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HomeMy WebLinkAboutReg 2021-10-04 Item 8 - Contract - Tukwila Park Gazebo Installation with Northwest Playground for $80,000COUNCIL AGENDA SYNOPSIS k‘)* 41 Initials ITEM No. �l' Meeting Date Prepared by Mayor's review Council review �C/r 10/4/21 MDA „ = 8 1908 ITEM INFORMATION STAFF SPONSOR: MATTHEW AUSTIN ORIGINAL AGENDA DATE: 10/4/21 AGENDA ITEM TITLE Contract for Tukwila Park Improvements CATEGORY ❑ Discussion Mtg Date 11 Motion Mtg Date 10/4/21 ❑ Resolution Mtg Date ❑ Ordinance Mtg Date ❑ Bid Award Mtg Date ❑ Public Hearing Mtg Date ❑ Other Mtg Date SPONSOR ❑ Council ❑ Mayor ❑ Admin Svcs ❑ DCD ❑ Finance ❑ Fire 11 P&R ❑ Police ❑ PW SPONSOR'S Staff are seeking Council approval for the Mayor to sign a contract to replace the destroyed SUMMARY gazebo at Tukwila Park. REVIEWED BY ❑ Trans&Infrastructure Svcs A ❑ LTAC ❑ DATE: 10/4/21 Community Svcs/Safety ❑ Finance & Governance ❑ Planning & Community Dev. Arts Comm. ❑ Parks Comm. ❑ Planning Comm. COMMITTEE CHAIR: DELOSTRINOS JOHNSON RECOMMENDATIONS: SPONsoR/ADMIN. Parks and Recreation Department COMMITTEE Forward to Regular Meeting on 10/4 COST IMPACT / FUND SOURCE EXPENDITURE REQUIRED AMOUNT BUDGETED APPROPRIATION REQUIRED $80,000 $80,000 $80,000 Fund Source: PARKS AND RECREATION CIP Comments: WCIA Reimbursement for Tukwila Park gazebo MTG. DATE RECORD OF COUNCIL ACTION MTG. DATE ATTACHMENTS 9/20/2021 Info Memo, Tukwila Park Improvements 2021 Northwest Playground Contract 195 196 City of Tukwila Allan Ekberg, Mayor INFORMATIONAL MEMORANDUM TO: Community Services and Safety FROM: Tracy Gallaway - Parks and Recreation Director BY: Matthew Austin - Parks Maintenance Supervisor CC: Mayor Ekberg DATE: 9/20/2021 SUBJECT: Tukwila Park Improvements ISSUE Replacement of the Tukwila Park gazebo. BACKGROUND On July 19, 2020, the gazebo at Tukwila Park was destroyed by a fire. Throughout the past 14 months, parks maintenance staff have been working on replacing the structure. DISCUSSION Staff worked with Public Works and the Washington Cities Insurance Authority (WCIA) to confirm that the replacement of the gazebo would be covered by insurance. Once confirmed, staff selected a contractor and a replacement structure. The new gazebo will be fire resistant, with a metal frame and roof and will have similar amenities such as integrated wiring, lighting, and electrical outlets for potential rentals. Attachment A is a contract to address the gazebo replacement. FINANCIAL IMPACT The gazebo replacement described in Attachment A will be reimbursed through WCIA with initial funding through the Parks and Recreation capital improvement budget utilizing a combination of King County Levy funds, Park Impact Fees and REET funds. Attachment A: Contract with Northwest Playgrounds for Tukwila Park Gazebo replacement Total $80,000 $80,000 RECOMMENDATION Staff recommends the City Council authorize the Mayor to sign the contract (Attachment A) with Northwest Playgrounds for $80,000 for installation of a new gazebo. ATTACHMENTS Attachment A: Northwest Playground Contract and Scope of Work. 197 198 City of Tukwila 6200 Southcenter Boulevard, Tukwila WA 98188 CONTRACT FOR SERVICES Contract Number. This Agreement is entered into by and between the City of Tukwila, Washington, a non -charter optional municipal code city hereinafter referred to as the City," and Northwest Playground Equipment, lnc, hereinafter referred to as "the Contractor," whose principal office is located at PO Box 2410, Issaquah, WA 98027. WHEREAS, the City has determined the need to have certain services performed for its citizens but does not have the manpower or expertise to perform such services; and WHEREAS, the City desires to have the Contractor perform such services pursuant to certain terms and conditions; now therefore. IN CONSIDERATION OF the mutual benefits and conditions hereinafter contained, the parties hereto agree as follows 1. Scope and Schedule of Services to be Performed by Contractor. The Contractor shall perform those services described on Exhibit A attached hereto and incorporated herein by this reference as if fully set forth. In performing such services, the Contractor shall at all times comply with all Federal. State. and local statutes, rules and ordinances applicable to the performance of such services and the handling of any funds used in connection therewith. The Contractor shall request and obtain prior written approval from the City if the scope or schedule is to be modified in any way. 2. Compensation and Method of Payment. The City shall pay the Contractor for services rendered according to the rate and method set forth on Exhibit B attached hereto and incorporated herein by this reference The total amount to be paid shall not exceed S80.000. 3. Contractor Budget. The Contractor shall apply the funds received under this Agreement within the maximum limits set forth in this Agreement. The Contractor shall request prior approval from the City whenever the Contractor desires to amend its budget in any way 4. Duration of Acareement. This Agreement shall be in full force and effect for a period commencing October 1st. 2021, and ending March , 2021, unless sooner terminated under the provisions 4Y hereinafter specified. 20 7 5. Independent Contractor. Contractor and City agree that Contractor is an independent contractor with respect to the services provided pursuant to this Agreement Nothing in this Agreement shall be considered to create the relationship of employer and employee between the parties hereto. Neither Contractor nor any employee of Contractor shall be entitled to any benefits accorded City employees by virtue of the services provided under this Agreement. The City shall not be responsible for withholding or otherwise deducting federal income tax or social security or contributing to the State Industrial Insurance Program, or otherwise assuming the duties of an employer with respect to the Contractor, or any employee of the Contractor. 6. indemnification. The Contractor shall defend, indemnify, and hold the Public Entity, its officers, officials, employees and volunteers harmless from any and all claims, injuries, damages losses or suits including attorney fees, arising out of or in connection with the performance of this Agreement, except for injuries and damages caused by the sole negligence of the Public Entity. CA Revised May 2020 Page 1 of 4 199 200 Should a court of competent jurisdiction determine that 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 Contractor and the Public Entity, its officers, officials, employees, and volunteers, the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence. It is further specifically and expressly understood that the indemnification provided herein constitutes the Contractor's waiver of immunity under Industrial Insurance, Title 51 RCW. solely for the purposes of this indemnification. This waiver has been mutually negotiated by the parties The provisions of this section shall survive the expiration or termination of this Agreement. 7. Insurance. The Contractor 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 Contractor, their agents. representatives, employees or subcontractors. Contractor's maintenance of insurance, its scope of coverage and limits as required herein shall riot be construed to limit the liability of the Contractor to the coverage provided by such insurance, or otherwise limit the City's recourse to any remedy available at law or in equity. A Minimum Scope of Insurance. Contractor shall obtain insurance of the types and with the limits described below: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1.000,000 per accident. Automobile liability insurance shall cover all owned, non -owned hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary. the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance with limits no less than $2.000,000 each occurrence. $2,000,000 general aggregate and $2.000,000 products -completed operations aggregate limit. Commercial General Liability insurance shall be as least at broad as ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products -completed operations. stop gap liability. personal injury and advertising injury, and liability assumed under an insured contract. The Commercial General Liability insurance shall be endorsed to provide a per project general aggregate limit using ISO form CG 25 03 05 09 or an equivalent endorsement. There shall be no exclusion for liability arising from explosion, collapse or underground property damage. The City shall be named as an additional insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO Additional Insured endorsement CG 20 10 10 01 and Additional Insured -Completed Operations endorsement CG 20 37 10 01 or substitute endorsements providing at least as broad coverage. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B Public Entity Full Availability of Contractor Limits. If the Contractor maintains higher insurance limits than the minimums shown above, the Public Entity shall be insured for the full available limits of Commercial General and Excess or Umbrella liability maintained by the Contractor, irrespective of whether such limits maintained by the Contractor are greater than those required by this Contract or whether any certificate of insurance furnished to the Public Entity evidences limits of liability lower than those maintained by the Contractor. C. Other Insurance Provision. The Contractor's Automobile Liability and Commercial General Liability insurance policies are to contain, or be endorsed to contain that they shall be primary insurance with respect to the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. D. Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M Best rating Revised May 2020 Faze 2 of .1 of not less than A. VH. E. Verification of Coverage. Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. Upon request by the City, the Contractor shall furnish certified copies of all required insurance policies, including endorsements, required in this Agreement and evidence of all subcontractors' coverage. F Subcontractors. The Contractor shall cause each and every Subcontractor to provide insurance coverage that complies with all applicable requirements of the Contractor -provided insurance as set forth herein, except the Contractor shall have sole responsibility for determining the limits of coverage required to be obtained by Subcontractors. The Contractor shall ensure that the Public Entity is an additional insured on each and every Subcontractor's Commercial General Liability insurance policy using an endorsement as least as broad as ISO CG 20 10 10 01 for ongoing operations and CG 20 37 10 01 for completed operations. G. Notice of Cancellation. The Contractor shall provide the City and all Additional Insureds for this work with written notice of any policy cancellation, within two business days of their receipt of such notice. H. Failure to Maintain Insurance. Failure on the part of the Contractor to maintain the insurance as required shall constitute a material breach of contract, upon which the City may, after giving five business days notice to the Contractor to correct the breach, immediately terminate the contract or, at its discretion, procure or renew such insurance and pay any and all premiums in connection therewith, with any sums so expended to be repaid to the City on demand or at the sole discretion of the City, offset against funds due the Contractor from the City 8. Record Keeping and Reporting. A The Contractor shall maintain accounts and records. including personnel, property, financial and programmatic records which sufficiently and properly reflect all direct and indirect costs of any nature expended and services performed in the performance of this Agreement and other such records as may be deemed necessary by the City to ensure the performance of this Agreement. B. These records shall be maintained for a period of seven (7) years after termination hereof unless permission to destroy them is granted by the office of the archivist in accordance with RCW Chapter 40.14 and by the City. 9. Audits and lnsnection§. The records and documents with respect to all matters covered by this Agreement shall be subject at all times to inspection, review or audit by law during the performance of this Agreement. 10. Termination. This Agreement may at any time be terminated by the City giving to the Contractor thirty (30) days written notice of the City's intention to terminate the same Failure to provide products on schedule may result in contract termination If the Contractor's insurance coverage is canceled for any reason. the City shall have the right to terminate this Agreement immediately. 11. Discrimination Prohibited. The Consultant, with regard to the work performed by it under this Agreement, will not discriminate on the grounds of racereligion, creed, color, national origin, age, veteran status, sex. sexual orientation, gender identity. marital status. political affiliation, the presence of any disability. or any other protected class status under state or federal law, in the selection and retention of employees or procurement of materials or supplies. 12. Assignment and Subcontract. The Contractor shall not assign or subcontract any portion of the services contemplated by this Agreement without the written consent of the City. 13. Entire Agreement. Modification. This Agreement, together with attachments or addenda, represents the entire and integrated Agreement between the City and the Contractor and supersedes all prior negotiations. representations, or agreements written or oral. No amendment or modification of this Agreement shall be of any force or effect unless it is in writing and signed by the parties. CA Revised May 202() Page 3 of 4 201 14. Severability and Survival. If any term, condition or provision of this Agreement is declared void or unenforceable or limited in its application or effect, such event shall not affect any other provisions hereof and all other provisions shall remain fully enforceable. The provisions of this Agreement, which by their sense and context are reasonably intended to survive the completion, expiration or cancellation of this Agreement. shall survive termination of this Agreement. 15. Notices. Notices to the City of Tukwila shall be sent to the following address: City Clerk, City of Tukwila 6200 Southcenter Blvd. Tukwila. Washington 98188 Notices to the Contractor shall be sent to the address provided by the Contractor upon the signature line below, 16. Aoolicable Law: Venue: Attorney's Fees. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. In the event any suit, arbitration, or other proceeding is instituted to enforce any term of this Agreement, the parties specifically understand and agree that venue shall be properly laid in King County. Washington. The prevailing party in any such action shall be entitled to its attorney's fees and costs of suit. DATED this day of , 20 CITY OF TUKWILA CONTRACTOR By 41fit Allan Ekberg, Mayor ATTEST/AUTHENTICATED City Clerk. Christy O'Flaherty APPROVED AS TO FORM: Office of the City Attorney Printed Name and Title 3a .6 14 6 r - Address: ret) 2Ll l G tA `L�,� w 9"i c CA Revised May 2020 Page 4 of 4 202 Price Total Price a e.,ck6;f A. Northwest Playground Equipment, Inc. PO Box 2410, Issaquah, WA 98027-0109 Phone (425) 313-9161 FAX (425) 313-9194 Email: sales(lnwplayground.com QUOTE This quote is only valid for 30 days. To: Tukwila Parks & Rec Re: Tukwila Park Pagoda 15460 65th Ave S Tukwila, WA 98188 Contact Name: Matthew Austin Email: matthew.austint57tukwilawa.gov Phone: Cell/Fax: Quote # 083121RR-01 Date: 8/31/2021 206-445-2245 Item # Oty Description EQUIPMENT Poligon OTC 20SS Shelter with Primary SS, IBC 2015 Building Code, Wind Speed 148655 1 110, Ground Snow Load 20, Min Clearance Height 7'5", Upper Roof Slope 6/12 and Anchor Bolts. NOTE: Carmel/Handrail - 7 Side / 0 Ends (Bays), MCH of 7.5, Electrical Access with 2 Cutouts & Frame Finish/Color - Galvanizing 148655 1 Sealed and Stamped Engineered Drawings with Calculations $ 41,170.00 $ 41,170.00 $ 1,000.00 Equipment Subtotal $ 42,170.00 Northwest Playground Equipment Discount: NPEI 20.00% $ (8,234.00) Poligon Freight. $ 6,000.00_ Equipment Total (less tax) $ 39,936.00 CERTIFIED INSTALLATION 1 Installation of Poligon Shelter Which Includes: Shelter Assembly, Unloading $ 29,400.00 Onsite, Disposal of Packaging and Did from Holes Offsite. Footings included with Excavation thru Existing Concrete, Disposal of Dirt from Holes, plus all Forming with Rebar and Concrete. Electrical set up will also be an additional cost Bond or CC Convenience Fee: Location Code: 1729 Prevailing Wage Job Installation Total: $ 29,400.00 Performance Bond (If Required): 3.0% $ Resale Certificate Required for Tax Exemption: Tax: 10.1% $ 7,002.94 ORDER TOTAL: $ 76,338.94 All quotes are subject to material and fuel surcharges. Acceptance of Proposal: (Please be sure you have read, signed, initialed and understand the Terms and Conditions on Page 2 of this Quote) The items, prices and conditions listed herein are satisfactory and are hereby accepted. TITLE Customer Signature Date Thank you for considering Northwest Playground Equipment, Inc. for your Park, Playground, Shelter and Sports Equipment requirements. PAGE 1 of 3 Rev mod 8111(2017 203 rt E31,kbik. A- Northwest Playground Equipment, Inc. PO Box 2410, Issaquah, WA 98027-0109 Phone (425) 313-9161 FAX (425) 313-9194 Email: sales@nwplayground.com Project Name: Tukwila Park Pagoda Quote # 083121RR-01 TERMS AND CONDITIONS QUOTE CONDITIONS AND ACCEPTANCE: This quote is only valid for 30 days. Orders placed or requested for delivery after 30 days are subject to price increases. (PIs Initial) It is the Buyer's responsibility to verify quantities and description of items quoted. Once your order has been placed, any changes including additions, deletions or color changes, will delay your shipment. EXCLUSIONS: Unless specified, this quote specifically excludes all of the following: Required Permits; Davis Bacon, Certified Payroll or Prevailing Wage fees Performance/Payment Bonds Site work and landscaping Removal of existing equipment Unloading; Receiving of inventory or equipment; Storage of equipment Equipment assembly and/or installation Safety surfacing; Borders or drainage requirements Landscaping Repairs DUE to poor access or in climatic weather FREIGHT AND DELIVERY: Shipping is FOB Origin. A 24 -hr Call Ahead is available at additional cost. Delivery is currently 5+ weeks after order submittal. Unless otherwise noted, all equipment is delivered unassembled. "' (PIs Initial)Buyer Is responsible to meet and provide a minimum of 2 ADULTS to unload truck A Check List, detailing all items shipped, will be mailed to you and a copy will be included with the shipment. Buyer is responsible for ensuring the Sales Order and Item Numbers on all boxes and pieces match the Check List. (PIs Initial)Shortages or damages must be noted on the driver's delivery receipt. Shortages or damages not noted become the buyers financial responsibility. Damaged Freight must be refused. Please notify Northwest Playground Equipment immediately of any damages. Shortages and Concealed Damage must be reported to Northwest Playground Equipment within 10 days of delivery. A reconsignment fee will be charged for any changes made to delivery address after order has been placed. TAXES: All orders delivering in Washington are subject to applicable sales tax unless a tax exemption or Reseller Permit is on file at the time the order is placed. PAYMENT TERMS: An approved Credit Application is required for new customers. 50% down payment is due at time of order with balance due upon delivery, unless other credit terms have been approved. Interest may be charged on past due balances at an annual rate of 18%. A 3% charge will be added to all credit card orders. RESTOCKING: Items canceled, returned or refused will be subject to a minimum 25% restocking fee. All return freight charges are the responsibility of the Buyer. MAINTENANCE/WARRANTY: Manufacturer's standard product warranties apply and cover equipment replacement and freight costs only; labor is not included, Northwest Playground Equipment offers no additional warranties. Maintenance of the equipment and safety surfacing is the responsibility of the customer. Any unauthorized alterations or modifications to the equipment (including layout) will void your warranty. INSTALLATION: (if applicable) A private locate service for underground utilities must be completed before your scheduled installation. Site must be level and free of loose debris (this includes ground cover/chips). A minimum 6 foot opening with good access must be available to the site for delivery trucks and tractor. An onsite dumpster must be provided for disposal of packaging materials. Arrangements must be made in advance for the disposal of dirt/rocks from within the installation area. Arrangements must be made in advance for the removal/disposal of existing equipment. Additional charges may apply if large rocks or concrete are found beneath the surface. Access to power and water must be available. Site supervision is quoted in 8 -hour days. Acceptance of Terms & Conditions Acceptance of this proposal, made by an authorized agent of your company, indicates agreement to the above terms and conditions. TITLE Customer Signature Date Thank you for choosing Northwest Playground Equipment PAGE 2 of 3 Revised 8/11/2017 204 6)(k:1);,P A. PAGE 3 of 3 Revised 8/11/2017 205 206 £iL&»4 a. pciigon FRAME COLOR: GALV ROOF COLOR: EVERGREEN COLORS MAY VARY SLIGHTLY FROM RENDERED IMAGE TUKWILA PARK SEATTLE, WA OTC 20 PROJECT: TUKWILA PARK LOCATION: SEATTLE, WA BUILDING TYPE: OTC 20 ROOF TYPE: STANDING SEAM BUILDING NUMBER: P12616 ORDER NUMBER: 69669 DRAWING LIST: SKEET NUMBER DRAWING DESCRIPTION CS COVER SHEET I ARCHITECTURAL ELEVATIONS 2 STRUCTURAL FRAMING PLAN 3 COLUMN LAYOUT 00 Okig. O. STOP!! NOT FOR CONSTRUCTION USE FOR PRELIMINARY PLANNING AND ESTIMATING ONLY FABRICATOR APPRQVALS: CITY OF PHOENIX, A2 APPROVED FABRICATOR .CO11-2010 CITY OF LOS ANGELES. CA APPROVED FABRICATOR 41596 CITY OF RIVERSIDE, CA APPROVED FABRICATOR /SPO6-0033 CITY OF HOUSTON, TX APPROVED FABRICATOR 0470 CLARK COUNTY, NV APPROVED FABRICATOR 0284 STATE OF UTAH APPROVED FABRICATOR 02008-14 CERTIFICATES; COUNTY CERTIFICATE OF COMPETENCY NO. 19 -OBOE. PCI (POWDER COATING INSTITUTE) 4000 CERTIFIED MATERIALS' pEgCglpT(QN SCHEDULE PIPE RMT PIPE LIGHT GAGE COLD FORMED STRUCTURAL STEEL PLATE ROOF PANELS (STEELI Mold GRANATION 553 ARADE I31 A519 A1503 (GRADE 501 A38 5653 GENERAL NOTES: UNLESS NO ED OTHERWISE, THIS STRUCTURE WAS DESIGNED TO ONLY SUPPORT WHAT IS SHOWN ON THESE DRAWINGS. THE MANUFACTURER MUST BE CONTACTED IF ANYTHING ELSE IS TO SE ATTACHED TO THIS STRUCTURE (WALLS, COLUMN WRAPS, RAILINGS, ETC.) SO THE DESIGN OF THIS STRUCTURE CAN BE REVIEWED AND POSSIBLY REVISED. UNLESS NOTED OTHERWISE, THIS STRUCTURE WAS DESIGNED 05 ASSUMING A 20' SEPARATION BETWEEN ANY ADJACENT STRUCTURE WITH AN EAVE HEIGHT EQUAL TO OR GREATER THAN THE EAVE HEIGHT OF THIS STRUCTURE IF THAT SEPARATION DOES NOT EXIST, THE MANUFACTURER MUST BE CONTACTED SO THE DESIGN OF THIS STRUCTURE CAN BE REVIEWED AND POSSIBLY REVISED. STRUCTURAL STEEL SHALL BE DETAILED. FABRICATED. AND ERECTED IN ACCORDANCE WITH THE LATEST EDITION OF THE AMERICAN INSTITUTE OF STEEL CONSTRUCTION (AISC) SPECIFICATION MANUAL ALL WELDING IS PERFORMED BY AMERICAN WELDING SOCIETY OCAWS) CERTIFIED WELDERS AND CONFORMS TO THE LATEST EDITION f AWS 01.1 OR D1.3 AS REQUIRED. PARTS SHOWN MAY BE UPGRADED DUE TO STANDARDIZED FABRICATION. REFER TO THE SHIPPING BILL OF MATERIALS FOR POSSIBLE SUBSTITUTIONS. FOR PROPER FIELD INSTALLATION OF THE BUILDING IT IS RECOMMENDED THAT THE PRIMARY FRAME INSTALLER AND THE ROOF INSTALLER HAVE A MINIMUM FIVE (5) YEARS DOCUMENTED EXPERIENCE INSTALLING THIS TYPE OF PRODUCT. FOR PROPER FIELD INSTALLATION OF THE BUILDING IT IS RECOMMENDED THAT ELECTRIC WIRING, IF REQUIRED, BE RUN THROUGH THE STRUCTURAL MEMBERS BEFORE THE BUILDING IS ERECTED. oC a 4 O _ O C Fr 7.5 M CG 0 0 o. g 0 s pp � i,v nt iE CS STOP!! NOT FOR CONSTRUCTION USE FOR PRELIMINARY PLANNING AND ESTIMATING ONLY TOP VIEW 1111111111111111111 HM1111111111111111 FRONT VIEW FINISH GRADE ]ASSUMED AT CONSTANT ELEvAi)ON UNLESS OTHERWISE NOTED] GENERAL ROOF NOTES: METAL ROOFING: • 24 GAUGE • GALVALUME COATED • KYNAR 500 PAINTED 2. TRIM COLOR MATCHES ROOF 3. SEE POUGON_COM FOR COLOR OPTIONS llllll� 11111111_ 111llljll 01, 111111 I- IIIIII1111 111111111111 ISOMETRIC VIEW f2 6 SIDE VIW N O O 1 STOP!! NOT FOR CONSTRUCTION N O EibiN;(34 USE FOR PRELIMINARY PLANNING AND ESTIMATING ONLY TOP VIEW !l�Gii II III IIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIII 1 FRONT VIEW FINISH GRADE (ASSUMED AT CONSTANT ELEVATION UNLESS OTHERWISE NOTED) Is 4:4 IIIIID ��JIllll__ IIIIIIIII jIIIIIIIII1II1I (111111( ISOMETRIC VIEW 027, 01.— IIIIIIIIIIII E 041 l1iJ� �I�r�iZi II'IIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIII I SIDE VIEW C Ra. 2 gE 3 K z 0 a (S z a' 2 USE FOR PRELIMINARY PLANNING AND ESTIMATING ONLY Efiv`64 8. STOP!! NOT FOR CONSTRUCTION C> u K-1 U BASEPLATE NOTES: 1. POUGON ENGINEERING WILL DETERMINE REQUIRED BASEPLATE DESIGN AFTER ENGINEERING PACKAGE IS ORDERED. 2. CUSTOMER MAY SUGGEST PREFERRED BASEPLATE DESIGN. 9 E Ni �o 0 c u 0 a e 1g0 o. w ii:, '....172: _ . 04 x AtOi a 1 eX at %ao et 212 Policy No.CPP1037280 COMMERICAL GENERAL LIABILITY WN GL 39 08 18 COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT The Commercial General Liability Enhancement Endorsement is an optional endorsement that provides coverage enhancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is. provided by this summary, refer to following endorsement for changes in your policy. SUMMARY OF COVERAGES PAGE Bodily Injury And Property Damage Liability • Non Owned Watercraft Up To 50 Feet 2 Property Damage Liability • Elevators 3 • Fire. Lightning, Explosion Or Sprinkler Leakage Exception 3 • Borrowed Equipment ($25,000 Per Occurrence, $50.000 Aggregate. $2,500 Deductible Per Occurrence 3 Supplementary Payments — Amended • Bail Bonds Up To $5,000 3 • Loss of Earnings Up To $500/Day 3 Who Is An Insured Amendments • Employee Bodily Injury To A Co -Employee 4 • Newly Formed Or Acquired Organizations For Up To 180 Days 4 • Blanket Additional Insured — Vendors — As Required By Contract 4 • Blanket Additional Insured — Lessor Of Leased Equipment 6 • Blanket Additional Insured — Managers Or Lessors Of Premises 6 • Blanket Additional Insured — State Or Governmental Agency Or Subdivision Or Political Subdivision — Permits Or Authorizations 7 • Blanket Additional Insured — State Or Governmental Agency Or Subdivision Or Political Subdivision — Permits Or Authorizations Relating To Premises 8 Damage To Premises Rented To You — $300,000 9 Medical Payments Increased Limit — $10,000 Or Amount Shown on Declarations 9 Conditions • Knowledge of Occurrence. Offense, Claim Or Suit Amended 9 • Unintentional Failure To Disclose Hazards 9 • Waiver of Subrogation 10 Insured Contract Amended 10 Personal And Advertising Injury Redefined • Televised, Videotaped Or Electronic Publication 10 WN GL 39 08 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission, Page 1 of 10 213 214 COMMERCIAL GENERAL LIABILITY WN GL 39 08 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. SECTION I — COVERAGES AMENDMENTS COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY A. Non Owned Aircraft Or Watercraft Item 2. Exclusions, Paragraph g. is replaced by the following: 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 in 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 50 feet long; and (b) Not being used to carry persons or property for a charge: This Subparagraph (2) applies to any person, who with your expressed or implied consent, either uses or is responsible for the use of the watercraft; (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; or (5) "Bodily injury" or "property damage" arising out of: (a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or (b) The operation of any of the machinery or equipment listed in Paragraph f. (2) or f. (3) of the definition of "mobile equipment". B. Damage To Property Coverage Extensions Item 2. Exclusions, Paragraph j. is replaced by the following: j. 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; WN GL 39 08 18 Includes copyrighted material of insurance Services Office, Inc„ with its permission. Page 2 of 10 (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. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion or sprinkler leakage) to premises, including the contents of such premises, rented to you for a period of seven or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in SECTION III — LIMITS OF INSURANCE. However, the provisions of this paragraph do not apply if coverage for Damage To Premises Rented To You is excluded by endorsement. 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. Paragraph (4) of this exclusion does not apply to "property damage" to borrowed equipment while not being used to perform operations at the jobsite. Subject to Paragraph 2. of SECTION III — LIMITS OF INSURANCE, the rules below fix the most we will pay for "property damage" under this provision; (1) $25,000 any one "occurrence", regardless of the number of persons or organizations who sustain damages because of that "occurrence"; (2) $50,000 annual aggregate; and (3) We will pay only for damages in excess of $2,500 as a result of any one "occurrence", regardless of the number of persons or organizations who sustain damages because of that "occurrence". We may, or if required by law, pay all or any part of any deductible amount, if applicable, to effect settlement of any claim or "suit". Upon notice of our payment of a deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products -completed operations hazard". The insurance provided for "property damage" from the use of elevators and for "property damage" to borrowed equipment is excess over any other valid and collectible property insurance (including any deductible portion thereof) available to the insured whether primary, excess, contingent or on any other basis. C. Damage To Premises Rented To You Item 2. Exclusions, the last paragraph is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion or sprinkler leakage to premises while 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 Paragraph 6. of SECTION III — LIMITS OF INSURANCE. COVERAGE B — PERSONAL AND ADVERTISING INJURY LIABILITY D. Personal And Advertising Injury Item 2. Exclusions is amended by replacing Sub -paragraphs b. and c. with the following: b. Material Published With Knowledge Of Falsity "Personal and advertising injury" arising out of oral, written, televised, videotaped or electronic publication, in any manner, of material, if done by or at the direction of the insured with knowledge of its falsity. c. Material Published Prior To Policy Period "Personal and advertising injury" arising out of oral, written, televised, videotaped or electronic publication, in any manner, of material whose first publication took place before the beginning of the policy period. SUPPLEMENTARY PAYMENTS — COVERAGES A AND B E. Supplementary Payments — Coverages A and B Item 1. is amended by replacing Subparagraphs b. and d. with the following: b. Up to $5,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. WN GL 39 08 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 10 215 SECTION II — WHO IS AN INSURED AMENDMENTS A. Employee Bodily Injury To A Co -Employee Paragraph 2. a. (1) is replaced by the following: However, none of these "employees"' or "volunteer workers" are insureds for "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). 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 the co -"employee" or "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 Paragraph (1)(a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if a suit seeking damages for "bodily injury" or "personal and advertising injury' to any co -"employee" or other "volunteer worker' arising out of and in the course of the co -"employee's" or "volunteer worker's" employment or while performing duties related to the conduct of your business, or a suit seeking damages brought by the spouse, child, parent, brother or sister of the co -'employee" or other "volunteer worker', is brought against you or a co -"employee" or a "volunteer worker', we will reimburse the reasonable costs that you incur in providing a defense to the co -"employee" or 'Vo'lunteer worker" against such matters, Any reimbursement made pursuant to this sub -section will be in addition to the limits of liability set forth in the Declarations. B. Newly Acquired Organizations Paragraph 3. a. is replaced by the following: a. Coverage under this provision is afforded only until the 180th day after you acquire or farm the organization or the end of the policy period, whichever is earlier; The following are added: C. Blanket Additional Insured — Vendors — As Required By Contract 1. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) (referred to throughout this endorsement as vendor) with whom you have agreed in a written contract, executed prior to loss, to name as an additional insured, 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. However, a. The insurance afforded to such vendor only applies to the extent permitted by law; and b. If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. 2. With respect to the insurance afforded to these vendors, the following additional exclusions apply: a. The insurance afforded the vendor does not apply to: (1) "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; (2) Any express warranty unauthorized by you; (3) Any physical or chemical change in the product made intentionally by the vendor; (4) Repackaging, except when 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; WN GL 39 08 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 216 Page 4 of 10 (5) 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; (6) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; 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 (8) "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: (7) (i) The exceptions Subparagraphs (4) or (ii) Such inspections, tests or servicing as agreed to make undertakes to make course of business, with the distribution products. 3. This Provision C. does not apply: a. 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: b. To any vendor for which coverage as an additional insured specifically is scheduled by endorsement: or c. When liability included within the "products -completed operations hazard" has been excluded for such product either by the provisions of the coverage part or by endorsement. contained in (6); or adjustments. the vendor has or normally in the usual in connection or sale of the 4. With respect to the insurance afforded to these vendors, the following is added to Section III — Limits Of Insurance: if coverage provided to the vendor is required by a contract or agreement, the most we will pay on behalf of the vendor is: a. The minimum amount required by the contract or agreement; or b. The Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 5. With respect to the insurance afforded to these additional insureds. the following additional exclusion applies: This insurance does not apply to: a. "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: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. WN GL 39 08 18 Includes copyrighted mater al of Insurance Services Office, Inc., with its permission. Page 5 of 10 217 D. Blanket Additional Insured — Lessor Of Leased Equipment 1. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement, executed prior to loss, that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured 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). However, the insurance afforded to such additional insured: a. Only applies to the extent permitted by law: and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. 2. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: a. The minimum amount required by the contract or agreement; or b. The Limits of Insurance shown in Declarations; whichever is less. This endorsement shall not increase applicable Limits of Insurance shown in Declarations. the the the 4. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: a. "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: (1) The preparing, approving, or failing to prepare or approve. maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured. if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury', involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. E, Blanket Additional Insured -- Managers Or Lessors Of Premises 1. Section II — Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) with whom you have agreed in a written contract, executed prior to loss, to name as an additional insured, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you, subject to the following additional exclusions: This insurance does not apply to: a. Any "occurrence" which takes place after you cease to be a tenant in that premises. b. Structural alterations, new construction or demolition operations performed by or on behalf of such additional insured. WN GL 39 08 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 10 218 However: a. The insurance afforded to such additional insured only applies to the extent permitted by law: and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: a. The minimum amount required by the contract or agreement; or b. The Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 3. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: a. "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: (1) The preparing, approving, or failing to prepare or approve. maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. F. Blanket Additional Insured — State Or Governmental Agency Or Subdivision Or Political Subdivision — Permits Or Authorizations Section II — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision with whom you have agreed in a written contract, executed prior to loss, to name as an additional insured, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. "Bodily injury". "property damage" or "personal and advertising injury" arising out of operations performed for the federal government. state or municipality: or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: a. The minimum amount required by the contract or agreement; or b. The Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. WN GI. 39 08 18 Includes copyrighted material of Insurance Services office. Inc., with its permission. Page 7 of 10 219 4. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: a. "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: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys. field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an engineer, architect or surveyor. G. Blanket Additional Insured — State Or Governmental Agency Or Subdivision Or Political Subdivision — Permits Or Authorizations Relating To Premises Section II — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision with whom you have agreed in a written contract, executed prior to loss, to name as an additional insured, subject to the following provision: 1. This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization in connection with premises you own, rent or control and to which this insurance applies: a. The existence, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or b. The construction, erection or removal of elevators; or c. The ownership, maintenance or use of any elevators covered by this insurance. However, a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: a. The minimum amount required by the contract or agreement: or b. The Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 3. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: a. "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: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. WN GL 39 08 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 220 Page 8 of 10 This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury' or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any professional services by you with respect to your providing engineering. architectural or surveying services in your capacity as an engineer, architect or surveyor. SECTION III — LIMITS OF INSURANCE AMENDMENTS A. Damage To Premises Rented To You Paragraph 6. is replaced by the following: 6. Subject to Paragraph 5. above, the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion or sprinkler leakage, while rented to you or temporarily occupied by you with permission of the owner is the greater of; a. $300,000, or b. The amount shown next to the Damage To Premises Rented To You Limit in the Declarations. However, the provisions of this paragraph do not apply if Damage To Premises Rented To You Coverage is excluded by endorsement. B. Medical Expense Limit Paragraph 7. is replaced with the following: 7. Subject to Paragraph 5. above, the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person is the greater of: a. $10,000: or b. The amount shown next to the Medical Expense Limit in the Declarations. This insurance does not apply if coverage for Medical Expenses is excluded either by the provisions of the coverage part or by endorsement. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS AMENDMENTS A. Knowledge Of Occurrence Item 2. Duties In The Event Of Occurrence, Offense, Claim or Suit is amended by adding the following: e. You must give us or our authorized representative prompt notice of an "occurrence", claim or loss only when the "occurrence", claim or loss is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership: (3) An executive officer or insurance manager, if you are a corporation: or (4) A member or manager, if you are a limited liability company. B. Other Insurance Item 4. Other Insurance, b. Excess Insurance (1) (a) (ii) is replaced by the following: (ii) That is fire, lightning, explosion or sprinkler leakage insurance for premises rented to you or temporarily occupied by you with permission of the owner: C. Unintentional Failure To Disclose Hazards Item 6. Representations is replaced by the following: 6. Representations And Unintentional Failure To Disclose Hazards a. 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. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. WN GL 39 08 18 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9 of 10 221 D. Waiver of Subrogation Item 8. Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following: We waive any right of recovery we may have because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a written contract, executed prior to loss. requiring such waiver with that person or organization and included in the "products -completed operations hazard". However, our rights may only be waived prior to the "occurrence" giving rise to the injury or damage for which we make payment under this Coverage Part. The insured must do nothing after a loss to impair our rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce those rights. SECTION V — DEFINITIONS AMENDMENTS A. Insured Contract Amended Paragraph 9. a. is replaced by the following: 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, explosion or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract": B. Personal And Advertising Injury Redefined Paragraph 14. d. and e, are replaced by the following: d. Oral, written, televised, videotaped or electronic publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or service; e. Oral, written, televised, videotaped or electronic publication of material that violates a person's right of privacy; WN GL 39 08 18 Includes copyrighted material of Insurance Services office, Inc., with its permission. Page 10 of 10 222 Policy No.CPP1037280 COMMERCIAL GENERAL LIABILITY WN GL 49 07 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU PRIMARY AND NONCONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom you are performing opera- tions when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with re- spect to liability for "bodily injury', "property dam- age" 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. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are complet- ed. However: 1. The insurance afforded to such additional in- sured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the in- surance afforded to such additional insured will not be broader than that which you are re- quired by the contract or agreement to provide for such additional insured. WN GL 49 07 15 B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sion applies: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the ren- dering of, or the failure to render, any profes- sional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against an additional insured allege negli- gence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any profes- sional services by you with respect to your providing engineering, architectural or survey- ing services in your capacity as an engineer, architect or surveyor. Includes copyrighted material of Insurance Services Office, inc., with its permission. Page 1 of 2 223 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or or- ganization other than another contractor or subcontractor engaged in performing op- erations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Sec- tion III -- Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: 1. The minimum amount required by the contract or agreement; or 2. The Limits of Insurance shown in the Declara- tions; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. WNGL490715 224 D. The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek any contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 POLICY NUMBER: CPP 1037280 COMMERCIAL GENERAL LIABILITY WN GL 50 07 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS PRIMARY AND NONCONTRIBUTORY 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 PER WRITTEN CONTRACT OR AGREEMENT WHERE YOU AGREE TO NAME A PARTY OR PARTIES AS ADDTTIONAL INSURED (S) PER WRITTEN CONTRACT OR AGREEMENT 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" or "prop- erty damage" caused, in whole or in part, by "your work" at the location designated and de- scribed in the schedule of this endorsement per- formed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional in- sured only applies to the extent permitted by law: and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to pro- vide for such additional insured. WN GL500715 B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sion applies: This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architectural or en- gineering activities. includes copyrighted material of Insurance Services Office Inc. with its permission. Page 1 of 2 225 This exclusion applies even if the claims against an additional insured allege negli- gence or other wrongdoing in the supervi- sion, hiring, employment, training or monitor- ing of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or failure to render any professional services by you with respect to your providing engineering, architectural or surveying services in your capacity as an en- gineer, architect or surveyor. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is: 1. The minimum amount required by the con- tract or agreement; or 2. The Limits of Insurance shown in the Decla- rations; whichever is less. This endorsement shall not increase the applica- ble Limits of Insurance shown in the Declara- tions. D. The following is added to the Other Insurance Condition and supersedes any provision to the con- trary: Primary And Noncontributory Insurance This insurance is primary to and will not seek con- tribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be pri- mary and would not seek contribution from any other insurance available to the additional insured. WN GL 50 07 15 Page 2 of 2 Includes copyrighted material of Insurance Services Office Inc. with its permission. 226 POLICY NUMBER: CPP 1037280 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projectls}: PER WRITTEN CONTRACT OR AGREE- MENT WHERE YOU AGREED TO PRO- VIDE A SEPARATE GENERAL AGGRE- ATE LIMIT FOR EACH PROJECT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes le- gally obligated to pay as damages caused by "occurrences" under Section I - Coverage A, and for all medical expenses caused by acci- dents under Section I - Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. A separate Designated Construction Proj- ect General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project Gen- eral Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed oper- ations hazard", and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Desig- nated Construction Project General Aggre- CG 25 03 05 09 gate Limit for that designated construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I - Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above: 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -completed Opera- tions Aggregate Limit, whichever is ap- plicable; and ' Insurance Services Office, Inc., 2008 Page 1 of 2 227 2. Such payments shall not reduce any Des- ignated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" in- cluded in the "products -completed operations hazard" will reduce the Products -completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Desig- nated Construction Project General Aggregate Limit. Page 2 of 2 228 D. If the applicable designated construction proj- ect has been abandoned, delayed, or aban- doned and then restarted, or if the authorized contracting parties deviate from plans, blue- prints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III - Limits Of In- surance not otherwise modified by this endorsement shall continue to apply as stipulated. Insurance Services Office, Inc., 2008 CG 25 03 05 09 COVERAGES CERTIFICATE NUMBER: Cert ID 20819 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. (NSR LTR TYPEOF INSURANCE AOOL INSO SUBR MAID POLICY NUMBER POLICY EFF IMMIDOIYYYY1 POLICY EXP (MM/DDIYYYY) _. LIMITS A X COMMERCLALGENERALLIABILITY INSURED 1425) 313-9161 Northwest Playground Equipment Inc Play Safe Construction, Inc. PO Box 2410 Issaquah WA 98027 INSURERS: INSURERC: EACHOCCURRENCE $ 1,000,000 INSURER E: INSURER F: CLAIMS -MADE 1 X J OCCUR Y Y CPP1037280 03/01/202103/01/2022 PREMISES EaENTECoccurrence) $ 100,000 MED EXP (Any one person) 6 5,000 _ PERSONALBADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 POLICY X EC ' LOC PRODUCTS-COMPIOPAGG $ 2,000 000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 A X ANY AUTO - CPP1037051 03/01/2021 03/01/2022 BODILY INJURY (Per person) S OWNED AUTOS ONLY ." SCHEDULED AUTOS BODILY INJURY (Per accident) S X HIRED AUTOS ONLY X NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) $ S A X UMBRELLALIAB X OCCUR UW31006108 03/01/2021 03/01/2022 EACH OCCURRENCE $ 5,000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE $ 5,000,000 DED X RETENT ON S 10,000 $ A WORKERS COMPENSATION ANDEMPLOYERS'LIABILMY CPP1037260 03/01/2021 03/01/2022 PER OTH- STATUTE X ER ANYPROPRIETOR/PARTNERJEXECUTIVE YIN NIA WA State Stop Gap E.L. EACH ACCIDENT S 1,000,000 OFFICE RIMEMBEREXCLUDED7 (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1, 000,000 5 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Seheduls, may be attached II more apace Is required) RE: Pagoda Project. City of Tukwila is included as Additional Insured with respect to work performed by or on behalf of the Named Insured and coverage is Primary i Nan -Contributory per Endorsement WNGL49. Waiver of Subrogation included per Endorsement WNGL39. Completed operations wording included per Endorsement WNGL50. Additional Insured shall apply by written contract and/or agreement. ACC)REr CERTIFICATE OF LIABILITY INSURANCE kr.-f DATE(MMIDDMYYY) 09/15/2021 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 policyfies) 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 CHOICE Insurance, LLC 8 1715 Market Street STE 100 Kirkland WA 98033 CONTACT NAME: Nick Ghaffari PHONE Ext). (425) 739-6565 {� , No): (425) 739-9955 ADDRESS: Serviceechoiceineurance.net INSURERS) AFFORDING COVERAGE NAM* INSURER A : Western National Mutual Insure 15377 INSURED 1425) 313-9161 Northwest Playground Equipment Inc Play Safe Construction, Inc. PO Box 2410 Issaquah WA 98027 INSURERS: INSURERC: INSURER D INSURER E: INSURER F: CERTIFICATE HOLDER CANCELLATION City of Tukwila 6200 Southcenter Blvd Tukwila WA 98188 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE r,. /1sidf/6Ci ACORD 25 (2016103) Q 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Page 1 of 1 229