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City Hall Annex 2nd & 3rd Floor Painting with Wheeler Painting
• NON-FORMALLY BID PUBLIC WORKS CONTRACT NO. 19-28 City Hall Annex 2"d & 3rd Floor Painting THIS CONTRACT is entered into between the City of Auburn, a Washington Municipal Corporation ("City"), and Wheeler Painting, Inc. ("Contractor"),whose mailing address is PO Box 1043, Maple Valley, WA 98038; RECITALS: 1. The City is in need of construction contracting services to complete the public work as described in this Contract. 2. Contractor is qualified to perform the construction contracting services described in the Scope of Work. 3. The City wishes to engage Contractor for the performances of these construction contracting services. 4. This contract was not formally bid because(check one) ® LIMITED PUBLIC WORKS CONTRACT: Engineer's Estimate<$50,000.00 and this contract was awarded using the Limited Public Works process as described in RCW 39.04.155. ❑ SMALL PUBLIC WORKS CONTRACT(SINGLE TRADE WORK): Engineer's Estimate<$75,500.00 17 SMALL PUBLIC WORKS CONTRACT(MULTIPLE TRADE WORK): Engineer's Estimate<$116,155.00 ri EMERGENCY PUBLIC WORKS CONTRACT: Per RCW 39.04.280, this work is exempt from competitive bidding requirements because the work is considered an emergency, meaning unforeseen circumstances beyond the control of the City either: (a) Present a real, immediate threat to the proper performance of essential functions; or(b)will likely result in material loss or damage to property, bodily injury, or loss of life if immediate action is not taken. ❑ COOPERATIVE PURCHASING AGREEMENT: This contract is being let under(cooperative contract No. X) between (agency)and(contractor) in accordance with RCW 39.34 (Interlocal Cooperation Act). ❑ Other ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 1 of 14 AGREEMENT 1) CONTRACTOR SERVICES The Contractor shall do all work and furnish all tools, materials and equipment for the completion of Contract 19-28 in accordance with this Contract form. Scope of work is as follows: Interior painting of 2nd floor and part of 3rd floor of the City Hall Annex, a total of 18,945 SF. • Mask, cover and protect • Wall prep to include fill dings, gouges, caulk cracks and spot prime as needed • Paint two coats to GWB walls and columns using multi-color paint scheme • Mobilization, material acquisition, debris removal, after hours sur-charge and prevailing wage fee • Remove existing plastic corner guards during prep work and dispose of off-site • Install client provided corner guards- 50 count The complete Contract includes the following parts, which are by this reference incorporated herein and made a part hereof. Any inconsistency in the parts of the Contract shall be resolved by the order in which they are listed: A. Non-Formally Bid Public Works Contract(this form) B. Construction Work Quote Form C. City of Auburn Construction Standards D. City of Auburn Design Standards E. Portions of Division 1 of WSDOT/APWA Standard Specifications for Road, Bridge and Municipal Construction as specifically referenced by the City of Auburn Construction Standards and the Contract. F. Washington State Department of Labor& Industries Prevailing Wage Rates and Benefit Key Code effective the date the Contractor submitted the Construction Work Quote Form G. On the Contract plans, working drawings, and standard plans, figured dimensions shall take precedence over scaled dimensions. H. In case of any ambiguity or dispute over interpreting the Contract,the City Engineer's decision will be final. 2) CITY OF AUBURN BUSINESS LICENSE The Contractor, subcontractors, and lower tier subcontractors, shall have an active City of Auburn business license. ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 2 of 14 3) NOTICE TO PROCEED A Notice to Proceed will be issued once the Contract has been fully executed by the Contractor and City, and all insurance and licensing requirements as set forth in the contract have been met.The Notice to Proceed Date shall be either the date the Contractor commenced contract work or the date the contract has been fully executed by the Contractor and City and all insurance and licensing requirements as set forth in the contract have been met,whichever occurs first. 4) TIME OF COMPLETION The Contractor shall complete the work within 45 working days from the Notice to Proceed Date. 5) LIQUIDATED DAMAGES (CHECK ONE) M Liquidated damages shall not apply to this contract. n Liquidated damages shall apply to this contract as follows: If said work is not completed within the time specified,the Contractor agrees to pay liquidated damages to the City as follows: A. To pay(according to the following formula) liquidated damages for each working day beyond the number of working days established for physical completion, and B. To authorize the Engineer to deduct these liquidated damages from any money due or coming due to the Contractor. C. Liquidated damages will not be assessed for any days for which an extension of time is granted. No deduction or payment of liquidated damages will, in any degree, release the Contractor from further obligations and liabilities to complete the entire Contract. Formula: Contract Price(without tax)x 0.15, divided by the original number of working days for completion. 6) HOURS OF WORK Allowed hours of work are as specified by the City Facilities Manager. 7) COMPENSATION The Contractor shall do all work and furnish all tools, materials, and equipment for the work and services contemplated in this Contract for compensation as follows: (Check One) Lump Sum Amount ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 3 of 14 ❑ Unit Bid Prices as listed in the Construction Work Quote Form ❑ Not to Exceed Amount, paid per the Force Account method as described in Section 1- 09.6 of the current WSDOT Standard Specifications for Road, Bridge and Municipal Construction The Lump Sum Amount, as specified above is $40,515.50 and Washington State Sales Tax of $4,05L55 for a total of$44,567.05.This project is subject to use tax, which shall be included lump sum, unit bid, or time and material compensation amount listed herein. The City's sales tax area is 1702 for work within King County and 2724 for work within Pierce County. No payment shall be issued until a Statement of Intent to Pay Prevailing Wages form, for the Contractor and each and every Subcontractor, has been approved by the State Department of Labor& Industries, and is received by the City. A. Performance Bond The Contractor shall furnish the City with an executed performance bond for the full Contract amount, unless the contact amount is $150,000.00 or less and the Contractor has elected to have 10%retainage held by the City, in which case a performance bond is not required for this project. B. Retainage(check one) n This is a Limited Public Works Contract AND the City has waived retainage requirements. ® This contract is $150,000.00 or less, therefore,the following applies: The Contractor may elect to furnish a performance bond, in which case the City shall hold back retainage in the amount of 5%of any and all payments made to the Contractor, OR have the City retain, in lieu of the performance bond, 10%of the total Contract amount, pursuant to RCW 39.08.010. The Contractor shall execute a "Declaration of Option for Performance Bond or Additional Retainage"to indicate his/her option. If furnishing a performance bond,the Contractor can choose to have the retainage held by the City in a non-interest bearing account, have it placed in an Escrow(interest bearing)Account, or submit a bond in lieu of retainage. Said retainage shall be held by the City for a period of 30 days after the Completion Date, or until receipt of all necessary releases from the State Department of Revenue and State Employment Security Department, including Affidavits of Wages paid for the Contractor and each and every subcontractor, and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. ❑ This contract is over, $150,000.00, therefore,the following applies: ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 4 of 14 The City shall hold back retainage in the amount of 5%of any and all payments made to the Contractor pursuant to RCW 39.08.010. The Contractor can choose to have the retainage held by the City in a non-interest bearing account, have it placed in an Escrow(interest bearing) Account, or submit a bond in lieu of retainage. Said retainage shall be held by the City for a period of 30 days after the Completion Date, or until receipt of all necessary releases from the State Department of Revenue and State Employment Security Department, including Affidavits of Wages paid for the Contractor and each and every subcontractor, and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. C. Defective or Unauthorized Work The City reserves its right to withhold payment from the Contractor for any defective or unauthorized work. Defective or unauthorized work includes, without limitation: work and materials that do not conform to the requirements of this Contract; and extra work and materials furnished without the City's written approval. If the Contractor is unable, for any reason,to satisfactorily complete any portion of the work,the City may complete the work by contract or otherwise,and the Contractor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Contract price specified above. The City further reserves its right to deduct the cost to complete the Contract work, including any additional costs, from any and all amounts due or to become due the Contractor. D. Final Payment: Waiver of Claims The submittal of the Final Invoice by the Contractor shall constitute a waiver of claims, except those previously and properly made and identified by the Contractor as unsettled at the time Final Invoice is submitted by the Contractor. 8) INDEPENDENT CONTRACTOR The parties intend that an Independent Contractor- Employer Relationship will be created by this Contract,the City being interested only in the results obtained under this Contract. 9) SUBCONTRACTING Work done by the Contractor's own organization shall account for at least 30 percent of the awarded Contract price. Before computing this percentage however,the Contractor may subtract (from the awarded Contract price)the costs of any subcontracted work on items the Contract designates as specialty items. ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 5 of 14 The Contractor shall not subcontract work unless the City approves in writing. Each request to subcontract shall be on the form the City provides. If the City requests,the Contractor shall provide proof that the subcontractor has the experience, ability, and equipment the work requires. The Contractor shall require each subcontractor to comply with RCW 39.12 (Prevailing Wages on Public Works)and to furnish all certificates and statements required by the Contract. No payment shall be issued until a Statement of Intent to Pay Prevailing Wages form, for the Contractor and each and every subcontractor, has been approved by the State Department of Labor& Industries, and is received by the City. Along with the request to sublet, the Contractor shall submit the names of any contracting firms the subcontractor proposes to use as lower tier subcontractors. Collectively, these lower tier subcontractors shall not do work that exceeds 25 percent of the total amount subcontracted to a subcontractor. When a subcontractor is responsible for construction of a specific structure or structures,the following work may be performed by lower tier subcontractors without being subject to the 25 percent limitation: A. Furnishing and driving of piling, or B. Furnishing and installing concrete reinforcing and post-tensioning steel. Except for the 25 percent limit, lower tier subcontractors shall meet the same requirements as subcontractors. The City will approve the request only if satisfied with the proposed subcontractor's record, equipment, experience and ability. Approval to subcontract shall not: 1. Relieve the Contractor of any responsibility to carry out the Contract. 2. Relieve the Contractor of any obligations or liability under the Contract and the Contractor's bond. 3. Create any contract between the City and the subcontractor, or 4. Convey to the subcontractor any rights against the City. The City will not consider as subcontracting: (1) purchase of sand, gravel, crushed stone, crushed slag, batched concrete aggregates, ready mix concrete,off-site fabricated structural steel, other off- site fabricated items, and any other materials supplied by established and recognized commercial plants; or(2)delivery of these materials to the work site in vehicles owned or operated by such plants or by recognized independent or commercial hauling companies. However, the Washington ENG-059.Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 6 of 14 State Department of Labor and Industries may determine that RCW 39.12 applies to the employees of such firms identified in A and B above in accordance with WAC 296-127. If dissatisfied with any part of the subcontracted work,the City may request in writing that the subcontractor be removed. The Contractor shall comply with this request at once and shall not employ the subcontractor for any further work under the Contract. This section does not create a contractual relationship between the City and any subcontractor. Also, it is not intended to bestow upon any subcontractor,the status of a third-party beneficiary to the Contract between the City and the Contractor. 10) TERMINATION The City may terminate this Contract for good cause. "Good cause" shall include, without limitation, any one or more of the following events: A. The Contractor's refusal or failure to supply a sufficient number of properly-skilled workers or proper materials for completion of the Contract work. B. The Contractor's failure to complete the work within the time specified in this Contract. C. The Contractor's failure to make full and prompt payment to subcontractors or for material or labor. D. The Contractor's persistent disregard of federal, state or local laws, rules or regulations. E. The Contractor's filing for bankruptcy or becoming adjudged bankrupt. After all the work contemplated by the Contract has been completed either by the Surety or the City,the City will calculate the total expenses and damages for the completed work. If the total expenses and damages are less than any unpaid balance due the Contractor,the excess will be paid by the City to the Contractor. If the total expenses and damages exceed the unpaid balance,the Contractor and the Surety shall be jointly and severally liable to, and shall pay the difference to,the City on demand. 11) PREVAILING WAGES Contractor shall file a "Statement of Intent to Pay Prevailing Wages" with the State of Washington Department of Labor& Industries prior to commencing the Contract work. The Contractor shall pay prevailing wages and comply with Chapter 39.12 of the Revised Code of Washington, as well as any other applicable prevailing wage rate provisions. The prevailing wage rate revision in effect on the date the Contractor submitted the Construction Work Quote Form is attached and by this reference incorporated herein and made a part hereof. No payment shall be issued until a Statement ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 7 of 14 of Intent to Pay Prevailing Wages form, for the Contractor and each and every subcontractor, has been approved by the State Department of Labor&Industries, and is received by the City. Retainage, if applicable, shall not be released until an Affidavit of Wages Paid form for the Contractor and each and every subcontractor, has been approved by the State Department of Labor & Industries, and is received by the City. 12) CHANGES The City may issue a written change order for any change in the Contract work during the performance of this Contract. If the Contractor determines, for any reason,that a change order is necessary,the Contractor must submit a written change order request to an authorized agent of the City within 10 calendar days of the date the facts and events giving rise to the requested change occurred. If the City determines that the change increases or decreases the Contractor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith,to reach agreement with the Contractor on all equitable adjustments. However, if the parties are unable to agree,the City will determine the equitable adjustment as it deems appropriate. The Contractor shall proceed with the change order work upon receiving either a written change order from the City or an oral order from the City. If the Contractor fails to request a change order within the time allowed,the Contractor waives its right to make any claim or submit subsequent change order requests for that portion of the Contract work. if the Contractor disagrees with the equitable adjustment,the Contractor must complete the change order work; however,the Contractor may elect to protest the adjustment as provided below: A. Procedure and Protest by the Contractor If the Contractor disagrees with anything required by a change order, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Contractor shall: 1. Within 2 days of receiving a written change order or oral order that the Contractor desires to protest,the Contactor shall give a signed written notice of protest to the City; and 2. Supplement the written protest within 14 calendar days with a written statement that provides the following information: a. The date of the Contractor's protest. b. The nature and circumstances that caused the protest. c. The provisions in this Contract that support the protest. d. The estimated dollar cost, if any, of the protested work and how that estimate was determined. ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 8 of 14 e. An analysis of the progress schedule showing the schedule change or disruption if the Contractor is asserting a schedule change or disruption. The Contractor shall keep complete records of extra costs and time incurred as a result of the protested work. The City shall have access to any of the Contractor's records needed for evaluating the protest. 3. The City will evaluate all protests, provided the procedures in this section are followed. If the City determines that a protest is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. B. Contractor's Duty to Complete Protested Work In spite of any protest, the Contractor shall proceed promptly with the work as the City has ordered. C. Contractor's Acceptance of Changes The Contractor accepts all requirements of a change order by: (1)endorsing it, (2) writing a separate acceptance, or(3) not protesting in the way this section provides. A change order that is accepted by the Contractor as provided in this section shall constitute full payment and final settlement of all claims for Contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. D. Failure to Protest Constitutes Waiver By not protesting as this section provides, the Contractor also waives any additional entitlement and accepts from the City any written or oral order(including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver By failing to follow the procedures of this section,the Contractor completely waives any claims for protested work and accepts from the City any written or oral order(including directions, instructions, interpretations, and determination). 13) CLAIMS The Contractor waives right to a claim if they have not followed the protest procedures outlined in this Contract. If resolution of a protest cannot be reached, and the Contractor wishes to pursue a claim, the Contractor shall give written notice of claim to the City within 15 calendar days of the City's notice of its final decision on the Contractor's protest. Any claim for damages, additional payment for any reason, or extension of time, whether under this Contract or otherwise, shall be conclusively deemed to have been waived by the Contractor unless a timely written claim is made ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 9 of 14 :, , , 1 , in strict accordance with the applicable provisions of this Contract. At a minimum, a Contractor's written claim must include the information set forth regarding protests in this Contract. Failure to provide a complete, written notification of claim within the time allowed shall be an absolute waiver of any claims arising in any way from the facts or events surrounding that claim or caused by that delay. The Contractor must, in any event, file any claim or bring any suit arising from or connected with this Contract prior to signing the Final Payment Form. 14) WARRANTY (CHECK ONE) ® No warranty applies to the Contract Work. n Warranty applies to the Contract Work as follows: All defects in workmanship and materials that occur within one year of the Contract Completion date shall be corrected by the Contractor. When defects are corrected, the warranty for that portion of the work shall extend for one year from the date such correction is completed and accepted by the City. The Contractor shall begin to correct any defects within 7 calendar days of its receipt of notice from the City of the defect. If the Contractor does not accomplish the corrections within a reasonable time,the City may complete the corrections and the Contractor shall pay all costs incurred by the City in order to accomplish the correction. 15) INDEMNIFICATION Contractor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the performance of this Contract, except for injuries and damages caused by the sole negligence of the City. The City's inspection or acceptance of any of the Contractor's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Contract 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 City, its ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 10 of 14 officers, officials, employees, agents 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 this indemnification constitutes the Contractor's waiver of immunity under Industrial Insurance, Title 51 RCW, solely for the purposes of this indemnification. The parties acknowledge that they have mutually negotiated this waiver. The provisions of this section shall survive the expiration or termination of this Contract. 16) INSURANCE Insurance requirements shall be as specified in the City of Auburn Construction Standards, Part 1, Section 1-07.18 (Insurance)which by reference is incorporated is a part of this contract. 17) CORRESPONDENCE (CHECK ONE) M Submittals and formal Requests for Information (RFI) shall not be required for this contract. n Submittals and Requests for Information(RFI) shall be as follows: A. Requests for Information (RFI's). RFI's shall be made electronically and shall be transmitted via e-mail to PWSubmittals@auburnwa.gov. The e-mail subject line of electronic RFI's shall include the following: Contract Number and Project Name/Number as applicable— RFI Title/Subject. Each e-mail shall be limited to 7 MB's in size. All RFI's shall accompany the City of Auburn "CIP Construction Request for Information" (RFI) form as a cover letter with enough information provided for the Engineer to respond accordingly. The time required to evaluate and review RFI's is not the same for all RFI's. The Contractor shall allow a minimum of 10 calendar days, unless otherwise noted, for the Engineer to respond. B. Submittals. All submittals shall be made electronically and shall be transmitted via e- mail to PWSubmittals@auburnwa.gov. The e-mail subject line of electronic submittals shall include the following: <<<Project Number>>>, <<<Project Name>>> - "Submittal Title". Each electronic email shall be limited to 7 MB's in size. All electronic submittals shall be clear, sharp high contrast electronic files in Word 2007, Excel 2007 or PDF formats. All submittals shall accompany the City of Auburn "Request for Submittal Approval" (RSA) form. Any submittals made without the RSA form or without all of the required information on the form filled out by the Contractor shall be rejected without review. No additional compensation or time extension shall be granted for a Contractor not supplying this form as a cover letter for their submittals or for an improperly filled out form. ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 11 of 14 18) MISCELLANEOUS A. Nondiscrimination. In the hiring of employees for the performance of work under this Contract,the Contractor, its subcontractors, or any person acting on behalf of Contractor shall not, by reason of race, religion, color, sex, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. B. Compliance with Laws. The Contractor shall comply with all federal, state and local laws, rules and regulations throughout every aspect in the performance of this Contract. C. Qualifications of Bidder. Before award of a public works contract, a bidder must meet at least the minimum qualifications of RCW 39.04.350(1)to be considered a responsible bidder and qualified to be awarded a public works project. D. Work Performed at Contractor's Risk. The Contractor shall take all precautions necessary and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of this Contract. All work shall be done at the Contractor's own risk, and the Contractor shall be responsible for any loss of or damage to materials,tools, or other articles used or held for use in connection with the work. E. Nonwaiver of Breach. The failure of the City to insist upon strict performance of any of the terms and rights contained herein, or to exercise any option herein conferred in one or more instances, shall not be construed to be a waiver or relinquishment of those terms and rights and they shall remain in full force and effect. F. Governing Law. This Contract shall be governed and construed in accordance with the laws of the State of Washington. If any dispute arises between the City and the Contractor under any of the provisions of this Contract, resolution of that dispute shall be available only through the jurisdiction, venue and rules of the King County Superior Court, King County, Washington. G. Attorney's Fees. To the extent not inconsistent with RCW 39.04.240, in any claim or lawsuit for damages arising from the parties' performance of this Contract, each party shall be responsible for payment of its own legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit; however, nothing in this subsection shall limit the City's right to indemnification under Section 10 of this Contract. H. Written Notice. All communications regarding this Contract shall be sent to the parties at the addresses listed on the signature page of this Contract, unless otherwise notified. Any written notice shall become effective upon delivery, but in any event 3 calendar days ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 12 of 14 after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Contract. I. Assignment. Any assignment of this Contract by the Contractor without the written consent of the City shall be void. J. Modification. No waiver,alteration, or modification of any of the provisions of this Contract shall be binding unless in writing and signed by a duly authorized representative of the City and the Contractor. K. Severability. If any one or more sections, sub-sections, or sentences of this Contract are held to be unconstitutional or invalid,that decision shall not affect the validity of the remaining portion of this Contract and the remainder shall remain in full force and effect. L. Entire Contract. The written provisions and terms of this Contract, together with any referenced documents and attached Exhibits , supersede all prior verbal statements by any representative of the City, and those statements shall not be construed as forming a part of or altering in any manner this Contract. This Contract, referenced documents, and any attached Exhibits contain the entire Contract between the parties. Should any language in any referenced documents or Exhibits to this Contract conflict with any language contained in this Contract, the terms of this Contract shall prevail. ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 13 of 14 IN WITNESS WHEREOF,the parties below have executed this Contract. WHEELER PAINTING, IN - THE CITY OF AUBURN r Signature) (S nature) By /-,( e , / .�� By Nancy Backus (Print name here) Its iP/2 x> Its Mayor (Authorized representative) DATE: /0 'p? • 1 9 DATE: 1b '31) ' Iq Contractor's State License No. WHEELPI062c4 State Tax Registration(UBI)No. 601-511-702 Federal Tax ID# Cil—f O 6.3:›3 APPROVED AS TO FORM: N '411447 • Steve Gross, City Attorney Notices to be sent to: Notices to be sent to: WHEELER PAINTING, INC CITY OF AUBURN Attn: Michele Wheeler Attn: Lisa Moore PO Box 1043 25 West Main Street Maple Valley, WA 98038 Auburn, WA 98001 Phone: 253-813-8270 Phone: 253.288-3158 E-mail: michele@wheelerpainting.com E-mail: Imoore@auburnwa.gov ENG-059,Revised 7/19 NON-FORMALLY BID PUBLIC WORK CONTRACT NO. 19-28 October 24,2019 Page 14 of 14 CITY OF r--.— � * Declaration of Option For Performance Bond or - a Additional Retainage WASHINGTON (Contracts Under$150,000 only) Project No. City Hall Annex 2nd & 3rd Floor Painting Contract No. 19-28 Note: This form must be submitted at the time the Contractor executes the Contract. The Contractor shall designate the option desired by checking the appropriate space. Wheeler Painting, Inc Po Box 1043 Maple Valley, WA 98038 The Contractor elects to: ❑ 1. Furnish a performance bond in the amount of the total contract sum, in which case the City shall hold back retainage in the amount of five percent (5%.) An executed performance bond on the required sum is included with the executed contract documents. 2. Have the City retain, in lieu of performance bond, ten percent (10%) of the total contract amount for a period of thirty (30) days after final acceptance or until receipt of all necessary releases from the State Department of Revenue and the Department of Labor and Industries and settlement of any liens filed under Chapter 60.28 RCW, whichever is later. In choosing Option 2, the Contractor agrees that if the Contractor, its heirs, executors, administrators, successors, or assigns shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and agreements in the Contract, and shall faithfully perform all the provisions of such contract and shall also well and truly perform and fulfill all the undertakings, covenants, terms, conditions and agreements of any and all duly authorized modifications of the Contract that may hereafter be made, at the time and in the manner therein specified, and shall pay all laborers, mechanics, subcontractors, and materialmen, and all persons who shall supply such person or persons, or subcontractors, with provisions and supplies for the carrying on of such work, on his or her part, and shall indemnify, defend and hold harmless the City of Auburn and its officials, agents, and employees from any claim for such payment, then the funds retained in lieu of a performance bond shall be released at the time provided in said Option 2; otherwise, the funds shall be retained until the Contractor fulfills the said obligations. Contractor Sin: . �� moi /ii Printed Name411_4(-/ Title Date l �,�R - ENG-114, Revised 11/18 WHEEPAI-01 CMCALLISTER AC®REY' JOG C CERTIFIATE I IAB! ITV INR®NC SIIE DATE(MM/DD/YYYY) ‘to,....------ v v.-. . v. 10/28/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER I.CONTACT Rebecca Wilson CONTACT -..___..._ _--- ........_._-......._..----- .._..__.......--- ---..._.._. PLC Insurance LLC PHONE FAX. 19401 40th Ave W,Suite 440 (A/C,No,Ext):(425)678 1221 !(A1C,No): EMAIL rebecca@plcins.com Lynnwood,WA 98036 ADDRESS: y _.— INSURER(S)AFFORDING COVERAGE___-- 1NAIC k_ __.___INSURERA:West American Ins Co_._ ...-_.__ -__--_ .-. 144393-__-__ INSURED I.INSURER B_The Ohio Casualty Insurance Company 124074 Wheeler Painting,Inc. I INSURER C: I P.O.Box 1043 1_INSURER D I Maple Valley,WA 98038 INSURER E._ INSURER F: 1 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IL ]TRPOLICY NUMBER ADDL SUBR POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE I INSD I WVD� i{MMIDDIYYYYI (MMIDDIYYYYI A X I COMMERCIAL GENERAL UABIUTY I 1,000,000 EACH OCCURRENCE--__--_-.. $ _,- CLAIMS-MADE FX]OCCURBKW53773181 12/1/2018 12/1/2019 oAMAGETORENTEo 1,000,000 L_...-� X I x PREMISES(Ea occurrence) $ _ MED EXUAny o _ gine person),_ $ 15,000 I PERSONAL&ADV INJURY1 s_ __,_--_ 1,000,000 _ —...._... 2,000,000 GEN'LAGGREGATE LIMIT APPLIESPER: 1 I GENERAL AGGREGATE I_$,._ POLICY[X l TECT 1 LOC I PRODUCTS-COMP/OP AGGI$ 2,000'000 I : OTHER: I IWA Stop Gap I$ 1,000,000 COMBINED SINGLE LIMIT 1,000,000 B I AUTOMOBILE LIABILITY _(Ea.accident]_ —__.__ $ ____._ —.. X ANY AUTO :; BA053773181 112/1/2018 12/1/2019 .BODILY INJURY(Per person) $_ — OWNED 1 SCHEDULED I AUTOS ONLY —_.1 AUTOS i._BODILY.INJURY(_F'er_accident)._$ _ __ . . X HIRED X 1 NON-OWNED I PROPERTY DAMAGE AUTOS ONLY ..—J AUTOS ONLY (Per acadentL .. -__ —.$ I 1 S B X I UMBRELLA LU1B I X I OCCUR I I EACH OCCURRENCE..- I$ 2,000,000 L 1 USO53773181 12/1/2018 12/1/2019 2,000,000 EXCESS UAB CLAIMS-MADE AGGREGATE I s __— I I DED 11l I RETENTION$ 10,000 $ WORKERS COMPENSATION j I__..J SETALUTE--1._....-_R l._ER",,.,.L....._.—_ AND EMPLOYERS'LIABILITY iI E.L._EACH-ACCIDENT-_--,,.__ Y!N ANY PROPRIETOR/PARTNER/EXECUTIVE --' S 'OFFICER/MEMBEREXCLUDED? [ ( N/A ... (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below 1 E.L.DISEASE-POLICY LIMIT I $ 1 I 1 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Auburn is included as Primary Additional Insured,including Waiver of Subrogation for General Liability,for operations performed by,or on behalf the named insured,as per attached form CG8810 0413.; CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Auburn ACCORDANCE WITH THE POLICY PROVISIONS. 25 West Main St. .Auburn,WA 98001 AUTHORIZED REPRESENTATIVE t�� I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 85 83 04 13 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 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 or written agreement. Such person or organization is an additional insured but only with respect to liability for "bodily injury" or "property damage": 1. 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". 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 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 a 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. ® 2013 Liberty Mutual Insurance CG 85 83 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission . Page 1 of 2 C. V'lith 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: I. 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. With respect to the insurance afforded to these additional insureds, the following is added to Section II - 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 the amount of insurance: 1. Required by contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declaration. whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. 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 insur- ance 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. © 2013 Liberty Mutual Insurance CG 85 83 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission . Page 2 of 2 COMMERCIAL GENERAL LIABILITY b. TOO last paragrapn of subsection 2.Exclusions is replaces by the following: CG 88 10 04 13 Eenlucians c.through n.do not apply to damage by fire,lightning.explosion,smoke or leakage non automatic lire protection systems to premises while rented to you or temporarily occupied by THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ R CAREFULLY. you'mt'1 permission of the owner.A separate firth of insurance applies to Damage To Premise, Rented To You as deserted in Section III-Limits Of Insurance. COMMERCIAL GENERAL LIABILITY EXTENSION 2. Paragraph 5.under Section III-Limits Of Insurance is replaced by the following: This endorsement modifes insurance provided under the lollcwing: 6. Subject to Paragraph 5.above,the Damage To Premises Rented To Yeti Limit is the most we will pay under Coverage A for damages because of"property damage"to. COMMERCIAL GENERAL LIABILITY COVERAGE PART a. Any one premise: INDEX (1) What rented to you.or ion of e SUBJECT PAGE (2) While rented ee by toe.ego you rtemporarily hbeing.top osonu smoke a leakage f.•omby you wets sautomanc owner thr NON-OWNED AIRCRAFT 2 protection systems;or b. Contents Leat you rent or lease as pad of a premises rental or lease agreement. NON-OWNED WATERCRAFT 2 3. As regards coverage provided by this provision D.EXTENDED DAMAGE TO PROPERTY RENTED TO PROPERTY DAMAGE LIABILITY-ELEVATORS 2 YOU(Tenant's Property Damage)-Paragraph 9.a.of Definitions is replaced'with the following' 9e. A contract fora lease ref premises However,that ponies of the contract fora lease o1 premises EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(Tenant's Property Damage) 2 that indemnifies any person or organization for damage by fire,lightr.ieg,explosion,smoke,or leakage from automatic fire protection systems to premises while rentec to you or temporarily MEDICAL PAYMENTS EXTENSION 3 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 ccntracr. EXTENSION OF SUPPLEMENTARY PAYMENTS-COVERAGES A AND B 3 E. MEDICAL PAYMENTS EXTENSION ADDRIONAL INSUREDS-BY CONTRACT.AGREEMENT OR PERMIT 3 If Coverage C Medical Payments is not olnerirse excluded.the Medical Payments provided oy this policy are amended as follows- PRIMARY AND NON-CONTRIBUTORY-ADDITIONAL INSURED EXTENSION S Under Paragraph 1.Insuring Agreement of Section I-Coverage C-Medical Payments, Subparagraph(b)of Paragraph a.is replaced by the following: ADDITIONAL INSUREDS-EXTENDED PROTECTION OF YOUR"LIMITS OF INSURANCE" 6 (b) The expenses are incurred and reposed within three years of the date of the accident and WHO IS AN INSURED-INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED- 8 F. EXTENSION OF SUPPLEMENTARY PAYMENTS-COVERAGES AAND B FELLOW EMPLOYEE EXTENSION-MANAGEMENT EMPLOYEES I. Under Supplementary Payments-Coverages A and B.Paragraph 1.6,is replaced by the following: NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 b. Up to$3,000 for con of bail bonds required because of eetheents or traffic law vre!abons arising air.of the use of any vehicle to which the Bodily Injury Liability Coverage applies.We do not have FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 to furnish these bonds. KNOWLEDGE OF OCCURRENCE,OFFENSE.CLAIM OR SUIT 7 2. Paragraph 1.d,is replaced by the IailOv Ing, d. All reasonable expenses inclined by the insured at our request to assist us in the investigation or LIBERALIZATION CLAUSE 7 defense of the claim or'suit,including actual loss of earnings up to$500 a day because of time off horn work. BODILY INJURY REDEFINED 7 G. ADDITIONAL INSUREDS-BY CONTRACT,AGREEMENT OR PERMIT EXTENDED PROPERTY DAMAGE a 1. Paragraph 2.under Section II-Who Is An Insured is amended to include as an insured any person or organization wham you have agreed to ado as an aerie/one'insured in a written contract.written WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US- 8 agreement or permit Such person or organizatithn is an additional insured but only with respect to liability WHEN REQUIRED IN A CONTRACTOR AGREEMENT WITH YOU ton'bodily injury','property damage'or'personal and advertising injury' caused in whole or in pert by. a. Your acts or emissions.or the acts or omissions of those acting on your behalf.in the performance of your on going operations for the additional insured Leal are the subject of the wren contract or written agreement prodded that the'bodily injury`or'property carnage-occurs, or the'personal and advertising injury is committed,subsequent to the signing of such wrihen contract or airmen agreement or e2013 Lorry!Alia!insuranca 92013 Lityny Mural!muss. CO89100413 hncuees.crgsryd s0teroh or hreServices smo Services:Ace.kc..ttnn is Fe:mrsuma . Pagel of CG 6B 100413 ceeescovniahreo mato,.ill IWKe,Inc..web¢ m oesssvnn Page 3018 Wan respect to coverage afforded by this endorsement.the provisions of the policy apply unless modified by the b. Premises or facilities rented by you or used by you:or endorsement- c- The maintenance,operation or use by you of equipment rented or leasea to you by such person A. LION-OWNED AIRCRAFT or organization;or Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily Injury And Property Damage Liability. d. Operations performed by you or on your behalf for which the stale or P011Ccal subdcdsion has exclusion g.Aircraft.Auto Or Watercraft dies not apply to an aircraft provided issued a permitmedsubject to the following additional provisions: 1. R is not owned by any insured; (1) This insurance docs not apply lo-bodily injury',.property damage',or'personal and 2. II is hired,chartered or leaned with a trained paid crew, advertising infury'arising out of the operations performed for the state o:p0iiboal 3. The pilot in command holds a currently eRectr+e certificate.Issued ey L^.e duly constituted authority of the subdivision: United States of America or Canada,designating her or him a commercial or airline pilo:;and 4. Ills not bong used to carry persons o:popery far a charge. (21 This insurance cons not apply to bodily iejur'or'property damage'induded within the 'completed operations hazard'. However.tee insurance afforded by this provsian does not apply if there is available to the insured other valid and colectible insurance.whether printery.excess(ether than insurance written to apply spoci(cal!y in excess of this (3) Insurance applies to premises you Own.retie or control but only with respect to the poacyl,contingent or on any other basis,that would also apply to the toss covered ender this provision. following hazards' B. NON-OWNED WATERCRAFT a) The existence.maintenance,repair,construction,erection.or removal of Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily Injury And Property Damage Liability, advertising signs sings,canopies,cedar entrances,coal holes,driveway's, manholes,marquees,heist array openings,sidevrl2 vaults,street banners.or Subparagraph(2)of erclusi0n g.Aircraft.Auto Or Watercraft is replaced by:he foilanng. decorations and similar exposures:or This exclusion does not apply to, (2) A watercraft you de not ovm that is: (b) The nonstrunion,erection.cr removal of elevators;or (al Less than 52 feet long;and (c) The ownership.maintenance,or use of any eleho:ors covered by this insurance. (b) Not being used to carry persons or property for a charge. However. C. PROPERTY DAMAGE LIABILITY-ELEVATORS 1. Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily Injury And Property Damage 1. The insurance afforded to such additional insured only applies to the extent perrnrted'by lave and Liability.Subparagraphs(3).(4)and(6)01 exclusion j.Damage To Propertydonot apply if such 2. II coverage provided to the additional insured is required by a costae;or agreement.;rte insurance 'property damages.Vehicleehfrom the use 01 ole istsrs.For the purpose a of this provision,repair pe•ratms do not arforded to such additional insured w.i7 not be brooder than that which you are required by the contact or include vehicle lets. Its are khs or heists used In automobile service or repair operations. agreement to provide for such additional insured. 2. The following is added to Section IV-Commercial General Liability Conditions.Condition 4.Other Insurance,Paragraph b.Excess Insurance: With respect to Paragraph 1.a.above.a person's or organization's status as an additional insured under this The insurance afforded by this provision of this endorsement is excess over any property insurance. endorsement ends when'. whether primary,excess,contingent or on any other basis. (1) All work.including materials.pans or equipment furnished in connection wree such work, D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU(Tenant's Prapeny Damage) on the project(other than ser.'ice,rlmintenence or repairs)to be performed by or on behalf of the additional insuredlsl et the location of the covered operations has been If Damage To Premises Rexed To You is not otherwise excluded from this Coverage Part. completed.or 1. Under Paragraph 2.Exclusions of Section 1-Coverage A-Bodily Injury and Property Damage _ Liability: (2) That portion of'your out of which the Injury or damage arises has been pin to its p, Damage perry is rep y intended use by any person or organization other than another contractor or subcontractor a. The fcur9 from me last paregra h of exclusion j. To Prolaced b the engaged in performing operations Icr a principal as a par of the same prejed. following: Paragraphs(1),(3)and(4)of this erclusion do not apply to'property damage'(other than '.;inn respect to Paragraph 1.b.above,a person's or organ_ato's status as an additional insured under this damage by lire,lightning.explosion,smoke,or leakage from an autcnlala fee protection system) endorsement ends when their written contract or vrlten agreement with You for such premises or facilities ends. to: (i) Premises rented to you for a period of 7 or fewer consecutive dares:Of With respects:o Paragraph 1.c.above,this insurance does not apply to any'occurrence'which lakes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. re) Contents that you rent or lease as part of a premises tenth!or lease agreement for a period of more than 7 days. The insurance pmvhded by this endorsement applies only if the written contract or written agreement Is signed Paragraphs(1).(3)and(4)of this exclusion do not apply to"property damage"to contents of prior to the bodily injury'or"property damage". premises rented M you for a period of 7 or fitter consecutive days. We hove no duty to defend an additional insured under this endorsement until we receive written notice of a's'et' A separate limit of insurance applies to lois coverage as described in Section III-Limits of by the additional insured as required in Paragraph b.of Condition 2.Duties In the Event Of Occurrence, Insurance. Offense.Claim Of Suit under Section IV-Commercial General Liability Conditions, di 2013 LiccryStetni!siva.,. Cots teco,ryxw.nsnnrwancn CO 86100413 1,:tikes wpx,'raU malarial urlauar_e Ger:ices VS., vlh its wrmk:on. Page 4018 CG 88 Leludee cepotsn:ed rr.no,bh of hnsiirance senses arca.rne.e:dn ss pe„rsscn. 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'9 ,:¢.suns p:I0e9 0.la 3.1.9 01 00112.!001.!011,1110 fled w 19 001000 u!000003 J0 0 nlu!60!0910100 e.nSol 100014ige 0.910 00102IEau 1100 014;0100 6110!10;Eewep A:ledold,,0 1.0)J::!Ap;xg- e Poe leugsed,JO/.Nu!npopq,ashes 0:1.010!revs+a I4.:O'und aN se ,So2D s/W'41n'pnplo>10111':140011. too 50!010,eJn:w 5ulsampe pue(<...,to f 0111 Aapoq,10:sown.we seak4dwa,asaol to 010U'Jaramo0 :e1 Aidde ad sago Bowe:BB:a se;1 zmoP lo,sa0A91dwa,12410 Jo uo!sndodos 020100,,p 0apnpu!'no.bq p0061550 sa1l/grsuodse 4b saaAoldwa. ;/4!!! 0600100 A u;dad PW:10[11 AI!PO8-Va600x:o3-I10!005 mpur•su0!snpz3 0410000'01 010:x4 prim se aloe3eo Alos!ldodas'nevi lot,Apedes apsruadns e w 6upee s!owl a0Ao;dwa, ge1l 04 Aq Pasne0 I nlln 5u¢!ual,pe pue I000slad,le,'bnlu!APPoq.el Ardde lou op 0/o4e)4)nue(0)5['10060101 '0 450:11'¢005 0;paw,ale 6uonouol a411uOwavopux soot Aq 9109!1.013 x3100001!0y:of padsal 41'00 '0 10/29/2019 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1430 Consumer toots Agent and Company Lookup Orders Independent Review Decisions WEST AMERICAN INSURANCE COMPANY Change History I Licensing I Appointments I Complaints I Orders I National Info I Ratings I Tax Filings Back to Search General information Contact information Name: WEST AMERICAN INSURANCE COMPANY Registered address Mailing address Corporate family group: LIBERTY MUT GRP O 350 E 96TH ST 175 BERKELEY STREET ............................................. Organization type: PROPERTY INDIANAPOLIS, IN 46240 BOSTON, MA 02116 Doing Business As (DBA): Unavailable Telephone Telephone WAOIC: 1430 513-867-3000 513-867-3000 NAIC: 44393 Status: ACTIVE Admitted date: 10/16/1945 Ownership type: STOCK back to top .......................... Company change history . View changes ^backtotop, ........................ Types of coverage authorized to sell o Insurance types Casualty Marine Ocean Marine Property Surety Vehicle back to top ............................. Agents and agencies that represent this company (Appointments) o, View,agents Viewagencies.. back to top Company complaint history o View.comptaints httns•//fnrtress_wannv/nic/r•.nnsumartnnikit/Cmmnanv/CmmnanvPrnfile asnx9WAClIC=1d3n i/' 10/29/2019 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1430 • back to top ............................. Orders issued since 2010 o (View orders] ^: back to top ........................_... Premium tax filings by tax year o 2018 2017 2016 2015 2014 back to top National information on insurance companies Want more information about this company? The NAIC's Consumer Information (CIS)page allows you to retrieve national financial and complaint information on insurance companies, plus has information and tips to help you understand current insurance issues. • back to top ............................. Ratings by financial organizations The following organizations rate insurance companies on their financial strength and stability. Some of these companies charge for their services. A.M. Best Weiss Group Ratings Standard and Poor's Corp ............................................................................................... Moody's.Investors Service Fitch IBCA, Duff and Phelps Ratings Disclaimer: Links to external or third-party websites are provided solely for visitors'convenience. Links you take to other sites are done so at your own risk and our office accepts no liability for any external linked sites or their content. Be aware that not all financial rating companies use the same rating processes. • back to top ........................ https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1430 2/2 10/29/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=011354&PPP= eta c5 Lite s Retirement Home 6 Auto Mean 5 Disability Other Lile Events 118 shims West American Insurance Company Follow 41 Print thispage (a member of Liberty Mutual Insurance Companies) AM Best 0:011354 NAIC A.44393 FEIN re 31-0624491 Address: 175 Berkeley St. Phone: 617-357-9500 Boston,MA 02116 Fax: 513-603-3179 UNITED STATES Web: www.libertymutualgroup.com Bests Credit Ratings Financial Strength Rating View Definition Long-Term Issuer Credit Rating View Definition • Rating: A(Excellent) Long-Term: a Affiliation Code: r(Reinsured) Outlook: Stable Financial Size Category: XV($2 Billion or greater) Action: Affirmed Outlook: Stable Effective Date: May 30,2019 Action: Affirmed Initial Rating Date: July 21,2005 Effective Date: May 30,2019 Initial Rating Date: October 02,1995 u Denotes Under Review Best's Rating Licensing: (Current since 12/11/2014).The company is licensed in the District of Columbia,AL,AK,AZ,AR,CA,CO,CT,DE,FL,GA,ID,IL,IN, IA,KS,KY,LA,ME,MD,MA,MI,MN,MS.MO,MT,NE,NV,NH,NJ,NM,NY,NC,ND,OH,OK,OR,PA,RI.SC,SD,TN,TX,UT,VT,VA,WA, WV,WI and WY. Total Assets DPW-Top Lines of Business $90,000.000 $80,000,000 --� ` A E° ::: • � _ _ { 540,000,000 $30,000,000 -a- .41ee t. tL Ie. ..5.2.4;•iff,;ii1 $20000000 ' T_ $10.000 000 2ote tot] zoto 2015 2014 —Commercial Multiple Peril -°•Auto(Commercial) —Data Years —Workers'Compensation—Inland Marine • Company Attributes Industry: Insurance Business: Property/Casualty Business Status: In Business Entity: Operating Company • Consolidated Type: Affiliated Single Company Organization Type: Stock Statement Type: NAIC PC Last Statement: 2nd Quarter 2019 • • rnnsumprc amhpct rnm/rmmnanvPrnfilp asny9Rl =3FRamhnnm=f1111cdRPPP= 9/R 10/29/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=011354&PPP= Top Line(s)of Business(based upon Direct Premiums'Written) Top State(s)of Business (based upon Direct Premiums Written) 1.Commercial Multiple Peril(Yew Definition) 1.California 2.Auto(Commercial)(View Definition) 2.Texas 3.Workers'Compensation(View Definition) 3.Washington 4.Inland Marine(View Definition) 4.New York 5.Other Liability(Occurrence)(view Definition) 5.New Jersey • • • • • • • i t 1 ' consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=011354&PPP= 2/5 10/29/2019 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1001 Consumer toots Agent and Company Lookup Orders Independent Review Decisions OHIO CASUALTY INSURANCE COMPANY THE Change History I Licensing I Appointments I Complaints I Orders I National Info I Ratings I Tax Filings I Back to Search General information Contact information Name: OHIO CASUALTY INSURANCE COMPANY THE Registered address Mailing address Corporate family group: LIBERTY MUT GRP O 62 MAPLE AVE 175 BERKELEY ST Organization type: PROPERTY KEENE, NH 03431 BOSTON, MA 02116 Doing Business As (DBA): Unavailable Telephone Telephone WAOIC: 1001 513-603-2400 617-357-9500 NAIC: 24074 Status: ACTIVE Admitted date: 04/10/1926 Ownership type: STOCK back to top Company change history 0 View changes back to top Types of coverage authorized to sell o Insurance types Casualty Disability Marine Ocean Marine Property Surety Vehicle back.to top, Agents and agencies that represent this company (Appointments) 0 View,agents. View agencies back to top ............................. Company complaint history o httns:/fortress.wa.onv/oic/consumPrfnnikit/Cmm11anv/CmmnanvPrnfilP asnx?WArllr:=1M1 vV, 10/29/2019 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1001 View complaints 1 • back to top Orders issued since 2010 o ( ....................................... View orders back to top Premium tax filings by tax year o 2018 2017 2016 2015 2014 back to top ........................ National information on insurance companies Want more information about this company? The NAIC's Consumer Information (CIS) page allows you to retrieve national financial and complaint information on insurance companies, plus has information and tips to help you understand current insurance issues. • back to top Ratings by financial organizations The following organizations rate insurance companies on their financial strength and stability. Some of these companies charge for their services. A.M. Best ..................................... Weiss Group Ratings Standard and__Poor's Corp Moody's Lnvestors Service Fitch IBCA Duff and Phelps Ratings Disclaimer: Links to external or third-party websites are provided solely for visitors'convenience. Links you take to other sites are done so at your own risk and our office accepts no liability for any external linked sites or their content. Be aware that not all financial rating companies use the same rating processes. ▪ back to top ........................ https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1001 2/2 10/29/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=002378&PPP= o * C� Lire&Retirement Home&Auto Heann&'uisaoiiily Diner Ude Events 118 sm.a Ohio Casualty Insurance Company Follow Fd Print this!Ng?. (a member of Liberty Mutual Insurance Companies) AM Best x:002378 NAIC p:24074 FEIN p:31-0396250 Address: 175 Berkeley Street Phone: 513-603-2400 Boston,MA 02116 Fax: 513-603-3179 UNITED STATES Web: www.LibertyMutualGroup.com Best's Credit Ratings Financial Strength Rating View Definition - Long-Term Issuer Credit Rating View Definition Rating: A(Excellent) Long-Term: a Affiliation Code: p(Pooled) Outlook: Stable Financial Size Category: XV($2 Billion or greater) . Action: Affirmed Outlook: Stable Effective Date: May 30,2019 Action: Affirmed • Initial Rating Date: July 21,2005 • ' I Effective Date: May 30,2019 Initial Rating Date: June 30,1924 u Denotes Under Review Best's Rating Licensing: (Current since 11/05/2018).The company is licensed in the District of Columbia,Guam and all states. Total Assets DPW-Top Lines of Business 56.600,000.000 566.400000,000 ._t $6200.000.000 { ^� 56,000000000 . _ $5,800000000 t , 5° S5,600.000,000 55.400,000,000 X3.07% • w4Sh.2i0 32%' 55.200,000,000 #: 55,000.000,000 y – 54,800,000,000 —Other Liability(Occurrence) 2015 sore 2016 2015 2014 '–'Commercial Multiple Peel—Inland Marine —Auto(Commercial)—Surety —Data Years —Workers'Compensation Company Attributes Industry: Insurance Business: Property/Casualty Business Status: In Business Entity: Operating Company Consolidated Type: Affiliated Single Company Organization Type: Stock Statement Type: NAIC PC Last Statement: 2nd Quarter 2019 • • cnnsumers.ambest.com/ComoanvProfile.asox?BL=36&ambnum=002378&PPP= 1/5 10/29/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=002378&PPP= Top Line(s)of Business (based upon Direct Premiums Written) Top State(s)of Business (based upon Direct Premiums Written) 1.Other Liability(Occurrence)(mew Definition) 1.California 2.Commercial Multiple Peril(View Definition) 2.New York 3.Inland Marine(me•..Definition) 3.Texas 4.Auto(Commercial)(View Definition I 4.Washington 5.Surety(View Definition) 5.New Jersey • • • • • • • • • • • • • ) consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=002378&PPP= 2/5