major items as lump sum. The intent is to minimize the need to measure unit items as the City will not be providing full time field observation. City of Bremerton 6-870 234-189 Manette Park Renovation 2 July 19 -870 Scope of Work Task 3 — 90%, 100% and Bid Set (PSBE) Objective Prepare 90%, 100%, and Bid Set PS&E for the project. Activities The following activities would be performed as part of this task: • Develop final engineering plans from the existing 60% plans. • Prepare a cost estimate at each deliverable stage. • Prepare special provisions at each deliverable stage. • Prepare contract documents for the 90% 100%, and Bid Set deliverables packages. Deliverables The following deliverables are associated with this task: • 90%, 100% and Bid Set Plans - the proposed plan sheets to be delivered for this task are listed in the budget spreadsheet in Exhibit C. • 90%, 100%, and Bid Set cost estimates. • 90%, 100%, and Bid Set contract documents. • Two hard copies and one PDF set of all plans (on 11 "x17" ), special provisions, and cost estimates at each design stage. o AutoCAD and PDF files of all drawings and documents provided on CD. Assumptions The following assumptions are associated with this task (in addition to the assumptions made under Task 2): • The total number of plan sheets for the design is fifteen as shown in Appendix C. • City will perform bid advertisement, provide all additional document reproduction and pay fees for advertisements and reproduction. • Special provisions and all drawings will follow WSDOT format. • No bid set addenda will be required during bidding. Task 4 — Subconsultants Objective Procure, manage and direct subconsultants to perform the work described herein. City of Bremerton 234-1896-870 Manette Park Renovation 3 July 11, 1017 Scope of Work Activities The following activities may be associated with this task: • Retain Shannon & Wilson, Inc. of Seattle to perform appropriate geotechnical studies for the project. Deliverables The following deliverables will be prepared: • Draft and final geotechnical report. Assumptions The following assumptions apply to this task: • Shannon & Wilson will install three soil borings at select locations using a truck mounted drill rig. • The geotechnical report will contain recommendations for the redi-rock retaining walls, light pole foundations, and restroom thickened slab. Task 5 — Directed Services (Work under this task will require prior written authorization from the City.) Objective Provide additional technical services as requested and authorized in writing by the City. Activities The following activities may be associated with this task: • Additional studies, engineering services during construction, and/or construction management support City. Deliverables The following deliverables will be prepared: • As requested by the City. Assumptions The following assumptions apply to this task: • Work under this task will require prior written authorization from the City. City of Bremerton Manette Park Renovation234-1896-870 Scope of Work 4 July 11, 2017 EXHIBIT B - SCHEDULE Work Element Completed By Notice to Proceed August 2, 2017 30% Cost Estimate (2 weeks) August 21, 2017 60% PS&E (8 weeks) October 16, 2017 90% PS&E (6 weeks) November 27, 2017 100% PS&E (6 weeks) January 8, 2018 BID SET PS&E (6 weeks) February 19, 2018 Construction May — July 2018 Project Closeout September 30, 2018 NOTE: The assumed turnaround time for City review of deliverables is 1 week. City of Bremerton 234-1896-870 Manelte Park Renovation S July 11. 1017 Scope of Work X Cw qG Q a Q O N N N N m to fh (D n �_ CO 1%N ^ O F U to N Vi M di M IA W rW e9 rM fA b9 N M N M - N N 6N9 6N9 NM C4 fn OO N N O N N N N n Q M A N N m m m N m N m o0 N N N W C 7 � a m K m to N IL o d w r N UU a S V1 O w m W v O W Q N U d n m m m m m m N N C U n N m w «+ 0 Li w E c m mIx W _4 N W N N N C a o m o s o Q m e Q Q Q Wicrn rr J D an W r CL p {p O N M M N N N N N m m V) O I O ....N. y •tU t9 C G C d C Cv C a m „ in m r m m a oiS K K La y CL c E y = m c0 m o 'di rn z o € m m to (n N y fp O p 11 C C O c cid m p cv c to ` o_ L,,, ooC CJ 'gad ym Ip O 'sa a 'o v C O (� •. -�'. .'7. V O U Z U C OJ C 5 a C O ail M U O a' (Y,t O Vy (� _ '� n L N y W W N J O f0 CL O Z c0 t0 z o •Q a p> gE� to H in F ¢ •� m y a� m Z z — w o- (pQ a`pp� O U CD U3 C ��WpQ (n H y H UJ U� V (n QQQIII 1 :m O Y C r a U coui Q X n 0 N 11 c cc O C CD C C O � m CL d 1.W d �0 C � G V V d a` v e( 0. N m O gi CL CL F N N O N (NO [ND O } N N '� NM NW 0 M f9 fp H fA fA N N M N M N U7 F � O O m N N N m c0 OD N t0 N N � ONE It C = idJ O m o CL Q N N aio m Vi vi m v O m � C (,. m N U ' N m a w W Q j C WE m 7 C a Y3 `S � a w m � o p � c ^' w w � m m c0 N r LU N C t C_ CL p O N N N N N N N M p N F K v1 N O O ti n N N IA Q co u u a L Z. W mB a a C_ d O ca �,.,. d N j < 0 0 lA ' O coCL Cl) w Q 2 a N m O gi CL CL ACORL> CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 8/9/2017 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 the terms and conditions of the policy, certain policies INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). EFF MMIDDY/YYYY PRODUCER Dealey, Renton & Associates P. O. BOX 12675 Oakland CA 94604-2675 LIMITS CONTANAME: Alison Muller PHM 510-465-3090 FAx 510-452-2193 E AMESS. Insurance.Certificates@dealeyrenton.com INSURERS AFFORDING COVERAGE NAIC # ZZ2893486906 INSURER A: Hanover American insurance Company 36064 11/1/2017 EACH OCCURRENCE $1,000,000 INSURED PARAMETRI MED EXP (Any one person) $10,000 INSURERB:Allmerlca Financial 41840 Parametrix, Inc. INSURER C: Hanover Insurance Company 22292 1019 39th Ave. SE Puyallup WA 98374-6502 INSURER D:Em to ers Insurance of Wausau1458 INsuRERE:XL Specialty Insurance Co. 3 885 INSURER F: PERSONAL &ADV INJURY $1,000,000 COVERAGES CERTIFICATE NUMBER: 398505088 REVISION NUMgERV � THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR OLICY 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER EFF MMIDDY/YYYY POLICY YY MM/DD1YY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR Y Y ZZ2893486906 11/1/2016 11/1/2017 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $10,000 X WA Stop Gap/EL PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO - X POLICY JECT F LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 WA Stop Gap $1,000,000 OTHER: B AUTOMOBILE LIABILITY Y Y AW2889472706 11/1/2016 11/1/2017 COMBINED Ea accident SINGLE $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNEDSCHEDULED AUTOS BODILY INJURY (Per accident) $ X HIREDAUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ C X UMBRELIALIAB X I OCCUR UH2891561606 11/1/2016 11/1/2017 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $10,000,000 DED X RETENTION$0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE r OFFICER/MEMBER EXCLUDED? J N / A WCCZ91447422016 11/1/2016 11/1/2017 X IPER STATUTE ORH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 (Mandatory in N Ifnd er edescribe und DESCs, RIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 E Professional Liability Claims Made Pollution Liability Included DPR9907916 11/1/2016 11/1/2017 $1,000,000 per Claim $1,000,000 Annual Aggregate Retroactive Date: 01/01/1969 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Project Name/Number: Marlette Park Renovation/233-1896-8AA City of Bremerton is named as Additional Insured as respects General and Auto. iability as required per written contract or agreement. General Liability is Primary/Non-Contributory per po licy form wording. ­ u ­­ I I,ANLtLLA I IUN City of Bremerton Attn: Colette Berna 680 Lebo Blvd. Bremerton WA 98310 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ZZ2 893486906 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL_ LIABILITY COVERAGE PART SUMMARY OF COVERAGES 1. Additional Insured by Contract, Agreement or Permit Included 2. Additional Insured — Primary and Non -Contributory Included 3. Blanket Waiver of Subrogation Included 4. Bodily Injury Redefined Included 5. Broad Form Property Damage — Borrowed Equipment, Customers Goods & Use of Elevators Included 6. Knowledge of Occurrence Included 7. Liberalization Clause Included 8. Medical Payments -- Extended Reporting Period Included 9. Newly Acquired or Formed Organizations - Covered until end of policy period Included 10, Non -owned Watercraft 51 ft. 11. Supplementary Payments Increased Limits - Bail Bonds $2,500 - Loss of Earnings $1000 12. Unintentional Failure to Disclose Hazards Included 13. Unintentional Failure to Notify Included This endorsement amends coverages provided under the Commercial General Liability Coverage Part through new coverages, higher limits and broader coverage grants. 1. Additional Insured by Contract, Agreement or Permit / The following is added to SECTION II — WHO IS v/ AN INSURED: Additional Insured by Contract, Agreement or Permit a. Any .person or organization with whom you agreed in a written contract, written agreement or permit that such person or organization to add an additional insured on your policy is an additional insured only with respect to liability for "bodily injury", "property damage", or "personal and advertising injury" caused, in whole or in', part, by your acts or omissions, or the acts or omissions of those acting on your behalf, but only with respect to: (1) "Your work" for the additional insured(s) designated in the contract, agreement or permit; (2) Premises you own, rent, lease or occupy;. or (3) Your maintenance, operation or use of equipment leased to you. b. The insurance afforded to such additional insured described above: (1) Only applies to the extent permitted by law; and (2) Will not be broader than the insurance which you are required by the contract, agreement or permit to provide for such additional insured. 421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 4 (3) Applies on a primary basis if that is required by the written contract, written agreement or permit. (4) Will not be broader than coverage provided to any other insured. (5) Does not apply if the "bodily injury", "property damage" or "personal and advertising injury" is otherwise excluded from coverage under this Coverage Part, including any endorsements thereto. c. This provision does not apply: (1) Unless the written contract or written agreement was executed or permit was issued prior to the "bodily injury", "property damage", or "personal injury and advertising injury". (2) To any person or organization included as an insured by another endorsement issued by us and made, part of this Coverage Part. (3) To any lessor of equipment: (a) After the equipment lease expires; or (b) If the "bodily injury", "property damage", "personal and advertising injury" arises out of sole negligence of the lessor (4) To any: (a) Owners or other interests from. whom land has been leased 'which takes place after the lease for the land ex- pires; or (b) Managers or lessors of premises if: (i) The occurrence takes place after you cease to be a tenant in that premises; or (ii) The "bodily injury", "property damage", "personal injury" or 'advertising injury' arises out of structural alterations, new con- struction or demolition operations performed by or on behalf of the manager or lessor. (5) To "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" or the offense which caused the "personal and advertising injury" involved the rendering of or failure to render any professional services by or for you. d. With respect to the insurance afforded to these additional insureds, the following is added to SECTION III — LIMITS OF INSURANCE: The most we will pay on behalf of the additional insured for a covered claim is the lesser of the amount: of insurance: 1. Required by the contract, agreement or permit described in Paragraph a.; or 2. Available under the applicable Limits of .Insurance shown in the Declarations. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 2. Additional Insured — Primary and Non - Contributory The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4. Other insurance: Additional Insured — Primary and Non - Contributory If .you agree in a written contract, written agreement or permit that the insurance provided to any person or organization included as an Additional Insured under SECTION II — WHO IS AN INSURED, is primary and non-contributory, the following applies: If other valid and collectible insurance is available to the Additional Insured for a loss covered under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary to other insurance that is available to the Additional Insured which covers the Additional Insured as a Named Insured. We will not seek contribution from any other insurance available to the Additional Insured except: (1) For the sole negligence of the Additional Insured; (2) When the Additional Insured is an Additional Insured under another primary liability policy; or (3) when b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in c. below. 421-2915 0615 Includes -copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 4 b. Excess Insurance (1) This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work'; (b) That is f=ire insurance for premises rented to the Additional Insured or temporarily occupied by the Additional Insured with permission of the owner; (c) That is insurance purchased by the Additional Insured to cover the Additional Insured's liability as a tenant for "property damage" to premises rented to the Additional Insured or temporarily occupied by the Additional with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION I — COVERAGE A — BODILY INURY AND PROPERTY DAMAGE LIABILITY. (2). When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. (3) When this insurance is excess over other Insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in . this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it. has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers 3. Blanket Waiver of Subrogation The following is added to SECTION IV — COMMERCIAL . GENERAL LIABILITY CONDITIONS, Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may .have against any person or organization with whom you have a written contract that requires such waiver because of payments we make for damage under this coverage form. The damage must arise out of your activities under a written contract with that person or organization. This waiver applies only to the extent that subrogation is waived under a written contract executed prior to the "occurrence" or offense giving rise to such payments. 4. Bodily Injury Redefined SECTION V - DEFINITIONS, Definition 3. "bodily injury" is replaced by the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person including death resulting from any of these at any time. "Bodily injury" includes mental anguish or other mental injury resulting from "bodily injury". S. Broad Form Property Damage — Borrowed Equipment, Customers Goods, Use of Elevators a. SECTION I — COVERAGES, COVERAGE A — BODILIY INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions subparagraph j. is amended as follows: Paragraph (4) does not apply to "property damage" to borrowed equipment while at a jobsite and not being used to perform operations. Paragraphs (3), (4) and (6) do not apply to "property damage" to "customers goods" while on your premises nor do they apply to the use of elevators at premises you own, rent, lease or occupy. b. The following is added to SECTION V — DEFINTIONS: 24. "Customers goods" means property of your customer on your premises for the purpose of being: 421-2915 06 15. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 4 a. worked on; or b. used in your manufacturing process. c. The insurance afforded under this provision is excess over any other valid and collectible property insurance (including deductible) available to the insured whether primary, excess, contingent 6. Knowledge of Occurrence The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. Duties in the Event of Occurrence, Offense, Claim or Suit: e. Notice of an "occurrence", offense, claim or "suit" will be considered knowledge of the insured if reported to an individual named insured, partner, executive officer or an "employee" designated by you to give us such a notice. 7. Liberalization Clause The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: Liberalization Clause If we adopt any revision that would broaden the coverage under this Coverage Form without additional premium, within 45 days prior to or during the policy period, the broadened coverage will immediately apply to this Coverage Part. 8. Medical Payments — Extended Reporting Period a. SECTION I — COVERAGES, COVERAGE C — MEDICAL PAYMENTS, Paragraph 1. Insuring Agreement, subparagraph a.(3)(b) is replaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident; and b. This coverage does not apply if COVERAGE C — MEDICAL PAYMENTS is excluded either by the provisions of the Coverage Part or by endorsement. 10. Non -Owned Watercraft SECTION I — COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions, subparagraph g.(2) is replaced by the following: g. Aircraft, Auto Or Watercraft (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge; This provision applies to any person who, with your consent, either uses or is responsible for the use of a watercraft. 11. Supplementary Payments Increased Limits SECTION I — SUPPLEMENTARY PAYMENTS COVERAGES A AND B, Paragraphs 1.b. and 1.d. are replaced by the following: 1.b.Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to fumish these bonds. 1.d.All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $1000 a day because of time off from work. 12. Unintentional Failure to Disclose Hazards The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 6. Representations: We will not disclaim coverage under this Coverage Part if you fail to disclose all hazards existing as of the inception date of the policy provided such failure is not intentional. 13. Unintentional Failure to Notify The following is added to SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. Duties in the Event of Occurrence, Offense, Claim or Suit: 9. Newly Acquired Or Formed Organizations Your rights afforded under this policy shall not be SECTION II — WHO IS AN INSURED, Paragraph prejudiced if you fail to give us notice of an SE SEis replaced by the following: "occurrence", offense, claim or "suit", solely due to your reasonable and documented belief that the a. Coverage under this provision is afforded until 'bodily injury" or "property damage" is not covered the end of the policy period. under this policy. ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED 421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 4 b. The covered "auto"; c. Your interest in the covered "auto"; or d. A claim under this Coverage Form. 3. Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the re- vision is effective in your state. 4. No Benefit To Bailee - Physical Damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any person or organization holding, storing or transporting property for a fee regardless of any other provision of this Coverage Form. 5. Other Insurance a. For any covered "auto" you own, this Coverage Form provides primary insur- ance. For any covered "auto" you don't own, the insurance provided by this Cov- erage Form is excess over any other collectible insurance. However, while a covered "auto" which is a "trailer" is con- nected to another vehicle, the Liability Coverage this Coverage Form provides for the "trailer" is: (1) Excess while it is connected to a mo- tor vehicle you do not own. (2) Primary while it is connected to a covered "auto" you own. b. For Hired Auto Physical Damage Cover- age, any covered "auto" you lease, hire, rent or borrow is deemed to be a covered "auto" you own. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". c. Regardless of the provisions of Para- graph a. above, this Coverage Form's Li- ability Coverage is primary for any liabil- ity assumed under an "insured contract". d. When this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary, we will .pay only our share. Our share is the proportion that: the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis. Hanover Insurance Group.. AW2889472706 6. Premium Audit a. The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy be- gan. We will compute the final premium due when we determine your actual ex- posures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance, if any. The due date for the final premium or retrospec- tive premium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due, the first Named Insured will get a refund. b. If this policy is issued for more than one year, the premium for this Coverage Form will be computed annually based on our rates or premiums in effect at the be- ginning of each year of the policy. 7. Policy Period, Coverage Territory Under this Coverage Form, we cover "acci- dents" and "losses" occurring: a. During the policy period shown in the Declarations; and b. Within the coverage territory. The coverage territory is: a. The United States of America; b. The territories and possessions of the United States of America; c. Puerto Rico; d. Canada; and e. Anywhere in the world if: (1) A covered "auto" of the private pas- senger type is leased, hired, rented or borrowed without a driver for a period of 30 days or less; and (2) The "insured's" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and posses- sions of the United States of America, Puerto Rico, or Canada or in a settle- ment we agree to. We also cover "loss" to, or "accidents" in- volving, a covered "auto" while being trans- ported between any of these places. CA 00 01 03 06 Copyright, ISO Properties, Inc., 2005 Page 9 of 12 14. AUTO LOAN PHYSICAL DAMAGE EXTENSION The following is added to SECTION III - PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance provision: When a "loss" results in a total loss to a covered auto you own for which a Loss Payee is designated in this policy, the most we will pay for "loss" in any one "accident" is the greater of: 1. The actual cash value of the damaged or stolen property as of the time of the "loss"; or 2. The outstanding balance of the initial loan, less any amounts for taxes, overdue payments, overdue payment charges, penalties, interest , any charges for early termination of the loan, costs for Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan, and carry-over balances from previous loans. 15. AUTO LEASE PHYSICAL DAMAGE EXTENSION The following is added to SECTION III - PHYSICAL DAMAGE COVERAGE, C. Limit Of Insurance provision: If, because of damage, destruction or theft of a covered "auto", which is a long-term leased "auto", the lease agreement between you and the lessor is terminated, 'We" will pay the difference between the amount paid under paragraph C. LIMIT OF INSURANCE 1. or 2. and the amount due at the time of "loss" under the terms of the lease agreement applicable to the leased "auto" which you are required to pay: less any fees to dispose of the auto; any overdue payments; financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; security deposits not refunded by the lessor; cost for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan; and carry over balances from previous leases. This coverage applies only to the initial lease for the covered "auto" which has not previously been leased. This coverage is excess over all other collectible insurance. SECTION IV - CONDITIONS 16. DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The following is added to SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit Or Loss: d. Knowledge of any "accident", claim, "suit" or "loss" will be deemed knowledge by you when notice of such "accident", claim, "suit" or "loss" has been received by: (1) You, if you are an individual; (2) Any partner or insurance manager if you are a partnership; or (3) An executive officer or insurance manager if you are a corporation. 17. BLANKET WAIVER OF SUBROGATION Paragraph 5, Transfer Of Rights Of Recovery Against Others To Us, SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions is replaced by the following: Includes copyrighted material of Insurance Services Office, Inc. with its permission. Copyright, Insurance Services Office. Inc.. 1996 461-0155 (9-97) Page 6 of 7 5. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, which have not been waived through the execution of an "insured contract", written agreement, or permit, prior to the "accident" or "loss" giving rise to the payment, those rights to recover damages from another are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after the "accident' or "loss" to impair them. 18. UNINTENTI014AL FAILURE TO DISCLOSE INFORMATION The following is added to SECTION IV BUSINESS AUTO CONDITIONS. B. General Conditions, paragraph 2. Concealment, Misrepresentation Or Fraud: Your unintentional error in disclosing, orJailure to disclose, any material fact existing after the effective date of this Coverage Form shall not prejudice your rights under this Coverage Form. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or nonrenewal. -lanover Insurance Group_ AWF8894727 5701120 19. HIRED AUTO - WORLDWIDE COVERAGE The following is added to SECTION IV - Business Auto Conditions, B. General Conditions, paragraph 7. Policy Period, Coverage Territory provision: e. Outside the coverage territory described 'in a., b., c., and d. above for an "accident" or "loss" resulting from the use of a covered "auto" you hire, without a driver, or your employee hires without a driver, at your direction, for the purpose of conducting your business, for a period of 30 days or less, provided the suit is brought within The United States of America or its territories or possessions. SECTION V - DEFINITIONS 20. MENTAL ANGUISH Paragraph C. 'Bodily injury", SECTION V - DEFINITIONS is replaced by the following: C. "Bodily injury" means bodily injury, sickness or disease sustained by a person including death or mental anguish resulting from any of these. Includes copyrighted material of Insurance Services Office, Inc. with its permission. Copyright, Insurance Services Office, Inc., 1996 461-0155 (9-97) Page 7 of 7 POLICY #:AW2889472706 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to- coverage provided by this endorsement, the provisions ofthe Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 11/1/2016 Countersigned By: Named Insured: Parametria, 'Inc. Authorized Representative) SCHEDULE Name of Person(s) or Organization(s): city of Bremerton Attn: Colette Berna 680 Lebo Blvd. Bremerton WA 98310 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998