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HomeMy WebLinkAbout5970 PUBLIC WORKS AGREEMENT THIS AGREEMENT is entered into between the City of Bremerton, a Washington Municipal Corporation ("City"), and Timberline Tree Care, LLC ("Contractor"), who's mailing address is 17197 Clear Creek Rd.NW, Poulsbo,ou sbo, WA 98370. The parties agree as follows: 1. CONTRACTOR SERVICES. The Contractor shall perform the following services for the City: Provide all labor and equipment to remove hazardous tree limbs in trees bordering the South perimeter of Kiwanis Park per the estimate dated 11/28/2018 included herein as Attachment A. 2. TIME OF COMPLETION. Contractor shall complete the work within 60 calendar days from the date of issuance of the City's Notice to Proceed. 3. COMPENSATION. The City shall pay the Contractor the total amount of $3,300.00, plus any applicable Washington State Sales Tax, for the work and services contemplated in this agreement. The City shall pay the Contractor ninety percent (90%) of the Contract amount upon completion and acceptance of the work by the City, and the remainder upon fulfillment of the conditions listed below and throughout this agreement. A. No Performance Bond. Because this contract including applicable sales tax is $150,000 or less, and pursuant to Chapter 39.08 RCW, the Contractor, in lieu of providing the City a performance bond, has elected to have the City retain the final ten percent (10%) of the Contract amount for a period of thirty (30) days after the date of final acceptance, or until receipt of all necessary releases from the State Department of Revenue and the State Department of Labor & Industries and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. B. Defective or Unauthorized Work. The City reserves its right to withhold payment from Contractor for any defective or unauthorized work. Defective or unauthorized work includes, without limitation: work and materials that do not conform to the requirements of this agreement; and extra work and materials furnished without the City's written approval. If Contractor is unable, for any reason, to satisfactorily complete any portion of the work, the City may complete the work by contract or otherwise, and Contractor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Contract price specified above. The City further reserves its right to deduct the cost to complete the Contract work, including any Additional Costs, from any and all amounts due or to become due the Contractor. C. Final Payment: Waiver of Claims. THE MAKING OF FINAL PAYMENT (EXCLUDING WITHHELD RETAINAGE) SHALL PRECLUDE ALL CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY CONTRACTOR AS UNSETTLED AT THE TIME REQUEST FOR FINAL PAYMENT IS MADE. PUBLIC WORKS AGREEMENT-Page 1 of 7 (between City of Bremerton and Timberline Tree Care,LLC) A. Procedure and Protest by the Contractor. If the Contractor disagrees with anything required by a work change directive or change order, including any direction, instruction, interpretation, or determination by the City, the Contractor shall: 1. Immediately give a signed written notice of protest to the City; 2. Supplement the written protest within fourteen (14) calendar days with a written statement that provides the following information: a. The date of the Contract's protest. b. The nature and circumstances that caused the protest. c. The provisions in this agreement that support the protest. d. The estimated dollar cost, if any, of the protested work and how that estimate was determined. e. An analysis of the progress schedule showing the schedule change or disruption if the Contractor is asserting a schedule change or disruption. The Contractor shall keep complete records of extra costs and time incurred as a result of the protested work. The City shall have access to any of the Contractor's records needed for evaluating the protest. 3. The City will evaluate all protests, provided the procedures in this section are followed. If the City determines that a protest is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. B. Contractor's Duty to Complete Protested Work. In spite of any protest, the Contractor shall proceed promptly with the work as the City has ordered. C. Contractor's Acceptance of Changes. The Contractor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by Contractor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Contractor also waives any additional entitlement and accepts from the City any written order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Contractor completely waives any claims for protested work and accepts form the City any written order (including directions, instructions, interpretations, and determination). 8. CLAIMS. The Contractor shall give written notice to the City of all claims other than change orders within fourteen (14) calendar days of the occurrence of the events giving rise to PUBLIC WORKS AGREEMENT-Page 3 of 7 (between City of Bremerton and Timberline Tree Care,LLC) Before beginning the work on the project described in this agreement, the Contractor shall provide a Certificate of Insurance evidencing: A. Automobile Liability insurance with limits no less than $1,000,000 combined single limit per accident for bodily injury and property damage; and B. Commercial General Liability insurance written on an occurrence basis with limits no less than $1,000,000 combined single limit per occurrence and $2,000,000 aggregate for personal injury, bodily injury and property damage. Coverage shall include but not be limited to: blanket contractual; products/completed operations/broad from property damage; explosion, collapse and underground(XCU) if applicable; and employer's liability. Any payment of deductible or self-insured retention shall be the sole responsibility of the Contractor. The City, its officials, employees, agents and volunteers shall be named as an additional insured on the insurance policy, as respects work performed by or on behalf of the Contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The Contractor's 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 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 reserves the right to receive a certified copy of all the required insurance policies. 12. MISCELLANEOUS. A. Nondiscrimination. In the hiring of employees for the performance of work under this Agreement or any sub-contract hereunder, the Contractor, its sub-contractors, or any person acting on behalf of such Contractor or sub-contractor shall not, by reason of race, religion, color, sex, national origin, or the presence of any sensory, mental, physical disability, or sexual orientation discriminate against any person who is qualified and available to perform the work to which the employment relates. B. Compliance with Laws. Contractor shall comply with all federal, state and local laws, rules and regulations throughout every aspect in the performance of this agreement. C. Work Performed at Contractor's Risk. Contractor shall take all precautions necessary and shall be responsible for the safety of its employees, agents, and subcontractors in the PUBLIC WORKS AGREEMENT-Page 5 of 7 (between City of Bremerton and Timberline Tree Care,LLC) IN WITNESS WHEREOF, the parties below have executed this agreement. CONTRACTO' THE ITY • :REMERTON Print ame: •► •. _ Mak Print . e: Jeff Elevado Title: J V+.- • Title: Parks and Recreation Director DATE 41lj " 1? DATE 75 12019 Notices to be sent to: Notices to be sent to: CONTRACTOR: CITY OF BREMERTON: Timberline Tree Care, LLC Steve Mutek, Park Operations Mngr. 17197 Clear Creek Rd.NW 680 Lebo Blvd. Poulsbo, WA 98370 Bremerton, WA 98310 (360) 990-4306 (360) 981-1691 (360)473-5882 (facsimile) APPROVED AS TO FORM: Roger A. Lubs ch Bremerton City Attome, ATTEST: ( 2uLDDdo Angela oods City Clerk PUBLIC WORKS AGREEMENT-Page 7 of 7 (between City of Bremerton and Timberline Tree Care,LLC) Timberline Tree Care LLC,#TIMBETC842JK 17197 Clear Creek Rd NW TIMBERLINE TREE CARE Poulsbo, WA 98370 r Stoll306 (360)990-4306 •. meganstoll@gmail.com www.timberlinetreellc.com ADDRESS ESTIMATE# 1397 City of Bremerton Parks and DATE 11/28/2018 Recreation 1701 5th St Bremerton WA 98337 AMOUNT Safety prune 3 large firs and one smaller fir by high voltage 1 3,000.00 3,000.00T power lines at Kiwanis Park. This work requires bucket truck access to work in the lower canopy and install ropes safely for a climber to reach the upper canopy. This work will require closing the park and the sidewalk and streetside parking in the vicinity of the trees. We will need to drive a bucket truck across the grass in the park, and can use mats under the truck tires to reduce impact to the turf. Scheduling this work during dry weather is important for both the turf and the safety of the climbers working around the power lines. This work is to include removing large dead limbs that may break, removing already broken limbs tangled in canopies, removing any live limbs that have compromised structure, crown and canopy inspection. Cleanup of material is not included in this price, per specifications in the walk-through. Additional administrative charges for municipality contract 1 300.00 300.00T SUBTOTAL 3,300.00 TAX (9%) 297.00 TOTAL $3,597.00 Accepted By Accepted Date ACcoREP® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/01/2019 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 NAME: Poulsbo Junction Insurance, Inc. A/C,No,Ext): FAX No): 19735 10th Ave NE,Suite N204 E-MAIL ADDDRDR ESS: INSURER(S)AFFORDING COVERAGE NAIC# Poulsbo WA 98370 INSURER A: Northfield Insurance Company 27987 INSURED f /y 1 Timberline Tree Care LLC INSURERINSURER CB:: 0 V I I - J a s. -ce,L�.J 17197 Clear Creek Road NW INSURER D: ` INSURER E: v Poulsbo WA 98370 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000, 00 DAMAGE RENTED CLAIMS-MADE X OCCUR PREM SESO(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A Y Y WS276138 08/16/2018 08/16/2019 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: v' GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- POLICY LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N 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 (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Bremerton ACCORDANCE WITH THE POLICY PROVISIONS. / 680 Lebo Blvd AUTHORIZED REPRESENTATIVE //�� Bremerton WA 98310 CysiN,v#- I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ACC)RE) VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE 02i26i2019OATC DD.'YYYY: 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. Ths form is used to report coverages provided to a single specific vehicle or equipment. Do not use this form to report liability coverage provided to multiple vehicles under a single policy.Use ACORD 25 for that purpose. PRODUCER CONTACT NAME LYNN COADY __ 4 State Farm KEN HALL STATE FARM PHONE PO BOX 965 FA No): (3b0)692-3319 Ac,No,For (360}692 2900 C MAIL E.,!.,_' ADDRESS lynn.coadymklr@statefarm.com 9576 RIDGETOP BLVD PRODUCER CUSTOMER ID/. SILVERDALE WA 983830965 INSURERS)AFFORDING COVERAGE NAIC 0 INSURED INSURER A: State Farm Mutual Automobile Insurance Company 25178 MEGAN STOLL INSURER B: 0 41 ) I 1 �) /`1 C 1) 17197 CLEAR CREEK RD NW INSURER c Ci L—SII C/ ,1-0 I INSURER ums,E r 0: ^ A �J POULSBO WA 983 70 722 5 w� ENSURER DESCRIPTION OF VEHICLE OR EQUIPMENT YEAR MARE!MANUFACTURER MODEL BOOT TYPE VEHICLE IDENTIFICATION NUMBEF 15991 DODGE D350 TRUCK 1B7ME36CXMS354785 DESCRIPTION VEHICLE/EQUIPMENT VALUE SERIAL NUMBER 5 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICY:IESi OF-INSURANCE LISTED BELOW HAS/HAVE,BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIODr,S)INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO I WHICH THIS CERTIFICATE MAY BF ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICYIIES)DESCRIBED HEREIN IS/ARE SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES). WSR ADDL. POLICY EFFECTIVE I POUCY EXPIRATION LTR earn) TYPE OF INSURANCE POLICY NUMBER DATE(IMI.DU'YYYYI I DATE(114Y0O YVYY) LIMITS X I VEHICLE LIABILITY CCMIBINED SINGLE UMrr s BOOS Y INJUR'/(Pm person) $ 25000 406 6968-F12-47 12/12/2018 i 06112!2019 BODILY INJURY(Per accident( f J0000 PROPERTY DAIJAcw $ 25000 GENERAL LIABILITY EtCHOCCIIRftCF $ OCCURRENCE GENERs. ar^,Hv:OAT f 'I CLAIMS MADE S INSR OSA POLICY EFFECTIVE I POLICY EXPIRATION LTR PAYEE TYPE OF INSURANCE POLICY NUMBER DATE(MWDDIYYYY) DATE(rWOONYYYV) OMITS/DEDUCTHSLL X VFH COLLISION LOSS ❑` ACV ❑AGREED NO f UMIT 406 6968-F12-47 12/12/2018 06/12/2019 ❑ ❑STATED AM' f 500 DEO I'. X VEH COMP L..---)VEH OTC 0ACV 0 ACRS,FO AMT S LIMIT — L 406 6968-F12-47 12/12/2018 06/12/2019 ❑ ❑STATED/AC $ 500 FFD EQUIPMENT —.__-__- ._._.._ _ 0 ACV 0 AGREED AMT — BASE BROAD 0 HC 0 STATED ANTS UNIT SPECIA. 0 f DED i REMARKS i INCLUDING Sf ECIAL CONDITIONS!OTHER COVL HADES)IArt.ch ACORD 101.AAdAion;.I k+,.-segs Scfwddc.N more spaco n rechorem ADDITIONAL INTEREST CANCELLATION Soled ono of the fdlowinq: ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The WDeOM1li nIDIRSI aescree;T Dela.nee heel:awed lu It*pdicyl''IsI uateDhlran el peacy nunberto). BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BC A fegueeI hoI Leen b trmik-1 to eel rhe addiem;I Irtereet 0ea01DY0 tela.Al the pdlrty(inl DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1111ed herrn by p%Iic5n e,' VEHICLE?EQUIPMENT INTEREST: I FA5E0 FRIA/ICED DESCRIPTION OF THE AODR(ONAL INTEREST NAME AND ADDRESS OF ADDITIONAL INTEREST ADDITIONAL INSURED LOSS PAYEE — LENDER'S LOSS PAYEE LOANI LEASE NUMBER - � AUTHORIZED REPRESENTATIVE C- {1)1997-2015 ACORD CORPORATION.All rights reserved ACORD 23(2016/03) The ACORD name and logo are registered marks of ACORD ACCPRI4h OATC IMM'UD�YYYYI `r. VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE 02/26/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS A CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED O ED 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. This form is used to report coverages provided to a single specific vehicle or equipment.Do not use this form to report liability coverage provided to multiple vehicles under a single policy.Use ACORD 25 for that purpose. ON PRODUCER Nr'°CT LYNN COADY Statefarm KEN HALL STATE FARM P"0"N„ r1 (360!692-2900 'FAX (360)698.3319 �+ PO BOX 965 nogl?E3`z:; lyrin.coady.nklrD(slatefarm.com 9576 RIDGETOP BLVD PRODUCERCUSUMAFR rot , SILVERDALE WA 983830965 INSURER(st AFFORDING COVERAGE NAIC 0 INSURED wsuRER A: State Farm Mutual Automobile Insurance Company 2517E MEGAN STOLL 'u'uRER B: o Li � 1 1 ci `{ 0,..c. �t 17197 CLEAR CREEK RD NW v RiM1RrR C' ` t, 0 INSUWIER D: A /� ( C w `,.' POULSBO ,.,%rA 0•]37„_2 5 \J{ V _..,.,r���1., IN<.unrRr DESCRIPTION OF VEHICLE OR EQUIPMENT YEAR MARE l MANUFACTURER MODEL BODY TYPE VEHICLE IDENTIFICATION NUMBER 2006 CHEVROLET COLORADO TRUCK 1GCDT136368238059 DESCRIPTION VUIICLEIEQUIPMENT VALUE SERIAL NUMBER $ COVERAGES CERTIFICATE NUMBER REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICYiIES:OF INSURANCE LISTED BELOW HASIHAVE BEEN ISSUED TO THE INSURED NA1vIED ABOVE FOR THE POLICY PERIODIS)INDICATED,NOTWITHSTANDING ANY REQUIREMENI,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 10 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICY(IES)DESCRIBED HEREIN IS/ARE SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS Of SUCH POLICY)IES). INSR Yawl POLICY EFFECTIVE POLICY EXPIRATION LTR ras.W TYPE OF INSURANCE POLICY NUMBER DATE IMM'DOfYYYYI DATE(MWDD/YYYY) LIMITS X I VEHICLE LIABILITY COMBINED SINGLE LIMIT S BODILY INJURY(Per person) $ 25000 r 4066967-F12-47 12112/2018 06/12/2019 BODILY INJURY(Per asctoentl I 50000 V PROPERTY DAMAGE S 25000 GENERAL LIABILITY ' EACH CCCURCNCE S OCCLRRENCE GENERAL AGGREGATE s CLAIMS MADE 5 NSA LOSS POUCY EFFECTIVE POLICY EXPIRATION LTR PAYEE TYPE Of INSURANCE POLICY NUMBER DATE(NWDOrYYYYI DATE(MLWDrt"YYY) LAM I DEDUCTIBLE X VEH COLLIS-'ON LOSS ❑' ACV ❑AGREED ANT S UNIT 4066967-F12-47 12/12/2018 06/12/2019 ❑ ❑STATED ANT S 500 DED X VEHCOMF I f VQ101C ❑' ACV ❑AGREED AMT $ EMT — 4066967-F12.47 12/12/2018 06/12/2019 ❑ 0 STATED AMT $500 DEO EQUIPMENT ❑ACV ❑AGREED AMT 1; UNIT BASIC _-BROAD ❑RC ❑STATED ANT S OED SPECIAL 1 ❑ i REMARKS(INCLUDING SPECIAL CONDITIONS I OTHER COVERAGES)(Attach ACORD 101,Addetional R.,,-,:uw.Si:IiWulo,II more space M required) ADDITIONAL INTEREST CANCELLATION Select one of the following: SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED The adderr151 otereet OBscnbed ware ray been blow to the pole ie3;listed herein by policy nuroMs+. BEFORE THE EXPIRATION DATE THEREOF.NOTICE WILL BE ArequesthasbeenstnmatedIOaddtheuddiIonaldueresteeernlwdbebwtoteP 51e0) DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 101.1 war by Lntc',numbe(s1 __....__ .. _.__... VEHICLE fEQUIPMENT INTEREST: LEASED FINANCED DESCRIPTION OF Ti IC ADDITIONAL INTEREST NAME AND ADDRESS OF ADDITIONAL MEREST ADDITIONAL INSURED LOSS PAYEE LENDER'S LOSS PAYEE LOAN'LEASE NumBER -- AUTHORIZED REPRESENtAIJVE;� ....... _ fLU .-rte Sri C. 1997-2015 ACORD CORPORATION,All rights reserved. ACORD 23(2016)03) The ACORD name and logo arc registered marks of ACORD T03S3E1 142;87 3 0'-:E?:15 POLICY NUMBER: WS276138 COMMERCIAL GENERAL LIABILITY CG 20 12 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. .'ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency or Subdivision or Political Subdivision: City of Bremerton, 680 Lebo Blvd, Bremerton, WA 98310 V Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Section II -Who Is An Insured is amended to include as 2. This insurance does not apply to: an insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, a. "Bodily injury", "property damage"or"personal and subject to the following provisions: advertising injury" arising out of operations performed for the federal government, state or 1. This insurance applies only with respect to operations municipality; or performed by you or on your behalf for which the state or governmental agency or subdivision or political b. "Bodily injury"or"property damage"included within subdivision has issued a permit or authorization. the "products-completed operations hazard". CG 20 12 05 09 Copyright, Insurance Services Office, Inc.,2008 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. V PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition (2) You have agreed in writing in a contract or and supersedes any provision to the contrary: agreement that this insurance would be primary and would not seek contribution from Primary And Noncontributory Insurance any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: WS276138 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Bremerton, 680 Lebo Blvd, Bremerton, WA 98310 Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV- Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 Copyright, Insurance Services Office, Inc.,2008 Page 1 of 1