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SUBJECT: Professional Services Agreement with RH2 Engineering for the Oyster Bay Avenue North Transmission Main Replacement Project AGENDA BILL CITY OF BREMERTON CITY COUNCIL JP hwet 6b- g? SIF Study Session Date: October 26, 2016 COUNCIL MEETING Date: November 2, 2016 Department: Presenter: Phone: PW&U Ned Lever (360) 473-2312 SUMMARY: The City has selected RI -12 Engineering to provide consulting engineering services to design a 24 -Inch water transmission main to replace an existing main that is in need of replacement. The main is approximately 2,400 linear feet long and will run on Oyster Bay Avenue North and Jones Street West between South Ridge Drive and H Street East at the northern access to the car dealerships. A scope of work was submitted and negotiated in the amount of $134,400. ATTACHMENTS: 1) Professional Services Agreement; 2) Exhibit A; 3) Exhibit B; 4) Exhibit C; and 5) Site Plan FISCAL IMPACTS (Include Budgeted Amount): The work is fully funded in the 2016 Water budget. $200,000 is budgeted in 2016 and $1.15M is budgeted in 2017. STUDY SESSION AGENDA: ❑x No Presentation ❑ Full Presentation STUDY SESSION ACTION: 0 Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION: Move to approve the Professional Services Agreement with RI -12 in the amount of $134,400, and authorize the Mayor to finalize and execute the agreement with substantially the same terms and conditions as presented. COUNCIL ACTION: [Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 01/07/15 CONTRACT MODIFICATION AGREEMENT NO.1 BETWEEN THE CITY OF BREMERTON AND R112 ENGINEERING PROJECT: Oyster Bay Avenue N 24 -Inch Transmission Main Replacement CONSULTANT: RH2 Engineering DATE: August 2, 2018 THIS CONTRACT MODIFICATION AGREEMENT SPECIFICALLY AMENDS THE Oyster Bay Avenue N 24 -Inch Transmission Main Replacement AGREEMENT (the "Contract") entered into between the City of Bremerton and RH2 Engineering on November 9, 2016. All provisions in the Contract shall remain in full force and effect except as expressly modified by this document. For valuable consideration and by mutual consent of the parties, the modifications to the Contract are as follows: I. Section I. Scone , is modified as follows: Additional design and CAD work associated with an alignment change. Section II. Term , is modified as follows: The Consultant shall complete the work described in this Contract Modification Agreement No. I by October 31, 2018 Section III. Compensation , is modified as follows: The original contract amount was $134,400. The City shall pay the Consultant for the additional work described above, based on time and materials, an amount not to exceed $2,000, for a total amended contract amount of $136,400, including this Contract Modification. H. Consultant accepts all requirements of this Contract Modification by endorsing below. Consultant further agrees that this Contract Modification constitutes full and final settlement of all of the Consultant's claims for contract time and for all costs of any kind, including without limitation, costs of delays related to any work either covered or affected by this Contract Modification, claims related to on-site or home office overhead, or lost profits. This Contract Modification does not limit the City's right to bring a claim for past performance. Pagel of 2 Contract Modification No. I August 2, 2018 Oyster Bay Ave N 24 -Inch Transmission Main Replacement -JRIGNAL o�PAGE NO. 2 OF? nWF-,'3 The undersigned consultant approves the foregoing Contract Modification as to the changes, if any, in the contract price specified for each item, including any and all supervision costs and other miscellaneous costs relating to the change in work, and as to the extension of time allowed, if any, for completion of the entire work due to said Contract Modification. This document will become a supplement of the contract and all provisions will apply hereto. It is understood that this Contract Modification shall be effective when approved by the City of Bremerton. The parties whose names appear below warrant that they are authorized to enter into a contract modification that is binding on the parties of this contract. In addition, Consultant warrants that it has or will inform the surety of this change, and shall take appropriate action to modify any bonds required under the contract to address this change. IN WITNESS WHEREOF, the parties have executed this Contract Modification on the day and year first written above. /� City Engineer / Public Works Director approved to processJ 1'141 / _ (Initials and Date) Co TANTTHE CITY OF BREMERTON �_5, By: _I"w Print Name: C'(EOFF �P 6. DILLHRP Print Name: Its: U IQECIT0P— Date: I?— 1Y APPROVED AS TO FORM: By: ROGER A. LUB IC , Brem on City Attorney NOTICES TO BE SENT TO: RH2 Engineering ATTN: Dave Matz 950 Pacific Avenue, Suite 1220 Tacoma, WA 98402 Page 2 of 2 Contract Modification No. 1 Oyster Bay Ave N 24 -Inch Transmission Main Replacement Its: a.rl av Date: ��►� 23 , �.o �$ ATTEST: By: r"L�-OD�3 ANdJELAAVOODS, City Clerk NOTICES TO BE SENT TO: City of Bremerton ATTN: Linda Fulton 345 6h Street, Suite 500 Bremerton, WA 98310 August 2, 2018 ^1i O AL j_f AW NO.,L10F Z S PROFESSIONAL SERVICES AGREEMENT Oyster Bay Avenue N 24 -Inch Transmission Main Replacement / 4530 The City of Bremerton ("City") and RI -12 Engineering ("Consultant"), referred to collectively as the "Parties," enter into the following Agreement for professional services: I. Scope: The Consultant agrees to perform the services more specifically described in the Scope of Work, dated October 3, 2016, 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 IKA 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 $134,400. 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 /RMEngineering Oyster Bay Ave N 24 -inch Transmission Main Replacement Rev 02-16 Page 1 of 7 r'RIQ ALL PAOENO. ZOi`��`P'.A S 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 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 AU 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 /RMEngineering Oyster Bay Ave N 24 -inch Transmission Main Replacement Rev 02-16 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 orsub-Consultants. Before beginning work on the project described in this Agreement, the Consultant shall provide a Certificate of Insurance evidencing: 1. Automobile Liability insurance with limits no less than $1,000,000 combined single limit per accident for bodily injury and property damage; and 2. Commercial General Liability insurance written on an occurrence basis with limits no less than $1,000,000 combined single limit per occurrence and general aggregate for personal injury, bodily injury and property damage. Coverage shall include but not be limited to: blanket contractual; products/completed 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. 4. Professional Liability insurance with limits no less than $1,000,000 limit per occurrence/claim. 5. Workers Com; ensation 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. Bremerton / R112Engineering Oyster Bay Ave N 24 -inch Transmission Main Replacement Rev 02-16 Page 3 of 7 3RIQNAL I PAGE NO. L i 0C Dwers 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 6t' 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 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 Consultant or provided by City without prior written consent of the City. The City will not unreasonably withhold its consent. Bremerton /RMEngineering Oyster Bay Ave N 24 -inch Transmission Main Replacement Rev 02-16 Page 4 of 7 :RtaNAL_PAQEHO.�o 2 -s 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. 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. SeverabilitShould 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. Cily Address: Consultant Address: City of Bremerton RH2 Engineering 345 6th Street 950 Pacific Avenue, Suite 1220 Bremerton, WA Tacoma, WA 98310 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. L. Compliance with Laws: Consultant shall comply with all applicable Federal, State, and local laws in performing its obligations under this Agreement. Bremerton /RMEngineering Oyster Bay Ave N 24 -inch Transmission Main Replacement Rev 02-16 Page 5 of 7 ;�ilf.'INAL \ PACE 1C), "'r— fiOF PA217�S 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 orprovisions 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 Bremerton I RMEngineering Oyster Bay Ave N 24 -inch Transmission Main Replacement Rev 02-16 Page 6 of 7 ..hl WAL � PAOEfJO.�OFC 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. 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 CONSULTANT 01Z*44��- �� "O� (signature) (sig re) V By: i�) L ! By:62C0FT 1 I L 1AA., MA (printed name) (printed name) its: `in Ol l� ©�' its: I)I Ry CTu e - Date: % �-� Date: 14-31-16 Approved as to form Bremerton Ci Vttornl 1T-clerk R:\Legal\Legal\Contracts\FORMS\Professional Services Agreement Form(2016).doc Bremerton /RMEngineering Oyster Bay Ave N 24 -inch Transmission MainReplacement Rev 02-16 Page 7 of 7 .;RIQBVAL_L_PAGENO.� OFZE+a?--S This page intentionally left blank October 3, 2016 ;Rte C EXHIBIT A Scope of Work City of Bremerton Oyster Bay Avenue N 24 -inch Transmission Main Replacement October 2016 Background The City of Bremerton (City) plans to replace an existing water transmission main from its existing reservoir connection along Sound Ridge Drive (valve cluster map 531A) to the north end of the car dealerships along Oyster Bay Avenue N (valve cluster map 540). This project will include approximately 2,400 linear feet of 24 -inch -diameter ductile iron (DI) water main replacement along Oyster Bay Avenue N and Jones Street W between Sound Ridge Drive and H Street East at northern access to the car dealerships. RH2 Engineering, Inc., (RH2) has prepared this Scope of Work and associated Fee Estimate to provide the water main design, assist with permitting, and provide services during bidding and construction for this project. The following tasks are included in this Scope of Work: • Task 1 — Project Management • Task 2 — Preliminary Design • Task 3 — Topographic Survey • Task 4 — Geotechnical Investigation and Report • Task 5 — Water Main Design • Task 6 — Regulatory and Permitting Assistance • Task 7 — Services During Bidding and Construction • Task 8 — Management Reserve Design Standards and References The following design standards and references are to be followed where relevant during the development of the project: • City Standard Details. • City Standard Special Provisions. • City Standard Construction Contract and General Conditions. • Washington State Department of Transportation (WSDOT) Standard Specifications for Road, Bridge, and Municipal Construction. AutoCAD® is to be used to prepare drawings and AutoCAD® Civil 3D may be used for the site design. Project schedules shall be prepared using Microsoft Project 2007 or newer, spreadsheets in Microsoft Excel 2010 or newer, and text documents in Microsoft Word 2010 or newer. 1 9/28/2016 9:12:46 AM \\rh2-515\local\Data\BRM\S40\2016 Main Replacement\Contract\PSA-SOW-BRM-2016 Main Replacetnentdoc 7,RI HNAL J_PAGE N0. JV OFFRLQ..~.0 City of Bremerton Exhi it A Oyster Bay Avenue N 24 -inch Transmission Main Replacement Scope of Work Plans shall be prepared in accordance with the City's standards. Color plans will be used for review purposes. Full-size plan sheets will be provided at 22 -inch by 34 -inch, and half-size sheets at 11 -inch by 17 -inch. Electronic plans and specification documents will be used for bidding purposes. Assumptions 1. One (1) bid set of plans 21411 be prepared for the water main replacement, with no anticipated project phasing. 2. The specifications are established as follows: a. Dater Main Replacement — VSDOT Standard Specifications for Road, Bridge, and Municipal Construction. 3. City willprovide non-technical specifcations (General Conditions and construction contract sections). 4. All permit fees will be paid directly by the City. 5. Once review comments are ready, a meeting with the City nill be conducted at the milestone reviews (60 and 90 percent) at the City Offices to discuss the comments. 6. RH2 will rely on the accuracy and completeness of any data, materials, or information provided by the City or others in relation to the work. Task 1— Project Management Services Objective: Manage RH2's project team and maintain frequent client communications, including phone calls and emails, in addition to progress meetings. Approach: 1.1 Provide direction, coordination, and oversight to the RH2 project team. Organize, manage, and coordinate technical disciplines as described herein, and implement quality assurance and quality control (QA/QC) to perform this Scope of Work in close coordination with City staff. 1.2 Document and retain information generated during the execution of the project. 1.3 Prepare monthly invoices and budget status summaries. 1.4 Prepare for and attend coordination meetings with City staff, as requested. Prepare meeting minutes. A total of two (2) meetings are in addition to the other milestone and review meetings mentioned in this Scope of Fork. 1.5 Create, maintain, and update an internal project design schedule. Monitor, modify, and update the project schedule throughout the design phase on a monthly basis to determine potential impacts of proposed changes. Adjust the schedule to reflect the current status of the project and revisions made to this Scope of Work. RH2 Deliverables: • Meeting agendas and minutes in electronic format. • Monthly invoices. • Project schedule. 2 9/28/16 9:12 AM \\rh2-515\local\Data\BRM\S40\2016 Main Replacement\Contract\PSA-SOW-BRM-2016 Main Replacement.docx City of Bremerton Exhibit A Oyster Bay Avenue N 24 -inch Transmission Main Replacement Scope of Work Task 2 — Preliminary Design Objective: Assist the City in evaluating water main replacement options, including: • Pipe size • Pipe material • Alignment • Existing service connections • Construction method (e.g., slip lining, pipe bursting, and water line in service or shut off) Approach: 2.1 Attend one (1) meeting with the City to evaluate and decide on water main replacement alignment, size, material, and construction method. 2.2 Provide preliminary construction cost estimates, advantages, and disadvantages for water main replacement options. Assumptions: • The City will perform a hydraulic analysis for each option based upon its WaterCAD program and estimated current and future water demands. • The following design assumptions are based on City desires: o 24 -inch DI pipe. o Existing water line needs to stay in seruice during construction of the new main. o Service connections need to be connected to water main other than the transmission main. Provided by City: • Hydraulic analysis results for options. RH2 Deliverables: • Preliminary cost estimates in electronic format. • Meeting agenda and minutes in electronic format. Task 3 — Topographic Survey Objective: Acquire up-to-date survey data of the project sites for design purposes. Subcontract with Sitts and Hill, Inc., of Tacoma, Washington, to survey the water main alignment. Evaluate utility locates and survey limits. Coordinate with surveyor for survey standards and AutoCAD format, and review survey. Approach: 3.1 Subcontract and coordinate with Sitts and Hill, Inc., for survey work for the water main replacement alignment. 3.2 Attend one (1) site visit to evaluate utility locates and survey limits with the City. 3.3 Review and revise survey data for the water main design. 3 9/28/16 9:12 AM \\rh2-515\local\Data\BRM\S40\2016 Main Replacement\Contract\PSA-SOW-BRM-2016 Main Replacement.docx City of Bremerton Exhibit A Oyster Bay Avenue N 24 -inch Transmission Main Replacement Scope of Work Assumptions: • Hosz.Zontal data avill be based upon existing City control. Vertical data will be based on NA VD -88. • City of Bremerton will coordinate utility locates by using the one -call locate gstem. If this process is not adequate or there are challenges, Sitts and Hill, Inc., will coordinate the on-site utility locates with aprivate utility locate company. The estimated cost of ,$4100 has been included in the contract for these private utility locates but still not be billed if City utility locates are adequate. RH2 Deliverables: • One (1) electronic copy of the AutoCAD® survey files (AutoCAD® and PDF) will be provided to the City. • Attend one (1) site visit. Task 4 — Geotechnical Investigation and Memorandum Objective: Acquire geotechnical information of the soil and groundwater conditions along the right-of-way for the proposed water main alignment. Evaluate geotechnical soil, existing soil pin wall, and groundwater conditions to support design and construction, and prepare recommendations and specifications for shoring, groundwater control, and backfill of the excavations for the water main. Approach: 4.1 Review available geologic, groundwater, soil pin wall design, and geotechnical information for the water main. 4.2 Perform one (1) site visit to review existing soil conditions based upon City -provided potholes. 4.3 Prepare a geotechnical memorandum with information on geological and groundwater conditions along the proposed water main alignment. Prepare recommendations for subgrade preparation and backfilling for the water main excavation. Provided by City: • Soil pin wall as-builts. • Equipment for field potholing. RH2 Deliverables: • Geotechnical investigation memorandum for the water main replacement alignment in hardcopy (two (2) copies) and electronic format. WATER MAIN REPLACEMENT DESIGN Task 5 — Water Main Design Objective: Design replacement of 24 -inch water main along Oyster Bay Avenue N and Jones Street W between Sound Ridge Drive and the northern access to the car dealerships. 4 9/28/16 9:12 AM \\rh2-515\local\Data\BRM\S40\2016 Main Replacement\Contract\PSA-SOW-BRM-2016 Main Replacemencdocx City of Bremerton -;RI INAL I PAGENO. 20FZDP,2:.S Exhibit A Oyster Bay Avenue N 24 -inch Transmission Main Replacement Scope of Work Approach: 5.1 Format base map received from surveyor and create base layout sheets. Walk alignment to review visible structures such as water meters, valves, and other utility facilities. Review is limited only to visible surface features. 5.2 Prepare preliminary water main layout. Visit site to review placement of proposed water mains. 5.3 Attend one (1) meeting with the City to review preliminary layout. 5.4 Prepare 60- and 90 -percent design of the water mains and appurtenances. 5.5 Prepare details for connection to the existing water mains. 5.6 Prepare traffic control plan along Oyster Bay Avenue N and Jones Street W. 5.7 Meet with the City to review 60- and 90 -percent design. 5.8 Perform in-house QA/QC review of plans at 60- and 90- percent design. 5.9 Prepare technical specifications. 5.10 Create standard detail sheets using City's standard details. 5.11 Prepare an engineer's probable construction cost estimate. 5.12 Finalize plans and specifications based on City and in-house QA/QC review comments. Provided by City: • Review comments for 60- and 90 -percent plans and specifications • Non-technical specifications, including general conditions and construction contract documents. RH2 Deliverables: One (1) full-size set of plans, four (4) half-size sets of plans, specifications in Microsoft Word format, and an electronic copy (PDF) of plans at both the 60- and 90 -percent design review stages. Task 6 — Regulatory and Permitting Assistance Objective: Assist the City with preparation of development permits for the water main construction. Approach: 6.1 Prepare the State Environmental Policy Act (SEPA) Checklist. Coordinate with the City to process the SEPA and publish a determination of project effect. Assumptions: • An environmental review via a SEPA Checklist will be required. • The amount of disturbance will be less than one (1) acre, excluding the project from the need to obtain a Construction Stormwater General Permit. • The project will not be constructed within critical areas and will not need to cross any water features, thus a Critical Areas Permit and/or Hydraulic Project Approval are not expected to be required. • The project is expected to be exempt from the need to obtain a Right-of-way Permit. 5 9/28/16 9:12 AM \\rh2-515\local\Data\BRM\S40\2016 Main Replacement\Contract\PSA-SOW-BRM-2016 Main Replacement.docx City of Bremerton Exhibit A Oyster Bay Avenue N 24 -inch Transmission Main Replacement Scope of Work RH2 Deliverables: • Two (2) hard copies of the permit applications and one (1) electronic copy (PDF) for the City. Task 7 - Bidding and Construction Support Objective: This task includes supporting the City, on an as -requested basis, with assistance during the bidding and construction of the project. The level of support provided will be at the direction of the City up to the budget amount available under this task. Anticipated support during bidding and construction may include: Approach: 7.1 Bidding Support: Attend pre-bid meeting. At the direction of the City and up to the budget amount respond to questions from bidders, subcontractors, equipment suppliers, and other vendors regarding the project, plans, and specifications. Prepare draft addenda items for use by the City in preparing addenda. 7.2 Construction Support: At the direction of the City and up to the budget amount, review specific construction submittals/resubmittals, assist with issuing clarifications to the construction contractor, assist with review of contractor changes and change order negotiation, conduct site visits, and participate in construction meetings, including the pre -construction meeting. Assumptions: • The City will take the lead in all tasks associated with bidding. • The City avill provide on-site inspection and n411 take the lead in administering and managing all aspects of the construction contract and communicating with the construction contractor. • Preparation of addenda to the bid documents is anticipated. • Up to eight (8) hours for request for information (RFI) review and comment are anticipated by RH2. • Participate in up to three (3) construction meetings is anticipated and will be coordinated with site visits for efficiency. • Up to three (3) site visits are anticipated. • Only at the request of the City will RH2 provide support services during project bidding and construction up to the hours authorized. RH2 Deliverables: • Record of bidder questions and inquiries. • Addenda documentation, as required for the City to distribute to plan holders. • Responses to submittals, clarification, changes, etc. as requested by the City. • Record drawings. 6 9/28/16 9:12 AM \\rh2-515\local\Data\BRM\S40\2016 Main Replacement\Contract\PSA-SOW-BRM-2016 Main Replacement.docx City of Bremerton JRUNAL 1 PAQE IO.I? OF24'x! -S Exhibit A Oyster Bay Avenue N 24 -inch Transmission Main Replacement Scope of Work Task 8 — Management Reserve Objective: Provide a discretionary allowance budget task for unanticipated labor, expenses, or professional services not specifically identified in Tasks 1 through 7 in this Scope of Work. No work can be performed under Task 8 without written authorization from the City. Approach: 8.1 Provide additional services, as requested. Address unanticipated services beyond what is identified in this Scope of Work, up to the level of the contingency. Project Schedule The goal of the City is to construct this project by the end of September 2017. Based upon the preliminary schedule, the notice to proceed/ contract execution will be obtained in October 2016, and RH2 should have the plans ready for bidding by March 2017, so it can be processed through the City for summer construction. 7 9/28/16 9:12 AM \\rh2-515\local\Data\BRM\S40\2016 Main Replacement\Contract\PSA-SOW-BRM-2016 Main Replacement.docx .;M"Ai 1 PAGE Tla.I((q OF This page intentionally left blank 1RIIAL1 PAGE N. Exhibit B Project Schedule Anticipated Notice to Proceed — November 10, 2016 Anticipated design completion — March 9, 2017 Anticipated Construction Completion — September 29, 2017 PSA with RH2 Engineering October 2016 Oyster Bay Avenue N 24 -inch Transmission Main Replacement Nf7MOLL PAGEno.LoFZ(D 'S This page intentionally left blank (N M -;FiI6HNAL- PAw Na. LJ OFZQrA?" ,S EXHIBIT C (page 1 of 2) -'RIQfNALJ Pk(aENO.�E EXHIBIT IC RH2 ENGINEERING, INC./CITY OF BREMERTON SCHEDULE OF RATES AND CHARGES RATE LIST RATE UNIT Professional $90 $/hr Professional 11 $104 $/hr Professional III $118 $/hr Professional IV $152 $/hr Professional $186 $/hr Professional VI $220 $/hr Professional VII $260 $/hr Professional VIII $303 $/hr Professional IX $303 $/hr Technician 1 $80 $/hr Technician II $83 $/hr Technician III $87 $/hr Technician IV $90 $/hr Administrative 1 $44 $/hr Administrative II $74 $/hr Administrative 111 $81 $/hr Administrative IV $136 $/hr Administrative V $152 $/hr CAD/GIS System $27.50 $/hr CAD Plots - Half Size $2.50 price per plot CAD Plots - Full Size $10.00 price per plot CAD Plots - Large $25.00 price per plot Copies (bw) 8.5" X 11" $0.09 price per copy Copies (bw) 8.5" X 14" $0.14 price per copy Copies (bw) 11" X 17" $0.20 price per copy Copies (color) 8.5" X 11" $0.90 price per copy Copies (color) 8.5" X 14" $1.20 price per copy Copies (color) 11" X 17" $2.00 price per copy Technology Charge 2.50% % of Direct Labor Mileage $0.540 price per mile (or Current IRS Rate) Subconsultants 15% Cost + Outside Services at cost Multiplier for each classification :is between 3.1 to 3.2 10114n0168:06AM Exhibit C (page 2 of 2) A`' & CERTIFICATE OF LIABILITY INSURANCE F71TE (MM/DDIYYYY) 0/31/2016 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 Sammamish insurance, Inc. 704 228th Ave NE, PMB 373 Sammamish WA 98074 CONTACT Allen FU itt CPCU NAME: g PHONE (425) 898-8780 FAX No: (425)836-2865 E-MAIL Fugitt@msn.com INSURERS AFFORDING COVERAGE NAIC # INSURER A:HartfOrd Casualty Ins. Co. 29424 INSURED Rh2 Engineering Inc 22722 29th Dr SE Ste 210 Bothell WA 98021 INSURER B :Sentinel Insurance Co., Ltd 11000 INSURERC:Continental Casualty Companv 20443 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:CL169802943 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER EFF MM/DIDY IYYYY POLICY EXP D/YYYY M LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS -MADE Fx_ OCCUR DAMAGE TO ccu RENTED PREMISESEa Occurrence)$ 300,000 MED EXP (Any one person) $ 10,000 X 52SEANX7343 5/29/2016 5/29/2017 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY F1 PRO-JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 4,000,000 Employee Benefits $ 4,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X 52UECBA6335 5/29/2016 5/29/2017 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident NON -OWNED HIRED AUTOS AUTOS Medical payments $ 10,000 X UMBRELLA.LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2 000 000 A EXCESS LIAB• CLAIMS -MADE DED I I RETENTION$ 10,000 $ 52SBANX7343 5/29/2016 5/29/2017 JC1)WMPLO ER�S'LLIABBILLIITYY YIN PER STATUTE X ERH A ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) N / A 52SBANX7343 5/29/2016 5/29/2017 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under - DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Professional Liability AER004312321 5/29/2016 5/29/2017 Per Claim 3,000,000$ Claims Made Deductible $200,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Oysteer Bay Ave N. 24 inch Transmission Main Replacement/4530 The City of Bremerton is added as an additional insured in connection with the above referenced project. CERTIFICATE HOLDER CANCELLATION ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Bremerton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 345 6th St. ACCORDANCE WITH THE POLICY PROVISIONS. Bremerton, WA 98310 AUTHORIZED REPRESENTATIVE A Fugitt CPCU/JONA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) BUSINESS LIABILITY COVERAGE FORM Form SS 00 08 04 05 © 2005, The Hartford QUICK REFERENCE BUSINESS LIABILITY COVERAGE FORM READ YOUR POLICY CAREFULLY BUSINESS LIABILITY COVERAGE FORM Beginning on Page A. COVERAGES 1 Business Liability 1 Medical Expenses 2 Coverage Extension - Supplementary Payments 2 B. EXCLUSIONS 3 C. WHO IS AN INSURED 10 D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE 14 E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS 15 1. Bankruptcy 15 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit 15 3. Financial Responsibility Laws 16 4. Legal Action Against Us 16 5. Separation Of Insureds 16 6. Representations 16 7. Other Insurance 16 8. Transfer Of Rights Of Recovery Against Others To Us 17 F. OPTIONAL ADDITIONAL INSURED COVERAGES 18 Additional Insureds 18 G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 20 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM' Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered. Throughout this policy the words "you" and "your" refer to the Named Insured shown in the Declarations. The words "we", "us" and "our" refer to the stock insurance company member of The Hartford providing this insurance. The word"insured" means any person or organization qualifying as such under Section C. - Who Is An Insured. Other words and phrases that appear in quotation marks have special meaning. Refer to Section G. - Liability And Medical Expenses Definitions. A. COVERAGES 1. BUSINESS LIABILITY COVERAGE (BODILY INJURY, PROPERTY DAMAGE, PERSONAL AND ADVERTISING INJURY) Insuring Agreement a. We will pay those sums that the insured becomes legally obligated to pay as damages because of "bodily injury", "property damage" or "personal and advertising injury" to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages -for "bodily injury", "property damage" or "personal and advertising injury" -to which this insurance does not apply. We may, at our discretion, investigate any "occurrence" or offense and settle any claim or "suit" that may result. But: (1) The amount we will pay for damages is limited as described in Section D. - Liability And Medical Expenses Limits Of Insurance; and (2) Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments, settlements or medical expenses to which this insurance applies. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Coverage Extension - Supplementary Payments. b. This insurance applies: (1) To "bodily injury" damage" only if: Form SS 00 08 04 05 (a) The "bodily injury" or "property damage" is caused by an "occurrence" that takes place in the "coverage territory"; (b) The "bodily injury"' or "property damage" occurs during the policy period; and (c) Prior to the policy period, no insured listed under Paragraph 1. of Section C. — Who Is An Insured and no "employee" authorized by you to give or receive notice of an "occurrence" or claim, knew that the "bodily injury" or "property damage" had occurred, in whole or in part. If such a listed insured or authorized "employee" knew, prior to the policy period, that the "bodily injury" or "property damage" occurred, then any continuation, change or resumption of such "bodily injury" or "property damage" during or after the policy period will be deemed to have been known prior to the policy period. (2) To "personal and advertising injury" caused by an offense arising out of your business, but only if the offense was committed in the "coverage territory" during the policy period. c. "Bodily injury" or "property damage" will be deemed to have been known to have occurred at the earliest time when any insured listed under Paragraph 1. of Section C. — Who Is An Insured or any "employee" authorized by you to give or receive notice of an "occurrence" or claim: and "property (1) Reports all, or any part, of the "bodily injury" or "property damage" to us or any other insurer; Page 1 of 24 © 2005, The Hartford BUSINESS LIABILITY COVERAGE FORM (2) Receives a written or verbal demand or claim for damages because of the "bodily injury" or "property damage"; or (3) Becomes aware by any other means that "bodily injury" or "property damage" has occurred or has begun to occur. d. Damages because of "bodily injury" include damages claimed by any person or organization for care, loss of services or death resulting at any time from the "bodily injury". e. Incidental Medical Malpractice (1) "Bodily injury" arising out of the rendering of or failure to render professional health care services, as a physician, dentist, nurse, emergency medical technician or paramedic shall be deemed to be caused by an "occurrence", but only if: (a) The physician, dentist, nurse, emergency medical technician or paramedic is employed by you to provide such services; and (b) You are not engaged in the business or occupation of providing such services. (2) For the purpose of determining the limits of insurance for incidental medical malpractice, any act or omission together with all related acts or omissions in the furnishing of these services to any one person will be considered one 'occurrence". 2. MEDICAL EXPENSES Insuring Agreement a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (1) The accident takes place in the "coverage territory" and during the policy period; (2) The expenses are incurred and reported to us within three years of the date of the accident; and (3) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. b. We will make these payments regardless of fault. These payments will not exceed the applicable limit of insurance. We will pay reasonable expenses for: (1) First aid administered at the time of an accident; (2) Necessary medical, surgical, x-ray and dental services, including prosthetic devices; and (3) Necessary ambulance, hospital, professional nursing and funeral services. 3. COVERAGE EXTENSION - SUPPLEMENTARY PAYMENTS a. We will pay, with respect to any claim or "suit" we investigate or settle, or any "suit" against an insured We defend: (1) All expenses we incur. (2) Up to $1,000 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which Business Liability Coverage for "bodily injury" applies. We do not have to furnish these bonds. (3) The cost of appeal bonds or bonds to release attachments, but only for bond amounts within the applicable limit of insurance. We do not have to furnish these bonds. (4) 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 $500 a day because of time off from work. (5) All costs taxed against the insured in the "suit". (6) Prejudgment interest awarded against the insured on that part of the judgment we pay. If we make an offer to pay the applicable limit of insurance, we will not pay any prejudgment interest based on that period of time after the offer. (7) All interest on the full amount of any judgment that accrues after entry of the judgment and before we have paid, offered to pay, or deposited in court the part of the judgment that is within the applicable limit of insurance. Any amounts paid under (1) through (7) above will not reduce the limits of insurance. Page 2 of 24 Form SS 00 08 04 05 b. If we defend an insured against a "suit" and an indemnitee of the insured is also named as a party to the "suit", we will defend that indemnitee if all of the following conditions are met: (1)The "suit" against the indemnitee seeks damages for which the insured has assumed the liability of the indemnitee in a contract or agreement that is an "insured contract"; (2) This insurance applies to such liability assumed by the insured; (3) The obligation to defend, or the cost of the defense of, that indemnitee, has also been assumed by the insured in the same "insured contract"; (4) The allegations in the "suit" and the information we know about the "occurrence" are such that no conflict appears to exist between the interests of the insured and the interest of the indemnitee; (5) The indemnitee and the insured ask us to conduct and control the defense of that indemnitee against such "suit" and agree that we can assign the same counsel to defend the insured and the indemnitee; and (6) The indemnitee: (a) Agrees in writing to: (i) Cooperate with us in the investigation, settlement or defense of the "suit"; (ii) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the "suit"; (iii) Notify any other insurer whose coverage is available to the indemnitee; and (iv) Cooperate with us with respect to coordinating other applicable insurance available to the indemnitee; and (b) Provides us with written authorization to: (i) Obtain records and other information related to the "suit"; and (ii) Conduct and control the defense of the indemnitee in such "suit". BUSINESS LIABILITY COVERAGE FORM So long as the above conditions are met, attorneys' fees incurred by us in the defense of that indemnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Notwithstanding the provisions of Paragraph 1.b -(b) of Section B. — Exclusions, such payments will not be deemed to be damages for "bodily injury" and "property damage" and will not reduce the Limits of Insurance. Our obligation to defend an insured's indemnitee and to pay for attorneys' fees and necessary litigation expenses as Supplementary Payments ends when: (1) We have used up the applicable limit of insurance in the payment of judgments or settlements; or (2) The conditions set forth above, or the terms of the agreement described in Paragraph (6) above, are no longer met. B. EXCLUSIONS 1. Applicable To Business Liability Coverage This insurance does not apply to: a. Expected Or Intended Injury (1) "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property; or (2) "Personal and advertising injury" arising out of an offense committed by, at the direction of or with the consent or acquiescence of the insured with the expectation of inflicting "personal and advertising injury". b. Contractual Liability (1) "Bodily injury" or "property damage"; or (2) "Personal and advertising injury" for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages because of: (a) "Bodily injury", "property damage" or "personal and advertising injury" that the insured would have in the absence of the contract or agreement; or Form SS 00 08 04 05 Page 3 of 24 BUSINESS LIABILITY COVERAGE FORM (b) "Bodily injury" or "property damage" (b) Performing duties related to the assumed in a contract or agreement conduct of the insured's business, or that is an "insured contract", (2) The spouse, child, parent, brother or provided the "bodily injury" or sister of that "employee" as a "property damage" occurs consequence of (1) above. subsequent to the execution of the This exclusion applies: contract or agreement. Solely for the purpose of liability assumed in (1) Whether the insured may be liable as an "insured contract', reasonable an employer or in any other capacity; attorneys' fees and necessary and litigation expenses incurred by or for (2) To any obligation to share damages a parry other than an insured are with or repay someone else who must deemed to be damages because of pay damages because of the injury. "bodily injury" or "property damage" This exclusion does not apply to liability provided: assumed by the insured under an "insured (i) Liability to such party for, or for contract". the cost of, that party's defense f. Pollution has also been assumed in the same "insured contract", and (1) "Bodily injury", "property damage" or .„ personal and advertising injury (ii) Such attorneys' fees and arising out of the actual, alleged or litigation expenses are for threatened discharge, dispersal, defense of that party against a seepage, migration, release or escape civil or alternative dispute of "pollutants": resolution proceeding in which damages to which this (a) At or from any premises, site or insurance applies are alleged. location which is or was at any time owned or occupied by, or c. Liquor Liability rented or loaned to any insured. "Bodily injury" or "property damage" for However, this subparagraph does which any insured may be held liable by not apply to: reason of: (i) "Bodily injury" if sustained within (1) Causing or contributing to the a building and caused by intoxication of any person; smoke, fumes, vapor or soot (2) The furnishing of alcoholic beverages to produced by or originating from a person under the legal drinking age or equipment that is used to heat, under the influence of alcohol; or cool or dehumidify the building, (3) Any statute, ordinance or regulation or equipment that is used to heat water for personal use, by relating to the sale, gift, distribution or the building's occupants or their use of alcoholic beverages. guests; This exclusion applies only if you are in the (ii)"Bodilyinjury" or "property fry business of manufacturing, distributing, damage„ for which you may be selling, serving or furnishing alcoholic held liable, if you are a beverages. contractor and the owner or d. Workers' Compensation And Similar lessee of such premises, site or Laws location has been added to your Any obligation of the insured under a policy as an additional insured workers' compensation, disability benefits with respect to your ongoing .or unemployment compensation law or operations performed for that any similar law. additional insured at that e. Employer's Liability premises, site or location and "Bodily injury” to: such premises, site or location is not and never was owned or (1) An "employee" of the insured arising occupied by, or rented or out of and in the course of: loaned to, any insured, other (a) Employment by the insured; or than that additional insured; or Page 4 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM (iii) "Bodily injury" or "property released as part of the damage" arising out of heat, operations being performed smoke or fumes from a by such insured, contractor or "hostile fire"; subcontractor; (b) At or from any premises, site or (ii) "Bodily injury" or "property location which is or was at any damage" sustained within a time used by or for any insured or building and caused by the others for the handling, storage, release of gases, fumes or disposal, processing or treatment vapors from materials brought of waste; into that building in connection (c) Which' are or were at any time with operations being performed transported, handled, stored, by you or on your behalf by a treated, disposed of, or processed contractor or subcontractor; or as waste by or for: (iii) "Bodily injury" or "property (i) Any insured; or damage" arising out of heat, smoke or fumes from a (ii) Any person or organization for "hostile fire"; or whom you may be legally responsible; (e) At or from any premises, site or location on which any insured or any (d) At or from any premises, site or contractors or subcontractors location on which any insured or working directly or indirectly on any any contractors or subcontractors insured's behalf are performing working directly or indirectly on operations if the operations are to any insured's behalf are test for, monitor, clean up, remove, performing operations if the contain, treat, detoxify or neutralize, "pollutants" are brought on or to or in any way respond to, or assess the premises, site or location in the effects of, "pollutants". connection with such operations by such insured, contractor or (2) Any loss, cost or expense arising out subcontractor. However, this of any: subparagraph does not apply to: (a) Request, demand, order or statutory (i) "Bodily injury" or "property or regulatory requirement that any damage" arising out of the insured or others test for, monitor, escape of fuels, lubricants or clean up, remove, contain, treat, other operating fluids which are detoxify or neutralize, or in any way needed to perform the normal respond to, or assess the effects of, electrical, hydraulic or "pollutants"; or mechanical functions (b) Claim or suit by or on behalf of a necessary for the operation of governmental authority for "mobile equipment" or its parts, damages because of testing for, if such fuels, lubricants or other monitoring, cleaning up, removing, operating fluids escape from a containing, treating, detoxifying or vehicle part designed to hold, neutralizing, or in any way store or receive them. This responding to, or assessing the exception does not apply if the effects of, "pollutants". "bodily injury" or "property However, this paragraph does not damage" arises out of the apply to liability for damages because intentional discharge, dispersal of "property damage" that the insured or release of the fuels, would have in the absence of such lubricants or other operating request, demand, order or statutory or fluids, or if such fuels, regulatory requirement, or such claim lubricants or other operating or "suit" by or on behalf of a fluids are brought on or to the governmental authority. premises, site or location with the intent that they be discharged, dispersed or Form SS 00 08 04 05 Page 5 of 24 BUSINESS LIABILITY COVERAGE FORM g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". 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" involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; (5) "Bodily injury" or "property damage" arising out of the operation of any of the equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment"; or (6) An aircraft that is not owned by any insured and is hired, chartered or loaned with a paid crew. However, this exceptiondoes not apply if the insured has any other insurance for such "bodily injury" or "property damage", whether the other insurance is primary, excess, contingent or on any other basis. h. Mobile Equipment "Bodily injury" or "property damage" arising out of: (1) The transportation of "mobile equipment" by an "auto" owned or operated by or rented or loaned to any insured; or Page 6 of 24 0 (2) The use of "mobile equipment" in, or while in practice or preparation for, a prearranged racing, speed or demolition contest or in any stunting activity. I. War "Bodily injury", "property damage" or "personal and advertising injury", however caused, arising, directly or indirectly, out of: (1) War, including undeclared or civil war; (2) Warlike action by a military force, including action in hindering or defending against an actual or expected attack, by any government, sovereign or other authority using military personnel or other agents; or (3) Insurrection, rebellion, revolution, usurped power, or action taken by governmental authority in hindering or defending against any of these. j. Professional Services "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional service. This includes but is not limited to: (1) Legal, accounting or advertising services; (2) Preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; (3) Supervisory, inspection, architectural or engineering activities; (4) Medical, surgical, dental, x-ray or nursing services treatment, advice or instruction; (5) Any health or therapeutic service treatment, advice or instruction; (6) Any service, treatment, advice or instruction for the purpose of appearance or skin enhancement, hair removal or replacement or personal grooming; (7) Optical or hearing aid services including the prescribing, preparation, fitting, demonstration or distribution of ophthalmic lenses and similar products or hearing aid devices; Form SS 00 08 04 05 (8) Optometry or optometric services including but not limited to examination of the eyes and the prescribing, preparation,, fitting,demonstration or distribution :of ophthalmic lenses and similar products; (9) Any: (a) Body piercing (not including ear piercing); (b) Tattooing, including but not limited to the insertion of pigments into or under the skin; and (c) Similar services; (10) Services in the practice of pharmacy; and (11) Computer consulting, design or programming services, including web site design. Paragraphs (4) and (5) of this exclusion do not apply to the Incidental Medical Malpractice coverage afforded under Paragraph 1.e. in Section A. - Coverages. k. Damage To Property "Property damage" to: (1) Property you own, rent or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; (2) Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3) Property loaned to you; (4) Personal property in the care, custody or control of the insured; (5) That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. BUSINESS LIABILITY COVERAGE FORM Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you for a period of 7 or fewer consecutive days. A separate Limit of Insurance applies to Damage To Premises Rented To You as described in Section D. - Limits Of Insurance. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3) and (4) of this exclusion do not apply to the use of elevators. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraphs (3) and (4) of this exclusion do not apply to "property damage" to borrowed equipment while not being used to perform operations at a job site. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products -completed operations hazard". I. Damage To Your Product "Property damage" to "your product" arising out of it or any part of it. m. Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products -completed operations hazard". This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. n. Damage To Impaired Property Or Property Not Physically Injured "Property damage" to "impaired property" or property that has not been physically injured, arising out of: (1) A defect, deficiency, inadequacy or dangerous condition in "your product" or "your work"; or (2) A delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms. This exclusion does not apply to the loss of use of other property arising out of sudden and accidental physical injury to "your product" or "your work" after it has been put to its intended use. Form SS 00 08 04 05 Page 7 of 24 BUSINESS LIABILITY COVERAGE FORM o. Recall Of Products, Work Or Impaired (c) Title of any literary or artistic work; Property (8) Arising out of an offense committed by Damages claimed for any loss, cost or an insured whose business is: expense incurred by you or others for the (a) Advertising, broadcasting, loss of use, withdrawal, recall, inspection, publishing or telecasting; repair, replacement, adjustment, removal (b) Designing or determining content or disposal of: of web sites for others; or (1) "Your product"; (c) An Internet search, access, (2) "Your work"; or content or service provider. (3) "Impaired property"; However, this exclusion does not if such product, work or property is apply to Paragraphs a., b. and c. withdrawn or recalled from the market or under the definition of "personal and from use by any person or organization advertising injury" in Section G. — because of a known or suspected defect, Liability And Medical Expenses deficiency, inadequacy or dangerous Definitions. condition in it. For the purposes of this exclusion, p. Personal And Advertising Injury placing an "advertisement" for or "Personal and advertising injury": linking to others on your web site, by itself, is not considered the business (1) Arising out of oral, written or electronic of advertising, broadcasting, publication of material, if done by or at publishing or telecasting; the direction of the insured with knowledge of its falsity; (9) Arising'out of an electronic chat room (2) Arising out of oral, written or electronic or bulletin board the insured hosts, publication of material whose first owns, or over which the insured publication took place before the exercises control; beginning of the policy period; (10) Arising out of the unauthorized use of another's name or product in your e-mail (3) Arising out of a criminal act committed address, domain name or metatags, or by or at the direction of the insured; any other similar tactics to mislead (4) Arising out of any breach of contract, another's potential customers; except an implied contract to use (11) Arising out of the violation of a another's "advertising idea" in your person's right of privacy created by "advertisement"; any state or federal act. (5) Arising out of the failure of goods, However, this exclusion does not products or services to conform with apply to liability for damages that the any statement of quality or insured would have in the absence of performance made in your such state or federal act; "advertisement"; (6) Arising out of the wrong description of (12) Arising out of: the price of goods, products or services; (a) An "advertisement" for others on (7) Arising out of any violation r of any your web site; intellectual property rights such as (b) Placing a link to a web site of copyright, patent, trademark, trade others on your web site; name, trade secret, service mark or (c) Content from a web site of others other designation of origin or displayed within a frame or border authenticity. on your web site. Content includes However, this exclusion does not information, code, sounds, text, apply to infringement, in your graphics or images; or "advertisement", of (d) Computer code, software or (a) Copyright; programming used to enable: (b) Slogan, unless the slogan is also (i) Your web site; or a trademark, trade name, service (ii) The presentation or functionality mark or other designation of origin of an "advertisement' or other or authenticity; or content on your web site; Page 8 of 24 Form SS 00 08 04 05 (13) Arising out of a violation of any anti- trust law; (14) Arising out of the fluctuation in price or value of any stocks, bonds or other securities; or (15) Arising out of discrimination or humiliation committed by or at the direction of any "executive officer", director, stockholder, partner or member of the insured. q. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to, manipulate "electronic data". r. Employment -Related Practices "Bodily injury" or "personal and advertising injury" to: (1) A person arising out of any: (a) Refusal to employ that person; (b) Termination of that person's employment; or (c) Employment-related practices, policies, acts or omissions, such as coercion, demotion, evaluation, reassignment, discipline, defamation, harassment, humiliation or discrimination directed at that person; or (2) The spouse, child, parent, brother or sister of, that person as a consequence of "bodily injury" or "personal and advertising injury" to the person at whom any of the employment-related practices described in Paragraphs (a), (b), or (c) above is directed. This exclusion applies: (1) Whether the insured may be liable as an employer or in any other capacity; and (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury. s. Asbestos (1) "Bodily injury", "property damage" or "personal and advertising injury" arising outof the "asbestos hazard". (2) Any damages, judgments, settlements, loss, costs or expenses that: BUSINESS LIABILITY COVERAGE FORM (a) May be awarded or incurred by reason of any claim or suit alleging actual or threatened injury or damage of any nature or kind to persons or property which would not have occurred in whole or in part but for the "asbestos hazard"; (b) Arise out of any request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, encapsulate, contain, treat, detoxify or neutralize or in any way respond to or assess the effects of an "asbestos hazard"; or (c) Arise out of any claim or suit for damages because of testing for, monitoring, cleaning up, removing, encapsulating, containing, treating, detoxifying or neutralizing or in any way responding to or assessing the effects of an "asbestos hazard". t. Violation Of Statutes That Govern E - Mails, Fax, Phone Calls Or Other Methods Of Sending Material Or Information "Bodily injury", "property damage", or "personal and advertising injury" arising directly or indirectly out of any action or omission that violates or is alleged to violate: (1) The Telephone Consumer Protection Act (TCPA), including any amendment of or addition to such law; (2) The CAN -SPAM Act of 2003, including any amendment of or addition to such law; or (3) Any statute, ordinance or regulation, other than the TCPA or CAN -SPAM Act of 2003, that prohibits or limits the sending, transmitting, communicating or distribution of material or information. Damage To Premises Rented To You — Exception For Damage By Fire, Lightning or Explosion Exclusions c. through h. and k. through o. do not apply to damage by fire, lightning or explosion to premises rented to you or temporarily occupied by you with permission of the owner. A separate Limit of Insurance applies to this coverage as described in Section D. - Liability And Medical Expenses Limits Of Insurance. Form SS 00 08 04 05 Page 9 of 24 BUSINESS LIABILITY COVERAGE FORM 2. Applicable To Medical Expenses Coverage We will not pay expenses for "bodily injury": a. Any Insured To any insured, except "volunteer workers". b. Hired Person To a person hired to do work for or on behalf of any insured or a tenant of any insured. c. Injury On Normally Occupied Premises To a person injured on that part of premises you own or rent that the person normally occupies. d. Workers' Compensation And Similar Laws To a person, whether or not an "employee" of any insured, if benefits for the "bodily injury" are payable or must be provided under a workers' compensation or disability benefits law or a similar law. e. Athletics Activities To a person injured while practicing, instructing or participating in any physical exercises or games, sports or athletic contests. f: Products -Completed Operations Hazard Included with the "products -completed operations hazard". g. Business Liability Exclusions Excluded under Business Liability Coverage. C. WHO IS AN INSURED 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. d. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Employees And Volunteer Workers Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or, limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), or to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co - "employee" or that "volunteer worker" as a consequence of Paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. If you are not in the business of providing professional health care services, Paragraph (d) does not apply to any nurse, emergency medical technician or paramedic employed by you to provide such services. (2) "Property damage" to property: (a) Owned, occupied or used by, Page 10 of 24 Form SS 00 08 04 05 (b) Rented' to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability, company). b. Real Estate Manager Any person (other than your "employee" or "volunteer worker"), or any organization while acting as your real estate manager. c. Temporary Custodians Of Your Property Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Legal Representative If You Die Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this insurance. e. Unnamed Subsidiary Any subsidiary and subsidiary thereof, of yours which is'a legally incorporated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this Coverage Part. The insurance afforded herein for any subsidiary not shown in the Declarations as a named insured does not apply to injury or damage with respect to which an insured under this insurance is also an insured under another policy or would be an insured under such policy but for its termination or upon the exhaustion of its limits of insurance. 3. Newly Acquired Or Formed Organization Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain financial interest of more than 50% of the voting stock, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and BUSINESS LIABILITY COVERAGE FORM b. Coverage under this provision does not apply to: (1) "Bodily injury" or "property damage" that occurred; or (2) "Personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. 4. Operator Of Mobile Equipment With respect to "mobile equipment" registered in your name under any motor vehicle registration law, any person is an insured while driving such equipment along a public highway with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of -the equipment, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. "Bodily injury" to a co -"employee" of the person driving the equipment; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. 5. Operator of Nonowned Watercraft With respect to watercraft you do not own that is less than 51 feet long and is not being used to carry persons for a charge, any person is an insured while operating such watercraft with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the watercraft, and only if no other insurance of any kind is available to that person or organization for this liability. However, no person or organization is an insured with respect to: a. "Bodily injury" to a co -"employee" of the person operating the watercraft; or b. "Property damage" to property owned by, rented to, in the charge of or occupied by you or the employer of any person who is an insured under this provision. 6. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a written Form SS 00 08 04 05 Page 11 of 24 BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a (e) Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy, provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement, or the issuance of the permit. with the distribution or sale of the A person or organization is an additional products; insured under this provision only for that (f) Demonstration, installation, period of time required by the contract, servicing or repair operations, agreement or permit. except such operations performed However, no such person or organization is an at the vendor's premises in connection with the sale of the additional insured under this provision if such product; person or organization is included as an additional insured by an endorsement issued r (g) Products which, after distribution by us and made a part of this Coverage Part, or sale by you, have been labeled including all persons or organizations added or relabeled or used as a as additional insureds under the specific container, part or ingredient of any additional insured coverage grants in Section other thing or substance by or for F. — Optional Additional Insured Coverages. the vendor; or a. Vendors (h) "Bodily injury" or "property Any person(s) or organization(s) (referred to damage" arising out of the sole negligence of the vendor for its below as vendor), but only with respect to own acts or omissions or those of "bodily injury" or "property damage" arising its employees or anyone else out of "your products" which are distributed acting on its behalf. However, this or sold in the regular course of the vendor's exclusion does not apply to: business and only if this Coverage Part provides coverage for "bodily injury" or (i) The exceptions contained in "property damage" included within the Subparagraphs (d) or (f); or "products -completed operations hazard". (ii) Such inspections, adjustments, (1) The insurance afforded to the vendor tests or servicing as the vendor is subject to the following additional has agreed to make or normally exclusions: undertakes to make in the usual This insurance does not apply to: course of business, in connection with the distribution (a) "Bodily injury" or "property or sale of the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of whom you have acquired such products, liability in a contract or agreement. or any ingredient, part or container, This exclusion does not apply to entering into, accompanying or liability for damages that the containing such products. vendor would have in the absence of the contract or agreement; b. Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized by you; whom you lease equipment; but only with respect to their liability for "bodily (c) Any physical or chemical change injury", "property damage" or in the product made intentionally personal and advertising injury by the vendor; caused, in whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization. or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Page 12 of 24 Form SS 00 08 04 05 (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after you cease to lease that equipment. c. Lessors Of Land Or Premises (1) Any person or organization from whom you lease land or premises, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land or premises leased to you. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: (a) Any "occurrence" which takes place after you cease to lease that land or be a tenant in that premises; or (b) Structural alterations, new construction or demolition operations performed by or on behalf" of such person or organization. d. Architects, Engineers Or Surveyors (1) Any architect, engineer, or surveyor, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In connection with your premises; or (b) In the performance of your ongoing operations performed by you or on your behalf. (2) With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. BUSINESS LIABILITY COVERAGE FORM e. Permits Issued By State Or Political Subdivisions (1) Any state or political subdivision, but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: (a) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (b) "Bodily injury" or "property damage" included within the "products - completed operations hazard". f. Any Other Party (1) Any other person or organization who is not an insured under Paragraphs a. through e. above, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and included within the "products - completed operations hazard", but only if (i) The written contract or written agreement requires you to provide such coverage to such additional insured; and (ii) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products - completed operations hazard". (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: Form SS 00 08 04 05 Page 13 of 24 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. The limits of insurance that apply to additional insureds are described in Section D. — Limits Of Insurance. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. — Liability And Medical Expenses General Conditions. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. D. LIABILITY AND MEDICAL EXPENSES LIMITS OF INSURANCE 1. The Most We Will Pay The Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. Aggregate Limits The most we will pay for: a. Damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard" is the Products -Completed Operations Aggregate Limit shown in the Declarations. b. Damages because of all other "bodily injury", "property damage" or "personal and advertising injury", including medical expenses, is the General Aggregate Limit shown in the Declarations. This General Aggregate Limit applies separately to each of your "locations" owned by or rented to you. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway or right-of-way of a railroad. This General Aggregate limit does not apply to "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner, arising out of fire, lightning or explosion. 3. Each Occurrence Limit Subject to 2.a. or 2.b above, whichever applies, the most we will pay for the sum of all damages because of all "bodily injury", "property damage" and medical expenses arising out of any one "occurrence" is the Liability and Medical Expenses Limit shown in the Declarations. The most we will pay for all medical expenses because of "bodily injury" sustained by any one person is the Medical Expenses Limit shown in the Declarations. 4. Personal And Advertising Injury Limit Subject to 2.b. above, the most we will pay for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization is the Personal and Advertising Injury Limit shown in the Declarations. 5. Damage To Premises Rented To You Limit The Damage To Premises Rented To You Limit is the most we will pay under Business Liability Coverage for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner. In the case of damage by fire, lightning or explosion, the Damage to Premises Rented To You Limit applies to all damage proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of these. 6. How Limits Apply To Additional Insureds The most we will pay on behalf of a person or organization who is an additional insured under this Coverage Part is the lesser of: a. The limits of insurance specified in a written contract, written agreement or permit issued by a state or political subdivision; or b. The Limits of Insurance shown in the Declarations. Such amount shall be a part of and not in addition to the Limits of Insurance shown in the Declarations and described in this Section. Page 14 of 24 Form SS 00 08 04 05 If more than one limit of insurance under this policy and any endorsements attached thereto applies to any claim or "suit", the most we will pay under this policy and the endorsements is the single highest limit of liability of all coverages applicable to such claim or "suit". However, this paragraph does not apply to the Medical Expenses limit set forth in Paragraph 3. above. The Limits of Insurance of this Coverage Part apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits of Insurance. E. LIABILITY AND MEDICAL EXPENSES GENERAL CONDITIONS 1. Bankruptcy Bankruptcy or insolvency of the insured or of the insured's estate will not relieve us of our obligations under this Coverage Part. 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit a. Notice Of Occurrence Or Offense You or any additional insured must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. Notice Of Claim If a claim is made or "suit" is brought against any insured, you or any additional insured must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You or any additional insured must see to it that we receive a written notice of the claim or "suit" as soon as practicable. c. Assistance And Cooperation Of The Insured You and any other involved insured must: BUSINESS LIABILITY COVERAGE FORM (1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investigation, settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or organization that may be liable to the insured because of injury or damage to which this insurance may also apply. d. Obligations At The Insured's Own Cost No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense, other than for first aid, without our consent. e. Additional Insured's Other Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or "suit" to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance. f. Knowledge Of An Occurrence, Offense, Claim Or Suit Paragraphs a. and b. apply to you or to any additional insured only when such "occurrence", offense, claim or "suit" is known to: (1) You or any additional insured that is an individual; (2) Any partner, if you or an additional insured is a partnership; (3) Any manager, if you or an additional insured is a limited liability company; (4) Any "executive officer" or insurance manager, if you or an additional insured is a corporation; (5) Any trustee, if you or an additional insured is a trust; or (6) Any elected or appointed official, if you or an additional insured is a political subdivision or public entity. Form .SS 00 08 04 05 Page 15 of 24 BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to you and any additional insured. 3. Financial Responsibility Laws a. When this policy is certified as proof of financial responsibility for the future under the provisions of any motor vehicle financial responsibility law, the insurance provided by the policy for "bodily injury" liability and "property damage" liability will comply with the provisions of the law to the extent of the coverage and limits of insurance required by that law. b. With respect to "mobile equipment" to which this insurance applies, we will provide any liability, uninsured motorists, underinsured motorists, no-fault or other coverage required by any motor vehicle law. We will provide the required limits for those coverages. 4. Legal Action Against Us No person or organization has a right under this Coverage Form: a. To join us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us on this Coverage Form unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this insurance or that are in excess of the applicable limit of insurance. An agreed settlement means a settlement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. 5. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom a claim is made or "suit" is brought. 6. Representations a. When You Accept This Policy By accepting this policy, you agree: (1) The statements in the Declarations are accurate and complete; (2) Those statements are based upon representations you made to us; and (3) We have issued this policy in reliance upon your representations. b. Unintentional Failure To Disclose Hazards If unintentionally you should fail to disclose all hazards relating to the conduct of your business at the inception date of this Coverage Part, we shall not deny any coverage under this Coverage Part because of such failure. 7. Other Insurance If other valid and collectible insurance is available for a loss we cover under this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when b. below applies. If other insurance is also primary, we will share with all that other insurance by the method described in c. below. b. Excess Insurance This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis: (1) Your Work That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work"; (2) Premises Rented To You That is fire, lightning or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (3) Tenant Liability That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; (4) Aircraft, Auto Or Watercraft 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 A. — Coverages. (5) Property Damage To Borrowed Equipment Or Use Of Elevators If the loss arises out of "property damage" to borrowed equipment or the use of elevators to the extent not subject to Exclusion k. of Section A. — Coverages. Page 16 of 24 Form SS 00 08 04 05 (6) When You Are Added As An Additional' Insured To Other Insurance That is other insurance available to you covering liability for damages arising out of the premises or operations, or products and completed operations, for which you have been added as an additional insured by that insurance; or (7) When You Add Others As An Additional Insured To This Insurance That is other insurance available to an additional insured. However, the following provisions apply to other insurance available to any person or organization who is an additional insured under this Coverage Part: (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract, written agreement or permit that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in c. below. (b) Primary And Non -Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (a) and (b) do not apply to other insurance to which the additional insured has been added as an additional insured. When this insurance is excess, we will have no duty under this Coverage Part 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. BUSINESS LIABILITY COVERAGE FORM 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: (1) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2) 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 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. 8. Transfer Of Rights Of Recovery Against Others To Us a. Transfer Of Rights Of Recovery If the insured has rights to recover all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. This condition does not apply to Medical Expenses Coverage. b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. Form SS 00 08 04 05 Page 17 of 24 BUSINESS LIABILITY COVERAGE FORM F. OPTIONAL ADDITIONAL INSURED COVERAGES If listed or shown as applicable in the Declarations, one or more of the following Optional Additional Insured Coverages also apply. When any of these Optional Additional Insured Coverages apply, Paragraph 6. (Additional Insureds When Required by Written Contract, Written Agreement or Permit) of Section C., Who Is An Insured, does not apply to the person or organization shown in the Declarations. These coverages are subject to the terms and conditions applicable to Business Liability Coverage in this policy, except as provided below: 1. Additional Insured - Designated Person Or Organization WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing operations; or b. In connection with your premises owned by or rented to you. 2. Additional Insured - Managers Or Lessors Of Premises a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional Insured - Designated Person Or Organization; but only with .respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Declarations. b. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: (1) Any 'occurrence" which takes place after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by, or on behalf of such person or organization. 3. Additional Insured - Grantor Of Franchise WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional Insured - Grantor Of Franchise, but only with respect to their liability as grantor of franchise to you. 4. Additional Insured - Lessor Of Leased Equipment a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in.the Declarations as an Additional Insured — Lessor of Leased Equipment, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any 'occurrence" which takes place after you cease to lease that equipment. 5. Additional Insured - Owners Or Other Interests From Whom Land Has Been Leased a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional Insured — Owners Or Other Interests From Whom Land Has Been Leased, but only with respect to liability arising out of the ownership, maintenance or use of that part of the land leased to you and shown in the Declarations. b. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: (1) Any 'occurrence" that takes place after you cease to lease that land; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. 6. Additional Insured - State Or Political Subdivision — Permits a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the state or political subdivision shown in the Declarations as an Additional Page 18 of 24 Form SS 00 08 04 05 Insured — State Or Political Subdivision - Permits, but only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. b. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance. does not apply to: (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the state or municipality; or (2) "Bodily injury" or "property damage" included in the "product -completed operations" hazard. 7. Additional Insured — Vendors a. WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) (referred to below as vendor) shown in the Declarations as an Additional Insured - Vendor, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business and only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard". b. The insurance afforded to the vendor is subject to the following additional exclusions: (1) This insurance does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; - (c) Any physical or chemical change in the "product made intentionally by the vendor; (d) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; BUSINESS LIABILITY COVERAGE FORM (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Subparagraphs (d) or (f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 8. Additional Insured — Controlling Interest WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or organization(s) shown in the Declarations as an Additional Insured — Controlling Interest, but only with respect to their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy these premises. Form SS 00 08 04 05 Page 19 of 24 BUSINESS LIABILITY COVERAGE FORM This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. 9. Additional Insured — Owners, Lessees Or Contractors — Scheduled Person Or Organization a. WHO IS AN INSURED under Section C. is amended to .include as an additional insured the. person(s) or organization(s) shown in the Declarations as an Additional Insured — Owner, Lessees Or Contractors, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: , (1) In the performance of your ongoing operations for the additional insured(s); or (2) In connection with "your work" performedfor that additional insured and included within the "products - completed operations hazard", but only if this Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard". b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to "bodily injury", "property damage" or "personal an advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. 10. Additional Insured — Co -Owner Of Insured Premises WHO IS AN INSURED under Section C. is amended to include as an additional insured the person(s) or Organization(s) shown in the Declarations as an Additional Insured — Co - Owner Of Insured Premises, but only with respect to their 'liability as co-owner of the premises shown in the Declarations. The limits of insurance that apply to additional insureds are described in Section D. — Limits Of Insurance. How this insurance applies when other insurance is available to an additional insured is described in the Other Insurance Condition in Section E. — Liability And Medical Expenses General Conditions. G. LIABILITY AND MEDICAL EXPENSES DEFINITIONS 1. "Advertisement" means the widespread public dissemination of information or images that has the purpose of inducing the sale of goods, products or services through: a. (1) Radio; (2) Television; (3) Billboard; (4) Magazine; (5) Newspaper; b. The Internet, but only that part of a web site that is about goods, products or services for the purposes of inducing the sale of goods, products or services; or c. Any other publication that is given widespread public distribution. However, "advertisement" does not include: a. The design, printed material, information or images contained in, on or upon the packaging or labeling of any goods or products; or b. An interactive conversation between or among persons through a computer network. 2. "Advertising idea" means any idea for an "advertisement". 3. "Asbestos hazard" means an exposure or threat of exposure to the actual or alleged properties of asbestos and includes the mere presence of asbestos in any form. 4. "Auto" means a land motor vehicle, trailer or semi -trailer designed for travel on public roads, including any attached machinery or equipment. But "auto" does not include "mobile equipment". 5. "Bodily injury" means physical: a. Injury; b. Sickness; or c. Disease sustained by a person and, if arising out of the above, mental anguish or death at any time. 6. "Coverage territory" means: Page 20 of 24 Form SS 00 08 04 05 a. The United States of America (including its territories and possessions), Puerto Rico and Canada; b. International waters or airspace, but only if the injury or damage occurs in the course of travel or transportation between any places included in a. above; c. All other parts' of the world if the injury or damage arises out of: (1) Goods or products made or sold by you in the territory described in a. above; (2) The activities of a person whose home is in the territory described in a. above, but is away for a short time on your business; or (3) "Personal and advertising injury" offenses that take place through the Internet or similar electronic means of communication provided the insured's responsibility to pay damages is determined in the United States of America (including its territories and possessions), Puerto Rico or Canada, in a "suit" on the merits according to the substantive law in such territory, or in a settlement we agree to. 7. "Electronic data" means information, facts or programs: a. Stored as or on; b. Created or used on; or c. Transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 8. "Employee" includes a "leased worker". "Employee" does not include a "temporary worker". 9. "Executive officer" means a person holding any of the officer positions created by your charter, constitution, by-laws or any other similar governing document. 10. "Hostile fire" means one which becomes uncontrollable or breaks out from where it was intended to be. 11. "Impaired property" means tangible property, other than "your product" or "your work", that cannot be used or is less useful because: a. It incorporates "your product" or "your work" that is known or thought to be defective, deficient, inadequate or dangerous; or BUSINESS LIABILITY COVERAGE FORM b. You have failed to fulfill the terms of a contract or agreement; if such property can be restored to use by: a. The repair, replacement, adjustment or removal of "your product" or "your work"; or b. Your fulfilling the terms of the contract or agreement. 12. "Insured contract" means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning or explosion to premises while rented to you or temporarily occupied by you with permission of the owner is subject to the Damage To Premises Rented To You limit described in Section D. — Liability and Medical Expenses Limits of Insurance. b. A sidetrack agreement; c. Any easement or license agreement, including an easement or license agreement in connection with construction or demolition operations on or within 50 feet of a railroad; d. Any obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; or f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization, provided the "bodily injury" or "property damage" is caused, in whole or in part, by you or by those acting on your behalf. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. includes that part of any contract or agreement that indemnifies a railroad for "bodily injury" or "property damage" arising out of construction or demolition operations within 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, road -beds, tunnel, underpass or crossing. However, Paragraph f. does not include that part of any contract or agreement: Form SS 00 08 04 05 Page 21 of 24 BUSINESS LIABILITY COVERAGE FORM (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, , architectural or engineering activities. 13. "Leased worker" means a person leased to you by a labor leasing firm under an agreement between you and the labor leasing firm, to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker". 14. "Loading or unloading" means the handling of property: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, watercraft or "auto"; b. While it is in or on an aircraft, watercraft or "auto"; or c. While it is being moved from an aircraft, watercraft or "auto" to the place where it is finally delivered; but "loading or unloading" does not include the movement of property by means of a mechanical device, other than a hand truck, that is not attached to the aircraft, watercraft or "auto". 15. "Mobile equipment means any of the following types of land vehicles, including any attached machinery or equipment: a. Bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads'; b. Vehicles maintained for use solely on or next to premises you own or rent; c. Vehicles that travel on crawler treads; d. Vehicles., whether self-propelled or not, on which are permanently mounted: (1) Power cranes, shovels, loaders, diggers or drills; or (2) Road construction or resurfacing equipment such as graders, scrapers or rollers; e. Vehicles not described in a., b., c., or d. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: (1) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or (2) Cherry pickers and similar devices used to raise or lower workers; f. Vehicles not described in a., b., c., or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the following types of permanently attached equipment are not "mobile equipment" but will be considered "autos": (1) Equipment, of at least 1,000 pounds gross vehicle weight, designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; (2) Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3) Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. 16. "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions. 17. "Personal and advertising injury" means injury, including consequential "bodily injury", arising out of one or more of the following offenses: a. False arrest, detention or imprisonment; b. Malicious prosecution; Page 22 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM c. The wrongful eviction from, wrongful entry Work that may need service, maintenance, into, or invasion of the right of private correction, repair or replacement, but occupancy of a room, dwelling or which is otherwise complete, will be premises that,; the person occupies, treated as completed. committed by or on behalf of its owner, The "bodily injury" or "property damage" landlord o'r lessor; must occur away from premises you own d. Oral, written or electronic publication of or rent, unless your business includes the material that slanders or libels a person or selling, handling or distribution of "your organization or disparages a person's or product" for consumption on premises you organization's goods, products or services; own or rent. e. Oral, written or electronic publication of b. Does not include "bodily injury" or material that violates a person's right of "property damage" arising out of: privacy; (1) The transportation of property, unless f. Copying, in your "advertisement", a the injury or damage arises out of a person's or organization's "advertising condition in or on a vehicle not owned idea" or style of "advertisement"; or operated by you, and that condition g. Infringement of copyright, slogan, or title of was created by the "loading or any literary or artistic work, in your unloading" of that vehicle by any "advertisement"; or insured; or h. Discrimination or humiliation that results in (2) The existence of tools, uninstalled injury to the feelings or reputation of a equipment or abandoned or unused natural person. materials. 18. "Pollutants" means any solid, liquid, gaseous or 20. "Property damage" means: thermal irritant or contaminant, including smoke, a. Physical injury to tangible property, "vapor, soot, fumes, acids, alkalis, chemicals and including all resulting loss of use of that waste. Waste includes materials to be recycled, property. All such loss of use shall be reconditioned or reclaimed. deemed to occur at the time of the 19. "Products -completed operations hazard"; physical injury that caused it; or a. Includes all "bodily injury" and "property b. Loss of use of tangible property that is not damage" occurring away from premises physically injured. All such loss of use you own or rent and arising out of "your shall be deemed to occur at the time of product" or "your work" except: "occurrence" that caused it. (1) Products that are still in your physical As used in this definition, "electronic data" is possession; or not tangible property. (2) Work that has not yet been completed 21. "Suit" means a civil proceeding in which or abandoned. However, "your work" damages because of "bodily injury", "property will be deemed to be completed at the damage" or "personal and advertising injury" earliest of the following times: to which this insurance applies are alleged. (a) When all of the work called for in "Suit" includes: your contract has been completed. a. An arbitration proceeding in which such (b) When all of the work to be done at damages are claimed and to which the the job' site has been completed if insured must submit or does submit with your contract calls for work at our consent; or more than one job site. b. Any other alternative dispute resolution (c) When that part of the work done at proceeding in which such damages are a job site has been put to its claimed and to which the insured submits intended use by any person or with our consent. organization other than another 22. "Temporary worker" means a person who is contractor or subcontractor furnished to you to substitute for a permanent working on the same project. "employee" on leave or to meet seasonal or short-term workload conditions. 23. "Volunteer worker" means a person who: a. Is not your "employee"; Form SS 00 08 04 05 Page 23 of 24 .4C40R o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) UN 1 201 05/20/2018 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 CIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INS IZED J�H REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. Riskagement IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jona Bolin NAME: Sammamish Insurance, Inc. (425) 898-8780 AX (425) 836-2865 PAHicNri Ext): No): 704 228th Ave NE, PMB 373 E-MAIL JonaBolin@msn.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # DAMAGE TRENTED 2,000,000 PREMISES Ea occurrence $ INSURERA: Ohio Security Insurance Company 24082 Sammamish WA 98074 INSURED INSURER B: The Ohio Casualty Insurance Company 24074 INSURER C: Continental Casualty Company 20443 RH2 Engineering Inc INSURER D: 22722 29th Dr SE Ste 210 INSURER E: PERSONAL &ADV INJURY $ 2,000,000 Bothell WA 98021 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1852003285 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. I LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR EACH OCCURRENCE $ 2,000,000 DAMAGE TRENTED 2,000,000 PREMISES Ea occurrence $ MED EXP (Any one person) $ 15,000 PERSONAL &ADV INJURY $ 2,000,000 A Y BZS57962270 05/29/2018 05/29/2019 AGGREGATE LIMITAPPLIES PER: GEPOLICY X POLICY PRO JECT LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS-COMP/OP AGG $ 4,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ X ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y BAS57962270 05/29/2018 05/29/2019 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ Per accident X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 B EXCESS LIAB CLAIMS -MADE US057962270 05/29/2018 05/29/2019 DED I X1 RETENTION $ 10,000 $ WORKERS COMPENSATIONPER OTH- X p` AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBEREXCLUDED? (Mandatory in NH) N/A BZS57962270 05/29/2018 05/29/2019 STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 C Professional Liability Claims Made AEH004312321 05/29/2018 05/29/2019 Per Claiim $3,000,000 Deductible $200,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Oysteer Bay Ave N. 24 inch Transmission Main Replacement/4530 The City of Bremerton is added as an additional insured in connection with the above referenced project. CERTIFICATE HOLDER CANCFI_I_ATION @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 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. 345 6th St. AUTHORIZED REPRESENTATIVE Bremerton WA 98310 /� _'e&_V -: ;r @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD BUSINESS LIABILITY COVERAGE FORM b. Donates his or her work; c. Acts at the direction of and within the scope of duties determined by you; and d. Is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 24. "Your product": a. Means: (1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a) You; (b) Others ,trading under your name; or (c) A person or organization whose business or assets you have acquired; and (2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b.' Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your product"; and (2) The providing of or failure to provide warnings or instructions. c., Does not include vending machines or other property rented to or located for the use of others but not sold. 25. "Your work": a. Means: (1) Work or operations performed by you or on your behalf; and (2) Materials, parts or equipment furnished in connection with such work or operations. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your work"; and (2) The providing of or failure to provide warnings or instructions. t Page 24 of 24 Form SS 00 08 04 05 E/VGInlz--EgINCj Original 2 Page No. 1 of 2 Pages CONTRACT MODIFICATION AGREEMENT NO.1 BETWEEN THE CITY OF BREMERTON AND RH2 ENGINEERING PROJECT: Oyster Bay Avenue N 24 -Inch Transmission Main Replacement CONSULTANT: RH2 Engineering DATE: August 2, 2018 THIS CONTRACT MODMICATION AGREEMENT SPECIFICALLY AMENDS THE Oyster Bay Avenue N 24 -Inch. Transmission Main Replacement AGREEMENT (tile "Contract") entered into between the City of Bremerton and RH2 Engineering on November 9, 2016. All provisions in the Contract shall remain in full force and effect except as expressly modified by this document. For valuable consideration and by mutual consent of the parties, the modifications to the Contract are as follows: I. Section _ I. Scope _ , is modified as follows: Additional design and CAD work associated with an alignment change. Section II. Term , is modified as follows: The Consultant shall complete the work described in this Contract Modification Agreement No. I by October 31, 2018 Section _ III. ComRensation , is modified as follows: The original contract amount was $134,400. The City shall pay the Consultant for the additional work described above, based on time and materials, an amount not to exceed $2,000, for a total amended contract amount of $136,40Q including this Contract Modification. lI Consultant accepts all requirements of this Contract Modification by endorsing below. Consultant further agrees that this Contract Modification constitutes full and final settlement of all of the Consultant's claims for contract time and for all costs of any ldnd, including without limitation, costs of delays related to any work either covered or affected by this Contract Modification, claims related to on-site or home office overhead, or lost profits. This Contract Modification does not limit the City's right to bring a claim for past performance. Page 1 of 2 Contract Modification No. 1 August 2, 2018 Oyster Bay Ave N 24 -Inch Transmission Main Replacement Original 2 Page No. 2 of 2 pages The undersigned consultant approves the foregoing Contract Modification as to the changes, if any, in the contract price specified for each item, including any and all supervision costs and other miscellaneous costs relating to the change in work, and as to the extension of time allowed, if any, for completion of the entire work due to said Contract Modification. This document will become a supplement of the contract and all provisions will apply hereto. It is understood that this Contract Modification shall be effective when approved by the City of Bremerton. The parties whose names appear below warrant that they are authorized to enter into a contract modification that is binding on the parties of this contract. In addition, Consultant warrants that it has or will inform the surety of this change, and shall take appropriate action to modify any bonds required under the contract to address this change. IN WITNESS WHEREOF, the parties have executed this Contract Modification on the day and year first written above. City Engineer / Public Works Director approved to process (initials and Date) CONS TANT f i rin, f..t l x yr rjnaivir XXIw l L3 By: Y• Print Name: Ep i . D LLARP Print Nance: r -- Date, ' F, /� APPROVED AS TO FORM: By: ,- ROGERA. LUB( VIC:) ,13rem rtoit City Attorney NOTICES TO BE SENT TO: RH2 Engineering ATTN: Dave Matz 950 Pacific Avenue, Suite 1220 Tacoma, WA 98402 Page 2 of 2 Contract Modification No. 1 Oyster Bay Ave N 24 -Inch Transmission Main Replacement Its: CIAA Date. A, Z -s 20 ►$ ATTEST: D: y ANGELAeS, City Clerk NOTICES TO BE SENT TO: City of Bremerton ATTN: Linda Fulton 345 61h Street, Suite 500 Bremerton, WA 98310 August 2, 2018 CONTRACT MODIFICATION AGREEMENT NO. 1 BETWEEN THE CITY OF BREMERTON AND BHC CONSULTANTS PROJECT: Sewage Pump Station CW -4 Upgrade and OF -12 Modifications CONSULTANT: BHC Consultants, LLC DATE: August 28, 2018 THIS CONTRACT MODIFICATION AGREEMENT SPECIFICALLY AMENDS THE Sewage Pump Station CW -4 Upgrade and OF -12 Modifications AGREEMENT (the "Contract") entered into between the City of Bremerton and BHC Consultants on November 15, 2017. All provisions in the Contract shall remain in full force and effect except as expressly modified by this document. For valuable consideration and by mutual consent of the parties, the modifications to the Contract are as follows: I. Section I. Scope , is modified as follows: See attached Exhibit A. Section II. Term , is modified as follows: The Consultant shall complete the work described in this Contract Modification Agreement by Deeezriber 31, 2019 Section III. Compensation , is modified as follows: The original contract amount was $260,760. Per Exhibit B, the City shall pay the Consultant fbr the additional work described above, based on time and materials, an amount not to exceed $86, 748 for a total amended contract amount of'$347,508, including this Contract Modification. II. Consultant accepts all requirements of this Contract Modification by endorsing below. Consultant further agrees that this Contract Modification constitutes full and final settlement of all of the Consultant's claims for contract time and for all costs of any kind, including without limitation, costs of delays related to any work either covered or affected by this Contract Modification, claims related to on-site or home office overhead, or lost profits. This Contract Modification does not limit the City's right to bring a claim for past performance. The undersigned consultant approves the foregoing Contract Modification as to the changes, if any, in the contract price specified for each item, including any and all supervision costs and other miscellaneous costs relating to the change in work, and as to the extension of time allowed, if any, for completion of the entire work due to said Contract Modification. Page 1 of 2 Contract Modification No. 1 August 2018 Sewage Pump Station CW -4 Upgrade and OF -l2 Modifications This document will become a supplement of the contract and all provisions will apply hereto. It is understood that this Contract Modification shall be effective when approved by the City of Bremerton. The parties whose names appear below warrant that they are authorized to enter into a contract modification that is binding on the parties of this contract. In addition, Consultant warrants that it has or will inform the surety of this change, and shall take appropriate action to modify any bonds required under the contract to address this change. IN WITNESS WHEREOF, the parties have executed this Contract Modification on the day and year first written above. City Engineer / Public Works Director approved to process BHC C NS TANTS By: Print Name: A'Zbrxw\c� C Its: C e s Pirr� Date: APPROVED AS TO FORM: By: ROGER A. L[! ICH, Bremerton City Attorney NOTICES TO BE SENT TO: BHC Consultants 1601 Fifth Avenue, Suite 500 Seattle, WA 98101 Page 2 of 2 Contract Modification No. 1 Sewage Pump Station CW -4 Upgrade and OF -12 Modifications (Initials and Date) THE CITY OF BREMERTON By: G•] Pc�,,,ir Navv�e Glee W eked Date: 0► 2 Co I 20 16 ATTEST: ■ WOODS,ANGELA NOTICES TO BE SENT TO: City of Bremerton ATTN: Engineering Division 345 6"' Street, Suite 100 Bremerton, WA 98310 August 2018 EXHIBIT A CITY OF BREMERTON SEWAGE PUMP STATION CW -4 UPGRADE AND OF -12 MODIFICATIONS AMENDMENT 1, SCOPE OF SERVICES August 28, 2018 Statement of Understanding, Amendment 1 The Scope of Services for the Sewage Pump Station CW -4 Upgrade and OF -12 Modifications project (Project) included the following goal: 4) Anticipate the redirection of beach laterals to upland gravity sewers or low-pressure sewers. During the initial phases of the Project, BHC's analysis indicated that it was possible to achieve this goal in the following manner: • Installing individual grinder pump stations (IPS) at 5 properties on 171h Street, west of CW -4, diverting the flow away from the beach laterals and toward the existing sewer on 17th Street in a new discharge pipeline, and ■ Installing a triplex grinder pump station (TPS) to serve 9 properties in the vicinity of Chester Avenue and 18th Street, east of CW -4, diverting the flow away from the beach laterals and toward the existing sewer on 181h Street in a new discharge pipeline that will convey the combined flow from all 9 affected properties. The City has directed BHC to incorporate the design of these facilities into the Project. In addition, the City has also requested that a new forcemain be designed to run along 171h Street, tying into the 8" CW -4 discharge force main on the east, and discharging into the existing sewer line on High Avenue. Valving will be provided to allow the City to manually direct CW -4 discharge to either the Crosstown Pipeline connection or to the High Avenue sewer line. This will allow the City to supplement low summer flows in the conveyance system to the CW -1 pump station. To accomplish these objectives, the following tasks will be performed under this Amendment 1 Task 031 — Public Outreach Description: The City will take responsibility for public outreach and will develop the plan to establish contact with the affected residents, conduct a public meeting to inform the affected residents of the project, obtain right -of -entry access to impacted residences during design, and obtain necessary easements for future access to impacted residences. One member of the City staff will be available to accompany the design team on all residence site visits and will pre -arrange access to the residence electrical panel for review to determine available electrical power supply capacity for the IPS. BHC will provide technical support for the public meeting and staff for residence site visits. Receivables from City: 1) Comments on the CW -4 pump station alternative configurations. Work Tasks: 1) Prepare a minimum of two alternative configurations for the CW -4 pump station for presentation at the public meeting. Present alternatives at public meeting. 2) For each IPS, BHC staff will review side sewer information provided by the City to determine probable location of existing sewer connection. BHC staff will visit each residence. Page 1 City of Bremerton Exhibit A Sewage Pump Station CW -4 Upgrade and OF -12 Modifications Addendum One, Scope of Services a) First meeting: Work with side sewer information and homeowner to determine location of existing sewer discharge from the residence. Establish probable IPS location and discharge pipeline route. Use City's portable GPS to identify key locations, site features, etc. A minimum of 2 staff are expected, either the project PM or PE and the project electrical engineer. b) Second meeting: BHC will have developed a site plan for the new facilities for each IPS (see Task 032), and this will be presented to the homeowner at the second meeting for confirmation. 3) For the TPS, BHC staff will meet with the affected adjacent property owners on two site visits to present the draft and final plan for the site. 4) The City will pothole the sewer pipeline at the proposed TPS location to provide information on the location and depth of the three adjacent house sewer lateral connections, including on-site measurements and the City's portable GPS. One geotechnical engineer from Landau will provide a visual review of the soils exposed during the potholing to identify potential geotechnical concerns. In addition, on the same day, the geotechnical engineer will provide a visual review of the IPS property at 1444 171h Avenue to identify potential geotechnical concerns. Deliverables: 1) One electronic copy of the CW -4 pump station alternatives for City comment prior to the public meeting. 2) 22" x 34" copies of the final CW -4 pump station alternative configurations for the public meeting. 3) One copy of the draft and final site plan for each IPS (developed under Task 032). Assumptions: 1) BHC's role at the public meeting will be limited to the technical aspects of the project. Meetings: 1) The BHC Project Manager will attend the public meeting. 2) Two (2) site visits are assumed to be required for the first round of IPS meetings. For example, on the first site visit, 3 of the 5 IPS homeowners will be available for discussion and access, while a second site visit would be required to meet with the remaining 2 homeowners. 1) An additional two (2) site visits will be required for the second round of IPS meetings, similar to above. 2) Meetings with the TPS homeowners are assumed to occur immediately prior to or after the IPS site visits. Task 032 — Design Engineering: IPS, TPS and 17th Street Forcemain Description: Perform preliminary and final design for five (5) IPS pump stations, one (1) TPS pump station and associated pipeline conveyance; and a new forcemain that will convey CW -4 discharge flow along 171h Street to High Avenue. Provide topographic base maps for the new facilities. Receivables from City: 1) Maps, record drawings and copies of easements for the existing sewer system and facilities, and side sewer records for the IPS properties. 2) Maps and record drawings for the existing sewer facilities adjacent to the TPS property. Work Tasks: 1) Coordinate with AES to perform the following surveying services: a) Provide individual base maps for the five (5) IPS properties, consisting of survey results for 171h Street abutting the property, and publicly available aerial photos for the actual property. b) In accordance with the requirements of the original Contract, develop a boundary and control survey and conduct a topographic survey for the full width of the right of way, for the following properties: August 28, 2018 Page 2 City of Bremerton Exhibit A Sewage Pump Station CW -4 Upgrade and OF -12 Modifications Addendum One, Scope of Services i) 171h Street, from Ohio Avenue to High Avenue. ii) Chester Avenue, from 50' south of the intersection of Chester Avenue and 181h Street to approximately 225' north of the same intersection. 2) Incorporate the new project elements into the overall project permitting effort, including field investigation of vegetation, soils and hydrology along the proposed utility improvements, and placement of flagging along wetland/waterway boundaries. 3) Perform preliminary and final design for the project elements. a) IPS Pump Stations. Following the initial site meeting at each property, develop a site plan showing the location of the IPS and discharge piping to 171h Street. Provide sufficient detail to allow Contractor to perform necessary sewer connections, IPS installation, and electrical power upgrades for each property. Each property will be shown on a separate drawing. b) TPS Pump Station. Determine the proposed location for the TPS on City property. Develop a site plan showing the location of the TPS; connection to existing sewer; electrical power supply requirements, including standby power; site civil improvements; and demolition of abandoned infrastructure. c) Chester Avenue Pipeline. Develop a site plan showing the route of the TPS discharge piping along Chester Avenue to the connection with the existing sewer line in 181h Street d) 171h Street Pipeline. Develop a site plan showing the route of the new pipeline along 17th Street, from Ohio Avenue to High Avenue. Show connections at either end of the pipeline, including manual valving to allow CW -4 discharge to flow to the Crosstown pipeline or High Avenue. Deliverables: 1) One (1) electronic copy (Adobe pdf and AutoCAD format) of the boundary and topographic survey mapping, to be integrated into the overall survey file for the project. 2) Results of Landau's field investigations will be incorporated into the critical areas report included in the original scope of work for the project. 3) Predesign and design work products will be incorporated into the design submittals included in the original scope of work for the project. 4) The drawing list for the entire CW -4 project is shown on the following page. It is projected that an additional ten (10) drawings will be developed for the new facilities, for a total of 35 drawings. Assumptions: 1) Additional location and topographic detail required for the IPS properties will be developed using a portable GPS system, supplied and operated by City staff. This will be completed under Task 031. Meetings: 1) None. Budget The Project Budget is $86,748, and is attached as Exhibit B. The Budget includes $8,500 for Management Reserve, which shall only be used upon written authorization of the City. Contract Term The Contract Term is extended to December 31, 2019 since the construction will be accomplished during 2019. August 28, 2018 Page 3 City of Bremerton Sewage Pump Station CW -4 Upgrade and OF -12 Modifications Addendum One, Scope of Services Exhibit A No. of Drawing Contract Drawing No. Title Original Amend.1 1 G-1 Cover Sheet, Vicinity Map, & Project location Map X 2 G-2 Index of Drawings, General, Survey, & Construction Notes X 3 G-3 Legend, Abbreviations, Symbols, & Designations X 4 _ G-4 Area Map, Staging Area, & Design Criteria X 5 _ EC -1 Temporary Erosion & Sedimentation Control Notes & Details X 6 C-1 Site Plan Demolition, Grading and TESC X 7 C-2 CW -4 Pump Station & Piping Plan X 8 C-3 CW -4 Pump Station Plan & Sections X 9 C-4 CW -4 Pump Station Sections and Details X 10 C-5 8" Ex. Forcemain Piping Plan/Profile - Connections X 11 C-6 17th Street pipeline —1 of 2 X 12 C-7 17th Street pipeline — 2 of 2 X 13 C-8 Chester Avenue pipeline and TPS Site X 14 C-9 Civil Details - 1 X 15 C-10 Civil Details - 2 X X 16 IPS -1 IPS, 17th Street. 1 of 5 17 IPS -2 IPS, 17th Street. 2 of 5 X 18 TPS -1 _Triplex grinder PS Details X 19 S-1 Structural General Notes X 20 S-2 Structural Typical Details X 21 S-3 Control Building Foundation and Slab Plan Electrical Symbols & Legend X 22 E-1 X 23 E-2 Electrical details 1 of 2 X 24 E-3 Electrical details 2 of 2 X 25 E-4 CW -4 Electrical Site Plan X 26 E-5 CW -4 Electrical Generator Building Plan X 27 E-6 CW -4 One Line Diagram X 28 E-7 CW -4 Load Calculations & Schedules X 29 E-8 CW -4 Control Panel Elevations & Details X 30 E-9 CW -4 P&ID X 31 E-10 CW -4 Control Wire Diagrams 1 of 2 X 32 E-11 TPS Electrical Site Plan, Power Supply, Genset Siting & Details X August 28, 2018 Page 4 3E #,®-- �����`� rd \ SL �`` §' J � � � ���: ! ; , _,._ � ■E; °, \ ��@ % `% � _ ■ t®~] ! J J J J J J 2�`f4 'j |!2 . 22gf� ;■., s: : ... ���4 ; � � ■s , ± s ■ " r 1- ] k ■_ ! 6�\ ■ §` k #|� �} oU fl=.. I ! , J § ;:; Ka = _,§ ■ = e � _ ©:� _�#� r,: ■ . § , - I ;TI 0 E |! 4)\& 3E ,.4$-fit=t13 - SO<3 Aco D® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) L....---'" 05/20/2019 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights tg4b �k Atgr (der in lieu of such endorsement(s). PRODUCER t 1 L L.IV�,.:.e CONTACT Jona Bolin NAME: Sammamish Insurance,Inc. PHONE (425)898-8780 FAX (425)836-2865 MAY 2 8 2019 (A/C,No, : (A/C,No): 704 228th Ave NE,PMB 373 ADDRIESS: JonaBolin@msn.com INSURER(S)AFFORDING COVERAGE NAIC# Sammamish City of Bremerton" 98074 INSURER A: Ohio Security Insurance Company 24082 INSURED Risk Management INSURER B: Continental Casualty Company 20443 RH2 Engineering Inc INSURER C: 22722 29th Dr SE Ste 210 INSURER D: INSURER E: Bothell WA 98021 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1952003492 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP X COMMERCIAL GENERAL LIABILITY (MM/DDNYYY) (MM/DDNYYY) LIMITS 2 , 000000 EACH OCCURRENCE $ CLAIMS-MADE X OCCUR DAMAGE TO RENTED 2,000,000 PREMISES(Ea occurrence) $ _ MED EXP(Any one person) $ 15,000 A Y BZS57962270 05/29/2019 05/29/2020PERSONAL&ADV INJURY $ 2'000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRO- X POLICY n ECT LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: Employers Liability $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) _ _ X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y BAS57962270 05/29/2019 05/29/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) $ UMBRELLA LIAB XOCCUR EACH OCCURRENCE $ 2,000,000 A X EXCESS LIAB CLAIMS-MADE BZS57962270 05/29/2019 05/29/2020 AGGREGATE $ 2,000,000 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under ESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ Professional Liability B Claims Made AEH004312321 05/29/2019 05/29/2020 Per Claim $3,000,000 Deductible $200,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project: Oysteer Bay Ave N.24 inch Transmission Main Replacement/4530 The City of Bremerton is added as an additional insured in connection with the above referenced project. 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. 345 6th St. AUTHORIZED REPRESENTATIVE Bremerton WA 98310N-/ .__,. I "Y ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD o CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) i 05/06/2020 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Sammamish Insurance, Inc. 704 228th Ave NE, PMB 373 Sammamish INSURED RH2 Engineering Inc 22722 29th Dr SE Ste 210 Bothell RCUMVMLJ MAY 2 8 ?W98074 City of Bremertorl Risk Management WA 98021 CERTIFICATE NUMBER: CL55 2003609 Jona Bolin INSURERS) AFFORDING COVERAGE INsuRERA: Ohio Security Insurance Company INsuRER B : The Ohio Casualty Insurance Company INsuRER C : Continental Casualty Company INSURER D INSURER E REVISION NUMBER: NAIC # 24082 24074 20443 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MWDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 210009000 �/ CLAIMS -MADE OCCUR GE TORENTED PREMISES Ea occurrence 2000000 $ ,, MED EXP (Any one person) $ 15,000 A Y BZS57962270 05/29/2020 05/29/2021 PERSONAL &ADV INJURY s 21000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICYPRO- 7 LOC PRODUCTS - COMP/OPAGG $ 410000000 Employers Liability s 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y BAS57962270 05/29/2020 05/29/2021 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 B EXCESS LIAB CLAIMS -MADE Y US057962270 05/29/2020 05/29/2021 AGGREGATE $ 21000,000 DED I X1 RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ C Professional Liability Deductible $200,000 Per Claim AEH004312321 05/29/2020 05/29/2021 Per Claim Aggregate 31000,000 51000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) The City of Bremerton is named as additional insured automatically where requried by contract as respects General Liability and Automobile Liability. Project: Oysteer Bay Ave N. 24 inch Transmission Main ReplacemenU4530 CERTIFICATE HOLDER 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. 345 6th St, AUTHORIZED REPRESENTATIVE Bremerton WA 98310„�� ©1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD � l ® MMIDD/YYYY) oRo CERTIFICATE OF LIABILITY INSURANCE DATE (OSMMIDD/Y THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer riahts to the certificate holder in lieu of such endorsement(s). PRODUCER Sammamish Insurance, Inc. 704 228th Ave NE, PMB 373 Sammamish INSURED RH2 Engineering Inc 22722 29th Dr SE Ste 210 RECEIVCU MAY 18 2021 City of BreM&tnn WA 98074 Office Jona Bolin (425) 898-8780 JonaBolin@msn.com INSURERS) AFFORDING COVERAGE INsuRERA: Ohio Security Insurance Company e : The Ohio Casualty Insurance Company INsuRERc: Continental Casualty Company D: INSURER E Bothell WA 98021 � INSURER F COVERAGES CERTIFICATE NUMBER: CL2151103766 REVISION NUMBER: (425) 836-2865 NAIC # 24082 24074 20443 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 INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 21000,000 CLAIMS -MADE � OCCUR PREIAGE TO MISES Ea occurrence) $ 210001000 MED EXP (Any one person) $ 15,000 PERSONAL &ADV INJURY $ 21000,000 A Y BZS57962270 05/29/2021 05/29/2022 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 41000,000 POLICY PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $ 410001000 Stop Gap - WA $ 21000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 13000,000 X BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y BAS57962270 05/29/2021 05/29/2022 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 210001000 AGGREGATE $ 210001000 B EXCESS�LIIAB CLAIMS -MADE Y US057962270 05/29/2021 05/29/2022 DED X RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ C Professional Liability Claims Made AEH004312321 05/29/2021 05/29/2022 Per Claim Aggregate $3,000,000 $53000,000 Deductible $2000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Bremerton is named as additional insured automatically where requried by contract as respects General Liability and Automobile Liability, Project: Oysteer Bay Ave N. 24 inch Transmission Main Replacement/4530 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, 345 6th St. AUTHORIZED REPRESENTATIVE Bremerton WA 98310 �/✓� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD