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HomeMy WebLinkAbout5742PROFESSIONAL SERVICES AGREEMENT Ilydrogeological Services 9 l The City of Bremerton ("City") and Robinson Noble, Inc. ("Consultant"), referred to collectively as the "Parties," enter into the following Agreement for professional services: I. Scope: The Consultant agrees to perform the services more specifically described in the Scope of Work, dated October 10, 2017, including any attachments thereto, attached hereto as Exhibit A, which is incorporated by reference herein. The Scope of Work may be modified only pursuant to Section VH.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 $24,000. 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 H 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. 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 Bremerton/Robinson and Noble Hydrogeological Services Rev 02-16 Page I of 9 expertise. Consultant and its personnel are independent Consultants and not employees of the City. Consultant and its personnel have no authority to bind the City or to control the City's employees and other Consultants. None of the benefits provided by the City to its employees, including, but not limited to, compensation, insurance, and unemployment insurance are available from the City to the employees, agents, representatives, or sub -Consultants of the Consultant. Consultant will be solely and entirely responsible for its acts and for the acts of Consultant's agents, employees, representatives and sub -Consultants during the performance of this Agreement. The City may, during the term of this Agreement, engage other independent Consultants to perform the same or similar work. As an independent Consultant, Consultant is responsible for its own management:. The City's administration and enforcement of this Agreement shall not be deemed an exercise of managerial control over Consultant or its personnel. As an independent Consultant, Consultant is responsible for payment of all taxes and licensing fees necessary to perform its obligations under this Agreement. These taxes and fees include but are not limited to State industrial insurance, Business & Occupation, State professional licensing, and City business licensing. If any taxes or fees due the City have been declared delinquent, the City may withhold the delinquent amount, plus any additional charges arising from the delinquency, from any payments due Consultant. V. Indemnification: A. Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the negligent performance of this Agreement except for that portion of the injuries and damages caused by the City's sole negligence, unless Consultant is conducting work pursuant to Subsection B below. The City's review or acceptance of any of the work when completed shall not be grounds to avoid any of these covenants of indemnification. B. Architects, Enizineers and Any Other Professional Listed In and Performing Services Defined in RCW 4.24.115. Should a court of competent jurisdiction determine that Consultant's services provided pursuant to this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51• RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. The provisions of this section shall survive the expiration or termination of this Agreement. Bremerton/Robinson and Noble Hydrogeological Services Rev 02-16 Page 2 of 9 VI. Insurance: The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, its agents, representatives, employees, sub -consultants or sub -Consultants. Before beginning work on the project described in this Agreement, the Consultant shall provide a Certificate of Insurance evidencing: 1. Automobile 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 Compensation insurance as statutorily required by the Industrial Insurance Act of the State of Washington, Title 51, Revised Code of Washington and employer's liability with limits not less than $1,000,000. Any payment of deductible or self insured retention shall be the sole responsibility of the Consultant. All required policies shall be provided on an "occurrence" basis except professional liability insurance (if required), which may be provided on a "claims -made" basis. The City shall be named as an additional insured on the Commercial General Liability insurance policy, as respects work performed by or on behalf of the Consultant and a copy of an endorsement that is acceptable to the City, which names the City as an additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all the required insurance policies and endorsements. The City further reserves the right to reject any unacceptable policies and/or endorsements. The Consultant's Commercial General Liability insurance shall contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. 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, Bremerton/Robinson and Noble Hydrogeological Services Rev 02-16 Page 3 of 9 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 upon payment to Consultant. All written information submitted by the City to the Consultant in connection with the services performed by the Consultant under this Agreement will be safeguarded by the Consultant to at least the same extent as the Consultant safeguards like information relating to its own business. If such information is publicly available or is already in Consultant's possession or known to it, or is rightfully obtained by the Consultant from third parties, Consultant shall bear no responsibility for its disclosure, inadvertent or otherwise. All data, documents and files created by Consultant under this Agreement may be stored at Consultant's office in Tacoma, Washington. Consultant shall make such data, documents, and files available to the City upon its request at all reasonable times for the purpose of editing, modifying and updating as necessary until such time as the City is capable of storing, such information in the City's offices. Duplicate copies of this information shall be provided to the City upon its request, and at reasonable cost. All documents, including all reports, drawings, specifications, computer software or other items prepared or furnished by Consultant pursuant to this Agreement, are instruments of service with respect to the project and are the property of the City. Any reuse by the City for other than the specific purpose intended will be at City's sole risk.. C. Use of Photographs and Images. Consultant shall not use or distribute photographs or images depicting City officials, personnel, property, or equipment whether prepared by Consultant or provided by City without prior written consent of the City. The City will not unreasonably withhold its consent. D. Work Performed at Consultant's Risk: Consultant shall take all precautions necessary and shall be responsible for the safety of its employees, agents, and sub -consultants in the performance of the work hereunder and shall utilize all protection necessary for that purpose. Bremerton/Robinson and Noble Hydrogeological Services Rev 02-16 Page 4 of 9 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. Severability: Should any part of this Agreement be found void, the balance of the Agreement shall remain in full force and effect. H. Modification: This Agreement may only be modified by written instrument signed by both Parties. I. Written Notices: All communications regarding this Agreement shall be sent to the parties at the addresses listed below by registered or 1st class mail, or by personal service, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. City Address Consultant Address Bremerton Public Works and Utilities Robinson Noble, Inc. 100 Oyster Bay Ave. N 2105 S C Street Bremerton, WA 98312 Tacoma, WA 98402 J. Waiver: Failure to enforce any provision of this Agreement shall not be deemed a waiver of that provision. Waiver of any right or power arising out of this Agreement shall not be deemed waiver of any other right or power. K. Non -Waiver of Breach: The failure of the City to insist upon strict performance of any of the covenants and agreements contained herein, or to exercise any option herein conferred in one or more instances shall not be construed to be a waiver or relinquishment of said covenants, agreements or options, and the same shall be and remain in full force and effect. L. Compliance with Laws: Consultant shall comply with all applicable Federal, State, and local laws in performing its obligations under this Agreement. M. Choice of Law and Venue: This Agreement shall be interpreted according to the laws of the State of Washington. Any judicial action to resolve disputes arising out of this Agreement shall be brought in Kitsap County Superior Court. Bremerton/Robinson and Noble Hydrogeological Services Rev 02-16 Page 5 of 9 N. Attorneys' Fees: In the event of litigation to enforce any of the terms or provisions herein, each party shall pay all its own costs and attorney's fees. O. Assignment: Any assignment of this agreement by the Contractor without the written consent of the City shall be void. VIII. Nondiscrimination: Consultant shall not discriminate in employment or services to the public on the basis of race, color, national origin, sex, religion, age, marital status, disability, or sexual orientation except for employment actions based on bona fide occupational qualification. IX. Termination: This Agreement shall remain in force until completion and acceptance of the services, terminated by written instrument upon mutual consent, or by the City of Bremerton for convenience. This Agreement may be immediately terminated for cause by a Party if the other Party substantially fails to perform through no fault of the terminating Party, and the non- performing Party does not commence correction of the failure of performance within thirty (30) days of the terminating Party's sending notice to the non-performing Party. Any Notice by Consultant shall include a report showing the status of all items listed in the Scope of Work current through the termination date. If the City receives reimbursement by any federal, state, or other source for work described in Section I herein, and that funding is withdrawn, reduced or limited in any way, or the project is cancelled or substantially reduced after the execution date of this Agreement and prior to the completion of the work, the City may summarily terminate this Agreement. A. Excusable Dela, 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. Rightspon Termination: In the event of termination, the City shall pay for all services. performed by the Consultant to the effective date of termination, as described on a final invoice submitted to the City. After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project which may be used by the City without restriction. Any such use not related to the project which Consultant -was contracted to perform shall be without liability or legal exposure to the Consultant. X. Suspension & Debarment. For contracts involving Federal funding, Consultant hereby certifies, by signing this agreement, that neither it nor its principals are presently debarred, Bremerton/Robinson and Noble Hydrogeological Services Page 6 of 9 Rev 02-16 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 Approved to form: Bremerton City tt ey R:\Legal\Legal\Contracts\FORMS\Professional Services Agreement Form (2016).doc Bremerton/Robinson and Noble Hydrogeological Services Page 7 of 9 CONSULTANT By' hHES E 1 s: ®2t.JC��AZ Date: lolzV l"6�- Atte t: r City Clerk Rev 02-16 EXHIBIT A SCOPE OF WORK 1) Review of the Wellhead Protection Area re-evaluation that a property owner recently conducted. 2) Provide technical assistance responding to Ecology's letter recently received by the city regarding effect on instream flows for one of our water rights applications. 3) Review technical sections and assist with the groundwater section of Bremerton water Utility Water System Plan. 4) Provide other hydrogeological technical assistance concerning issues such as water rights, wellhead protection, groundwater, well development, data management and analysis, and in -stream flows, as requested in writing. Deliverables will be in the form of technical memos. EXHIBIT B SCHEDULE The schedule for this project will commence upon signing of his contract and shall conclude by December 31, 2019. EXHIBIT C BUDGET AND FEES Hydrogeologist will work on a time and expense basis. The budget for this contract shall not exceed $24,000. Fee schedule is attached. Bremerton/Robinson and Noble Hydrogeological Services Rev 02-16 Page 8 of 9 'General Fee Schedule January 2017 !Professional I'lositions Fee per Hour Princii)al Engineer, Hydrogeologist or Environmental Scientist 0176 AssooMe EngineeT, IH4(,drogeologist.or-lEnvironrnentaI Scientist $161 gineerr IHVd roqeologisl or E nviron mental Scientist SeniorEnc $136 Senior Pr oject Engineer, H0 ror goologi.qorEovironmerital Scientist $;11 Prp:t w Engineer, 1HYdroqe*Ioqist orlEnvironmewal Scientist $1 C0 Staff Engineer, Hvdrogeologistor Envircinment'al Scientist Senior, Field Staff $87 Field Staff 1.,70 Legal Suppon4Experl Mitnen Service&Testimony 150% of ram' - Support Positions Senipr GISICAD Speciali" $ �W Senjot-Technician UK 5 e ni o r A drai nist rato r $AI I GISICAQ Specialist Tiw6inicdan Administrator $7(1 Cleric,511 Support S70 Other Fees and Costs Suboontractst profossional*orviws I M Management Fee oulside 00ratofy �'wvices cohs (WC60o'sub0611; f act$ Other Costs Tr"ol to wo) Trawl Wwd Cost +10ya Per diem pr-OwAing 5l2te 1to +10% Met direcl exp4nses com -.10% Field andl;4oralo;y $00 f0110-Ali,119 I I WS I" schedule is sut))K,,( to ohanqe according tocongt'ICII or ProleSSOW4 SeivV-S Agrocment conditions. Bremerton/Robinson and Noble Hydrogeological Services Rev 02-16 Page 9 of 9 10 AC40 V CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 10/31/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 Leavitt Group Northwest 2121 70th Ave West, #B University Place WA 98466 CONTACT Cath Fleck NAME: �' PHONE(253) 565-3500 FAX, X No; (253)565-7209 AEDORless:cathy-fleck@leavitt.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Underwriters at Lloyds of London 15792 INSURED Robinson Noble, Inc. 2105 South C St. Tacoma WA 98402 INSURER BAmerican Fire & Casualty Company 24066 INSURERCOhio Casualty Co. 24074 INSURER D: INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:CL1612111431 '--R t1S1_0_N 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 POLICY EFF MMIDDIYYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY j� CLAIMS -MADE x YOCCUR ��ii - EACH OCCURRENCE $ 2 , 000 , 00 DAMAGE TO RENTED 100 00 PREMISES Ea occurrence $ TQ - MED EXP (Any one person) $ 10,000 X Pollution X Y PGlARK05609-01 11/30/2016 1 30/2017 X Professional PERSONAL& ADV INJURY $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4 , 000 , 0 0 POLICY X PRO-F—]LOC PRODUCTS - COMP/OP AGG $ 4,000,00-0 Each Claim -Cont Poll $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,0 0 Ea accident BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BAA56823788 11/30/2016 11/30/2017 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccid.nt $ NON -OWNED X HIRED AUTOS X AUTOS - Limit $ 2,000,000 C X Excess HNOA ES056823788 11/30/2016 11/30/2017 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER X OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1 000 0 A OFFICER/MEMBERE-XCLUDED? F (Mandatory in NH) N/A PGlARK05609-01 11/30/2016 11/30/2017 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below Wash Stop Gap E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Bremerton is named as Additional Insured per the t rms and conditions of forms CG 20 10 07 04, CG 20 37 07 04, PGI EL 018 0210, PGI EL 019 02 10, PGI EL 0210 CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014101) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Bremerton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. 345 6th Street, Suite 600 AUTHORIZED REPRESENTATIVE Bremerton, WA 98337 / Mark Hanks/CAFLEC U.J _ ACORD 25 (2014101) INS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1 I/ Policy number: PGIARK05609-01 COMMERCIAL GENERAL LIABILITY CO 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional' Insured Persons) Or.Or anization s : Location "And nescription Of Completed Operations. ,Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an additional insured. However, this status exists only for -the, roject specified in that contract... :Information required to complete this -Schedule, if -not shown-`atiove,:wili be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional Insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard CG 20 37 07 04 h 0 130. Properties, Inc., 2004 V Policy Number: PGIARK05609-01 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured -Persons) Or Or anization s : Location(s),Of Covered Operations Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an Additional insured. However, this status exists only for the project specified in that contract. Information required to complete this Schedule, if not shown above, will -be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional Insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: ' This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 Endorsement Number: ADDITIONAL INSURED ENDORSEMENT This endorsement, effective attaches to and forms a part of Policy Number . This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: CONTRACTORS POLLUTION LIABILITY COVERAGE Name of Person or Organization: ,Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to ,./name name as an additional insured. However, this status exists only for the project specified in that contract. The person or organization shown in this Schedule is included as an insured, but only with respect to that person's or organization's liability arising out of COVERED OPERATIONS performed for that insured. PGI EL 018 0210 Page 1 of 1 WAIVER OF SUBROGATION ENDORSEMENT This endorsement, effective attaches to and forms a part of Policy Number . This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: PROFESSIONAL LIABILITY COVERAGE CONTRACTORS POLLUTION LIABILITY COVERAGE SCHEDULE Name of Person or Organization: Endorsement Number: Any person(s) or organization(s) to whom the Named Insured agrees, in a written contract, to provide a waiver of subrogation. However, this status exists only for the project specified in that contract. The Company waives any right of recovery it may have against the person or organization shown in the above Schedule because of payments the Company makes for injury or damage arising out of the insured's work done under a contract with that person or organization. The waiver applies only to the person or organization in the above Schedule. Under no circumstances shall this endorsement act to extend the policy period, change the scope of coverage or increase the Aggregate Limits of Insurance shown in the Declarations. PGI EL 019 0210 Page 1 of 1 PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT This endorsement, effective attaches to and forms a part of Policy Number . This endorsement changes the Policy. Please read it carefully. SCHEDULE Name of Person or Organization: Endorsement Number: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to provide Primary and/or Non-contributory status of this insurance. However, this status exists only for the project specified in that contract. In consideration of the premium charged, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non-contributory to this insurance. PGI EL 020 0210 Page 1 of 1 LLOYD'S Insurance is effective with certain UNDERWRITERS AT LLOYD'S LONDON UNIQUE MARKET REFERENCES: B6049B0116FA00012— 45% B0180PN1600336— 55% COMMERCIAL GENERAL LIABILITY — OCCURRENCE FORM CONTRACTOR'S POLLUTION LIABILITY — OCCURRENCE FORM PROFESSIONAL LIABILITY — CLAIMS MADE FORM PLEASE READ THE ENTIRE FORM CAREFULLY POLICY NUMBER: PGIARK05609-01 RENEWAL OF: PGIARK05609-00 COMPANY: Certain Underwriter's at Lloyd's, London 1. NAMED INSURED: MAILING ADDRESS: Robinson and Noble, Inc. 2105 South C Street Tacoma, WA 98409 2. POLICY PERIOD: a. Inception Date: 11/30/2016 b. Expiration Date: 11/30/2017 at 12:01 A.M. Standard Time at your mailing address shown above. 3. LIMITS OF LIABILITY: Policy Aggregate Limit for All Claims and Damages: $4,000,000 Policy Aggregate Limit for All Claims Expenses: $4,000,000 Commercial General Liability Each Occurrence: $2,000,00V General Aggregate: $4,000,000 Products -Completed Operations Aggregate: $4,000,000 Personal and Advertising Injury: $2,000,000 Medical Expense: $10,000 Damage to Premises Rented to You: $100,000 Contractors Pollution Liability Each Claim: $2,000,000 Aggregate: $4,000,000 Each Claims Expense: $2,000,000 Aggregate Claims Expense: $4,000,000 Professional Liability Each Claim: $2,000,000 Aggregate: $4,000,000 Each Claims Expense: $2,000,000 Aggregate Claims Expense: $4,000,000 4. DEDUCTIBLE: Commercial General Liability $10,000 per Occurrence Contractors Pollution Liability $10,000 per Claim Professional Liability $10,000 per Claim Mold, Mildew & Fungus $10,000 per Claim PGI EL 001 0216 Page 1 of 2 4S-1LA:;�_ .acoRn®CERTIFICATE OF LIABILITY INSURANCE MI°D/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 111.. 11/27/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL 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 RECEIVED NAMEACT Cathy Fleck Leavitt Group Northwest PHONN Ex : (253)565-3500 AIC FAX No: (253)565-7209 E-MAIL ADDRESS: y cath fleck@leavitt.com 2121 70th Ave West, #B. DEC 0 . 2017 INSURERS AFFORDING COVERAGE NAIC # INSURER A:Underw`riters at Lloyds of London 15792 University Place WA 98466 INSURED �, ityVl Risk Management INSURER B:AIDerlCan Fire & Casualtyman 24066 INSURERC:Ohio Casualty Co. 24074 Robinson and Noble, Inc. INSURER D: dba: Robinson Noble, Inc. 2105 South C Street INSURER E INSURER F: Tacoma WA 98402 COVERAGES CERTIFICATE NUMBER-CL17112716957 RFVISION NigMRF_a-,' 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 POLICY EFF MM1LD'C1 YY POLICY EXP MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS -MADE (�fLCUR DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ MED EXP (Any one person) $ 10,000 X Pollution - Claims Made' , X PGIARK05609-02 11/30/2017 11/ 0/2018 X Professional -Claims de PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,0100, GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JEC LOC PRODUCTS - COMP/OPAGG $ 4,000,000 Each Claim -Cont Poll $ 2,000,000 OTHER: AUTOMOBILE LIABILITY 4 COMBINED SINGLE LIMIT $ 1,000,900e Ea accident X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOSX AUTOS ' L BAA56823788 11/30/2017 11/30/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X Excess HNOA Limit $ 2,000,000 C Excess HNOA ES056823788 11/30/2017 11/30/2017 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N I A PGIARK05609-02 11/30/2017 11/30/2018 PER OTH- STATUTE X ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYE $ 1,000,0 If yes, describe under DESCRIPTION OF OPERATIONS below Washington Stop Gap E.L. DISEASE -POLICY LIMIT I $ 1,000,000 DESCRIPTIONY OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City op Bremerton is name as Additional sured per thV2ter2s and conditions of forms CG 20 10 7 04, CG 20 07 04, PGI EL 0110, PGI ELO1 02 10, PGI EL10 CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) INS025 0.014011 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Bremerton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. 345 6th Street, Suite 600 AUTHORIZED REPRESENTATIVE Bremerton, WA 98337 Mark Hanks/CAFLEC ACORD 25 (2014/01) INS025 0.014011 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number: PGIARK05609-02 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR / ORGANIZATION �� This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ izations : Locations Of Covered Operations Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an Additional insured. However, this status exists only for the pro'ect specified in that contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to"bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 Policy number: PGIARK05609-02 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization (s): Location And Description Of Completed Operations Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an additional insured. However, this status exists only for the project specified in that contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section 11— Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 ADDITIONAL INSURED ENDORSEMENT This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: CONTRACTORS POLLUTION LIABILITY COVERAGE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an additional insured. However, this status exists only for the project specified in that contract. The person or organization shown in this Schedule is included as an insured, but only with respect to that person's or organization's liability arising out of COVERED OPERATIONS performed for that insured. PGI EL 018 0210 Page 1 of 1 WAIVER OF SUBROGATION ENDORSEMENT This endorsement, effective attaches to and forms a part of Policy Number . This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: PROFESSIONAL LIABILITY COVERAGE CONTRACTORS POLLUTION LIABILITY COVERAGE SCHEDULE Name of Person or Organization: Endorsement Number: Any person(s) or organization(s) to whom the Named Insured agrees, in a written contract, to provide a waiver of subrogation. However, this status exists only for the project specified in that contract. The Company waives any right of recovery it may have against the person or organization shown in the above Schedule because of payments the Company makes for injury or damage arising out of the insured's work done under a contract with that person or organization. The waiver applies only to the person or organization in the above Schedule. Under no circumstances shall this endorsement act to extend the policy period, change the scope of coverage or increase the Aggregate Limits of Insurance shown in the Declarations. PGI EL 019 0210 . Page 1 of 1 PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT This endorsement changes the Policy. Please read it carefully. SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to provide Primary and/or Non-contributory status of this insurance. However, this status exists only for the project specified in that contract. In consideration of the premium charged, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non-contributory to this insurance. PGI EL 020 0210 Page 1 of 1 ----1 ® A� o CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 11/27/2018 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 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(les) 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 Leavitt Group Northwest PO Box 65770 University Place WA 98464 ONTACTNAME: y a CONTACT-NAME,Cth Fleck a/cNNo Ext: (800) 726-8771 n/AX No: (866)728-9168 ADDRESS:cathy-fleck@leavitt.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:AXIS Surplus Insurance Company 26620 INSURED Robinson and Noble, Inc. dba: Robinson Noble, Inc. 2105 South C Street Tacoma WA 98402 INSURER B: INSURER C: INSURERD: INSURER E: INSURER F: rnvGoenGc f'_FRTIFIrATF PJIIMRFR•18-19 MASTER CERT REVISION NUMBER: vTHIS 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 POLICY EFF MM/DDIYYYY POLICY EXP MM/DDrrM LIMITS X COMMERCIAL GENERAL LIABILITY Bremerton, WA 98312 AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ 2,000,000 DAMAGE TO TED PREM SES (E. olccurrrence $ 100,000 A CLAIMS-MADE1XI OCCUR MED EXP (Any one person) $ 10,000 X EMP1800010601 11/30/2018 11/30/2019 PERSONAL & ADV INJURY $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OPAGG $ 4,000,000 POLICY ixi PRO - ECT EI LOC Contractors Poll -Each Claim $ 2, 000, 000 OTHER: Poll Liab Claims Made EMP1800010601 11/30/2018 11/30/2019 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 Ea accident BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AIRED NON OWNED X HIRED AUTOS X AUTOS EMP1800010601 11/30/2018 11/30/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ 1 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N ER STATUTE X ERRH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 • OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A EMP1800010601 11/30/2018 11/30/2019 E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below Washing ton Stop Gap 9 A Professional Liability EMP1800010601 11/30/2018 11/30/2019 Each Claim 2,000,000 Claims Made Aggregate 4,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached ff more space is required) RE: Twin Lakes ASR Designation The City of Bremerton is additional insured as required by written contract per attached endorsements CG2010 07/04, CG2037 07/04, PGI EL 018 02 18 and PGI EL 020 02010 CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) I NS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Bremerton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn : Cami Apofelbeck ACCORDANCE WITH THE POLICY PROVISIONS. 100 Oyster Bay Ave. N. Bremerton, WA 98312 AUTHORIZED REPRESENTATIVE Hanks/CAFLEC Mark ACORD 25 (2014/01) I NS025 (201401) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Policy Number EMP1800010601 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ izations : Locations Of Covered Operations Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an Additional insured. However, this status exists only for the project specified in that contract. Information required to complete this Schedule if not shown above will be shown in the Declarations A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by. - 1. y:1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after.- 1. fter:1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 Policy number: EMP1800010601 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Or Organization (s): O erations Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an additional insured. However, this status exists only for the pro.ect specified in that contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 ADDITIONAL INSURED ENDORSEMENT This endorsement changes the Policy. Please read it carefully. This endorsement modifies insurance provided under the following: CONTRACTORS POLLUTION LIABILITY COVERAGE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to name as an additional insured. However, this status exists only for the project specified in that contract. The person or organization shown in this Schedule is included as an insured, but only with respect to that person's or organization's liability arising out of COVERED OPERATIONS performed for that insured. PGI EL 018 0210 Page 1 of 1 PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT This endorsement changes the Policy. Please read it carefully. SCHEDULE Name of Person or Organization: Any person(s) or organization(s) whom the Named Insured agrees, in a written contract, to provide Primary and/or Non-contributory status of this insurance. However, this status exists only for the project specified in that contract. In consideration of the premium charged, it is hereby agreed that this policy shall be considered primary to any similar insurance held by third parties in respect to work performed by you under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and non-contributory to this insurance. PGI EL 020 0210 Page 1 of 1 .t/-S--1-4,11 51 1 1 1 - SGI . A�0® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/5/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain pol' t*e t an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). t PRODUCER CONTACT Cathy Cth Fleck NAME: y Leavitt Group Northwest DEC 16 2019 (A/C No,Ext): (800)726-8771 FAX No): (866)728-9168 PO Box 65770 E-MAIL ADDRESS: Cathy-fleck@leavitt.com City of Bremerton INSURER(S) AFFORDING COVERAGE NAIC# University Place WA 98464 zisk Management INSURER A:Crum & Forster Specialty Insurance Co INSURED INSURER B:Ohio Security Insurance Co Robinson and Noble, Inc, DBA: Robinson Noble, Inc. INSURERc:Ohio Casualty Insuran e Co 2105 South C St. INSURER D: 0It._1 C.,,,,kc... +- ( lc )b-r . INSURER E: 1 ) Q, 1 1 S CI Tacoma WA 98402 INSURERF: COVERAGES CERTIFICATE NUMBER:19/20 Master 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 TYPE OF INSURANCE A POLICY EFF POLICY EXP INSD WVD POLICY NUMBER (MM/DDIYYYY) (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2 y 0,000 / DAMAGE A CLAIMS-MADE X OCCUR ., PREMISESO(Ea o currrrence) $ 100,000 V X Y EPK-129209 11/30/2019 11/30/2020 MED EXP(Any one person) $ 10,000 / PERSONAL &ADV INJURY $ 2,000,000 ` GEN'LAGGREGATE LIMIT APPLIES PER: V/ GENERAL AGGREGATE $ 4,0150,000 POLICY X Fin LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: - $ t" AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ v,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED AUTOS AUTOS X BKS56823788 11/30/2019 11/30/2020 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accident) $ C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ .,✓Z, 000,000 EXCESS LIAB CLAIMS-MADE ES056823788 11/30/2019 11/30/2020 AGGREGATE $ '2,000,000 DED X RETENTION$ Excess Automobile Liability $ WORKERS COMPENSATION PER X OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 14)00,000 OFFICER/MEMBER EXCLUDED? N/A A (Mandatory in NH) EPK-129209 11/30/2019 11/30/2020 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under V DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Bremerton is named as Additional Insured per the terms and conditions of forms EN0319 02/11, EN0118 02/11, EN0301 09/14 and CG8901 12/08 attached CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Bremerton THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Attn: Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. 345 6th Street, Suite 100 Bremerton, WA 98337 AUTHORIZED REPRESENTATIVE D E. Olson/CAFLEC /du C,,._^ 1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) Additional Named Insureds Other Named Insureds ihbinson Noble, Inc. Doing Business As ( OFAPPINF(02/2007) COPYRIGHT 2007,AMS SERVICES INC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -.�/� COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) or Organization(s): Where Required By Written Contract SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated in the Schedule shown above performed for that additional insured and included in the "products- completed operations hazard". ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0319-0211 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED WITH WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART THIRD PARTY POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s) Where Required by Written Contract A. SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but solely with respect to "claims" caused in whole or in part, by "your work" for that person or organization performed by you, or by those acting on your behalf. This insurance shall be primary and non-contributory, but only in the event of a named insured's sole negligence. B. We waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for "damages" arising out of"your work" performed under a designated project or contract with that person(s) or organization(s). C. This Endorsement does not reinstate or increase the Limits of Insurance applicable to any "claim" to which the coverage afforded by this Endorsement applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0118-0211 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AGGREGATE LIMITS OF INSURANCE PER PROJECT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Under the Common Provisions, Section IV — LIMITS OF INSURANCE AND DEDUCTIBLE, item 2. is amended by the addition of the following: The General Aggregate Limit applies separately to each of your projects away from premises owned by or rented to you. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. EN0301-0914 Page 1 of 1 COMMERCIAL GENERAL LIABILITY CG89011208 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. HIRED AUTO AND NON-OWNED AUTO LIABILITY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Coverage ® A. Hired Auto Liability ® B. Non-Ownership Liability A. Insurance is provided only for those coverages when an "X" is shown in the Declarations or in the Schedule. 1. Hired Auto Liability The insurance provided under Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, applies to "bodily injury" or "property damage" arising out of the maintenance or use of a "hired auto" by you or your "employees" in the course of your business. 2. Non-Owned Auto Liability The insurance provided under Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, applies to "bodily injury" or "property damage" arising out of the use of any "non-owned auto" in your business by any person. B. For insurance provided by this endorsement only: 1. The exclusions, under Paragraph 2. Exclusion of Section 1 - Coverage A - Bodily Injury and Prop- erty Damage Liability, other than exclusions a., b., d., f., and i. and the Nuclear Energy Liability Exclusion, are deleted and replaced by the following: a. "Bodily injury" to: (1) An "employee" of the insured arising out of and in the course of: (a) Employment by the insured; or (b) Performing duties related to the conduct of the insured's business; or (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of Para- graph (1) above. 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 the dam- ages because of the injury. This exclusion does not apply to: (1) Liability assumed by the insured under an "insured contract"; or (2) "Bodily Injury" arising out of and in the course of domestic employment by the insured unless benefits for such injury are in whole or in part either payable or required to be provided under any workers compensation law. b. "Property damage" to: Includes copyrighted material of Insurance Services Office, Inc., CG 89 01 12 08 with its permission. Page 1 of 2 (1) Property owned or being transported by, or rented or loaned to the insured; or (2) Property in the care, custody or control of the insured. 2. Section II, Who Is An Insured, is replaced by the following: 1. Each of the following is an insured under this endorsement to the extent set forth below: a. You; b. Any other person using a"hired auto" with your permission; c. For a"non-owned auto": (1) any partner or "executive officer" of yours; or (2) any "employee" of yours but only while such "non-owned auto" is being used in your business; and d. Any other person or organization, but only for their liability because of acts or omissions of an insured under a., b. or c. above. 2. None of the following is an insured: a. Any person engaged in the business of his or her employer for "bodily injury" to any co-"employee" of such person injured in the course of employment, or to the spouse, child, parent, brother or sister of that co-"employee" as a consequence of such "bodily injury", or for any obligation to share damages with or repay someone else who must pay damages because of the injury. b. Any partner or "executive officer" for any "auto" owned by such partner or officer or a member of his or her household; c. Any person while employed in or otherwise engaged in duties in connection with an "auto business", other than an "auto business" you operate; d. The owner or lessee (of whom you are a sublessee) of a "hired auto" or the owner of a "non-owned auto" or any agent or "employee" of any such owner or lessee; e. Any person or organization for the conduct of any current or past partnership or joint venture that is not shown as a Named Insured in the Declarations. C. Section III -Limits of Insurance, Paragraph 2., The General Aggregate Limit, does not apply. D. The following additional definitions apply: 1. "Business" means the business or occupation of selling, repairing, servicing, storing or parking "autos". 2. "Hired Auto" means any "auto" you lease, hire, rent or borrow. This does not include any "auto" you lease, hire, rent or borrow from any of your "employees", your partners or you "executive Officers" or members of their households. 3. "Non-Owned Auto" means any "auto" you do not own, lease, hire, rent or borrow which is used in connection with your business. This includes "autos" owned by your "employees", your partners or "executive officers", or members of their households, but only while used in your business or your personal affairs. Includes copyrighted material of Insurance Services Office, Inc., CG 89 01 12 08 with its permission. Page 2 of 2