Loading...
HomeMy WebLinkAboutCP1219 15-03,Pacific Coast GeneralA Utz � C AUBURN Nancy Backus, Mayor WASHINGTON 25 West Main Street * Auburn WA 98001 -4998 * www.auburnwa.gov * 253- 931 -3000 May 21, 2015 CERTIFIED MAIL RETURN RECEIPT REQUESTED Pacific Coast General PO Box 1577 Port Orchard, WA 98366 NOTICE TO PROCEED RE: Project No CP1219, Valley AC Main Replacement, Contract #15 -03 You are hereby notified to proceed as of May 26, 2015 with the work on the above - referenced project, within the time period specified, in accordance with the provisions of the contract documents, copy enclosed. This project has 90 working days for completion. If you have any questions, please contact the City Inspector for the project, Seth Loop at 253 - 804 -5082 or the Contract Administration Specialist, Cindy West at 253 - 931 -3002. Sincerely, gri kAssistant Director of Engineering /City Engineer Community Development & Public Works Department IG /cw /mm Enclosure cc: anilDaskamCity @h. -, erk7 Joel Chalmers, Project Engineer Seth Loop, Project Inspector File 13.11 Project CP1219 AUBURN* MORE l -1-IAN YOU IMAGINED CONTRACT Contract No. 15_03 THIS AGREEMENT AND CON-TRACT, made and entered into, in duplicate, at Auburn. Washington, this 8 day of May 20 15, by and between the CITY OF AUBURN, WASHINGTON, a municipal corporation; and Pacific Coast General, LLC, hereinafter called the CONTRACTOR. WITNESSETH: That, in consideration of the terms and conditions contained in the Contract Documents entitled °CP12197 Valley AC Main Replacement," which are by this reference incorporated herein and made a part of this Contract, the parties hereto covenant and agree as follows. 1. The CONTRACTOR shall do all work and furnish all tools, materials and equipment for Project CP1219, Valley AC Main Replacement — abandoning 6 -inch and 8 -inch asbestos cement water main; installing approximately 3,000 linear feet of 12 -inch and 300 linear feet of 4 -inch water main, boring and jacking 6 water service lines, associated pavement restoration, and appurtenances for a unit bid price of eight hundred ninety -six thousand seven hundred fifty -three dollars and sixty -five cents ($896.753.65) and Washington State Sales Tax of eighty -five thousand one hundred ninety -one dollars and sixty cents S(85,191.60) for a total contract value of nine hundred eighty -one thousand nine hundred forty -five dollars and twcnty -five cents (5981,945.25) in accordance with and as described in the Contract Documents which are by this reference incorporated herein and made a part hereof, and shall perform any alterations in or additions to the work provided under this Contract and every pan thereof. This Contract shall be executed by the Contractor and returned to the City within 7 calendar days after the receipt of the dated notification of award and the Contract time shall commence within 5 working days alter execution of the Contract by the City and so desitmated on the Notice to Proceed. Physical completion shall be within 90 working days of the date on the Notice to Proceed. If said work is not completed within the time specified, the CONTRACTOR agrees to pay liquidated damages to the CITY OF AUBURN, as specified in Section 1 -08.9 (Liquidated Damages) of the Standard Specifications. The CONTRACTOR shall provide and bear the expense of all equipment, work and labor of any son whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in this Contract and every part thereof; except such as are mentioned in the Contract Documents to be furnished by the CITY OF AUBURN. 11, The CITY OF AUBURN hereby promises and agrees with the CONTRACTOR to employ, and does employ the CO \TRACTOR to provide the materials and to do and cause m be done the above described work and to complete and finish the same according to the Contract Documents and the terms and conditions herein contained and hereby contracts to pay for the same according to said Contract Documents and the aforesaid proposal hereto attached. at the time and in the manner and upon the conditions provided for in this Contract. III. The CONTRACTOR for himself, and for his heirs, executors, administrators, successors, and assigns, does hereby agree to the full performance of all the covenants herein contained upon by part of the CONTRACTOR. IV. It is further provided that no liability shall attach to the CITY OF AUBURN, WASHINGTON by reason of entering into this Contract, except as expressly provided herein. IN WITNESS WHEREOF the parties hereto have caused this Contract to be executed the day and year first hereinabove written. Countersigned: this 00 + day of 20-LS ATTEST: L&" IZq Danielle E_ Daskam, City Clerk APPWOVED XS)TO FORM: B. Heid,'Eit�Attomey CITY OF AUBURN, WASHINGTON By Nanc ckus, Mayor PACIFIC COAST GENERAL, LLC Authorized Official Signature CONTRACTBOND CONTRACT NO. 15 -03 BOND NO. 106269950 BOND TO CITY OF AUBURN, WASHINGTON KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned, Pacific Coast General, LLC, PO Box 1577, Port Orchard, WA 98366, as principal, and Travelers Casualty and Surely Company of America a corporation, organized and existing under the laws of the State of Connecticut as a surety corporation, and qualified under the laws of the State of Washington to become surety upon bonds of contractors with municipal corporations, as surety, are jointly and severally held and firmly bound to the City of Auburn, Washington, in the penal sum of nine hundred eighty -one thousand nine hundred forty -five dollars and twenty -five cents ($981,945.25), for the payment of which sum we jointly and severally bind ourselves and our successors, heirs, administrators or personal representatives as the case may be. This obligation is entered into in pursuance of the Statutes of the State of Washington and the Ordinances of the City of Auburn, Washington. Dated at Auburn, Washington, this 8th day of May 20_t5_. Nevertheless, the conditions of the above obligation are such that: WHEREAS, the City of Auburn on the 20ih day of April, 2015, let to the above bounden principal a certain Contract. The said Contract being numbered 15 -03, and providing for the construction of Project CP1219, Valley AC Main Replacement - abandoning 6 -inch and 8 -inch asbestos cement water main, installing approximately 3,000 linear feet of 12 -inch and 300 linear feet of 4 -inch water main, boring and jacking 6 water service lines, associated pavement restoration, and appurtenances (which Contract is referred to herein and is made a part hereof as though attached hereto), and WHEREAS, the said principal has accepted, or is about to accept, the said Contract, and undertake to perform the work therein provided for in the manner and within the time set forth: NOW, THEREFORE, if the above bounden principal shall faithfully and truly observed and comply with the terms, conditions, and provisions of said Contract in all respects and shall well and truly and fully do and perform all matters and things by them undertaken to be performed under said Contract, upon the terms proposed therein, and any and all duly authorized modifications of said Contract that may hereafter by made, and within the time prescribed therein, and until the same is accepted, and shall pay all laborers, mechanics, subcontractors and material men, and all persons who shall supply principal or subcontractors with provisions and supplies for the carrying on of said work and shall hold said City of Auburn, Washington, harmless from any loss or damage occasioned to any person or property by reason of any carelessness or negligence on the part of said principal or any subcontractor in the performance of said work, and shall in all respects faithfully perform said Contract according to law, and shall indemnify and hold the City of Auburn, Washington, harmless from any damage or expense by reason of failure of performance, as specified in said Contract, and r y The undersigned principal and the undersigned surety present this contract bond related to the Contract, PROVIDED that this document shall not be enforceable unless and until the City of Auburn awards and executes the Contract to the undersigned principal. No obligations under this bond, for the performance of the above- referenced contract, shall be enforceable until the City of Auburn has executed the contract to the undersigned principal. The Surety, hereby agrees that modifications and changes may be made in the terms and provisions of the aforesaid Contract without notice to Surety, and any such modifications or changes increasing the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this Contract Bond in a like amount, such increase; however, not to exceed twenty — five percent (25 %) of the original amount of this bond without the consent of the Surety. PROVIDED, however, that after the acceptance of this Contract and the expiration of the lien period, and if there are no liens pending, then the penal sum of this bond, shall be reduced to either ten percent (10 %) of the value of the improvements to the City or two thousand dollars ($2,000), whichever is greater, to warranty against defects appearing or developing in the material or workmanship provided or performed under this Contract within a period of one (1) year after acceptance. Not withstanding the reduction of this bond, the principal and surety shall hold the City of Auburn harmless from all defects appearing or developing in the material or workmanship provided or performed under this Contract within a period of one (1) year after acceptance, THEN and in that event this obligation shall be void; but otherwise it shall be and remain in full force and effect. It is hereby expressly agreed that if any legal action is necessary to be brought under the conditions of this bond, that the decisions of the Courts of the State of Washington shall be binding. IN WITNESS WHEREOF, the above - bounden parties have executed this instrument this 8th day of May 20_5_. ��N U u Uri�� l GOp ST G acifie Coast General, LLC, Principal LpRPORAT�c16 By fill iNG````� Travelers Casualtv.and Suretv Comoanv of America 1 Surety A Marie Poulin torney in act Servco Pacific Insurance ` r,- 221 S. 28th Street, Suite 101 Tacoma, WA 98402 (253) 207 -5500 Resident Agent's Address R Phone Number ATTORNEY IS INVALID AMOk POWER OF ATTORNEY TRAVELERSJ Farmington Casualty Company St. Paul Mercury Insurance Company Fidelity and Guarani Insurance Company Travelers Casualty and Surety Company Fidelitv and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surely Company' ofAmerica St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company Attorney -In Fact Nn. 1-27132 Certificate No. 005951858 KNOB' ALL MEN BY THESE PRESENTS: That Farmington Casualty Company. SL Paul Fire and Marine Insurance Company. St Paul Guardian Insurance Company. St. Paul Mercury Insurance Company- Travelers Casualty and Surety Company. Travelers Casuals and Surety Company of America, and United States Fidelity and Guaranty Company are corporations duly urgani,ed under the Imes of the State of Connecticut. that Fidelity and Guaranty Insurance Company is a corporation duly Organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, file., is a coporation duly organized under the laws of the Stale of Wisconsin (hcmin collectively called the "Connpanics •), and that the Companies do hereby make. constitute and appoint Michael R. Highsmith, and Nlaric Poulin Of the City Of Seattle , State of Washington , their trite and lawful Auumey(s) -in -Fact. each in their separate capacity if more than one is named above. to Sign. cxccme, seal and acknowledge any and all bonds, recugnirnces, conditional undertakings and other writing, obligatory in the nature thereof on behalf of the Companies in their-business of,guaraneeing the fidelity of persons, guaranteeing the performance of contracts and executing or _guaranteeing humfs ;Old undertakings required or perniittted'in any'aciiuns of proceedings allowed by law. - tis IN WITNESS WHEREOF, the Companies have caused this instrument Io be si ^Hell and iFrcircorporate seal, to be hereto affixed, this day of 16th June 2014 N;vUJ � \• by Farmington Casualty Company' .�� �) Fidelity and Guaranty, nsuratoce�Cornpany�0 Fidelity and Guarani Insurance Underwriters. Inc. St. Paul Fire and Marine Insurance Cwmnpany SL Paul Guardian Insurance Cumpmn' St. Paul Mercury Insurance Company Travelers Casualty and Surety Company' Travelers Casually and Snrey Company of America United Slates Fidelity and Guaranty Company ,9_r'�19y� Nr�Arllm �c� o PYD =MS a9m / /,p��q •` ' ,i1 �^ �O� yO PYON9)r: 1983 0 +z CON • rummest 5 :e r 1951 sr nL C°i V�Spaxx, o 9 pl a less �p Irk 15.. ry/ ^,w ♦ . �M1 AINS' State of COTOOMICnl Cite of Hanford ss. 8y 'Agog Rnhen L. Raney, eC u... Viae Presidcnu On this the 16111 day of J1.111C 2014 • before me personally appeared Robert L. Kart who acknowledged himself to be the Senior Vice IYcsidcni Of Farmington Casualty Company, Fidelity and GuannlY Insurance Connpemy, Fidelity and Guaranty Insurance Undcrwritcn, lac, St. Paul Fire and Marine Insurance Company. SL Paul Guardian InlmaKC Company. St. Paul Mercury Insurance Company. Tmcelers Casualty and Surety Company, "travelers Gnuzlty and Surely Company of America. and United States Fidelity and Guaranty Company. and that he. as ,such, being authorized so to do. executed the foregoing instrument for the purposes therein contained by signing on behalf of the cogmmtiuns by himself as it duly authorized officer. p,Tlf In Witness Whereof, I hereunto set iris hand and official seal. TM Sly Commission expires the 301h day of June. 30 I6. O p��,p) i 58440 -8 -12 Printed in U.S.A. " W 1 :C 'I'etrcuulLt Public /a ir% h c This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company, Fidelity and Guaranty Insurance Company. Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company. Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President. any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Atiomeys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances. contracts of indemnify, and other writings obligatory in the n:nuro of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her, and it is FURTHER RESOLVED. that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary: and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemmit, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary: or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority: and it is FURTHER RESOLVED. that the signature of each of the following offers: President, any Executive Vice President, any Senior Vice President. any Vice President, any Assistant Vice President, :my Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attomey or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Auomeys -in -Pact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. 1, Kevin E. Hughes, the undersigned, Assistant Secretary. of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc.. St. Paul Fire and Marine Insurance Company, St. ]',In] Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and Un'iedSttams Fidelity and Guaranty Company, do hereby certify that the above and foregoing is a true and coffee( copy of the Power of Attorney executed by said Companigs� which is imfull forcefiandyeffect and has not been revoked. IN TESTIMONY WHEREOF. I have hereunto set my hand and affixed the seals of saidCompanics this day of 201. �1�� 1P t Kevin> .Hughes, Assistant SectYtary a6 aI. ., exqqx � n. L��ax` �9$I „4 ®0 ..SE aL:to �;SBAL'i X, toax S '^ 1 o�is...... To verify the authenticity of this Power of Attorney, call 1- 800321 -3880 or contact us at www.travelersbond.coni. Please refer to the Allomey -In -Fact number, the above -named individuals and the details of the bond to which the power is attached. Page 1 o1'2 A Search > TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA General I Contact I Licensing I Appointments Complaints I Orders I Natio tin nal info I Rags I Tax Pilings Back to Search General information Name: TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Corporate family group: TRAVELERS G R P evnap s v. :e Organization type: PROPERTY WAOIC: 10 NAIC: 31194 Status: ACTIVE Admitted date: 04/01/1977 Ownership type: STOCK ^. back atop Contact information Registered address ONE TOWER SQUARE HARTFORD, CT 06183 Telephone 860 - 277 -0111 Types of coverage authorized to sell , 3;...n=. ? back [p ipp Agents and agencies that represent this company (Appointments) ,•,ha k, �,. View agents View agencies back to top Company complaint history }vngt i<[nkg View complaints * tack to top Disciplinary orders 2008 -2015 yg3_sk r No disciplinary orders are found Mailing address ONE TOWER SQUARE HARTFORD, CT 06183 Telephone 860- 277 -0111 The orders posted here are unverified electronic duplicates of the official orders actually entered. To be certain you have the official version of the order as entered, request a hard copy from Renee Moines at 360 - 725 -7047 or email legal @oic.wa.gov. Looking for other orders? Our online orders search allows you to search a ten year history of all orders, including enforcement orders, administrative orders, and general orders. ed to. tap http: / /www. insurance .wa.gov /consuniertooIkit/ Company /ConipanyProtile.aspx ?WAOIC =10 5/6/2015 Page 2 of 2 Premium tax filings by tax year 2014 2013 2012 2011 2010 hawk w lop 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. r oac�, [o wp 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 ^ ba,c ". top littp: / /w%v-,v. insurance .cva.gov /consumertoolkit/ Company /CompatiyProfile.aspx ?WAOlC =10 5/6/2015 A.M. Best's Consumer Insurance Information Center Page 1 of 1 A.M. Best's 40 Member Center Lad In iS pn uo Need Coverage? How Does your Insurer Rate? State Insurance Information Find Insurers ey state or coverage type Enter a company Name �FS�. seleu a stale Consumer Home I Terns to Know I My a Best's Ramg is lmponant I Contact Us Q Life & Retirement © Health & Disability Q Cars. Home Q Other Life Events Travelers Casualty and Surety Co America IR Print this pall F- „come« m Tm.eleo nwm <M Ben e. paid NAle a'J" FEIN 9 io,ma7])0 Address: One Tower Snooze Phone: 860- 277-0111 HaMooL CT 06183 Fax: 860 -277 -7002 UNITED STATES N7eb: wmv.havelers com Best's Ratings View Definition Need More information? Financial Strength Rating. A ++ f I Purchase an insurer raison, complete with Outlook: Stable rating history, madded share and is list of Effective Date: May 23. 2014 (Upgraded I competitive insurers for $ 9.95. Financial Size Category: AV (S2 Billion or greater) ••Q>sT View Samoie Be, Llcansingt The company is licensed in the District of Columbia, Guam, Puerto Rico, U.S. Virgin Islands and all states. Top I-Ill of Business pleased, ores eraavomr Yert —) 1. Other Liability (Claimshmade) tmewoedr., —) 2. Surety rvi.w Deadnma7 3. Fidelity fide. Dermloel 4. Bu a ry and Theft N w Der re, 5, Other Liability (Occurrence) Mew Denrsold 1 Top States) of Business pmsaa uesn pvaN 1-- mer, 1. California 2, Newyork 3. Texas 4 Florida 5, Illinois Visit our NewsRoom for the latest News and Press Releases for this company and ids A.M. Best Group. Terms of Use NI information provided m the A.M. Bast websile, including bun Not added to text, data, ratings, Floods, images, photos, graphics, and charts is awned by or licensed to A.M. Best Company and Is protected by United Stales copyright laws and international treaty provisions. A.M. Best and its licensors retain all copyright and other proprietary rights to the webslte content. Best's Credit Ratings, obtamed through any source, may not be reproduced, distributed to Third Parties, w stared in a database or Febieval system in any form for commercial purposes without the prof written permission of the A M. Best Company. All unauthorized use of Best's Credit Ratings or other published information is strictly prohibited, By logging into Best's Member Center or accessing this sue, you accept and agree to be bound by our complete Terms of Liste. Customer Seruce I Product Support I Member Cent er I Contact in I Careers About A M Bet I Site &to I Pdaacv Policy .of I Terms of Use I y_ag_aI 6 Licensing Copydgm O ]015 A.M. Batt Company, Inc. ALL RIGHTS RESERVED, A M. Ben Wpndwiee Headquarters, Ambesl Road, Old eck, Now Jersey, 08858, USA. http:Hwww3.ambest. com / Consumers /CompanyProfile.aspx ?BI, 36 &ambnum= 003609 &PP... 5/6/2015 ACC) & CERTIFICATE OF LIABILITY INSURANCE DAS�e M2D�) 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 CNT NAMEACT Michael Highsmith ServCO Pe.C1f1C Insuranc0 PHONE —5504 FAL N (206)260 -2903 1100 Dexter Ave. N. nDOaEss:michaelh8servcopacific. com INSURERS AFFORDING COVERAGE NAIC0 Ste 220 INSURERAColonv Insurance Company A XII 39993 Seattle WA 96109 INSURED INSURER B American Fire and Cas Co A XV 24066 INSURERC:TOrus Specialty Ins Cc A -XI 44776 Pacific Coast General, LLC; Janann Leasing; 011ala INSURER D:We s tches ter Surplus Lines Insurance 10172 PO BOX 1577 INSURER E $ 100,000 R INSURER F: $ 5,000 Port Orchard WA 98366 1 COVERAGES CERTIFICATE NUMBER-CL155804274 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AODLSIJOR J= wyn POLICY NUMBER POLICY EFF (MMIDDIYYYYI POLICY EXP IMMIDDNYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X OCCUR DAMAGET R E PREMISES( Ea occunonce $ 100,000 R MED EXP (My ono person) $ 5,000 WA Stop Gap Liability X Y 103 GL 0000122 -01 5/21/2014 5/21/2015 PERSONAL S ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY PE� LOC PRODUCTS- COMPIOPAGG $ 2,000,000 Stop Gap Liability S 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S 1,000,090 BODILY INJURY (Per parson) $ X ANY AUTO B ALL OWNED SCHEDULED X Y BAA55B59989 5/21/2014 5/21/2015 BODILY INJURY (Par accident) $ AUTOS AUTOS NON -0WNEO R R PROPERTY DAMAGE Per accident) $ HIRED AUTOS AUTOS Underinsured motorist $ 1, 000, 00D X UMBRELLA LIAD R OCCUR EACH OCCURRENCE S 1,000 000 AGGREGATE $ 1,000,000 C EXCESS LIAR CLAIMS -MADE DED RETENTIONS 0 1 $ 1 70339L140ALI 10/6/2014 10/6/2015 WORKERS COMPENSATION LIT STATUTE X ORH AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR PARTNERIEXECUTIVE EL EACH ACCIDENT Is 1,000,000 A OFFICEFJMEMBER EXCLUDED? ❑ (Mandatory in NH) NIA 103 GL 0000122 -01 5/21/2014 5/2112015 E.L. DISEASE -EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT I $ 11000,000 E 6descnbeunder DESCRIPTION OF OPERATIONS below WA Sto Gap P P Y D Pollution Liability X Y 627594827001 5/7/2015 5/7/2016 Each Loss $1,000,000 Aggregate $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Contract: 15 -03 Project No: CP1219, Vallley AC Main Replacement The City of Auburn and its officers, elected officials, employees, agents and volunteers are Additional Insured per the attached forms and endorsements. Coverage is Primary and Non - Contributory and Waiver of Subrogation Applies. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014101) I NS025 on14m t ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of 25 West Auburn Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Auburn, WA 98001 -4998 AUTHORIZED REPRESENTATIVE M Highsmith /JENNIF ACORD 25 (2014101) I NS025 on14m t ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Pacific Coast General Cobrry Fhsurance Cempwy 103 GL 0000122.01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s) (Additional Insured): I Location(s) of Covered Operations: All persons or organizations as required by written As designated in written contract with the Named contract with the Named Insured Insured A. SECTION II —WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury ", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to. Additional Insured Contractual Liability "Bodily injury" or "property damage" for which the additional insured(s) are obligated to pay damages by reason of the assumption of liability in a contract or agreement. Finished Operations at Work "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 U156P -0310 Includes copyrighted material of ISO Properties, Inc., Page 1 of 2 with its permission. 103 GL 0000122. 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. Negligence of Additional Insured "Bodily injury" or "property damage" arising directly or indirectly out of the negligence of the additional insured(s). C. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance is amended and the following added: The insurance afforded by this Coverage Part for the additional insured shown in the Schedule is primary insurance and we will not seek contribution from any other insurance available to that additional insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U156P -0310 Includes copyrighted material of ISO Properties, Inc., Page 2 of 2 with its permission. Pacific Coast General, LLC 103 GL 0000122-01 Colony hsurarim Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION - COMPLETED OPERATIONS & ONGOING OPERATIONS AS SCHEDULED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Operations All persons or organizations required by written As required by written contract for commercial contract with the named insured projects only or commercial non -OCIPs A. Section II — Who Is An Insured is amended to include the person(s) or organization(s) shown in the Schedule (called additional insured), but only with respect to: (1) Liability for "bodily injury" or "property damage" caused, in whole or in part, resulting from "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard" when you and such person(s) or organization(s) have agreed in writing in a con- tract or agreement that such person(s) or organization(s) be named as an additional in- sured on your policy. (2) Liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by resulting from: (a) Your acts or omissions; or (b)The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the loca- tion(s) designated above. B. Section IV — Commercial General Liability Conditions, 4. Other Insurance is amended and the following added: If you are required by written contract to provide primary insurance, the insurance afforded by this Coverage Par, for the additional insured shown in the Schedule is primary insurance and we will not seek contribution from any other insurance available to that additional insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U462 -0310 Includes copyrighted material of ISO Properties, Inc., 2004 Page 1 of I with its permission. Padric Coast General 103 GL 0000122- 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any rights of recovery we may have against any person or organization because of payments we make for injury or damage resulting from your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard" if: a. you agreed to such waiver; b. the waiver is included as part of a written contract or lease; and c. such written contract or lease was executed prior to any loss to which this insurance applies. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U047 -0310 Includes copyrighted material of ISO Properties, Inc., Pane 1 of 1 with its permission. Pacific Coast General LLC BAS55859989 COMMERCIAL AUTO American Fire & Casualty Co CA 88 10 01 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. . COVERAGEINDEX SUBJECT ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT ACCIDENTAL AIRBAG DEPLOYMENT AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS AMENDED FELLOW EMPLOYEE EXCLUSION AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE BROAD FORM INSURED BODILY INJURY REDEFINED EMPLOYEES AS INSUREDS (including employee hired auto) EXTENDED CANCELLATION CONDITION EXTRA EXPENSE - BROADENED COVERAGE GLASS REPAIR - WAIVER OF DEDUCTIBLE HIRED AUTO PHYSICAL DAMAGE(including employee hired auto) HIRED AUTO COVERAGE TERRITORY LOAN /LEASE GAP PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) PERSONAL EFFECTS COVERAGE PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE RENTAL REIMBURSEMENT SUPPLEMENTARY PAYMENTS TOWING AND LABOR UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION II - LIABILITY COVERAGE is amended as follows: BROAD FORM INSURED PROVISION NUMBER 3 12 18 5 13 1 21 2 22 10 15 6 20 14 16 11 8 9 4 17 19 SECTION 11 - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period. However, "insured" does not include any organization that: (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self- insured retention plan available to that organization; 02010 Liberty Mutual Insurance Company. All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but only for acts within the scope of their employment by you. Insurance provided by this endorse- ment is excess over any other insurance available to any "employee ". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties re- lated to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee ". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation, maintenance or use of a covered "auto ", provided that you and such person or organization have agreed in a written contract, agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured ". However, such person or organization is an "insured ": (1) Only with respect to the operation, maintenance or use of a covered "auto "; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para- graphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including actual loss of earn- ings up to $500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added: SECTION II - LIABILITY, exclusion B.5. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. SECTION III - PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos ": a. You hire, rent or borrow; or 02010 Liberty Mutual Insurance Company. All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 2 of 7 b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen property as of the time of the "loss "; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $750 per "accident ", we will also cover the actual loss of use of the hired "auto" if it results from an "accident ", you are legally liable and the lessor incurs an actual financial loss. E. This coverage extension does not apply to: (1) Any "auto" that is hired, rented or borrowed with a driver; or (2) Any " auto" that is hired, rented or borrowed from your "employee ". For the purposes of this provision, SECTION V - DEFINITIONS is amended by adding the following: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. 7. TOWING AND LABOR SECTION III - PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended by the addition of the following: We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is dis- abled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For "light trucks ", we will pay up to $50 per disablement. "Light trucks" are trucks that have a gross vehicle weight (GVW) of 10,000 pounds or less. c. For "medium trucks" , we will pay up to $150 per disablement. "Medium trucks" are trucks that have a gross vehicle weight (GVW) of 10,001 - 20,000 pounds. However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE- ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE; is amend- ed to provide . a limit of $50 per day and a maximum limit of $1,500 ©2010 Liberty Mutual Iris ura rice Company. All rights reserved. CA 881001 10 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 3 of 7 9. RENTAL REIMBURSEMENT SECTION III -PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or "loss ", to an "auto" for which we also pay a "loss" under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto." - b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto ". d. This coverage does not apply unless you have a business necessity that other "autos" avail- able for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Coverage Extension. f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10. EXTRA EXPENSE -BROADENED COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000. 11. PERSONAL EFFECTS COVERAGE A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V- DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is worn or carried by an insured." "Personal effects" does not include tools, equipment, jewelry, money or securities. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow- ing: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov- erage or warranty. 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu- sions 4.c. and 4.d. is deleted and replaced with the following: 02010 Liberty Mutual Insurance Company. All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 4 of 7 Exclusion 4.c. and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto" and physical damage coverages are provided for the covered "auto "; or If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a $100 deductible. 14. LOAN / LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one "accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the "loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the "loss ", h. Financial penalties imposed under a lease due to high mileage, excessive use or ab- normal wear and tear, c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a "Balloon Loan ", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto ", g. Security deposits not refunded by a lessor, h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto ", I. Any amount representing taxes, j. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the "loss ". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss ". This adjustment is not applicable in Texas. B. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto" that incurred the loss serves as collateral, or lease written on the covered "auto" that incurred the loss. C. SECTION V - DEFINTIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. 02010 Liberty Mutual Insurance Company. All rights reserved. CA 38 10 01 10 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 5 of 7 15. GLASS REPAIR • WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is: a. In the charge of an "insured "; b. Legally parked; and c. Unoccupied. The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or organization engaged in the automobile business. SECTION IV • BUSINESS AUTO CONDITIONS is amended as follows: 17. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 18. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV.- BUSINESS AUTO CONDITIONS, paragraph A.2 -a. is replaced in its entirety by the following: a. In the event of "accident ", claim, "suit" or "loss ", you must promptly notify us when it is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. Member, if you are a limited liability company; 4. An executive officer or the "employee" designated by the Named Insured to give such notice, if you are a corporation. To the extent possible, notice to us should include: (1) How, when and where the "accident" or "loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 19. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has waived those rights before an "accident" or "loss ", our rights are waived also. ©2010 Liberty Mutual Insurance Company. All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 6 of 7 20. HIRED AUTO COVERAGE TERRITORY SECTION IV - BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period, Coverage Territory, is amended by the addition of the following: f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a "suit ", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V - DEFINITIONS is amended as follows: 21. BODILY INJURY REDEFINED Under SECTION V - DEFINTIONS, definition C. is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 22. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A. - CANCELLATION condition applies except as fol- lows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancella- tion. ©2010 Liberty Mutual Insurance Company. All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 7 of 7 Named Insured Endorsemonl Number Pacific Coast General LLC Policy Symbol Policy Number Polley Period Effecti ve Cate or Endorsement CPW G27594827 001 05!07/2015 to 05/0712016 05/07/2015 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. Tie remainderof the informab'on Is tote completed only when this endorsement is Issued subsequent to the preparation at we polity, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT OWNERS, LESSEES OR CONTRACTORS — SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: Name of Person or Organization' Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. S. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site 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. ENV -3100 (08 -04) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 ADDITIONAL INSURED ENDORSEMENT — PRODUCTS - COMPLETED OPERATIONS HAZARD Named Insured Endorsement Number Pacific Coast General LLC Policy Symbol Poicy Number Policy Period EBec ve Date of Endorsement CPW G27594827 001 05/07/2015 to 05/07/2016 05/07/2015 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART SCHEDULE Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for bodily injury or property damage caused, in whole or in part, by your work performed for that additional insured and included in the products - completed operations hazard. All other terms and conditions remain the same. ENV -3225 (10.08) Copyright ®20080. Page 1 of 1 ADDITIONAL INSURED ENDORSEMENT— PRODUCTS - COMPLETED OPERATIONS HAZARD PRIMARY & NON- CONTRIBUTORY Named Insures - Endorsement Number Pacific Coast General LLC Policy Symbol Policy Number Policy Penad Effective Dale or Endorsement CPW G27594827 001 05/07/2015 to 05107/2016 05/07/2015 issued By (Name at Insurance Company) Westchester Surplus Lines Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART SCHEDULE Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for bodily injury or property damage caused, in whole or in part, by your work performed for that additional insured and included in the products completed operations hazard. Furthermore, the coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above under any other third party liability policy. All other terms and conditions remain the same. ENV -3226 (10 -08) copyright ®2oo9p Page 1 of 1 Named Insured Endorsement Number Pacific Coast General LLC Policy Symbd Policy Number Policy Penod Etteulve Dace of Endorsement CPW G27594827 001 05/07/2015 to 05107/2016 05/07/2015 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insen the policy number, The remainder of the information is to be completed only when this endorsement Is Issued subsequent to the preparalion of the policy, THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT - OWNERS, LESSEES OR CONTRACTORS (PRIMARY AND NON- CONTRIBUTORY) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE CONTRACTOR'S POLLUTION LIABILITY COVERAGE SCHEDULE: Name of Person or Organization: Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (It no entry appears above, IN applicable to this endorsement.) SECTION II - WHO IS AN INSURED is amended to include: as A. SECTION II - WHO IS AN INSURED is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to bodily injury or property damage occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site 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. C, The coverage provided hereunder shall be primary and not contributing with any other insurance available to those designated above under any other third party liability policy. ENV-3101 (08 -04) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 Named Insured Endorsement Number Pacific Coast General LLC Policy symbol Polity Number Policy Period Effective Date of Enoorsemont CPW G27594827 001 05/07/2015 to 05/07/2016 05/07/2015 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert Me policy number. The remainder of me intormatlon is to be completed only when this endorsement is issued subsequent to the preparation of Me policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Oroanizatiom Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products - completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same. ENV -3143 (03 -05) Includes copyrighted material of Insurance Services Office, Inc. with its permission Page 1 of 1 iN FCI Ye. F—Ii iNs Hft ' 1 +1 i 9 � i �•A r ":1 !iOQp�Q A y List of Active Carriers 0 BERM snxs.M nrx m ms m..l. .ins s.mWU P. ' `-Y' 9;--: ..°9 >„oM•L.nro.Pawom Wnlwa6M..,a MO4 +6r x.snwms �.ms.'.I ,e :e.Pn.ey Iv . 3 y '.n 3AF aw^Wm x rs`T '� ��,�_ .°.l_,L.tL Ell Ik 1 •. 'l GNeL VID[mMry COMPPNV CRED. ON 290 GRFElY1LLE Sc $C 29o0t hLl �w 4 1\ Ly.�C�'•'i .F I t Yi GVIOPU$IR INSU ML WC i!$OFA$i AMLPIGNUN[ G r $CHAUMBURa IL 60173 A.+SF`Yy1 X "I�.YJ• i � CAMOL SPEOMry INSUMNCt COM 16W A5064 COW "O" •S1N F.y V : .WLFION. WI$3563 �V UlAVN1 U M O.L STREET { f Y4}�YA LONDOfl L10_ IONWN,VKf16AA ..' ff(( x _µ ......... 21E0R4F YPFD •+t�N,?y�r. ii yv e YY3S I O r .. j'A. l54NnviTE,dm A 9'e (' aKun�.s ' "�°�.f 'i'X :a•r:%...-v%:. F.'.G 1 i'%Ln of Ati.. Ca_� Irrz ctfW.+. Came_.. He E61 Ms Fav fAm Tp g HOD awn Gy R l7 CAIAUNA WAK ON LIV. IB MAN$fII SFPEEi �� k <y ..... 4 - � LOAMR UK el aTa ~ �^ +' l 1_ 11 - 0 0 34macE YAgO O S pI C PVC SUMWf COMMM KL CAmel m PI LONDON UK ECIV San d Zp 3310 PFA Mt ROAD CADUNSPEGALn WSUg ECOMPAM AIWRA CJ. 30324 F lf• t C - V. yF' CLNtEN1WL GSUALI'r COMPAM ]300 WOODORESI CE i ESi WRMINf AM,ALJS249 r'•%. :I ' M 1 �J CNRYSURELYCOMPAN 1. PAR MSnMLL E 0110082 3' S ONFUME S1RFIl SJ',N i f 1 K x CERLTIN VHDFPWNiFflS Ai LLOV D$LOIdJOn IONWII XM EUWJ jf , f' . ,.� CIURR$ SCILR IM15U4WCC COMPNtt IIS WORK I'D . NFw YORK NY tdll9 I� y, j;y 3'• ...... I ; '•' C..KD CRUM. MORUU FCD \IPANY IS AR]UNiPIN NFN RDAD T Lam, WAFREN. .t 1 LINCINNAR SPIMLry UNDFR VAS INNMNCL COMPAm 621M SOM OLMORF ROAD FAIRAELD, OH OM4 ! 2 CUFfNWNAMFRXA UlaW NCF CJMPAVV JE6IG MRG DA`I[Mlf MYrYUFL 1R INl2 l.., ty CIU INSVIUIICECOMPAHl ' ll0. 2MI16iEP CU Rl MINCIPIGWNE A 11• % COLOIM1VSURAVCCOANTM LONON UK FC30.3BB K2'75IONI PUVRPPq Al `..� P n 1a 16AL. 1a 2. .ma oWu-- wl' D 1e 11 aW :' A.M. Best's Consumer Insurance Information Center Page I of 1 A.M. Best's C.a m4a taurt „S iam. C -eatpr 40 Member Center Los In l SiionU Need Coverage? How Does Your Insurer Rate? State Insurance Information v Find insurers by state or coverage type. Enlera company rvame L"' 1 selenastate Consumer Home I terms to Rnow I My a Basis Roung is Important I Contact Us Q Life & Retirement O Health & Disability Q Car & Home Q Other Life Events Colony Insurance Company EJ Print Nis.aoe 4 mem4v s." Gowal •Y 0.111 03293 ri sides FEIN. 1i- t4llrve Address: P.O. Be. 469012 Phone 804 -560 -2000 San Antonio, T% 78246 Fax: 804- 5604820 UNITED STATES Web www colonvspecialtv.dom Best's Ratings View Demotion Need More information? Financial Strength Rating'. A ' { I ? rchase an insurer hoped, complete with Outlook Stable rating history, market share and a list of Effective Date: October 02, 2014 (Affirmed competitive insurers for S 9.95. Financial Site Category: )(II (11.00 Billion l0 $7.25 Billion) View Sample Report Licensing: The company is licensed In Virginia. It also operates on a surplus lines or non - admitted basis in the District of Columbia, U.S. Virgin Islands, AL, AK. AZ AR. CA, CO, CT, DE, FL. GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM. NY. NC, ND, OH, OK, OR, PA, RI, SC, SO, TN, Tit, UT. W. WA, WV, WI and WY. Top Lines) of Business le auv ii .e D,r.a p,.mwm, wime.l 1. Other Liability (Occurrence) Mew Deennion I 2. Products Liability ha Deraidex) 3. Commercial Multiple Peril Mew Dcnne;on) 4. Other Liability (Claimsernade) Mew oenoeioa ) 5. Allied Lines (View Nfirska) Top States) of Business te...a, oeea p­uma wins, 1. California 2. New York 3 Texas 4. Florida S. Louisiana Vial our NewaRoom for the latest News and Press Releases for this company and its A Best Group. Terms of Use All information provided on the A.M. Best website, including but not limited to text, data retires, refines, images, photos, graphics, and than$ is owned by or licensed to AM. Best Company and is protected by United States copyright laws and international treaty provisions. A M. Best and its licensors retain all copyright antl Other proprietary rights to the website content. Best's Credit Ratings, obtained through any source, may net be reproduced, distributed to Third Parties, Or stored in a database or reversal system in any form for commercial purposes without the prior written permission of ins A.M, Best Company. All unauthorized use of 6esfs Credit Ratings or other published information is strictly prohibited. By logging into Best's Member Center or accessing his site, you accept and agree to he bound by our complete Terms of Use. Customer Serve I Product Suopon I Member Center I Contact Info I Careers About A M Fast I Site Mao I Pnvacv Policy I Saxodt I Terms of Use I Lear a Licensee Copyright®2015A.M. Best Company.1m, ALL RIGHTS RESERVED. A.M. Best Worldrvide Headquarters, Ambest Road, Olawipk, New Jersey, 08858, U.SA, httm / /w,�vw3.ambest.com/ Consumers/ ComnanvProfile .asox ?BL= 36 &ambnum-003283 &PP... 5/6/201 A Search > AMERICAN FIRE AND CASUALTY COMPANY AMERICAN FIRE AND CASUALTY COMPANY General I Contact I Licensing 1 AppointrnenG I conngaints I Orden I National Info I Ratings I Taz Filings Back [o Search General information Name: AMERICAN FIRE AND CASUALTY COMPANY Corporate family group: LIBERTY MUT GRP what is th_sj Organization type: PROPERTY WAOIC: 68 NAIC: 24066 Status: ACTIVE Admitted date: o7 /oi /1g81 Ownership type: STOCK ° back to top Types of coverage authorized to sell Insurance types Casualty Marine Ocean Marine Property Surety Vehicle back to too Contact information Registered address 62 MAPLE AVE KEENE, NH 03431 Telephone 513- 867 -3000 Agents and agencies that represent this company (Appointments) View agents View agencies back to top Company complaint history View Complaints 1 bac4jq top Disciplinary orders 2008 -2015 111,t,,lm,' Page 1 of 2 Mailing address 175 BERKELEY ST BOSTON, MA 02116 Telephone 617- 357 -9500 Year Order Number 2012 12 -0253 The orders posted here are unverified electronic duplicates of the official orders actually entered. To be certain you have the official version of the order as entered, request a hard copy from Renee Moines at 360 - 725 -7047 or email legal @oic.wa.gov. Looking for other orders? Our online orders search allows you to search a ten year history of all orders, Including enforcement orders, administrative orders, and general orders. back to top httn•//ivtvw incnrance_ wa 5 /611)!ll S A.M. Best's Consumer Insurance Information Center Page 1 of 1 A.M. Best's jYRj avjr p inawaYo p.10eq iii Member Cantor Lee In Sio, U Need Coverage? How Does Your Insurer Rate? State Insurance Information Find'msuwm by State or coverage type. Enter a company Name 1=1 I seen a slate Consumer Ham. I Terms to Know I Why a BeSt's Reung Is Imppnam t Contact Us Q Life & Retirement O Health & Disability Q Car & Home O Other Life Events American Fire and Casualty Company Print lhispage Ia m.mew Pt uxnr coronet nsi.aK. cn„Pan..l AM Rev. W12. NAICe 24W FEIN# 5M141nv Address: 175 Berkeley Street Phone. 513b03 -2400 Boston, MA 02116 Fee $13-603 -3179 UNITED STATES Web: www. LlbertvMmUSIGNai com Best's Ratings View Definition am Need More information? Purchase an insular report, complete with Financial Strength Rating: A rating history, maBat share and a list of Outlook Stahle competitive insurers for S 995Enectiva Date: Septemher 24, 2014 (AKnnatl) View Sample Report Financial Size Category: XV (S2 Billion or greater) Licensing: The company is licensed in the District of Columbia, AL, AK, AZ, AR, CA, CO, CT, DE, FL, GA, 10, IL, IN, IA, KS, KY. LA. ME. MD, MA, Ml, MN, MS, MO, MT, NE. NV, NH, NJ, NM, NY, INC, ND, OH, OK OR, PA, RI, SC. SD, TN, TX, UT, VT, VA, WA, WV, WI and Wy. Top Lines) of Business Ilvs.e rw oe.a P,....nw vaamp 1. Commercial Multiple Peril lvewoereeien) 2. Auto commereial),vwocnm long 3. Workers'Compensation Na.oeennivnl 4. Other Liability (Occurrence) view oesnnan 1 5, Auto( Parsonal)IsAe,.eeennil Tap State(s) of Business Ie.a.a „pe. o,.a P,.mvm. wmml 1. California 2. Washington 3. Pennsylvania 4. New Jersey 5. Til Visit our NewsRoom for the latest News and Press Releases for This company and its A . Best Group. Terms of Use All information provided on the A.M. Best websile, including but Not limned to texl, data, ratings, reports, images, photos, graphics, and charts is owned by or licensed to A M. Best Company and Is protected by United Slates copyright laws and international treaty provisions. A M. Best and Its licensors retain all copyright and other proprietary rights to the websile content. Best s Credit Ratings, obtained through any source, may Not pre reproduced, distributed to Third Parties, or stored in a database or retrieval system in any form for commercial purposes without the prior written permission of the A . Best Company. All unauthorized use of Best's Credit Ratings or other published information is strictly prohibited. By "ging into Best's Member Center or accessing this Site, you accept and agree to be bound by our complete Terms of Use. Customer Service I PmtluCl Support I Member Center I Contact Info I Center s About A M Best I Sit, Map l Pnvacv Pdi<v I Sol I Terms of Use l Lerial A Licenvrn Copyugnt O 2015 A.M. Best Company. Inc. ALL RIGHTS RESERVED. A . Best Wedowee Headquarters, Ambest Road, Oldwerk, New Jersey, 089513, U. SA. httn• / /tanvv.v"d amhrct rntn /C'.nncnmP.rq /CmmnnnvPrnfilF acnY9RI = 1CkIhmhmtm= 00() 1 ?R.CPP 5/A /1) n) G _i , NN YG'JmsM Mroppal PV'3n vllryaUNJpYYemtfl aaa rcq, i11e 5loCluf ta'e eeX >.I.aa[yn.00ll.ar.R.:Gmla'Ilq m. >.aencYam. eI Y.GI O.».. 13inq PI m me [amn� nceenuC >Y PS SUryNa lnebw[IaYm of Wetnnglu anal ry[fY�mnen lx NS Gme['x ]eaC[aoNOb Imu!n AJUrn e NC5PfC1AL1Y 1N5UUNCFCOYi4W[v/. VROIFS510lN1 UlNEAMURFS IIPB IM 5T,l Fllss. ROAD LO ll !J >VA.U91558 iNR000J1 TRANSIOXi MURU4 DJSUNANCE XSSTTI4011 tM 10. 80Y U.ibS N >MILiO N, BM HMS% iOMUM KINL MIT!IMUS ML LID LG TDCO A1ANNE EUROPE VISIIMJICE LTD L ITT I`AOFUN >LL S@EFi UEWION.1F 11IE TO OD MARINE SVECLILIV WSU"WE COMPRM' rM PIIMMU'LiV INSUXAME ONI RAIA G. COMPANY RALA CV ,PA TWIT IOfT INSUMNCt CO AIPAM II'll AVtrvL14 OI ILL Si ?RS LOSPN4ELFS. CA !IMb) TORUS MUFANCE Ma T. XR IEAUENNAILSIPIFi IONIN3N.."Q,T3P NPXIIORSIUI. IlTLA"L TORUS SPEC JL P6UMNCE CUMPAM CEMIR XKSIl.11. N1.111L IWlVEIERS EXCESS AND SURRIR ULIES COAIPPNY ONt 10WEX S0UARl XARI FORO.C1p6133 .. i.,,n... m,.. .., ............. 9U FLIICNURCX SIRI EI A.M. Best's Consumer Insurance Information Center Page I of I [Aii�!..[M.. QQB����errs��$$t''s nn r„�(r�pp, qn �� ' 6`G'34`mlLS:!'4ee �1�4u4XY Ci��.4 iYM ember Center: Lee In l Sign UP Need Coverage? .��:n How Does Your Insurer Rate? State Insurance Information or Find insurers by state eweraae ryce. Enteraeompany Name t =el seleGa stale Consumer —Home I Terms In rcmw very a Best's Rating is Important I Conran Us I3 Life & Retirement O Health & Disability Q Car & Home O Other Llfe Events Torus Specialty Insurance Company IQ Print this pane I. —.a. sfE,so, in—cra cxa+Pl M are. 11132 NAICY 44778 FEIN 51- 0335x32 Address: Harterside Financial Center Plaza Five Phone. 201 - 743-7700 Suite 2900 Fax 201443 -7701 Jersey City, NJ 07311 Web: www torus cum UNITED STATES Best's Ratings View Definition Need More information? Financial Strength Rating A- Porchesg an insu rer report, complete with Outlook' Stable Im rating history, maret share and a list of Effective Date April 30, 2015 (ARirmed competitive insurers for $ 9.95. Financial Size Category: XI ($750 Million to $1.00 Billion) Vex, Sample Reoon Licensing: The company is licensed in Delaware. It also operates on a surplus lines or non - admired basis in the District of Columbia, Guam, Puerto Rico, U.S . Virgin Islands, AL, AK, AZ, AR, CA, CO, CT, FL, GA HI, ID, IL. IN. IA, KS, Cl(. LA, ME, M0, MA, Ml, MN, MS, M0, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA RI, SC, SD, Ti TX, UT, VT, VA, WA, NN, WI and Wy. Top Lines) of Business leaea uni oreu wemums ansurn 1. Medical Professional Liability tmewoermnma) 2. Other Liability (Occurrence) Mew or ition) 3. Other Liability (Claims-made) (view oengann ) 4. Inland Marine to cafireon) Top State(s) of Business tu—.p„ Dr.a P,.,..m.wre ,l 1. California 2. Now York 3 Florida 4. Texas 5. New Jersey Visit our NewsRoom for the latest News and Press Releases for this company and its A.M. Best Group Terms of Use All information provided on the A.M. Best website, including but not livened to text, data, ratings, reports, images, photos, grapncs, and chains is owned by or licensed to AM. Best Company and is protected by United States copyright laws and international treaty provisions. A.M. Best and its licensors retain all copyright and other proprietary rights to the website content. Best's Credit Ratings, obtained through any source, may not he reproduced, distributed to Thud Parties, or stored in a database Of retrieval system in any form for commercial purposes without the prior written permission of the A M. Best Company. All unauthorized use of Best's Credit Ratings or other published information is strictly prohibited. By" ing into Best's Member Center or accessing this site, you accept and agree to be bound by bor complete Terns of Usg. Customer Service I Prgmcl SuPWN I Member Center I Contact his I Careers About A M. Best I Site &I. I Pn.acv Policy I Secun I Terms of Ilse I Legal a Beaernihe Copyright O 2015 A.M. Best Company, Inc. ALL RIGHTS RESERVED. A.M. Best WMd.Wde Headquarters, Ambast Read, Oldwick. New Jersey, 01 U S A. ht tit:il). ambest. com / Consumers /COlnpanvProfile.asox ?BL =36LX anilm =01 143211... 5/6/2016 the a Broker% /Carriers. lia W AI vs•Cin.,c List of Active Carriers 5 � / �y h:cLSion on this list does not nEKala Nat The comer meets the requirement as an appmprla:e insurer. Th. 5ugloe Una Passer Is solely rasoo"Ibl. for betcmsere, the cua110[allons of each comer. Being an thU list means Me Tamer Is ? 1 racM,Mpn ny Me Sur,lut Una Association 0( WaSnNgton Inc! AM99 by broker%for Me Tinier Will be aTTepeo (Or W.R. R(RKICY INSURANCE (EUROPE} LID. 40 UME STREET LONDON, ECRM ]qW WESTCHCSTER SURPLUS LINES INSURANCE COMPANY 936 WAINLITSIREET PHILADELPHIA, PA 19106 WESTERN HERITAGE INSURANCE COMPANY 9200 E. PIMA CENTER PARC.YAY SCOUSDAI E AZ 85258 WESTERN WORT D INSURANCE COMPANY - 400 PARSON S POND DRAT FRANMIN IARES, W D7417 -A.M. Best's Consumer Insurance Information Center Page I of I A.M. Best's .v J glamm ef CenWrr iii Member Gecer: Late l Sign Up Need Coverage? How Does Your Insurer Rate? State Insurance Information Find insurers by state or coverage type. ® Enter a Company Name �iiili/I setea a stale Consumer Home I Terms I. Know I why a Best's Rat, is Important I Contact Us Q Llfe & Retirement O Health & Disability Q Car 8 Home O Other Life Events Westchester Surplus Lines Insurance Co A Print this pane N —lie or ACE INe Gewpl ♦Y. 8....133 uHC110172 FEIN* M-2139927 Address'. P.O. Box 1000 Phone 215-640 -1000 Philadelphia, PA 19106 Fax: UNITED STATES Web. www results com Best's Ratings View Definition ) Need More information? Financial Strength Rating: A ++ , t 1 ' ^ Purchase an insurer report, complete with rating history, market share and a list of Outlook: Ste: competitive insurers for $ 9.95. Effective Date: April : V ($ Billion - `v View Sari Resort Financial Size Category: %V (S2 Billion or greater) Licensing: The company is licensed in Georgia. It also operates on a surplus lines or non admitted basis in the District of Columbia, At AK, AZ, AR, CA, CO. CT, DE, FL, HI, ID, IL, IN. IA, KS, KY, LA, ME, MD, MA MI, MN, MS, MO, MT, NE, NV, NH, NJ, Ni NY, N0, NO, OH, OK, OR, PA, RI, SC, SO, TN, T%, UT, VT, VA, WA, M. Wt and WY. Top Line(s) of Business leas.a vane D..a P,.,,.,,,m vweem 1. Allied Lines mewo,rmannl 2. Other Liability (Occurrence) rview oeenni in I 3. Other Liability (Claimstrtatle) Mew Denpi on r 4. Fire ivz.Cenneent 5. Earthquakef,13slinnien) Top State(s) of Business (Ni. use. Di ,,I P,mmma wmem 1. Florida 2. Texas 3. California 4. Louisiana 5. South Carolina Visit our NewsRsom for the latest News and Press Releases for this company and Its A.M. Best Group. Terms of Use All information provided on the A.M. Best website, including but not limited to text, data, ratings, reasons. images, photos, graphic, and charts is owned by or licensed to AM, Best Company and is protected by United States copyright laws and international treaty provisions. A.M. Best and its licensors retain all copyright and other proprietary fights to the website content. Best's Credit Ratings, obtained through any source, may not be reproduced, distributed to Third Parties, or stored in a database or retrieval system in any form for commercial purposes without the prior written permission of the A.M. Bost Company. All unauthorized use of Best's Credit Ratings or other published inforsecon is strictly prohibited. By legal into Bast's Member Center m accessing this site, you accept and agree to be bound by our complete Terms of Use. Customer Servic I Product Support I Member Cent I Contact Ism I Careers About A M Ben l Site neap I Pbvacv Policv I SSa ent I Terms of use I Legal a Lieensine Copyright® 2015 A M. Best Company, Inc ALL RIGHTS RESERVED. A.M. Best Woddwke Headquarters. Ambest Road, Ofe dick, New Jersey, 08859. US A. hrfnt// w�vwi. amhesLcnmK '.nngllmers /C.mmnnnvPrnllle asnv9R1: iFR mhnnm= (1(144, i P P i/0 1N) S IL BOND 1N'L1EU.OF4RETA1NAGE. .r!3 �!t' ,. (Retainage'B6nd- RGW60'N')'rY <-•; Bond No. 106269951.i,,,0- KNOW ALL-PERSONS BY.THESE-PRESENTS;,THAT�w ,,..,:,!vt Pacific Coast General, LLC, PO Box 1577, Port Orchard; WAt98366 u1..,= a corporation organized under the laws of the State of Washington and registered'etotdo : business-,In z the•State of Washington as'a contractor, as Principal; and 'l iTFaveleFCr,'6 ualti.?and SuretDfComo n)7,6f 1(: � America corporation organized under the laws of the State of Connecticut and registered to,tiransact• business-in the'State`of Washington'as'surety !as ^Surety, their heirs;' executors;ladministrafors, "si ccess'drs and assigns areryointlytand se'verallytheid and bound to the City of Auburrn; Wash ington{ hereinafte'r�callebTCITY ;ra'nd #are'similar`fy held and bound unto the beneficiaries of the`'tr st fund f&6- ted`by`- ,R0W,060281 in'the sum of five percent (5 %) of all amounts earned by the Principal on the contract described below. ;tl ' THE CONDITIONS OF THIS BOND OBLIGATION,AREtTHAT:) WHEREAS, on the ath day of May 2015;' the,PnnciI561,executed r Contract No. 15 -03 with the CITY for Project Number CP1219, Valley AC Main Replacement; and r.: a t,:•.. ='f': WHEREAS; said contract and RCW 60:28 require'.ttie'CITY to' Withh =old from the Principal the sum of five percent (5 %) from`mo'nies'earned by the Pr'incipal�on estimates during the progress of the construction, hereinafterreferted to as earned retained funds'; and WHEREAS, the Principal has requested that 'tKd'fCITY not' retain= any =earned retained funds as allowed under•13CW60.28; NOW, THEREFORE, the conditio6-of-ihis obligation,is' 'such that +the surety is held and bound to the CITY and to the beneficiaries of the trust fund created by RCW 60.28 in the sum of five percent (5 0/6%) of'ihelfinal contract cost Which shall 'include any increases due to change orders, increases in quantities of work, addition of new items of work, or otherwise,:he ?eafter referred -f6`6a the final contract cost. If all purposes of RCW 60.28 and all contract obligat'ions;'s a fulfilled, then this, obligation shall be null and void; otherwise, it shall remain in full `force °and effect until release is authorized in writing by the CITY. IT IS FURTHER EXPRESSLY AGREED THAT: 1. The liability of the Surety under;this bond shall not exceed five percent (5 %) of the final contract cost, if no monies are retained by the CITY pursuant to RCW 60.28 on estimates during the progress of construction. Retainage Bond Page 1 of 3 2. In the event this bond ceases to comply.'wtth CITY standards; the CITY reserves the right to resume the actual withholding of eaed` m'tetained funds according to the contractors designated option for management of �etainage urider:RGW 60.28.011(4). In the event the CITY resumes withholding of earned retained funds, the liability of the Surety under this bond shall not exceed t_tie actual amount of the earned retained funds which were covered by this bond and released by the CITY prior to resumption of actual withholding. 3. The Surety hereby consents to and waives notice of a_ ny extension in the time for performance of the contract, assignment of obligations under ?the contract, or contract alteration, amendment, or change order. 4. Any suit under this bond must be instituted within the: time period provided by applicable law with venue in King County, Washington. This bond and any proceeds therefrom shall be subject to all claims and liens and in the same manner and priority as set forth for retained percentages in RCW 60.28. 5. Until written release of this obligation by the CITY, this bond may not be terminated or canceled by the Principal or the Surety for any reason. Any extension of time for the Principal's performance on the contract, assignments of obligations under the contract, or any amendment to the contract or change orders of any kind shall not release the Surety from its obligation under this bond, 6. The contractor shall comply with all applicable requirements of RCW 60.28. 7. RCW 60.28 requires the CITY to accept a retainage bond in lieu of withholding earned retained funds and the Surety hereby waives any defense that this bond or bond form is void or otherwise not authorized by law. 8. Any claim or suit against the CITY to foreclose the liens provided for by RCW 60.28 shall be effective against the Principal and Surety and 'any judgment under 60.28 against the CITY shall be conclusive against the Principal and Surety. WITNESS our hands this 8th PST 9 % GF1 "10 .t.�,; LpRPORATF yr ,a % SEALj. SHI NG; Retainage Bond Page 2 of 3 day of May , 2015 PRINCIPAL: Pacific Coast General, LLC PO Box 1577 Port Orchard, WA, 98366 By (Sign ure of Authonzed Representative) Print Type Name 11 SURETY: Travelers Casu nd,Surety Company of America By: _ (Signature of ATorriby in- • c for Surety') Marie Poulin, Attorney -In -Fact , — (Typed Name of Attorney- in;Fact) Dated 'fib( Local Agent Name, Phone, & Address Servco Pacific Insurance 221 S. 28th Street, Suite 101 Tacoma, WA 98402 (253) 207 -5500 CITY OF AUBURN: Accepted By:� /1 X" Ingrid aub, A irector of Engineering Services /City Engineer Dated: S.1IS1Ze►S- *This bond must be accompanied by a fully executed Power of Attorney appointing the Attomey -in -Fact before it becomes effective. Retainage Bond Page 3 of 3 4 RED BORDER AM POWER OF ATTORNEY TRAVELERSJ Farmington Casually Company St. Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company 'frayelers Casualty and Surety Company Fidelity and Guaranty Insurance Undenrriters. Inc. Tr:nrelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company Attorney' -In Fact Au. 927 32 Certificate No. 005951862 KNOW ALL MEN BY THESE PRESENTS. That Farmington Casualty Company. St. Paul Fire and Marine Insurance Company. St. Paul Guardian Insurance Company. St. Paul Mercury Insurance Company. Travelers Casualty and Surety Company. Travelers Casualty and Surely Company of America, and United State. Fidelity and Guarnnly Company are corporations duly organized under the laws of the State of Cunncclicut. that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insm.mce Underwriters. Inc., is it corporation duly organized under the law, of the State of Wisconsin (herein collectively called the "Companies'), and [hill the Companies do hereby make. constitute and appoint tblichael R. Highsmith. and Marie Poulin of the City of Seattle , State of WOShlnaton , their true and lawful Atmrneyfs) -in -Fact, each in their separme capacity if mom than one Is named above, to sign, execute, seal and acknowledge any and all bands, recognizance,, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their, business at guaranteeing the fidelity of persons, guaranteeing the performance of n„ contracts and e,eenuina or cuamn(ecing bonds and undertakings required or perni4ded'in anracuons or proceedings allowed by law. IN WITNESS WHEREOF, the Companies hnyc caased this m trumenta be signed and their c npotitle seals to be hereto affixed, thin 16th June 21114 °, day of Farmington Casualty Company \ \1' 9 ��> SL Paul Mercury Insurance Company ss Fidelity and Guaranty9n ati ancr\Gompaliv '1'r :n'cicrs Casuahy and Surety Compam' Fidelity and Guaran V Insui"ce`Underw'nters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company eI.51, fe rm fQ ;'oMOaar' n �`YV'' t o �+ 1977 %/i- Iris ` `sj colts, 1896 ye ea O 1951 X'vf ®o^ .. Sf:aLS.+o'> ",SEAL, z° ° mxuoet� 9'QS\ �l .,: I 1Nmsort. r, 5 Art AM State of Connecticut City of Hartford s. By: 444 Rohn I- Raney„ enior \ ice President 16th Junc 2014 On [his the day of . beliae Inc pnsunally appeared Robert L. Raney. who acknowledged himself to he the Senior Vice President of Farmington Casualty Company, Fidelity and Gallium), Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine INmma1CC Company. St. Paul Guardian Insurance Company. St. Paul Alercury Insurance Company, Tr: velcrs Casualty and Surety Company.Travelers Casualty and Surety Company of America, and [Jutted States Fidelity :Inc[ Guaranty Company, and that he, as such. being authorized so to do, executed the foregoing instmment for the purposes therein container) by signing on behalf of the corporations by himself as a duly authorized officer. 0 -T!T hn \fitness Whereof, I hereunto set my hand and official seal_ My Commission expires the 30th day of Jute. 2016_ P iOUBU�s -CT's' 58440 -8 -12 Printed in U.S.A. AWt .Tctrsuult -t4 Public 1 'this Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., SL Paul Fire and Marine Insurance Company. St. Paul Guardian Insurance Company. St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, which resolutions are now in fill force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer. the Corporate Secretary or any Assistant Secretary may appoint Atiomcys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her cer ifiade of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, reeognizances, contracts of indemnity, and other writings obligatory in the nature of it bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him ar her: and it is FURTHER RESOINED. that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary: and it is FURTHER RESOLVED, that any bond. recognizance, contract of indemnity, or writing obligatory in the nature of it hond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer. any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary: or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority: and it is FURTHER RESOLVED. that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President. any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries re Attorneys -in -Fact for purposes only of executing and attesting bonds and undenakings and other writings obligatory in the nature thereof, and any such Power of Attorney or cenific:ve bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. 1. Kevin E. Hughes, the undersigned. Assistant Secretary, of Farmington Casualty Company, Fidelity and Guaranty Insurance Company. Fidelity and Guaranty Insurance Underwriters, Inc.. St. Paul Fire and Marine Insurance Company. St. Paul Guardian Insurance C`onipany. St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and Unitedi States Fidelity and Guaranty Company do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies%hich is imfull torte and'cffecl and has not been revoked. IN TESTIMONY WHEREOF, 1 have hereunto set my hand and nffixcd the seals of said Companies This day of V�( . 20 E Kevin E. Hughes. Assistant Sec taR ry Y6CNY1Y A10? pO`y IY,r`' `,IyY ,NSYgaH` 'N� M1O e nlPrVn� 4.e�{f1,t/m 3' 6 � ��oNeoNNr�'m 1983 0 1977 9_.. is nnrttrarm, rumpo, �'� 19$E !'S 1P ti � fay i/ xeii.......�w W1e ��. ✓i +ice �S{P To verify the authenticity of this Power of Attorney, call 1- 800 - 421 -3880 or contact us at www.travelersbond.coni. Please refer to the Attomey -In -Fact number. the above-named individuals and the details of the bond to which the power is attached. WARNING: THIS POWER OF Page 1 o1'2 ti IN Search > TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA General I Contact I Licensing I Appointments I _Complaints I Orders I National Info I Ratings I T_a_x Filings Back to Search General information Name: TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA Corporate family group: TRAVELERS GRP wbat,ism1s> Organization type: PROPERTY WAOIC: to NAIC: 31194 Status: ACTIVE Admitted date: 04/01/1977 Ownership type: STOCK ^: back wjop Contact information Registered address ONE TOWER SQUARE HARTFORD, CT 06183 Telephone 860 - 277 -0111 Types of coverage authorized to sell ,vllattnt> Insurance types _ Casualty Marine Ocean Marine Property Surety Vehicle back to top Agents and agencies that represent this company (Appointments) ,eq,,hs.1 View agents view agencies T back [o top Company complaint history \Vhats Njs> View complaints r back to cop Disciplinary orders 2008 -2015 No disciplinary orders are found Mailing address ONE TOWER SQUARE HARTFORD, CT 06183 Telephone 860 - 277 -0111 The orders posted here are unverified electronic duplicates of the official orders actually entered. To be certain you have the official version of the order as entered, request a hard copy from Renee Moines at 360 -725 -7047 or email legal @oic.wa.gov. Looking for other orders? Our online orders search allows you to search a ten year history of all orders, including enforcement orders, administrative orders, and general orders. T back to t9p http: //hvww. insurance. wa. gov /consumertoolkitI Company /ConipanyProfile.aspx ?WAOIC =10 5/6/2015 Page 2 of 2. Premium tax filings by tax year.-... L th,I 2014 2013 2012 2011 2010 ° back otop. 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 Phel s Ratings back to top http: /hvww. insurance .wa.govlconsumertoolkitI Company lCompanyllrolile.aspx ?WAOIC =10 5/6/2015 r *^— A.M. Best's Consumer Insurance Information Center Page 1 of 1 A.M. ._.B.. eist''s ft Vn Member Center � Ian Need Coverage? ® How Does Your Insurer Rate? State Insurance Information Find inu revs byatals or coverage type. Emera emnpany rvame FM--1 seleua sole Consulmer —Ho Ime I Terms to Know I Vv11y u Bas's Ratng is Important I Contact Us Q Life & Retirement O Health & Disability Q Car & Home O Other Llfe Events Travelers Casualty and Surety Co America a Print this Page a —au m Tm.el.a. Gwn1 au. s.ermere ueic. anax FEIN aemumn Address. One Towar Square Phone: 860.277 -0111 Hantord, CT 06183 Fax 800.2774002 UNITED STATES Web'. www Nevelers core Bests Ratings view Datlmtion Need More information? Financial Strength Rating: A� Purchase an insurer report, complete with Outlook. Stable rating history, market share and a list of Effective Date: May 23, 2014 (Upgraded) competitive insurers for $ 9.95. View Sample Report Financial Size Category : XV ($2 Billion or greater) 0 Licensing: The company is licensed in the District of Columbia, Guam, Puerto Rico, U.S. Virgin Islands and all states, Top Lines) of Business Ienen ueMi Dion erem— write., 1. Other Liability (ClaimsHnade) Mew penmr o) 2. Surety N,0k,fimiee) 3. Fidelity lv.uermdanI 4. Burglary and Theft tv ceanlr nl 5. Other Liability (Occurrence) Msw' ommme ) Top Stales) of Business I...e U. wen Pumum...In 1. California 2. New York 3. Texas 4. Florida 5. Illinois Visit our NewsRoom for the latest News and Press Releases for this company and'ds A M. Bast Gmup. Terms of Uae All information provided on We A M. Best website, Including but not limited to tort, data, ratings, reports, images, photos, grannies, and Glaris is mead by or Incensed to A.M. Best Company and is protected by United States copyright laws add international treaty provisions. A.M. Bost and its licensers retain all copyright and other proprietary rights to Ug website content. Bests Credit Ratings, obtained through any source, may not be reproduced, distributed to Thing Parties, or Stored in a goal ar rea l system in any tans for commercial purposes without the prior written permission of the A.M. Best Company. All unauthorized use of Best's Credit Ratings or other published information's strictly prohibited. By loggNg into Best's Member Center or accessing this site you accept and agree to be bound by our complete Terms of Use. Customer Senice I Product Support I Member Comer I Contact Into I Car_ About A.M Best l Site Ma I Privacy Policy I Security I Terms of Use I Legal B Ccene re Commight4) 2015 A M. Best Company, Inc. ALL RIGHTS RESERVED. AM Besl Worldwide Headpuaners Amthesl Road, OldwiCk, New Jersey, 08058, U 5 A. http: / /kvww3.ambest.com/ Consumers /CompanyProfile.aspx ?BC, 36 &ambnum = 003609 &PP... 5/6/2015 CITY OF AUBURN CONTRACT CHANGE ORDER AGREEMENT NO. 1 Contract No.,Project No.and Project Title: 15-03, CP1219, Valley AC Main Replacement Project Contractor Name and Address: Pacific Coast General, LLC. PO Box 1577 Port Orchard, WA 98366 The Contractor is hereby directed to make the changes to the Contract as described herein. This document and all attachments are a supplement to the contract. All work,materials and measurements for the type of construction involved shall be in accordance with the contract documents of the above named project unless stated otherwise in this change order. Summary of Proposed Changes: 1. New Pay Item CO#1-1 (1-inch Meter Setter Replacing 3/4-inch Meter Setter):A new pay item "1- inch Meter Setter Replacing 3/4-inch Meter Setter" is added to the Contract and will be paid per each and shall include all work, materials, and labor to change the 3/4-inch meter setters specified for existing pay items "Water Service Connection 3/4 inch Meter with 1 inch Diam. Service Line"and "Trenchless Service Connection" in the Contract Documents to 1-inch meter setters. Compensation for the 1-inch meter setters is based upon the negotiated price. Work shall conform to Section 7-15 of the Contract Documents and the attached City of Auburn Standard Details Water-13 and Water-16. The Contract time is extended by 0 days. Item Sch. Sec.No. Item Description Quantity Units Unit Price Total Price -inch Meter Setter Peplacing -inc eter CO#1-1 A 7-15 Setter 49 EA 156.09 $ 7,648.41 Subtotal $ 7,648.41 Washington State Sales Tax(9.5%)on applicable items $ 726.60 TOTALI $ 8,375.01 Base Amount Total-incl.Tax 1.'TotaIt6st this C/O :` " " , $ 7;648:41 '$ "A,18,375.01 ' 2. Total Cost Previous C/O $ - $ 3.":.Qri inal Contract Amount; _il„ :;,, ," $",.; 2896,753.65 .;$ 9&4,945.25 4. "Revised Contract Amount " ;$ 904,402.06 $ 990,320.26 This change order constitutes full and complete compensation for all labor,equipment,materials,overhead,profit,any and all indirect costs,and time adjustment to perform the above described changes. All other costs are non-compensable. Contractor: Date ,r CITY OF AUBURN CONTRACT CHANGE ORDER AGREEMENT NO. 1 Contract No.,Project No.and Project Title: 15-03, CP1219, Valley AC Main Replacement Project Inspector: 7//7 / Date Project Manager: Date City Engineer: Date Approved by: Qyor, City oAutfurn Date