HomeMy WebLinkAbout6125CITY OF
BREMERTON
THE CITY OF PRIDE AHD OPPORTUNITY
Executive Correspondence Routing Memo
Date: June 24, 2020
Description: PSA Hydrogeological Oversight Well 6R Re-Development
This has already been reviewed by Legal.
Action Requested: Signature
Originator: Ted Danielson
Coordination/Approval/ Recommendation:
Public Works Director: Recommended Initials/date G /
U?
Public Works& Utilities 1100 Oyster Bay Ave.N., Bremerton, WA 98312* Phone(360)473-5315 * Fax(360)473-5018
DocuSign Envelope ID: 9C8627EB-DD46-4907-997B-8688FAD4A0D5
PROFESSIONAL SERVICES AGREEMENT
Hydrogeological Oversight
Well 6R Re-Development
The City of Bremerton ("City") and Robinson Noble, Inc. ("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, 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 $20,185.00. 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.
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Bremerton/Robinson Noble,Inc.
Hydrogeological Oversight—Well 6R Re-Development
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DocuSign Envelope ID: 9C8627EB-DD46-4907-997B-8688FAD4A0D5
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 negligent
performance of this Agreement except for that portion of the injuries and damages caused by the
City's sole negligence, unless Consultant is conducting work pursuant 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
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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-contractors.
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
operations/broad form property damage; explosion, collapse and underground
XCU) if applicable; and
3. Excess Liability insurance with limits not less than $1,000,000 limit per
occurrence and aggregate; and
4. Professional Liability insurance with limits no less than $1,000,000 limit per
occurrence/claim; and
5. Workers Compensation insurance as statutorily required by the Industrial
Insurance Act of the State of Washington, Title 51, Revised Code of Washington
and employer's liability with limits not less than$1,000,000.
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.
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The Consultant's insurance shall be primary and non-contributory insurance as respects the
City and shall contain a waiver of subrogation against the City for claims arising out of any
operations, liabilities and obligations to which coverage applies. It 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 6th
Street, Suite 100, 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 become
the property of the City upon payment to Consultant. 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 Tacoma, 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
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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.
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 Tacoma, Washington, and.onsite at Well 6R. 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 1st 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.
Notices to be sent to: Notices to be sent to:
CITY: CONSULTANT:
Attn: Thomas Knuckey Attn: James E. Hay
City of Bremerton Robinson Noble, Inc.
100 Oyster Bay Ave N 2105 South C Street
Bremerton, WA 98312 Tacoma, WA 98402
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.
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DocuSign Envelope ID: 9C8627EB-DD46-4907-997B-8688FAD4A0D5
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.
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. Equal Employment Opportunity Statement: It is the policy of the City of Bremerton to
offer equal employment opportunity to all individuals. The City of Bremerton will administer all
actions with respect to employment practices in compliance with federal, state and local laws, and
will not discriminate in any employment practice on the basis of age(40+), sex,race, creed, color,
national origin, sexual orientation/gender identity, marital status, military status, or the presence
of any physical,mental or sensory disability.
X. ADA Statement: The City of Bremerton does not discriminate on the basis of disability
in programs and activities, which it operates pursuant to the requirements of the Americans with
Disabilities Act of 1990, and ADA Amendments Act. This policy extends to both employment
and admission to participation in the programs, services and activities of the City of
Bremerton. Reasonable accommodation for employees or applicants for employment will be
provided.
XI. 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.
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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.
XII. 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.
IN WITNESS WHEREOF,the parties below have executed this Agreement.
CITY: CONSULTANT:
CITY OF BREMERTON ROBINSON NOBLE, INC.
Digitally signed by James E Hay
By:
James E Hay D7eeo 020.06.1814:50:26
0
Print e: Thomas Knuckey Print Name:James E.Hay
Its: Director, Public Works&Utilities Its:Principal Hydrogeologist
Date: 6/Z4//2.-¢=7 Date: June 18,2020
APPROVED AS TO FORM:ATTEST:
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DocuSign Envelope ID: 9C8627EB-DD46-4907-997B-8688FAD4A0D5
By: By:
Roger A. Lubovich, Bremerton City Attorney Angela Hoover, City Clerk
R:\Legal\Legal\Forms\FORMS ON COB WEB\Professional Services Agreement Rev.07 2018.docx
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DocuSign Envelope ID: 9C8627EB-DD46-4907-997B-8688FAD4A0D5
6/29/20206/29/2020
EXHIBIT A
SCOPE OF WORK
Professional hydrogeological oversight and direction of Well 6R pump re-development to
include:
1) Review of City-provided hydrographs;findings and recommendations to be summarized
in a brief, letter report.
2) Attend pre-bid meeting and communicate with the City and its selected Contractor
regarding project scope and bidding.
3) Attend pre- and post-redevelopment video inspections (subcontracted by the contractor).
4) Conduct a site visit at the start of mechanical surge development,up to 5 additional
partial day) site visits as needed, and interim communications with the Contractor by
phone.
5) Conduct and analyze two step-rate tests. One pre-rehabilitation and one post-
rehabilitation.
6) Submit a summary letter report discussing findings of video inspections, step-rate tests,
and re-development activities, and provide a recommended frequency of future re-
development for the well.
EXHIBIT B
SCHEDULE
The schedule for this project will commence upon signing of this contract and shall conclude by
December 31, 2020
EXHIBIT C
BUDGET AND FEES
Hydrogeologist will work on a time and expense basis. The budget for this contract shall not
exceed$20,185.00.
Fee schedule follows:
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r0"„
angimmilorrimm
ROBINSON'"
NOBLE
General Fee Schedule January 1,2020
Professional Positions Fee per Hour
Principal Engineer,Hydrogeologist or Environmental Scientist 190
Associate Engineer,Hydrogeologist or Environmental Scientist 173
Senior Engineer,Hydrogeologist or Environmental Scientist 148
Senior Project Engineer,Hydrogeologist or Environmental Scientist 128
Project Engineer,Hydrogeologist or Environmental Scientist 115
Staff Engineer,Hydrogeologist or Environmental Scientist 104
Senior Field Staff 94
Field Staff 81
Legal Support/Expert Witness Servicesllestimony 150% of above rates
Support Positions
Senior GIS/CAD Specialist 97
Senior Technician 97
Senior Administrator 84
GIS/CAD Specialist 84
Technician 84
Administrator 73
Clerical Support 73
Other Fees and Costs
Subcontracts/ Professional services 15%
Management Fee Outside laboratory services 15%
Construction subcontracts 15%
Other Costs Travel(auto) 0.64/mileTravel(other)Cost+10%
Per diem Prevailing State rate+10%Other direct expenses Cost+10%
Field and laboratory testing/equipment rental See following pages
This fee schedule is subject to change according to contract or Professional Services Agreement conditions.
Robinson Noble, Inc. rates effective January 1,2020
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DocuSign Envelope ID: 9C8627EB-DD46-4907-997B-8688FAD4A0D5
Hydrogeologic Equipment Rental Schedule
January 1,2020
Equipment Unit Rate,
Water Level Transducer and Data Logger Per day 25
Field Laptop Computer Per day 40
Electric Water Level Sounder(s) 0 to 300 ft Flat fee per project 30
over 300 ft Flat fee per project 60
DC Submersible Purge Pump(Single Stage) Per pump List price+10%
DC Submersible Purge Pump(Dual Stage) Per pump List price+ 10%
Double-Ring lnfiltrometer Per day 50
Schonstedt Gradient Magnetometer Per day 75
Geonics EM-61 Metal Detector Per day 500
Downhole Gamma/Resistivity/Temperature Per day 500
Logging Equipment
Downhole Caliper Logging Equipment Per day 350
Draw Works Per day 600
Mechanical Sieve Sample Equipment Flat fee per well 50
2-inch Gasoline-powered Centrifugal Pump
Includes hoses)
Per day 100
2-inch Submersible Pump+Controller Per day 180
Generator&Fuel Per day 70
Hand Auger Per day 50
Survey Gear(laser level&rod) Per day 85
FlowTracker Acoustic Doppler Velocimeter
per day 200StreamGagingEquipment
pH Field Meter Per day 25
GPS Per day 20
Other Equipment Negotiated Negotiated
Digital Camera Per day 10
This fee schedule is subject to change according to contract or Professional Services Agreement conditions.
Robinson Noble,Inc. rates effective January 1,2020
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Environmental Equipment Rental and Consumable Schedule
January 1,2020
Equipment Unit Rate
Water Level Transducer and Data Logger Per day 50
Field Laptop Computer Per day 40
Electronic Water Level Sounder Per day 30
Electronic Interface Probe Per day 75
DC Operated Peristaltic Pump Per day 45
2-inch Gasoline-powered Centrifugal Pump
includes hoses) Per day 100
2-inch Submersible Pump+Controller Per day 350
Generator&Fuel Per day 70
Low-Flow Bladder Pump Per day 175
Photoionization Detector Per day 75
Combustible Gas Indicator Per day 65
GPS Per day 20
Water Quality Meter Per day 200
Teflon Water Bailer Per day 30
Soil Sampling Equipment(manual) Per day 25
Mechanical Sieve Sample Equipment Flat fee per project 50
Survey Gear(laser level&rod) Per day 85
pH Field Meter(soils) Per day 50
Soil Vapor Extraction System Per month 750
Digital Camera Per day 10
Hand Auger Per day 50
Other Equipment Negotiated Negotiated
Consumable Items:
Polyethylene Purge/Sampling Tubing Each 10 feet 2,50
DC Submersible Purge Pump(Single stage) Per pump List price+ 10%
DC Submersible Purge Pump(Dual Stage) Per pump List price+ 10%
Silicone Peristaltic Pump Head Tubing Each foot 4.00
Bladders for Low-Flow Bladder Pump Each 5.00
Water Sample Bailer Each 10
Bailer Rope/String Each 10 feet 1.00
Personal Protection Equipment Per day per person 50
This fee schedule is subject to change according to contract or Professional Services Agreement conditions.
Robinson Noble, Inc. rates effective January 1,2020
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Geotechnical Field and Laboratory Testing Schedule
January 1,2020
Test Vie_
Portable Nuclear Density Gauge Per Hour 5.00
Slope Inclinometer Per day 250
Direct Shear Point 200
Moisture-Density Relationship Curves: Each 1 pt
Each Multiple ptspts$225
Sieve Analyses(Gradations-Wet Sieve) Each 150
Bulk Sieve(if gravelly or a10Ib) Add 70
200 Wash Each 80
Hydrometer Analysis Each 175
Failing Head Permeability Each 165
Atterberg Limits Each 220
Liquid Limit and Plastic Limit)
Moisture Content Each 12
Dynamic Cone Penetrometer Day 225
Points Each 20
Resistivity 4-point Gauge Day 300
Hand Auger Per day 50
Consolidation Test Incremental Loading 550
9 loads,0.126 TSF to 32 TSF,4 unloads) 50/each additional load
Shelby Tube Extrusion/Sample Description 40
Single-Ring Infiltrometer Per day 50
This tee schedule is subject to change according to contract or Professional Services Agreement conditions.
Robinson Noble, Inc. rates effective January 1,2020
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tt1_
DocuSign Envelope ID: 9C8627EB-DD46-4907-997B-8688FAD4A0D5
DATE (MM/DD/YYYY)
A � o® CERTIFICATE OF LIABILITY INSURANCE
il/24/2020
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, certai (j licie�pa�fg�; � e an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements . i"'�� t V
PRODUCER �E)�LL fj Cathy Fleck
Leavitt Group Northwest
PO Box 65770 Grou
COY of Bremerton
City AttOmey'S 0MCe
University Place WA 98464
INSURED
Robinson and Noble, Inc, DBA: Robinson Noble, Inc.
2105 South C St.
NAME.
PHONE (800) 726-8771 FAX (866)728-9168
C. No. Ext): (A/C, No):
E-MAIL cath fleck@leavi
•tt. com
ennwcccY-
INSURERISI AFFORDING COVERAGE
INSURERA:
Crum
& Forster
Specialt
INSURERB:OhlO
Security
Insurance
INSURERC:OhlO Casualty In
E:
(Tacoma WA 98402 INSURERF:
COVERAGES CERTIFICATE NUMBER:20/21 GL/AL/SG/UIffi REVISION NUMBER:
NAIC k
44520
24082
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
MMIDID/YYYY
MMIDD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
y 2 , 000, 000
A
CLAIMS -MADE ❑X OCCUR
PREM SESOEaEo curOrence
5 100, 000
X
Y
EPK133151
11/30/2020
11/30/2021
MED EXP (Any one person)
5 10, 000
PERSONAL & ADV INJURY
5 2 , 000 , 000
GEN'LAGGREGATELIMITAPPLIESPER:
GENERAL AGGREGATE
5 4,000,000
POLICY � PRO ❑ LOC
JECT
PRODUCTS-COMP/OPAGG
5 4,000,000
OTHER:
5
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
5 1 , 000 , 000
BODILY INJURY (Per person)
5
B
ANYAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
X
BKS56823758
il/30/2020
11/30/2021
BODILY INJURY (Per accident)
5
PROPERTY DAMAGE
Per accident
5
NON -OWNED
X HIRED AUTOS X AUTOS
5
X
UMBRELLALIAB
X
OCCUR
EACH OCCURRENCE
5 2 000 000
C
EXCESS LIAR
CLAIMS -MADE
ES056S23788
11/30/2020
11/30/2021
gGGREGATE
5 2, 000, 000
DED
X
RETENTION 5 0
Excess Auto Liability
5
WORKERS COMPENSATION
ANDEMPLOYERS' LIABILITY Y / N
PER
STATUTE
X
OTH-
ER
A
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
EPK133151
11 /30/2020
11/30/2021
E.L. EACH ACCIDENT
5 1 , 000 , 000
E.L. DISEASE - EA EMPLOYEE
5 1, 000, 000
E.L. DISEASE -POLICY LIMIT
5 1 000 000
A
Professional Liability
EPK133151
11/30/2020
11/30/2021
Each Claim: 2,000,000
Aggregate 4, 000, 000
DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be aNached if more space is required)
City of Bremerton is named as Additional Insured per written contract and the terms and conditions of
forms EN0320 02/11, EN0118 02/11, EN0301 09/14 and CG8901 12/08 attached
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
,ity of Bremerton
Attn : Thomas Knuckey
THE EXPIRATION DATE THEREOF,
ACCORDANCE WITH THE POLICY
NOTICE WILL BE DELIVERED IN
PROVISIONS.
345 6th St, Ste. 100
Bremerton, WA 98337
AUTHORIZED REPRESENTATIVE
D E. Olson/CAFLEC
ACORD 25 (2014/01)
INS025 (201401)
U 1968-2014 AGUKU GUKF'UKAI IUN. All rlgrltS reserved.
The ACORD name and logo are registered marks of ACORD
Additional Named Insureds
Other Named Insureds
Robinson Noble, Inc.
Doing Business As
OFAPPINF (02/2007)
COPYRIGHT 2007, AMS SERVICES INC