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12-065 - Green River Construction - 2012 Annual Sewer Repair (590 Minklter Boulevard)
12-065(a) Council Approval N /A. Sheet 1 of 1 CITY OF TUKWILA 01 ¢I CONTRACT CONTRACT CHANGE ORDER NO. 1 1908 DATE: BUDGET NO. 402.98.594.353.65.00 PROJECT NO.91240201 CONTRACT NO.: 12-065 CG-) PROJECT NAME: 2012 Annual Sewer Repair Lift Station #3 Upgrades TO: Green River Construction, Inc You are hereby directed to make the herein described changes to the plans and specifications or do the following described work not included in the plans and specifications on this contract: NOTE: This change order is not effective until approved by the "Owner" and a notice to proceed is issued. Conditions: A. The following change, and work affected thereby, are subject to all contract stipulations and covenants; B. The rights of the "Owner" are not prejudiced; C. All claims against the "Owner" which are incidental to or as a consequence of this change are waived; and D. The Contractor must submit all Field Overhead and Home Office Overhead Rates for approval in advance of all change orders. CHANGE: 1. During excavation for the new manhole section and lid it was discovered that the City provided manhole section was the wrong diameter. The Contractor was required to purchase a new manhole; section to complete the upgrades to the lift station 2. Lower the existing power conduit from the hot box to the yard light to provide 24" of cover. 3. Extend brackets for ladder to manhole wall due to the change in the diameter of the manhole section. 4. Revise the completion date from August 31, 2012 to October 1,2012 r ACC TE Date Contractorl��l���%�/ By r. Title %%7.w Orig/alContrac (without tax) 15,150.00 APPROVED BY THE CITY OF TUKWILA Previous Change Order 0.00 Date This Change Order (without tax) 3.036.31 By REV. CONTRACT AMOUNT 18,186.31 Additional Calendar Days due to this change: 31 S�-pO- �6 /IVAS ORIGINAL: City Clerk (1 of 2) cc: Finance Department (w /encumbrance) Contractor (2 of 2) Construction Inspector GREEN RIVER CONSTRUCTION CO., INC. 6402 South 144 St., Suite 91 Tukwila, Washington 98168 Office: (206) 246 -9456 Fax: (206) 246 -2274 September 5, 2012 Mr. Mike Cusick City of Tukwila 6300 Southcenter Boulevard, #100 Tukwila, Washingotn 98168 Re: Lift Station #3 Upgrades, Contract No. 12 -065, Change Order Request Dear Mike: We are requesting that the following be added to our contract for additional work at this site. 1. Lower Electrical Conduit Labor (2 ea) 8.0 Hrs $47.91/Hr 383.28 Operator 4.0 Hrs $61.56/Hr S 246.24 Labor Subtotal 629.52 MU 29% 182.56 Labor Total PC -120 4.0 Hrs $75.34/Hr 301.36 MU 21% S 63.29 Equipment Total Subtotal WSST 9.5% Total 812.08 S 364.65 1,176.73 s t rsT I 1,288.5 'li 2. Extra stainless to weld extend brackets for ladder Supt 3.0 Hrs $61.15/Hr 183.45 MU 29% S 53.20 Labor Total 236.65 Material (Metal Super. #210 119073) 93.26 MU 21% 19.59 Material Total S 112.85 Subtotal 349.50 WSST 9.5% S 33.20 Total 382.70 Mr. Mike Cusick Lift Station #3 Upgrades COR Page Two September 5, 2012 3. Extra Riser Section Material (Granite 49055) 1,248.00 MU 21% S 262.08 Subtotal WSST @9.5% Tota I Sincerely, Jerry Knudson President 1,510.08 S 143.46 1,653.54 Enclosures Green River Construction Weighted Wage Rates 2012 Small Drainage Program #12 -092 JDS Group Ltd, an independent franchisee dba METAL SUPERMARKETS (SEATTLE) Phone: 253- 395 -1835 22029 70th Avenue South �'.N'...,..� y...,, V Fax: 253 395 -5068 KENT, WA, 980324911 i kent @metalsupermarkets.com FEIN 20- 5569602 The Convenience Stores For Metal" V r J INVOICE 210- 119073. Date 19- Jul -12 Bill to: GREEN RIVER CONSTR. Shipment to: JOEL 206 730 2830 Sales Rep: Jeff Qty Product SF304/383 1 SS FLAT 304 .375 X 3.000 Add'l Cost Order P.O. Shipment Terms 207218 Pick -Up CREDIT CARD Lgth Unit Price Comment Total Unit 40.00 2.1293 $85.17 INCH Sub TOTAL $85.17 Add'1 Costs $0.00 Taxes $8.09 TOTAL $93.26 Tax# PLEASE PAY FROM THIS INVOICE, NO STATEMENT WILL FOLLOW. THANK YOU FOR YOUR BUSINESS. THANKS AGAIN, JERROD Customer Copy U�.T.0 GRANITE PRECAST 41188AKERV|EVVSPUR 8ELL|NGHA0.VVA 98228 Phone: (380)G71'22S1 Fax: (30O)GT1'O78O Job Number: o Ship to: CITY OFTUKVYLA w4o28.1*^T* STREET, aTE. #1 TUKWILA, WA 98168 Sold to: GREEN RIVER CONSTRUCTION 6402 S. 144TM STREET, aTs#1 TUKWILA, WA 98168 7,500 $1,07310 o $0.00 U 0 *175.00 Structure Total 7,500 7116/2012 NET I OTH wal R M- NOW D43952 KAE Al 6494613 om Item 0000anuon Weight Unit Price TX Extension Structure: 1 072XO5R 72"X4�V.75" TALL RISER W/N0JOINTS 2 K8A,RAMmB{75^ COIL RAM NEKJ5^X.75^X14.5' 1 os(-oeL|VERv osUVEnv Total Weigh INVOICE 49055 Invoice Date: 7M6/2012 Custorner Copy Taxable $0.00 Non-Taxable $1.24O.Oo Sub Total $1.248.00 Tax *U.UO Invoice Total *1.248.00 Less Deposit $000 Invoice Balance n1 24800 'rr $1,073.00 $175.00 $1,248.00 Equipment Blue Book Rate Calculation Date /llleh I Equipment Name /Type �4 �6 book!/ A�i Hourly Rate (pg. Discontinued Yes No If yes, year discontinued Rate Adjustment Factor, if current Rate Adjustment Factor Calcuation for Discontinued RAF Model Year /RAF Discontinued Year Regional Adjustment Factor Attachment Rates 1 2 3 Estimated Operating Cost Total Hourly Ratq 12 -065 Council Approval N/A CITY OF TUKWILA Short Form Contract Contractor/ Green River Construction Company, Inc Vendor Name: Gerry Knudson Project No. q l d. q o,>O I Address: 6402 s 144 Street, Suite 1 Tukwila, WA 98168 Budget Item 90 a. S y4.3S3 6s e U Telephone: 206 246- 9456 Project Name: Lift Station #3 Upgrades at 590 Minkler Blvd Please initial all attachments, then sign and return copies one and two to: City of Tukwila, Public Works Department, 6300 Southcenter Boulevard, Suite 100, Tukwila, Washington 98188. .Retain copy three for your records until a fully executed copy is returned to you. AGREEMENT This Agreement, made and entered into this /o� d ay of -�V� 20 1 a? by and between the City of Tukwila, hereinafter called the City, and Green River Construction Company Inc, hereinafter called the Contractor. The City and the Contractor hereby agree as follows: 1. SCOPE OF WORK Lift Station #3 Upgrades at 590 Minkler Blvd per the attached drawing, details, Tukwila Infrastructure Design Construction Standards, and 2012 Standard Specifications for Road, Bridge, and Municipal Construction. 2. TIME OF COMPLETION 9 f The work shall be commenced (VU -114 and be completed no later thanA U J l 3l, �O1 �L 3. CONTRACT SUM The City shall pay the Contractor for the performance of the work the sum of $15,150.00 plus applicable Washington State sales tax. 4. PAYMENTS The City shall make payments on account of the contract at completion of project. 5. ACCEPTANCE AND FINAL PAYMENT Final payment shall be due 10 days after completion of the work, provided the contract is fully performed and accepted. ,.,C c 16 S 512 6. GENERAL CONDITIONS The City and the Contractor agree upon the following general conditions which shall govern: A. Contract Documents The contract includes this Agreement, Scope of Work and Payment Exhibit. The intent of these documents is to include all labor, materials, appliances and services of every kind necessary for the proper execution of work, and the terms and conditions of payment therefore. The documents are to be considered as one, and whatever is called for by any one of the documents shall be as binding as if called for by all. The Contractor agrees to verify all measurements set forth in the above documents and to report all differences in measurements before commencing to perform any work hereunder. Tukwila Infrastructure Design Construction Standards. 2012 Standard Specifications for Road, Bridge, and Municipal Construction. B. Materials, Appliances and Employees Except as otherwise noted, the Contractor shall provide and pay for all materials, labor, tools, water, power and other items necessary to complete the work. Unless otherwise specified, all material shall be new, and both workmanship and materials shall be of good quality. Contractor warrants that all workmen and subcontractors shall be skilled in their trades. C. Surveys, Permits and Regulations The City shall furnish all surveys unless otherwise specified. Permits and licenses necessary for the prosecution of the work shall be secured and paid for by the Contractor. Easements for permanent structures or permanent changes in existing facilities shall be secured and paid for by the City unless otherwise specified. The Contractor shall comply with all laws and regulations bearing on the conduct of the work and shall notify the City in writing if the drawings and specifications are at variance therewith. D. Protection of Work, Property and Persons The Contractor shall adequately protect the work, adjacent property and the public and shall be responsible for any damage or injury due to his act or neglect. E. Access to Work The Contractor shall permit and facilitate observation of the work by the City and its agents and public authorities at all times. F. Changes in the Work The City may order changes in the work, the contract sum being adjusted accordingly. All such orders and adjustments shall be in writing. Claims by the Contractor for extra cost must be made in writing before executing the work involved. G. Correction of Work The Contractor shall re- execute any work that fails to conform to the requirements of the contract and that appears during the progress of the work, and shall remedy any defects due to faulty materials or workmanship which appear within a period of one year from date of -2- completion of the contract and final acceptance of the work by the City unless the manufacturer of the equipment or materials has a warranty for a longer period of time, which warranties shall be assigned by Contractor to City. The provisions of this article apply to work done by subcontractors as well as to work done by direct employees of the Contractor. H. Owner's Right to Terminate Contract Should the Contractor neglect to prosecute the work properly, or fail to perform any provision of the contract, the City, after seven days' written notice to the contractor, and his surety, if any, may without prejudice to any other remedy the City may have, make good the deficiencies and may deduct the cost thereof from the payment then or thereafter due the Contract or, at the City's option, may terminate the contract and take possession of all materials, tools, appliances and finish work by such means as the City sees fit, and if the unpaid balance of the contract price exceeds the expense of finishing the work, such excess shall be paid to the Contractor, but if such expense exceeds such unpaid balance, the Contractor shall pay the difference to the City. I. Payments Payments shall be made as provided in the Agreements. Payments otherwise due may be withheld on account of defective work not remedied, liens filed, damage by the Contractor to others not adjusted, or failure to make payments properly to the subcontractors. J. Contractor's Liability Insurance Contractor will carry public liability and property damage insurance with carriers satisfactory to the City, in the following amounts: $50,000 property damage 500,000 public liability (each person) $1,000,000 public liability (each occurrence) with endorsements naming the City as an additional insured and will provide the City with certificates of insurance prior to start of construction and with 30 days notice prior to cancellation. K. Performance Bond The Contractor shall fizrnish to the City prior to start of construction a performance bond in an amount of 100% of the contract in a form acceptable to the City. In lieu of bond for contracts less than $25,000, the City may, at the Contractor's option, hold 5% of the contract amount as retainage for a period of 30 days after final acceptance or until receipt of all necessary releases from the Department of Revenue and the Department of Labor and Industries and settlement of any liens, whichever is later. L. Liens The final payment shall not be due until the Contractor has delivered to the City a complete release of all liens arising out of this contract or receipts in full covering all labor and materials for which a lien could be filed, or a bond satisfactory to the City indemnifying the City against any lien. M. Separate Contracts The City has the right to let other contracts in connection with the work and the Contractor shall properly cooperate with any such other contracts. -3- N. Attorneys Fees and Costs In the event of legal action hereunder, the prevailing parry shall be entitled to recover its reasonable attorney fees and costs. O. Cleaning Up The Contractor shall keep the premises free from accumulation of waste material and rubbish and at the completion of the work he shall remove from the premises all rubbish, implements and surplus materials and leave the building broom -clean. P. Indemnification The Contractor shall indemnify, defend and hold harmless the City, its officers, agents and employees, from and against any and all claims, losses or liability, including attorney's fees, arising from injury or death to persons or damage to property occasioned by an act, omission or failure of the Contractor, its officers, agents and employees, in performing the work required by this Agreement. With respect to the performance of this Agreement and as to claims against the City, its officers, agents and employees, the Contractor expressly waives its immunity under Title 51 of the Revised Code of Washington, the Industrial Insurance Act, for injuries to its employees and agrees that the obligation to indemnify, defend and hold harmless provided for in this paragraph extends to any claim brought by or on behalf of any employee of the contractor. This waiver is mutually negotiated by the parties. This paragraph shall not apply to any damage resulting from the sole negligence of the City, its agents and employees. To the extent any of the damages referenced by this paragraph were caused by or resulted from the concurrent negligence of the City, its agents or employees, this obligation to indemnify, defend and hold harmless is valid and enforceable only to the extent of the negligence of the Contractor, its officers, agents, and employees. Q. Prevailing Wages The Contractor shall pay all laborers, workmen and mechanics the prevailing wage and shall file the required "Statement of Intent to Pay Prevailing Wages" in conformance with RCW 39.12.040. R. Discrimination Prohibited The Contractor shall comply with all Equal Employment Opportunity regulations and shall not discriminate against any employee, applicant for employment, or any person seeking the services of the Contractor on the basis of race, color, religion, creed, sex, age, national origin, marital status or the presence of any sensory, mental or physical handicap. sa IN WITNESS WHEREOF, the parties hereto executed this Agreement the day and year first above written. CITY OF TUKWILA By: SignatuY L�G% Printed Name:! r r. 1 Title: 4 Date: By: Sig ature Printed Name: "e Title: Date: ATTEST /AUTHENTICATED: u hX't� C W 0, J City Clerk u APPROVED AS TO FORM: Office of the City Attorney BY: -5- 2012 Annual Sewer Repair at 590 Minkler Boulevard Map Lift station #3 map Lift station #4 map ManorStone is perfect for terraced gardens, raised planters, tree rings, stairs and retaining walls up to 3'6 I Please contact your Sales Representative or local Mutual Materials branch for stocking colors. Custom colors may be available by special order. Flat Face 305 mm 406 mm 16.14 pc m 25 mm 2.79 m 27 kg pc 45 pcs 6" 12" 16" 1.5 pc /ft 1 inch 30 ft 60 lb. pcc Flat Face, Straight -Sided ^¢T "152mm 305 mm 406 mm 16.14 pc m 25 mm 2.79 m2 45 pcs 27 kg 1 pc 6" 12" 16" 1.5 pc ft' I 1 inch 30 ftz 160 lb. pc ki NOT TO EXCEED 3' 6" Eg t ,z At WALL HEIGHT COURSES 10 Ft. I IS Ft 20 Ft. 25 Ft. 30 Ft. 35 Ft. s ;s;: 'fit e r 1' 2 15 23 30 38 45 53 .wE I' .;.H.. ,,.:Mk,w -•f d.,?Y;,$ 2' 4 30 45 I 60 I 75 105 f A ��merS3* s. iii i 5.�, Ai �e714 3 6 I 45 68 90 113 135 158 *EXAMPLE: It takes 45 ManorStones to build a wall 20' long 1'6" tall. Maximum Height: 3'6". Minimum diameter circle: 55". Radius Face 152 mm 305 mm 406 mm 16.14 pc m 25 mm 2.79 m 27 kg pc 45 pcs 6" 12" 16" I 1.5 pc ft I 1 inch I 30 ft I 60 lb. pc Radius Face, St rai ht -Sided uw 152 mm \\�y, 305 mm 406 mm 16.14 pc m 25 mm 2.79 m 27 kg pc 45 pcs R" I 6" 12" 16" I 1.5 pc ft' I 1 inch 30 ft I 160 lb. pc Flat Face 305 mm 406 mm 16.14 pc m 25 mm 2.79 m 27 kg pc 45 pcs 6" 12" 16" 1.5 pc /ft 1 inch 30 ft 60 lb. pcc Flat Face, Straight -Sided ^¢T "152mm 305 mm 406 mm 16.14 pc m 25 mm 2.79 m2 45 pcs 27 kg 1 pc 6" 12" 16" 1.5 pc ft' I 1 inch 30 ftz 160 lb. pc ki NOT TO EXCEED 3' 6" Eg t ,z At WALL HEIGHT COURSES 10 Ft. I IS Ft 20 Ft. 25 Ft. 30 Ft. 35 Ft. s ;s;: 'fit e r 1' 2 15 23 30 38 45 53 .wE I' .;.H.. ,,.:Mk,w -•f d.,?Y;,$ 2' 4 30 45 I 60 I 75 105 f A ��merS3* s. iii i 5.�, Ai �e714 3 6 I 45 68 90 113 135 158 *EXAMPLE: It takes 45 ManorStones to build a wall 20' long 1'6" tall. ManorStone I Mutual Materials Page 1 of 2 1_4 .Y,,, +,,.,1, �4 �.rin7� �r,m {r�rn{�ccinn a�{ nYl l�' �tl( `iC {�l�Y(�CC'AY1P- 7'1Y(1(Jl]C;t .S�1 Pt�117�7I7 %all... 02/07/2012 Home About U A Products a ManorStone Please choose a shape below for detailed dimensions, packaging information and stocking colors. Masonry Products I iardscape Products Pavers and ArchitectLlral A 7 S Radius Face f Dimensions: 6" x 12" x 16" Coverage: 1.5 pcs ft2 Celtik Wall Available with tapered sides (as shown) or straight Rornan Pisa sides. Note: Straight -sided units are available in Gray and Rornan Stacl:Stone Harvest Blend only. Tuscan Stone Environrr7ental Flat Face Manor Stoni Rt_.cyclecl Dimensions: 6" x 12" x 16" Coverage: 1.5 pcs ft2 gg Available with tapered sides or straight sides (as shown). Pisa 2 l 't 1_4 .Y,,, +,,.,1, �4 �.rin7� �r,m {r�rn{�ccinn a�{ nYl l�' �tl( `iC {�l�Y(�CC'AY1P- 7'1Y(1(Jl]C;t .S�1 Pt�117�7I7 %all... 02/07/2012 A Products a ManorStone Please choose a shape below for detailed dimensions, packaging information and stocking colors. Masonry Products Shape Color Collections: I iardscape Products Pavers and ArchitectLlral Shapes: Slabs 7 Retaining WaH Radius Face f Dimensions: 6" x 12" x 16" Coverage: 1.5 pcs ft2 Celtik Wall Available with tapered sides (as shown) or straight Rornan Pisa sides. Note: Straight -sided units are available in Gray and Rornan Stacl:Stone Harvest Blend only. Tuscan Stone Environrr7ental Flat Face Manor Stoni Rt_.cyclecl Dimensions: 6" x 12" x 16" Coverage: 1.5 pcs ft2 Traditional Available with tapered sides or straight sides (as shown). Pisa 2 1_4 .Y,,, +,,.,1, �4 �.rin7� �r,m {r�rn{�ccinn a�{ nYl l�' �tl( `iC {�l�Y(�CC'AY1P- 7'1Y(1(Jl]C;t .S�1 Pt�117�7I7 %all... 02/07/2012 ManorStone I Mutual Materials Page 2 of 2 ManorStone Colors: Blended CN1U Corner Star-kSrone Dimensions: 6" x 8" x 16" Cornerstone Coverage: 1.5 pcs /ft2 Cottacie St.:rne The Corner Unit saves time when building an outside 90 corner The running bond pattern is maintained N_.i Ural glen eiQs when using the corner units. The two -sided textured unit can also be used to build pillars, finish top-of-the- Lifestyle wall steps or outside corners of stairs. The overlapping corner units can be secured using a high strength concrete adhesive The Corner Unit is available in Flat a .dy�ar�, c a orie s Face only, but is suitable for use with both flat and radius face walls. Featured Projects Face Brick Colors: Blended CN1U Permeable Pavers' Antique Blend tiardscape Khaki ar G ray Color photographs show the general appearance of color and texture ranges. H photography and the internet, final color and product selection should be made product shipped is not guaranteed to match the photograph. Home About Us Contact Us Sitemap Newsletter The Legal Stuff Login t,rf„- /Av�Tnu mnf„almateriale car n /ni-nfe sional/ products hardscaDe- troducts /retaining- wall... 02/07/2012 ManorStone I Mutual Materials Page 3 of Step 12 Place Top Course: A layer of concrete adhesive must be applied to the blocks in order to affix the t( course blocks firmly on top of the adhesive, ensuring both surfaces are free of d secure Follow adhesive installation guidelines. Pisa2 Revers -a -Caps or Coping the wall. Step 13 Encapsulate the Drainage Layer Finish Grading: Fold the excess filter fabric over the top of the drainage layer and extend up the Ideally, place an impervious layer of soil on top of the filter fabric and compact n grading and/or swales. For other treatments such as pavers, concrete, or aspha that heavy compaction /paving equipment remains a minimum of 36" (1.0m) frorr the surface above and below the wall to ensure water will flow away from and nc Home About Us Contact Us Sitemap Newsletter The Legal Stuff Login t fa, .l nt„al, atP,•i�lc rrn�� /r rnfE>cctnn �lr rnf�t7[ 1C��1A1 "(�4C �t�P. -Y1 C( Wall... 02/07/2012 ManorStone I Mutual Materials Pace 1 of 3 ManorStone Installation Instructions Products The following are the basic steps involved in constructing a gravity wall [VII. sonry Products from ManorStone. ManorStone is designed for gravity walls up to 3' 6'' tall. d 1 PrOdUCtS ,c Pavers and Architectural Step 1 Plan: S, labs With your final design in hand, begin to establish the wall location and i proposed grades. Locate all utilities and contact local utility companies Retaining Wa115 before digging. Mark a line where the front of the wall will be placed, keeping in mind the 1" (25 mrrt) setback per course. 1`dedlterranean Celtik YJall Step 2 Excavate: Excavate a trench down to the foundation grades specified in the design. Roman Pisa The front of the trench should be 6" (150mm) from the planned face of the block. The trench should be a minimum of 24" (750mm) wide (front to Rornan StackStone back) and 12" (300mm) deep. This depth assumes one unit is buried (unit height of 6" [152rnrnj) plus the compacted granular base minimum depth of 6" (150mm). The rear 6" (150mm) of the trench is excavated to account for Tuscan Stone the drainage layer. Excavations should be conducted in accordance with Erivironanental local codes Maraorstone. Recycled Step 3 Verify Foundation Subgrade: Traditional Once the foundation trench has been excavated to the specified elevations, the checked to ensure that it has the required allowable bearing capacity specified i. Pisa 2 Step 4 Prepare the Compacted Granular Base: r_,.- __.ii..._..._. 1 i-• a, if tc/ l- i< irrlw-- ino_rimcliwtc /rotainina_ wall M/07/2012 ManorStone I Mutual Materials Page 2 of 3 Start the base at the lowest elevation of the wall. The base should be composec ManorStone (less than 8% fines), angular granular material (3/4 minus crushed rock), and cc Standard Proctor Density (SPD). The minimum base thickness is 6" (150rnm) or on 'e founding soil. Geotextile might be required under the granular base. The mirnmL 24" (600mm) wide (front to back) and 6" (150mm) deep. The additional 6" (150n Cor n StoF) placement of the drain. C uUDgeSton Step 5 Step the Base: N,,i':!iral EI °rrterits When the grade in front of the wall slopes up or down, the base must be steppe stepped base as the wall steps up in elevation, the foundation steps must be loc U f es tyl embedment is achieved. The height of each step is 6" (152rnm), the height of 1 must be accounted for at each step. I iardscahe AcCesscri :s Step 6 Place Filter Cloth: Lay the approved filter fabric (geotextile) along the bottom of the rear of the tree Fe atured E excavation to the proposed wall height. Leave adequate material at the top to fo (completely containing the drainage material) Stake the filter cloth against the s Face Brick: Step 7 Place the Drain: Blended CNIJ Various options for drain placement may exist, depending on how the pipe is to through the wall face or connected to a positive outlet (sewer). The drainage sy: Permeable Pavers outlets must; be planned prior to construction. In the case of connecting to a pos placed at the lowest possible elevation and sloped at a minimum of 2 At the n Hardscape granular material to slope down on the sides towards the drain trench. In the 6" place the approved drain tile (4" perforated drain with filter sock) on top of the fit coverage. Step 8 Place the First Course: Position a level string to mark location of the back of the first course (should be wall face) Place the first course of blocks side -by -side (touching) on the granulE then space the blocks slightly apart to allow for the 1" (25mm) setback. Ensure r side to side. Extra care should be taken at this stage as it is critical for accurate base course before beginning the second course. Step 9 Second Additional Courses: Sweep top of underlying course and stack next course in a running bond patterr above the joint between adjacent blocks below (8" [200mm] offset). Continue sU courses (24" [600mm]) before backfilling. Step 10 Backfill Drainage Material: A free- draining, 3/4" (19mm) clear stone drainage material is placed immediatel compacted with a light manual tamper. The drainage layer must be a minimurn c protected from the native material by the filter cloth. Step 11 -Continue Stacking Backfilling: Continue stacking units and backfilling as described in Steps 10 11 until the d the design. l ti n,r.,r r ,ii i�ln atari7fc rntt /nrnf CC7 n1 "lat /Y l'n tll fC /�lAYC1 C( Allf -11YC Cjil('r ��T PtAlilltl S ��71� 02 O ISTA!lAT14N lNSTRUCTION3 Amax. h¢lght 3 minimum d14li*ieter circle S' 5 Excavation: First, mark the area of the wail with chalk or spray paint and then string a line (Photo A). Dig out a 2. Base Preparation: If the project requires a perforated drain, cover the back and the bottom of the trench with a geotextile to prevent soil from blocking the drainage system. Measure a membrane with excess length of about 12" (30 cm) at the top of the bank, which will be folded over the completed drainage fill. 3. Foundation: Prepare a 3" (75 mm) deep foundation with 5/8" minus Base Rock (Photo C). Then tamp (compact) EN P this base and level it front to back and side to side (Photo D). If needed, install a 4" (100 mm) perforated drain over this foundation and connect it to the existing drainage system. The drain will be covered with 3/4" Drain Rock during backfilling. 4. First Course: Lay the base course of retaining wall blocks (Photo E). Using a string line at the back of the units for alignment, place units side by side on the gravel checking for level in both directions. Begin laying block at the lowest point of the wall. It is easier to start at a`straight section of the wall. Complete the base course before proceeding to the second course. Be aware that the blocks have a 1" set back. When curves are laid out, space the base course block slightly apart to allow for their set back. g,, to 12 1 I au W watt Height l (max. 5. Second Additional Courses: Start placing the second course (Photo F). Center each unit on the seams of the first course. The connecting lip should be pointed down to overhang the back edge of the base units. This will create a batter to the wall for better stability. To cut blocks for the ends of the wall, or in tight curved sections, use a hammer and chisel to score the unit on all sides. Pound the chisel, using a three (3) pound sledge on the score line, until the unit splits. Always wear eye protection when splitting stones. If many cuts are needed, a saw may be the easiest way to get precision cuts. 4. Backfilling: After each course is laid, backfill behind the wall with 3/4" gravel or drain rock (Photo G). This step is important to promote drainage and to prevent soil from leaching through the wall face. As an additional safeguard, a geotextile can be used between the backfill and the drain rock. 5. Top Course: A recommended option for finishing the wall is to secure the top course with construction adhesive (Photo H). Apply a bead of the adhesive with a caulking gun. Lay the top course down on the bead and press firmly. Finish backfilling behind the wall. The straight -sided units make good top courses for straight walls, giving the wall a finished look. ManorStoneO is a registered trademark of Mutual Materials Co. ManorStoneO is manufactured in the United States and distributed by Mutual Materials Co. Puget Sound Locations Port Orchard, WA 360 377 3939 Western Oregon Locations Auburn, WA 253 939 7854 Redmond, WA 425 881 6700 Clackamas, OR 503 655 71 66 Bellevue, WA 425 452 2300 Tacoma, WA 253 589 6434 Durham, OR 503 624 8860 Bellingham, WA 360 676 2880 Hillsboro, OR 503 640 4731 Everett, WA 425 353 9677 Eastern Wasington Locations Salem, OR 503 375 6050 Olympia, WA 360 357 3343 Spokane, WA 509 922 4100 Vancouver, WA 360 693 4766 For more information visit our website at mutual materials www.mutualmalterials.com (HARD SOLUTIONS1 m u a a enals Co. Mutual Materials Company, 605 -119th Avenue NE, Bellevue, Washington 98005 (425) 452 -2869 www.mutuaIrrlaterials.com CAUTION: IMPORTANT SAFETY INFORMATION Wet cutting or grinding of this product is highly recoi'nmended to reduce exposure to hazardous dust particles. Dry- sawing or grinding of BRIC -BLOCK OR PAVERS IS NO T recommended by Mutual Materials Company and will result in the release of respirable crystalline` silica dust particles may cause respiratory ailments (such as silicosis) and even cancer due to prolonged unprotected exposure to dust produced by drys cutting. M itual Materials Company recommends engineering ways to limit exposure (manufactured shapes, wet cutting, vacuum systems, etc.). Appropriate ventilation and enclosures should be pro-idPd for workers engaged in any necessary dry cutting or grinding of this product. Consult with your local regulatory agency for recommendations. Protect yourself and your employees with proper protective equipment and adequate training on how to correctly use it. The use of a NIOSH approved respirators, tight fitting goggles and protective gloves are required if dry" cuttineor grinding these units Specific MSDS information is available from the manufacturer and/or selling agent upon request or at our website listed above. Sept -toot These segmental retaining wall ury g hgpe been selected to conform to Industry standards for the particular type printed on this tag. Post delivery sawing or grinding of the product constitutes material modihca for which the manufacturer denies any and all liability, If there are any questions regarding quality or specification, contact the selling agent bnrnediately. T selling agent and /or manufacturer accept no responsibility for off quality, wrong color, or damaged units that are placed in the wall. Units showing damage upon delivery should be brought to the attention of the carrier at the time of delivery. Use will constitute acceptance by the buyer. t la.Ct yoit r local Mutilal, Materials representative for additional design options for walls exceeding 3 feet using ManorStone and CottageStone. The 3 ft. limit is tZd on specific soft load oading and design criteria, and is an approximate guideline, appropriate for non- critical wall applications. Your conditions may be different. Ing -this design and loading lUrilt may result in retaining wall failure. Contact your local Mutual Materials representative for more detailed Informat>s and tance.i IMPORTANT Check the local building code for specittc retaining wall design and construction requirements. to _�AT M__.._anorS lit: MF616A001 SRW 45 E02 000 4" PIPE DAY LIGHTING A TT CURB LINE THE CONTRACTOR SHALL OBTAIN i ELECTRICAL PERMIT FROM THE CITY TUKWILA l FOR INSTALLATION OF THE YARD LIGHT MATCH EXISTING BOLT PATTERN THE CONTRACTOR IS RESPONSIBLE FOR PERMIT COSTS. (4) Tr7-6NC STEEL ANCHOR BOLTS ASTM 1 A576, A151 GRADE 1021- 1046 50,000 PSI =MIN, ABOVE GRADE EXCAVATE AS REQUIRED YIELD MEAN DIA. OF ROD STOCK 0.908! 011•, OUT OF ROUND TOLERANCE EXISTING POW ea: FOR INSTALLATION OF THE I !0.0 ROLL A O TH RE A DS PER BLOCK WALL. WASHER E 2 A 1- OP 10 GALV. STL. WASHERS. LV ST FLAT WA SH METER BOX SOIL REMOVED FROM THE EXCAVATION GROUT BASEPIATE EMBED ANCIIOR BOLTS MIN OF 3 FEET CAN BE DUMPED AT THE CITY OF TUKWILA WITHN B -SHR NX CORE DRILL &EXTEND j DUMP SITE AT NO COST TO CONTRACTOR. CAULK AT EDGE 3/4• CHAMFER TYP. CONDUITS INTO THE MH. COORDINATE WITH ENGINEER FOR LOCATION FINISHED GRADF RELOCATE EXISTING 6 HAND HOLE TO THE WEST FOR THE INSTALLATION a CONTRACTOR TO PROVIDE GRASS SOD THE CONTRACTOR SHALL CONNECT OF THE CONCRETE COLLAR FOR DISTRUBED AREAS ADJACENT TO CONDUIT FROM THE YARD LIGHT TO THE 6415MRS 6' ONCRE7 SLAB BLOCK WALL. EXISTING CONDUIT MATCH EXISTING EVENLY SPACED BELOW GRADE `iC SF SIZE AND MATERIAL MATCH EXISTING GRADES 4- d PROVIDE WIRE AND GROUND FROM YARD LIGHT EXIST CONDUIT Q 'N--�' d TO EXISTING POINT OF CONNECT IN THE PANEL OR /A d GFI. 2A72,1012G I_ INSTALL CITY PROVIDED IN" c i CITY PROVIDED MH SECTION 30'± EXTRUDED CURB CONTRACTOR TO ASSUME THAT THERE IS 40LF t I 4 HOOPS @8'O.C. LADDER MATCH EXISTING CONDUIT AND WIRE REQUIRED TO INSTALL 8' O.C. TOP, BALANCE AND TOP WI HATCH C RE.TE COLLAR THE YARD LIGHT. 12- p.Q 3'CLEARANCE DEMO I 2* CLEARANCE C PROPOSED CONDITIONS EXISTING BLOCK WALL f�✓ 50SF ±TO THE EAST I T� f`:Y:i'��r 1 SQUAREORROUND SEE SHEET 2 FOR DETAILS CONTRACTOR TO SAVE BLOCKS NOTE: co4cRETEPER FOR REUSE ON NEW WALL DEMO EXISTING MANHOLE CONE CONCRETE STRENGTH SHALL BE 3,000 PSI AT 280AYS. REINFORCING SHALL BE ASTM EXISTING LADDER A675 DEFOf MED, CFADE60. YARD LIGHT DETAIL LIFT STATION .#3 r 3551 EXISTING POWER NOT TOSCALE METER BOX TO REMAIN IN PLACE DEMO EXISTING -tom LIGHT POLE BASE VINor PROTECT CONDUIT °4�� FOR FUTURE USE 4 WM HOTBOX PROTECT EXISTItifCr i EXISTING 4" FORCE MAIN r° EXISTING DRYWELL CONDUIT INTO HE"""` MH EXISTING MH LID LID �V EXISTING GRASS AND A s b.s Y .S ic`' av F ,k�'' ps t P., BARK DUST AREA b r P r• A PORTION OF THE MANHOLE r c� �rt� o IS UNDER THE BLOCK WALL. EXISTING HAND H(OIL V4 V .d d d C A A' d .1 DEMO PAVEMENT FOR REMOVAL f OF MANHOLE CONE SECTION CALL 48 HOURS 0 2 4 8 DEMO EXISTING EXTRUDED CURB BEFORE YOU DIG SCALE: 9 =4' SAW CUT PAVEMENT FOR INSTALLATION 1- 800- 424 -5555 S ITE ADDRESS 590 MINKLE BLVD. EXISTING CONDITIONS PROPOSED CONCRETE COLLAR I by I aak I ot JgRtLA PUBLIC WORKS 11"PEPT. --w- LIFT STATION #3 UPGRADES z d'e A I I ENGINEERING- STREETS- WATER SEWER PARKS BUILDING- I Pane I I I I 2 J PLAN SHEET I (ielC bh no I I �IlakllrtV!l �EkmRa!m Oak fCVISNfS EXISTING MAN HOLE 60" DIA PROPOSED BLOCK WALL POLE A PORTION OF SECTION 26 T. 23 N R 4. E, REUSE W.M. W, CONTRACTOR THE MANORSTONE WALL RADIUS FACE 6 "X12 "X16" MATCH EXISTING COLOR AM AND FIXTURE KING COUNTY, WASHINGTON EXISTING BLOCK WALL VERIFY DIA. AND WALL HIGH? PROPOSED LIGHT BASE 3 FEET HIGH TO REMAIN IN PLACE DAVIT BASE IN TOP\ 70 SF INSTALLED PER MANUFACTURES RECOMMENDATIONS ON 12" OF 518" CRUSHED BASE ROCK AND PERFORATED SEE DETAIL 4" PIPE DAY LIGHTING A TT CURB LINE THE CONTRACTOR SHALL OBTAIN i ELECTRICAL PERMIT FROM THE CITY TUKWILA l FOR INSTALLATION OF THE YARD LIGHT MATCH EXISTING BOLT PATTERN THE CONTRACTOR IS RESPONSIBLE FOR PERMIT COSTS. (4) Tr7-6NC STEEL ANCHOR BOLTS ASTM 1 A576, A151 GRADE 1021- 1046 50,000 PSI =MIN, ABOVE GRADE EXCAVATE AS REQUIRED YIELD MEAN DIA. OF ROD STOCK 0.908! 011•, OUT OF ROUND TOLERANCE EXISTING POW ea: FOR INSTALLATION OF THE I !0.0 ROLL A O TH RE A DS PER BLOCK WALL. WASHER E 2 A 1- OP 10 GALV. STL. WASHERS. LV ST FLAT WA SH METER BOX SOIL REMOVED FROM THE EXCAVATION GROUT BASEPIATE EMBED ANCIIOR BOLTS MIN OF 3 FEET CAN BE DUMPED AT THE CITY OF TUKWILA WITHN B -SHR NX CORE DRILL &EXTEND j DUMP SITE AT NO COST TO CONTRACTOR. CAULK AT EDGE 3/4• CHAMFER TYP. CONDUITS INTO THE MH. COORDINATE WITH ENGINEER FOR LOCATION FINISHED GRADF RELOCATE EXISTING 6 HAND HOLE TO THE WEST FOR THE INSTALLATION a CONTRACTOR TO PROVIDE GRASS SOD THE CONTRACTOR SHALL CONNECT OF THE CONCRETE COLLAR FOR DISTRUBED AREAS ADJACENT TO CONDUIT FROM THE YARD LIGHT TO THE 6415MRS 6' ONCRE7 SLAB BLOCK WALL. EXISTING CONDUIT MATCH EXISTING EVENLY SPACED BELOW GRADE `iC SF SIZE AND MATERIAL MATCH EXISTING GRADES 4- d PROVIDE WIRE AND GROUND FROM YARD LIGHT EXIST CONDUIT Q 'N--�' d TO EXISTING POINT OF CONNECT IN THE PANEL OR /A d GFI. 2A72,1012G I_ INSTALL CITY PROVIDED IN" c i CITY PROVIDED MH SECTION 30'± EXTRUDED CURB CONTRACTOR TO ASSUME THAT THERE IS 40LF t I 4 HOOPS @8'O.C. LADDER MATCH EXISTING CONDUIT AND WIRE REQUIRED TO INSTALL 8' O.C. TOP, BALANCE AND TOP WI HATCH C RE.TE COLLAR THE YARD LIGHT. 12- p.Q 3'CLEARANCE DEMO I 2* CLEARANCE C PROPOSED CONDITIONS EXISTING BLOCK WALL f�✓ 50SF ±TO THE EAST I T� f`:Y:i'��r 1 SQUAREORROUND SEE SHEET 2 FOR DETAILS CONTRACTOR TO SAVE BLOCKS NOTE: co4cRETEPER FOR REUSE ON NEW WALL DEMO EXISTING MANHOLE CONE CONCRETE STRENGTH SHALL BE 3,000 PSI AT 280AYS. REINFORCING SHALL BE ASTM EXISTING LADDER A675 DEFOf MED, CFADE60. YARD LIGHT DETAIL LIFT STATION .#3 r 3551 EXISTING POWER NOT TOSCALE METER BOX TO REMAIN IN PLACE DEMO EXISTING -tom LIGHT POLE BASE VINor PROTECT CONDUIT °4�� FOR FUTURE USE 4 WM HOTBOX PROTECT EXISTItifCr i EXISTING 4" FORCE MAIN r° EXISTING DRYWELL CONDUIT INTO HE"""` MH EXISTING MH LID LID �V EXISTING GRASS AND A s b.s Y .S ic`' av F ,k�'' ps t P., BARK DUST AREA b r P r• A PORTION OF THE MANHOLE r c� �rt� o IS UNDER THE BLOCK WALL. EXISTING HAND H(OIL V4 V .d d d C A A' d .1 DEMO PAVEMENT FOR REMOVAL f OF MANHOLE CONE SECTION CALL 48 HOURS 0 2 4 8 DEMO EXISTING EXTRUDED CURB BEFORE YOU DIG SCALE: 9 =4' SAW CUT PAVEMENT FOR INSTALLATION 1- 800- 424 -5555 S ITE ADDRESS 590 MINKLE BLVD. EXISTING CONDITIONS PROPOSED CONCRETE COLLAR I by I aak I ot JgRtLA PUBLIC WORKS 11"PEPT. --w- LIFT STATION #3 UPGRADES z d'e A I I ENGINEERING- STREETS- WATER SEWER PARKS BUILDING- I Pane I I I I 2 J PLAN SHEET I (ielC bh no I I �IlakllrtV!l �EkmRa!m Oak fCVISNfS LADDER 518" SS ANCHOR PROVIDED BY THE CITY BOLTS TYP. STAINLESS STEEL DAVIT BASE 6" 4000 PSI SLAB CL OF LADDER CAST IN THE LID PORTLAND CEMENT CONCRETE v: NEW NEW BARREL SECTION t 12" X 24" CONCRETE COLLAR z CENT.ERD ON JOINTS 3000 PSI CONCRETE 42" C.C. TYP. 6' -00 MANHOLE BARREL PROVIDED BY THE CITY LW HATCH 46" BY 48" 16" :a.LAC DER •6 ':D DAVIT BASE 112" X 3" SS FLAT BA iiiaiiiivi iiiaii� CAST IN THE LID 1/2"X 2" SS FLAT BAR LID IS PROVIDED BY THE CITY CONTRACTOR TO PROVIDE FIELD FILLET WELD AT BRACKET AND LADDER (TYP) CONTRACTOR TO CUT OFF EXCESS BRACKET FLUSH WITH LADDER EXISTING MANHOLE BARREL TOP LID AND BARREL SECTION SUPPLIED BY CITY ROTATE LID PER DIRECTION OF ENGINEER LIFT STATION #3 60" DIA MANHOLE FENCING AROUND WORK AREA. CONCRETE COLLAR SECTION NTS T LS# 3 11' DEEP 1. SAW CUT EXISTING AC PAVEMENT FOR THE REMOVAL OF THE MANHOLE CONE SECTION. 2. EXCAVATE AND REMOVE CONE SECTION. OVER EXCAVATE FOR THE CONCRETE COLLAR. 3. LOCATE AND PROTECT EXISTING CONDUITS ENTERING THE WET WELL. 4. CHIP LIP OF EXISTING-BAR REL SECTION SO THAT THE NEW MANHOLE CAN SIT ON THE EXISTING BARREL SECTION. NO CHIPPED MATERIAL IS FALL IN TO THE WET WELL. 5. INSTALL CITY PROVIDED MANHOLE SECTION AND FLAT TOP LID WITH GASKETS BETWEEN 'SECTIONS. ROTATE LID PER DIRECTION OF ENGINEER. 6. INSTALL CONCRETE COLLAR BETWEEN MANHOLE SECTIONS. 7. GROUT INSIDE JOINT BETWEEN MANHOLE SECTIONS. g CORE DRILL MANHOLE SECTION FOR THE INSTALLATION OF CONDUIT INTO MANHOLE. PROVIDE PVC CONDUIT AND COUPLING FROM EXISTING CONDUIT. MATCH SIZE (SCH 40) 9. BACK FILL TRENCH TO SUBGRADE WITH CRUSHED SURFACING TOP COURSE GRAVEL AND COMPACT. l CALL .HOURS 10. INSTALL CITY PROVIDED LADDER IN WET WELL USING STAINLESS STEEL ANCHORS. BEFORE E YOU DIG 11. THE ANCHORS BOLTS ARE TO BE PROVIDED BY THE CONTRACTOR. 1- 800 -424 -5555 12. RESTORE PAVEMENT AND DISTRUDED LANDSCAPE MATCH EXSITING. 13. THE MANOR STONE BLOCK WALL IS TO BE INSTALL PER MANUFACTURERS RECOMMENDATIONS. 14. THE LIFT STATION IS TO REMAIN IN OPERATION. 15. THE CONTRACTOR SHALL RESTORE THE LANDSCAPING. MATCH EXISTING. O r ,,f- O Sr r 41 or =X;~IRFS: '3' /Z A( I I I I PUBLIC WO1� S DEPT. I I c~ ENGINEERING- STREETS WATER- SEWER PARKS BUILDING I rw�n I I I LIFT STATION ##3 DETAIL SHEET I I 2 1 2� flow I I scale m� revisims �n,�� rl Client 121099 GREERIVE8 DAT ACORD. CERTIFICATE OF LIABILITY INSURANCE 5/18/20 /20 D/YIYY) 12 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 Propel Insurance Seattle Commercial Insurance 925 4th Ave, Suite 3200 Seattle, WA 98104 INSURED Green River Construction Co Inc 6402 South 144th Street, #1 Tukwila, WA 98168 CONTACT Tara Love NAME: PHONE 206.676.4233 (A/C N 866.577.1326 (A/C, No, Ext): ADDRESS: trl @propelinsurance.com INSURER(S) AFFORDING COVERAGE I NAIC I INSURER A: American Fire and Casualty Comp I INSURER B: Ohio Casualty Insurance Company I INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFF POLICY EXP LIMITS N R I TYPE OF INSURANCE INSR IWVD I POLICY NUMBER (MM /DDIYYYYI I( MM /DDIYYYYI A GENERAL LIABILITY X X BKA54943633 12/08/2011 12/08/20121 EACH OCCURRENCE 1$1.000,000 X MMERCIAL GENERAL LIABILITY PRE I SES E TO 1 PREMMI a occurrence/ CO CLAIMS -MADE Fx] OCCUR MED EXP (Any one person) 1 $15 ,000 X1 PD Ded:1 I PERSONAL ADV INJURY 1 $1,000,000 1 GENERAL AGGREGATE 1 $2,000,000 I PRODUCTS COMP /OP AGG 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I POLICY n JEC LOC I A AUTOMOBILE LIABILITY X X BAA54943633 12/0812011 12/08/20121 ff COM LIMIT 1$1,000,000 X ANY AUTO 1 BODILY INJURY (Per person) 1 ALL OWNED SCHEDULED I BODILY INJURY (Per accident) I AUTOS AUTOS X HIRED AUTOS X NON -OWNED I PROPERTY DAMAGE Is (Per accident) AUTOS 1 is B I yl UMBRELLA LIAB I X I OCCUR �I I US054943633 12/08/2011 12/08/2012) EACH OCCURRENCE 1$2.000,000 1$2.000,000 I EXCESS LIAB n CLAIMS -MADE AGGREGATE 1 I DED I XI RETENTION $10000 I Is A WORKERS COMPENSATION BKA54943633 12/08/2011 12/08/201 WC STATU- 1E I l i AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y N WA Stop Gap E.L. EACH ACCIDENT 1 $1,000,000 OFFICERIMEMBER EXCLUDED? N A I E.L. DISEASE EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under I E.L. DISEASE- POLICY LIMIT 1 $1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) RE: Job #212291 Lift Station #3 Upgrades 590 Minkler Blvd, Tukwila, WA 98188. City of Tukwila, Walton CWNA Tuwkila 1, LLC., Kidder Mathews, WCV Commercial Properties, LLC and Walton Calwest Holdings, LLC are named additional insured per the attached endorsement. CERTIFICATE HOLDER CANCELLATION City of Tukwila SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 6300 Southcenter Blvd #100 ACCORDANCE WITH THE POLICY PROVISIONS. Tukwila, WA 98188 AUTHORIZED REPRESENTATIVE I ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/051 4 rtf 1 The ACORD name and logo are registered marks of ACORD Certificate of Insurance Effective immediately, Propel Insurance will no longer issue certificates of insurance not handled in accordance with statutory laws. We will only issue the most current edition of the ACORDO certificates of insurance. in addition, the only information allowed to be entered in the Description of Operations area of the ACORDO certificates of insurance are the description of operations, the locations and /or vehicles covered by the in -force policy. The issuance or modification of a certificate of insurance that in any way misrepresents any material term, condition, coverage or other provision as set forth in the policy, or deliberately or falsely amends or alters the insurance policy or assists in such issuance or modification violates the state law and subjects the violator to civil and criminal penalties. Please note a certificate of insurance is simply a summary of the designated insurance policy and does not cannot modify or amend the referenced insurance policy or confer any right upon the certificate holder. In addition, the certificate holder is owed no duty to be notified in the event the insurance policy is cancelled. For purposes of this notice, "certificate" or "certificate of insurance" means any ACORDO certificate of insurance, which is prepared or issued by an insurer or insurance agent as evidence of property or casualty insurance coverage but does not include an actual copy of the insurance policy or insurance binder. Please contact your state department of insurance for further explanation or inquiries. Green Rig "er Construction Co Inc BKA54943633 COMMERCIAL GENERAL LIABILITY CG 85 83 10 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED CONTRACTORS PRODUCTS /COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph 2. under Section li Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract or written agreement. Such person or organization is an additional insured but only with respect to liability for "bodily injury" or "property damage Caused by "your work" performed for that additional insured that is the subject of the written contract or written agreement; and 2. Included in the "products- completed operations hazard The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage'. We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV Commercial General Liability Conditions. B. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I Coverage A Bodily Injury And Property Damage Liability: This insurance does not apply to: 1. 'Bodily injury" or "property damage" that occurs prior'to you commencing operations at the location where such "bodily injury" or "property damage" occurs. 2. `Bodily injury" or "property damage" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawing and specifications; and b. Supervisory, inspection, architectural or engineering activities. ©2010 Liberty Mutual Insurance Company. All rights reserved. CG 85 83 10 09 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 Green River Construction Cc Inc BKA54943633 C. With respect to the insurance afforded by this endorsement, exclusion I. Damage To Your Work of Paragraph 2. Exclusions under Section I Coverage A Bodily Injury And Property Damage Liability is replaced by the following: Damage To Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products- completed operations hazard D. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III Limits Of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. E. With respect to the insurance afforded by this endorsement, Section IV Commercial General Liability Conditions is amended as follows: 1. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claims Or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit' to all insurers whom also have insurance available to the additional insured; and C. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. Paragraph 4. of Section IV Commercial General Liability Conditions is amended as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non contributory, this insurance is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. ©2010 Liberty Mutual Insurance Company. All rights reserved. CG 85 83 10 09 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 careen mivar t,onsuucuun uo inc BKA54943633 COMMERCIAL GENERAL LIABILITY CG 88 1010 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage)' 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS COVERAGES A AND.B 3 ADDITIONAL INSUREDS BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS- EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 5 WHO IS AN INSURED INCIDENTIAL MEDICAL ERRORS /MALPRACTICE AND WHO IS AN INSURED FELLOW EMPLOYEE EXTENSION MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY AQUIRED ENTITIES 6 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 7 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU 0 2010 Liberty Mutual Insurance Company. All rights reserved. CG 88 10 10 09 lnrlurips rnnvrinhteri material of Incnranrp .5'prvireC Offirp Inn with itc narmiccinn Pane_ 1 of 7 bKAb4V4JtJJJ With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by. the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I Coverage A Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I Coverage A Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY ELEVATORS 1. Under Paragraph 2. Exclusions of Section I Coverage A Bodily Injury And Property Damage Liabil- t• sty, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section 1- Coverage A -Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III Limits of Insurance. 0 2010 liberty Mutual Insurance Company. All rights reserved. CG 88 10 10 09 Innhirinc rnnvrinhtari mntnri; l o f Inc%irinrr Snrvirac Offinp Inn... with itc narmiccinn Pnnw 9 of 7 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner, A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III Limits Of Insurance. 2. Paragraph 6. under Section III -Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) Paragraph 9.a. of Definitions is replaced with the following: 9.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, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section 1- Coverage C Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 1. Under Supplementary Payments -Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 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. 2. Paragraph 1.d. is replaced by the following: 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. G. ADDITIONAL INSUREDS BY CONTRACT, AGREEMENT OR PERMIT Paragraph 2, under Section II Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or 0 2010 Liberty Mutual Insurance Company. All rights reserved. CG 88 10 10 09 includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury "property damage or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (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 expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (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. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties in the Event Of Occurrence, Offense, Claim Or Suit under Section IV Commercial General Liability Condi- tions. 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I Coverage A Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "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: ©2010 Liberty Mutual Insurance Company. All rights reserved. rr- RR in in no „o 1....e ca.,,;, nt4;,.e 1— ire Pana A of 7 0r\r,U"V�t0w0 (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. d. "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. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. H. PRIMARY AND NON CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: if an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. 1. ADDITIONAL INSUREDS- EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. 0 2010 Liberty Mutual Insurance Company. All rights reserved. CG HR 10 10 09 Incluries convriahted material of Insurance Services office, Inc., with its permission. Page 5 of 7 d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice.of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III Limits of Insurance of this policy, whichever are less. These limits a inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED- INCIDENTIAL MEDICAL ERRORS MALPRACTICE WHO IS AN INSURED FELLOW EMPLOYEE EXTENSION- MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co- "employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co- "employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury or caused in whole or in part by their intoxica tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid arid collectable insurance available to your "employee K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section 11- Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. 0 2010 Liberty Mutual Insurance Company. All rights reserved. CG 88 10 10 09 Includes coovriohted material of Insurance Services Office. Inc.. with its permission. Pape 6 of 7 L. FAiLURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES n Under Section IV Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence offense, claim or "suit" by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II Who Is An Insured or a person who has been designated by them to receive reports of "occurrences offenses, claims or "suits" shall have received such notice from the agent, servant or "employee N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. 0. BODILY INJURY REDEFINED Under Section V Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section 1V Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. 0 2010 Liberty Mutual Insurance Company. All rights reserved. CG 88 1010 09 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 /21/12 abouttlank State of Washington Department of Labor Industries Prevailing Wage Section -Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Statement of Intent to Pay Prevailing Wage Document Received Inte.nt Id: Affidavit Id: Status: Approved On Date: 5/17/2012 512464 5/18/2012 Company Details IGREEN RIVER CONST COMPANY INC UBI#:600582949 6402 S 144TH ST STE I Reg#: GREENRC148MM SEATTLE, WA 98168 E-mail: roxanne @greenriverconstruction.com 1206-246-9456 Industrial Insurance Account Id: 371,119-00 Filed By Knudson, Jerry Prime Contractor I Company Name GREEN RIVER CONST COMPANY INC Contractor Registration No. WA UBI Number Phone Number Project Information Awarding Agency Awarding Agency Contact Awarding Agency Contact Phone Number Contract Number Project Name Bid due date Award Date GREENRC148MM 600582949 206-246-9456 TUKWILA, CITY OF 6300 S CENTER BLVD #101 TUKWILA WA 98188 Mike Cusick J 206-431-2441 21229 Life Station #3 Upgrades 5/14/2012 5/15/2012 I ;/21112 Project Site Address or Directions about:blank Intent Details Does your company intend to hire subcontractors to No perform all work? Does your company intend to hire any No subcontractors? Will your company have employees perform work on Yes this project? Wage Fringe ;Workers Do you intend to use any apprentices? (apprentices No are considered employees.) $40.03 $0.00 2 i Will this project utilize American Recovery and No Reinvestment Act (ARRA) funds? $49.90 $0.00 2 Specifically, will this project utilize any No weatherization or energy efficiency upgrade funds (ARRA or otherwise)? Underground Sewer How many owner /operators performing work on the 0 project own 30% or more of the company? Wate r '[What is the estimated contract amount? Or is this a $16,589.25 time and materials estimate? Existing Notes Expected project start date: (MM-DD-MY) 5/29/2012 In what county (or counties) will the project be done? King In what city (or nearest city) will the project be done? Tukwila ;Journey Level Wages County i Trade Occupation Wage Fringe ;Workers King Laborers General Laborer $40.03 $0.00 2 King Power Equipment Shovel, Excavator, $49.90 $0.00 2 Operators- Backhoes, Tractors: I Underground Sewer 15 To 30 Metric Tons Wate r a Show /Hide Existing Notes No note exists .hni t-hinnk 2!