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CP1815 #19-03 2018 Citywide Ada & Sidewalk Improvements
CITY or T TRT T Nancy Backus, Mayor WASHINGTON 25 West Main Street * Auburn WA 98001-4998 *www.auburnwa.gov * 253-931-3000 February 21, 2019 CERTIFIED MAIL RETURN RECEIPT REQUESTED Bob Kiyohara Transportation Systems, Inc 6917 166th Avenue East Sumner, WA 98390 RE: Award of Contract No. 19-03 Project No. CP1815: 2018 Citywide ADA and Sidewalk Improvements Letter of Award Dear Mr. Kiyohara: Bids for construction of the above-referenced project were opened by the City Clerk at Auburn City Hall on Thursday, February 7, 2019, at 11:00 AM. Five (5) responsive bids were received and have been tabulated. Your firm submitted the lowest responsible bid. The total award amount including Washington State sales tax is $451,184.00. The City Council, at their meeting on February 19, 2019, approved award of the contract, including additive bid (Schedule F)to your firm. This letter serves as your notification of award for the subject project and is a contract specification. Please execute and return the following contract documents and other required information to the attention of Amanda DeSilver, Contract Administration Supervisor, within seven (7) calendar days after receiving this letter of award: a) Contract, in duplicate. b) Contract Bond, in duplicate. c) Power of Attorney for your bonding company, in duplicate. d) Certificate(s) of insurance naming the City of Auburn as additional insured, in duplicate, for all required insurance coverages. Please include the Contract Number, Project Number and Project Name on the certificate(s). e) Escrow Agreement, in triplicate. A pre-construction meeting has been scheduled for 10:00 AM on Thursday, March 14, 2019, in Conference Room #1, located on the second floor of One East Main Street, Auburn. The City requires that the Contractor have the appropriate personnel at the pre-construction meeting. This would include, at a minimum, the project manager and the on-site superintendent. The Contractor is encouraged to include any of their staff or sub-contractor staff they feel are critical to the project. ENG-006,Revised 09/18 AUBURN * MORE THAN YOU IMAGINED Transportation Systems, Inc February 21, 2019 Page 2 of 2 The Contractor shall submit electronically one (1) day prior to the pre-construction meeting: a) Preliminary Progress Schedule for the first 30 working days. b) Breakdown of lump sum items except for Traffic Control Supervisor, Mobilization and Record Drawings. c) SPCC Plan per Section 1-07.15(1)of the Contract Documents. Please bring the following items to the pre-construction meeting: a) Requests to sublet work for all subcontractors and lower tier subcontractors. b) Emergency call list. c) A schedule of equipment and labor rates, as outlined in Section 1-09.6 (Force Account) to be utilized in the event of any Force Account activities. As noted in the contract documents, a Notice to Proceed will be issued within five (5) working days of the contract execution date, which is the date the contract has been fully executed by the City. If you do not have a current Business License to work in the City of Auburn, an application has been included and should be returned to the Customer Service Center, One East Main Street, Auburn, as soon as possible. All subcontractors and lower tier subcontractors working on the project must also have a City of Auburn Business License. Please contact me at 253-804-5071, or the Contracts Administration Supervisor, Amanda DeSilver at 253-876-1980 with any contract administration related questions. Sincerely, 7 ahtikAa-- ii_e_.&/ Aleksey Koshman Associate Engineer Public Works Department AK/ad/as Enclosures cc: Shawn Campbell, City Clerk Debra Alvarez, Project Inspector File 13.11 (CP1815) ENG-006, Revised 09/18 _« CITY OF AUBURN- U K U RN Nancy Backus, Mayor WASH I NGTON 25 West Main Street * Auburn WA 98001-4998 * www.auburnwa,gov * 253-931-3000 April 3, 2019 CERTIFIED MAIL RETURN RECEIPT REQUESTED Bob Kiyohara Transportation Systems, Inc 6917 166th Avenue East Sumner, WA 98390 • NOTICE TO PROCEED RE: CP1815, 2018 Citywide ADA & Sidewalk Improvements, Contract#19-03 You are hereby notified to proceed as of April 5, 2019 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 60 working days for completion. If you have any questions, please contact the inspector for the project, Debra Alvarez at 253-876-1922 or the Contract Administration Supervisor at 253-876-1980. Sincerely, Aleksey Koshman Associate Engineer Public Works Department AK/ad/as Enclosure cc: Shawn Campbell, City Clerk Jacob Sweeting, Assistant Director of Engineering/City Engineer Matt Larson, Senior Project Engineer Debra Alvarez, Project Inspector File 13.11 (CP1815) ENG 017, Revised 12/18 AUBURN * MORE THAN YOU IMAGINED CONTRACT Contract No. 19-03 THIS AGREEMENT AND CONTRACT, made and entered into, in duplicate, at Auburn, Washington, this 21 day of Xao , 2019, by and between the CITY OF AUBURN, WASHINGTON, a municipal corporation, and Transportation Systems, Inc. 6917 166th Avenue East. Sumner. WA, 98390, hereinafter called the CONTRACTOR. WITNESSETH: That, in consideration of the terms and conditions contained in the Contract Documents entitled "CP1815, 2018 Citywide ADA and Sidewalk Improvements Project," which are by this reference incorporated herein and made a part of this Contract, the parties hereto covenant and agree as follows: I. The CONTRACTOR shall do all work and furnish all tools, materials and equipment for Project CP1815, 2018 Citywide ADA and Sidewalk Improvements Project — repairing damaged sidewalk by replacement, installing or rebuilding curb ramps to meet ADA requirements and constructing new sidewalk segments to fill in gaps in the pedestrian network for a unit bid price of four hundred forty-eight thousand, one hundred forty-seven dollars and sixty cents ($448,147.60) and Washington State Sales Tax of three thousand thirty-six dollars and forty cents ($3,036.40) for a total contract value of four hundred fifty-one thousand, one hundred eighty-four dollars and zero cents ($451,184.00) 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 part 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 after execution of the Contract by the City and so designated on the Notice to Proceed. Physical completion shall be within 60 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 sort 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. II. The CITY OF AUBURN hereby promises and agrees with the CONTRACTOR to employ, and does employ the CONTRACTOR to provide the materials and to do and cause to 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. CITY OF AUBURN, WASHINGTON ByYO" Bei4AA,,k$ NA ckus, Mayor Countersigned: this 3rci day of loci I , 2019 APPROVED AS TO FORM: ' \,,' S eve Gross, i y Attorney TRANSPORTATION SYSTEMS, INC By ,®i/(---- A thorized Official Signature CONTRACT BOND CONTRACT NO. 19-03 BOND NO. 30061583 BOND TO CITY OF AUBURN, WASHINGTON KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned, Transportation Systems, Inc, 6917 166th Avenue East, Sumner, WA, 98390, as principal, and Western Surety Company , a corporation, organized and existing under the laws of the State of South Dakota 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 four hundred fifty-one thousand, one hundred eighty-four dollars and zero cents ($451,184.00), 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 Zcci day of 4Lpr U , 2019. Nevertheless, the conditions of the above obligation are such that: WHEREAS, the City of Auburn on the 19th day of February, 2019, let to the above bounden principal a certain Contract. The said Contract being numbered 19-03, and providing for the construction of Project CP1815, 2018 Citywide ADA and Sidewalk Improvements Project - repairing damaged sidewalk by replacement, installing or rebuilding curb ramps to meet ADA requirements and constructing new sidewalk segments to fill in gaps in the pedestrian network (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 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 completion 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 Contract Completion. Notwithstanding 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 Contract Completion, 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 28th day of February /2019. By:Y Transportation Systems, Inc Western Surety Company Surety • By C al/JEA Holli Albers, Attorney in Fact • 1201 Pacific Avenue, Suite 1000 Tacoma, WA 98402 253-759-2200 Resident Agent's Address & Phone Number r Western Surety Company POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents.That WESTERN SURETY COMPANY,a South Dakota corporation,is a duly organized and existing corporation having its principal office in the City of Sioux Falls,and State of South Dakota.and that it does by virtue of the signature and seal herein affixed hereby make,constitute and appoint Michael S Mansfield,Sara Sophie Sellin, Donald Perce11 Shanklin Jr, Misti M Webb,Tamara A Ringeisen, Kari Michelle Motley,Bryan Richard Ludwick,Individually of Portland,OR Cynthia L Jay,Eric A Zimmerman,James B Binder,Aliceon A Keltner,Brandon K Bush,Jacob T Haddock,Individually of Seattle,WA Karen C Swanson,Jamie L Marques,Carley Espiritu, Christopher Kinyon,Brent E Heilesen,Peter J Comfort,Annelies M Richie, Kyle Joseph Howat,Kristine A Lawrence,Heather L Allen,Holli Albers,Individually of Tacoma,WA Dana M Brinkley,Linda D Shaddon,Individually,of Medford,OR its true and lawful Attorney(s)-in-Fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf bonds,undertakings and other obligatory instruments of similar nature -In Unlimited Amounts - and to bind it thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts of said Attorney,pursuant to the authority hereby given.are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duly adopted.as indicated,by the shareholders of the corporation. In Witness Whereof, WESTERN SURETY COMPANY has caused these presents to be signed by its Vice President and its corporate seal to be hereto affixed on this 7th day of January,2019. WESTERN SURETY COMPANY r,�`S�tRE Tye, u,s POA / .,40P q1 yeS .W; =1 ,i;r: n,»� 'aul T.Brutlat,Vice President State of South Dakota JT ss County of Minnehaha On this 7th day of January,2019.before me personally came Paul T.Bruflut,to me known,who,being by me duly sworn,did depose and say: that he resides in the City of Sioux Falls,State of South Dakota;that he is the Vice President of WESTERN SURETY COMPANY described in and which executed the above instrument; that he knows the seal of said corporation;that the seal affixed to the said instrument is such corporate seal;that it was so affixed pursuant to authority given by the Board of Directors of said corporation and that he signed his name thereto pursuant to like authority,and acknowledges same to be the act and deed of said corporation. My commission expires J.MOHR NOTPAY"UdLIC �� June 23,2021 .,S sagm oaKor, J.Mohr.Notary Public CERTIFICATE I,L.Nelson,Assistant Secretary of WESTERN SURETY COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force,and further certify that the By-Law of the corporation printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said corporation this ePleth day of / Gor1-60...ere, .20/9. WESTERN SURETY COMPANY look; 1 ,t 4�t'Sf Av vt• free . I.. Nelson,Assistant Secretary Form F4280-7-2012 Go to www.cnasurety.com >Owner/Obligee Services>Validate Bond Coverage,if you want to verify bond authenticity. . 1 Authorizing By-Law ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following By-Law duly adopted by the shareholders of the Company. Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, and Assistant Secretary,Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President.any Vice President. Secretary,any Assistant Secretary,or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies,or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. 3/15/2019 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1446 Consumer tools Agent and Company Lookup Orders Independent Review Decisions WESTERN SURETY COMPANY Change History I Licensing I Appointments I Complaints I Orders I National Info I Ratings I Tax Filings Back to Search] General information Contact information Name:WESTERN SURETY COMPANY Registered address Mailing address Corporate family group: CNA INS GRP 0 101 S REID ST 151 N FRANKLIN ST Organization type: PROPERTY SIOUX FALLS,SD 57103 CHICAGO,IL 60606 Doing Business As (DBA): Unavailable Telephone Telephone WAOIC: 1446 605-336-0850 312-822-5000 NAIC: 13188 Status:ACTIVE Admitted date:07/22/1958 Ownership type: STOCK Company change history o View chang J >dr4 to-tof Types of coverage authorized to sell o Insurance types Casualty Marine Property Surety Vehicle bank to rn, Agents and agencies that represent this company (Appointments) 0 View agents J View agencies Sars to We Company complaint history o i View complaints Orders issued since 2010 o No orders are found Premium tax filings by tax year o 20,18 2017 2016 2015. 2014 tldtk to National information on insurance companies Want more Information about this company?The_NAIC's Consumerinformation(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. 4 Beck iu tap Ratings by financial organizations The following organizations rate insurance companies on their financial strength and stability.Some of these companies charge for their services. IWeiss Group Ratings Standard and Poors.Corp _ Mood 's Investors Service Fitch IBCA,Duffand Phelpsatin s Disclaimer:Links to external or third-party websites are provided solely for visitors'convenience,Links you take to other sites are done so at your own risk and our office accepts no liability for any external linked sites or their content.Be aware that not all financial rating companies use the same rating 3/15/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=000974&PPP= eliN III 0 G3 Lne 6 Rebmment Rome&Aule health&Osab,bly Oleo,Ula Events 76 save Western Surety Company Fell, dr Pnntihaoegg (a member of CNA Insurance Companies) AM Best e:000974 NAIC b-13188 FEIN e'48.0204900 Address: 151 North Franklin Street Phone: 312822.5000 Chicago,IL 60606 Fax: UNITED STATES Web: www.cnasurely.com Best's Credit Ratings Financial Strength Rating View Definition Long•Torm Issuer Credit Rating View Definition Rating: A(Excellent) Long•Term: a Financial Size Category: XIV(51.5 Billion to$2 Billion) Outlook: Positive Outlook: Stable Action: Affirmed Action: Affirmed Effective Date: July 05,2018 Effective Date: July 05,2018 Initial Rating Date: June 21,2005 Initial Rating Date: June 30.1922 u Denotes Under Revrew Bows Ralag Licensing: Licensed Territory:(Current since 03l2212002).The company is licensed in the District of Columbia,Puerto Rico and all states. Total Assets DPW-Top Lines of Business 52150.000.00�msm ® 52,100.000.000 52,9se,soo,00 1. iiruri � ii"t"i.�II" ... �i �. 01,e50,090,00 t ��'� �xi st.s9o.000.oD Ifl 1, 51.750.000.00 _92.40% 5,.700000.00 i li..�� $1.850.000.00 20T MIT NM 2015 2011 —Data Years —Sunny--F,dokty Company Attributes Industry: Insurance Business: Property/Casualty Business Status: in Business Entity: Operating Company Consolidated Type: Affiliated Single Company Organization Type: Stock Statement Type: NAIC PC Last Statement: 3rd Quarter 2018 .u- Client#: 147813 TRANSYSTI ACORDr5 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDONYYY) 3/27/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Casondra Mossuto Propel Insurance PHONE 800 499-0933 FAX 866 577-1326 _(A/C,No,Ext): (A/C,No): Tacoma Commercial Insurance EDORoss: casondra.mossuto@propelinsurance.com 1201 Pacific Ave,Suite 1000 INSURER(S)AFFORDING COVERAGE NAIC# Tacoma,WA 98402 INSURER A:Charter Oak Fire Insurance Company 25615 INSUREDINSURER B:Travelers Property Casualty CoofAmerica 25674 Transportation Systems Inc. INSURER c:Westchester Surplus Lines Insurance Co. 10172 6917 166th Ave E INSURER D:Travelers Indemnity Company 25658 Sumner,WA 98390 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVO POLICY NUMBER (MMIDD/YYYY) (MM/DD(YYYY11 LIMITS A X COMMERCIAL GENERAL LIABILITY X X DTCO2G691089IND18 09/19/2018 09/19/2019 EACH OCCURRENCE $1,000,000 p CLAIMS-MADE X OCCUR PREMISES(Ee occurrrence) $300,000 X PD Ded:$2,500 MED EXP(Any one person) $10,000 PERSONAL BADV INJURY _$1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2,000,000 POLICY I J CT 0 LOC PRODUCTS-COMP/OP AGG 52,000,000 OTHER: $ D AUTOMOBILE LIABILITY X X BA2G69108918CNS09/19/2018 09/19/2019 COMacciBINdent)SI $1,000,000ED NGLE LIMIT {Ea X ANY AUTO BODILY INJURY(Per person) $ OWNED ONLY SCHEDULED ( ) $ AUTOS BODILY INJURY Per acciden HIRED NON-OWNED PROPERTY DAMAGE x AUTOS ONLY X AUTOS ONLY (Per accident) 5 B X UMBRELLA UABX OCCUR CUP7J5615271826 09/19/2018 09/19/2019 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000 000 DED X RETENTION$10000 $ A WORKERS COMPENSATION DTCO2G691089IND18 09/19/2018 09/19/2019 PER 0TH• AND EMPLOYERS'LIABILITY STATUTE ER Y I N ANYIPROPRIETOR PARTNEREDED?ECUTIVE NIA WA Stop Gap Only E.L.EACH ACCIDENT 51,000,000 O(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If Yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT s1,000,000 C Pollution G7118254A001 09/19/2018 09/19/20191 Occ:$1,000,000 Agg: $2,000,000 Ded: $5,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RE: Project CP1815:2018 Citywide ADA and Sidewalk Improvements Additional Insured Status applies per attached form(s). CERTIFICATE HOLDER CANCELLATION City of Auburn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 25 West Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Auburn,WA 98001 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S3586283/M3356073 CTOO COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for"bodily injury", requiring insurance" specifically requires you " ro ertdama e"or" ersonal in u and to provide such coverage for that additional p p y g p ry ' insured, and then the insurance provided to b) If, and only to the extent that, the injury or the additional insured applies only to such damage is caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring insur- requiring insurance" applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to the independent acts earlier. or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the additional insured for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the "written contract requiring insurance", the in- "written contract requiring insurance" specifically surance provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that "written contract requiring in- this insurance is primary to "other insurance" surance". This endorsement shall not in- available to the additional insured which covers crease the limits of insurance described in that person or organization as a named insured Section III—Limits Of Insurance. for such loss, and we will not share with that b) "other insurance". But the insurance provided to The insurance provided to the additional in- the additional insured by this endorsement still is sured does not apply to "bodily injury", "prop- excess over any valid and collectible "other in- erty damage" or "personal injury" arising out surance", whether primary, excess, contingent or of the rendering of, or failure to render, any on any other basis, that is available to the addi- professional architectural, engineering or sur- tional insured when that person or organization is veying services, including: an additional insured under such "other insur- i. The preparing, approving, or failing to ante". prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement: ders or change orders, or the preparing, approving, or failing to prepare or ap- a) The additional insured must give us written prove, drawings and specifications;and notice as soon as practicable of an "occur- rence" or an offense which may result in a ii. Supervisory, inspection, architectural or engineering activities. claim. To the extent possible, such notice should include: CG D2 46 08 05 ©2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" any provider of"other insurance"which would or offense took place; cover the additional insured for a loss we ii. The names and addresses of any injured cover under this endorsement. However. this persons and witnesses; and condition does not affect whether the insur- ance provided to the additional insured by iii. The nature and location of any injury or this endorsement is primary to "other insur- damage arising out of the "occurrence"or ance" available to the additional insured offense. which covers that person or organization as a b) If a claim is made or "suit" is brought against named insured as described in paragraph 3. the additional insured, the additional insured above. must: 5. The following definition is added to SECTION V. i. Immediately record the specifics of the —DEFINITIONS: claim or"suit" and the date received; and "Written contract requiring insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement under which you are required to include a The additional insured must see to it that we in- receive written notice of the claim or"suit" as person or organization as an additional soon as practicable. sured on this Coverage Part, provided that the "bodily injury" and "property damage"oc- c) The additional insured must immediately curs and the "personal injury" is caused by an send us copies of all legal papers received in offense committed: connection with the claim or "suit", cooperate a. After the signing and execution of the with us in the investigation or settlement of contract or agreement by you; the claim or defense against the "suit", and otherwise comply with all policy conditions. b. While that part of the contract or d) The additional insured must tender the de agreement is in effect: and fense and indemnity of any claim or "suit" to c. Before the end of the policy period. Page 2 of 2 ©2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 COMMERCIAL GENERAL LIABILITY POLICY NUMBER: ISSUE DATE: - - THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Project Designated Project(s): General Aggregate(s): EACH "PROJECT" FOR WHICH YOU HAVE AGREED, GENERAL AGGREGATE LIMIT IN A WRITTEN CONTRACT 4THICH IS IN EFFECT SHOWN ON THE DECLARATIONS DURING THIS POLICY PERIOD, TO PROVIDE A SEPARATE GENERAL AGGREGATE LIMIT, PROVIDED THAT THE CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS. A. For all sums which the insured becomes legally 3. Any payments made under COVERAGE A. obligated to pay as damages caused by "occur- for damages or under COVERAGE C. for rences" under COVERAGE A. (SECTION I), and medical expenses shall reduce the Desig- for all medical expenses caused by accidents un- nated Project General Aggregate Limit for der COVERAGE C (SECTION I), which can be that designated "project". Such payments attributed only to operations at a single desig- shall not reduce the General Aggregate Limit nated "project" shown in the Schedule above: shown in the Declarations nor shall they re- 1. A separate Designated Project General Ag duce any other Designated Project General Ag- gregate Limit applies to each designated Aggregate Limit for any other designated "pro- ject'', and that limit is equal to the amount of "project"shown in the Schedule above. the General Aggregate Limit shown in the 4. The limits shown in the Declarations for Each Declarations, unless separate Designated Occurrence, Damage To Premises Rented Project General Aggregate(s) are sched- To You and Medical Expense continue to uled above. apply. However, instead of being subject to 2. The Designated Project General Aggregate the General Aggregate Limit shown in the Limit is the most we will pay for the sum of all Declarations, such limits will be subject to the damages under COVERAGE A., except applicable Designated Project General Ag damages because of "bodily injury" or "prop- gregate Limit. erty damage" included in the "products- B. For all sums which the insured becomes legally completed operations hazard", and for medi- obligated to pay as damages caused by "occur- cal expenses under COVERAGE C, regard- rences" under COVERAGE A. (SECTION I), and less of the number of: for all medical expenses caused by accidents un- a. Insureds; der COVERAGE C. (SECTION I), which cannot be attributed only to operations at a single desig- b. Claims made or"suits" brought; or nated "project" shown in the Schedule above: c. Persons or organizations making claims or bringing "suits". CG D2 11 01 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 COMMERCIAL GENERAL LIABILITY 1. Any payments made under COVERAGE A. vided, any payments for damages because of for damages or under COVERAGE C. for "bodily injury" or "property damage" included in medical expenses shall reduce the amount the "products-completed operations hazard" will available under the General Aggregate Limit reduce the Products-Completed Operations Ag- or the Products-Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gregate Limit, whichever is applicable; and gate Limit nor the Designated Project General 2. Such payments shall not reduce any Desig- Aggregate Limit. nated Project General Aggregate Limit. E. For the purposes of this endorsement the Defini- C. Part 2.of SECTION III—LIMITS OF INSURANCE tions Section is amended by the addition of the is deleted and replaced by the following: following definition: 2. The General Aggregate Limit is the most we "Project" means an area away from premises will pay for the sum of: owned by or rented to you at which you are per- forming operations pursuant to a contract or a. Damages under Coverage B; and agreement. For the purposes of determining the b. Damages from "occurrences" under applicable aggregate limit of insurance, each COVERAGE A (SECTION I) and for all "project" that includes premises involving the medical expenses caused by accidents same or connecting lots, or premises whose con- under COVERAGE C (SECTION I) which nection is interrupted only by a street, roadway, cannot be attributed only to operations at waterway or right-of-way of a railroad shall be a single designated"project"shown in the considered a single "project". SCHEDULE above. F. The provisions of SECTION III — LIMITS OF D. When coverage for liability arising out of the INSURANCE not otherwise modified by this en- "products-completed operations hazard" is pro- dorsement shall continue to apply as stipulated. ft Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D2 11 01 04 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE —This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Aircraft Chartered With Pilot H. Blanket Additional Insured — Lessors Of Leased B. Damage To Premises Rented To You Equipment C. Increased Supplementary Payments I. Blanket Additional Insured — States Or Political Subdivisions— Permits D. Incidental Medical Malpractice E. Who Is An Insured — Newly Acquired Or Formed J. Knowledge And Notice Of Occurrence Or Offense Organizations K. Unintentional Omission F. Who Is An Insured — Broadened Named Insured L. Blanket Waiver Of Subrogation — Unnamed Subsidiaries M. Amended Bodily Injury Definition G. Blanket Additional Insured — Owners, Managers N. Contractual Liability—Railroads Or Lessors Of Premises PROVISIONS INJURY AND PROPERTY DAMAGE LI- A_ AIRCRAFT CHARTERED WITH PILOT ABILITY: The following is added to Exclusion g., Aircraft, Exclusions c. and g. through n. do not apply Auto Or Watercraft, in Paragraph 2. of SECTION to "premises damage". Exclusion f.(1)(a) I — COVERAGES — COVERAGE A BODILY IN- does not apply to "premises damage" caused JURY AND PROPERTY DAMAGE LIABILITY: by: This exclusion does not apply to an aircraft that a. Fire; is: b. Explosion; (a) Chartered with a pilot to any insured; c. Lightning; (b) Not owned by any insured; and d. Smoke resulting from such fire, explosion, (c) Not being used to carry any person or prop or lightning; or erty for a charge. e. Water; B. DAMAGE TO PREMISES RENTED TO YOU unless Exclusion f. of Section I — Coverage A 1. The first paragraph of the exceptions in Ex- — Bodily Injury And Property Damage Liability clusion j., Damage To Property, in Para is replaced by another endorsement to this graph 2. of SECTION I — COVERAGES — Coverage Part that has Exclusion — All Pollu- COVERAGE A BODILY INJURY AND tion Injury Or Damage or Total Pollution Ex- PROPERTY DAMAGE LIABILITY is deleted. elusion in its title. 2. The following replaces the last paragraph of A separate limit of insurance applies to Paragraph 2., Exclusions, of SECTION I — "premises damage" as described in Para- COVERAGES — COVERAGE A. BODILY graph 6. of SECTION III — LIMITS OF IN- SURANCE. CG D3 16 11 11 O 2011 The Travelers Indemnity Company.All rights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph 6. of SEC- C. INCREASED SUPPLEMENTARY PAYMENTS TION III—LIMITS OF INSURANCE: 1. The following replaces Paragraph 1.b. of Subject to 5. above, the Damage To Prem- SUPPLEMENTARY PAYMENTS — COVER- ises Rented To You Limit is the most we will AGES A AND B of SECTION I — COVER- pay under Coverage A for damages because AGE: of "premises damage" to any one premises. b. Up to $2,500 for the cost of bail bonds The Damage To Premises Rented To You required because of accidents or traffic Limit will apply to all "property damage" law violations arising out of the use of any proximately caused by the same "occur- vehicle to which the Bodily Injury Liability rence", whether such damage results from: Coverage applies. We do not have to fur- fire; explosion; lightning; smoke resulting from nish these bonds. such fire, explosion, or lightning; or water; or any combination of any of these causes. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVER- The Damage To Premises Rented To You AGES A AND B of SECTION I — COVER- Limit will be: AGES: a. The amount shown for the Damage To d. All reasonable expenses incurred by the Premises Rented To You Limit on the insured at our request to assist us in the Declarations of this Coverage Part; or investigation or defense of the claim or b. $300,000 if no amount is shown for the "suit", including actual loss of earnings up Damage To Premises Rented To You to $500 a day because of time off from Limit on the Declarations of this Coverage work. Part. D. INCIDENTAL MEDICAL MALPRACTICE 4. The following replaces Paragraph a. of the 1. The following is added to the definition of "oc- definition of "insured contract" in the DEFINI- currence" in the DEFINITIONS Section: TIONS Section: "Occurrence" also means an act or omission a. A contract for a lease of premises. How- committed in providing or failing to provide ever, that portion of the contract for a "incidental medical services", first aid or lease of premises that indemnifies any "Good Samaritan services"to a person. person or organization for "premises damage" is not an "insured contract"; 2. The following is added to Paragraph 2.a.(1) of SECTION II—WHO IS AN INSURED: 5. The following is added to the DEFINITIONS Section: Paragraph (1)(d) above does not apply to "bodily injury" arising out of providing or fail- "Premises damage" means "property dam- ing to provide: age" to: (i) "Incidental medical services" by any of a. Any premises while rented to you or tern- your "employees" who is a nurse practi- porarily occupied by you with permission tioner, registered nurse, licensed practical of the owner; or nurse, nurse assistant, emergency medi- b. The contents of any premises while such cal technician or paramedic; or premises is rented to you, if you rent such (ii) First aid or "Good Samaritan services" by premises for a period of seven or fewer consecutive days. any of your "employees" or "volunteer workers", other than an employed or vol- 6. The following replaces Paragraph 4.b.(1)(b) unteer doctor. Any such "employees" or of SECTION IV — COMMERCIAL GENERAL "volunteer workers" providing or failing to LIABILITY CONDITIONS: provide first aid or "Good Samaritan ser- (b) That is insurance for "premises damage"; vices" during their work hours for you will or be deemed to be acting within the scope 7. Paragraph 4.b.(1)(c) of SECTION IV — of their employment by you or performing COMMERCIAL GENERAL LIABILITY CON- duties related to the conduct of your busi- DITIONS is deleted. ness. Page 2 of 6 ©2011 The Travelers Indemnity Company.All rights reserved. CG D3 16 11 11 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 5. of 4. Any organization you newly acquire or form, SECTION III—LIMITS OF INSURANCE: other than a partnership, joint venture or lim- For the purposes of determining the applica- ited liability company, of which you are the ble Each Occurrence Limit, all related acts or sole owner or in which you maintain the ma- omissions committed in providing or failing to jority ownership interest, will qualify as a provide "incidental medical services", first aid Named Insured if there is no other insurance or "Good Samaritan services" to any one per- which provides similar coverage to that or- son will be deemed to be one "occurrence". ganization. However: 4. The following exclusion is added to Para- a. Coverage under this provision is afforded graph 2., Exclusions, of SECTION I — COV- only: ERAGES — COVERAGE A BODILY INJURY (1) Until the 180th day after you acquire or AND PROPERTY DAMAGE LIABILITY: form the organization or the end of the Sale Of Pharmaceuticals policy period, whichever is earlier, if you "Bodily injury" or "property damage" arising do not report such organization in writing out of the willful violation of a penal statute or to us within 180 days after you acquire or ordinance relating to the sale of pharmaceuti- form it; or cals committed by, or with the knowledge or (2) Until the end of the policy period, when consent of, the insured. that date is later than 180 days after you 5. The following is added to the DEFINITIONS acquire or form such organization, if you Section: report such organization in writing to us "Incidental medical services" means: within 180 days after you acquire or form a. Medical, surgical, dental, laboratory, x-ray it, and we agree in writing that it will Con or nursing service or treatment, advice or tinue to be a Named Insured until the end instruction, or the related furnishing of of the policy period; food or beverages; or b. Coverage A does not apply to "bodily injury" b. The furnishing or dispensing of drugs or or "property damage" that occurred before medical, dental, or surgical supplies or you acquired or formed the organization; and appliances. c. Coverage B does not apply to "personal in- "Good Samaritan services" means any emer- jury" or "advertising injury" arising out of an gency medical services for which no compen- offense committed before you acquired or sation is demanded or received. formed the organization. 6. The following is added to Paragraph 4.b., Ex- F. WHO IS AN INSURED — BROADENED NAMED cess Insurance, of SECTION IV — COM- INSURED—UNNAMED SUBSIDIARIES MERCIAL GENERAL LIABILITY CONDI- TIONS: The following is added to SECTION II — WHO IS AN INSURED: The insurance is excess over any valid and collectible other insurance available to the in- Any of your subsidiaries, other than a partnership, sured, whether primary, excess, contingent or joint venture or limited liability company, that is on any other basis, that is available to any of not shown as a Named Insured in the Declara- your "employees" or "volunteer workers" for tions is a Named Insured if you maintain an own- "bodily injury" that arises out of providing or ership interest of more than 50% in such subsidi- failing to provide "incidental medical ser- ary on the first day of the policy period. vices", first aid or "Good Samaritan services" No such subsidiary is an insured for"bodily injury" to any person to the extent not subject to or "property damage" that occurred, or "personal Paragraph 2.a.(1) of Section II — Who Is An injury' or "advertising injury" caused by an of- Insured. fense committed after the date, if any, during the E. WHO IS AN INSURED — NEWLY ACQUIRED policy period, that you no longer maintain an OR FORMED ORGANIZATIONS ownership interest of more than 50% in such sub- The following replaces Paragraph 4. of SECTION sidiary. II —WHO IS AN INSURED: CG D3 16 11 11 ©2011 The Travelers Indemnity Company.All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY G. BLANKET ADDITIONAL INSURED — OWNERS, H. BLANKET ADDITIONAL INSURED — LESSORS MANAGERS OR LESSORS OF PREMISES OF LEASED EQUIPMENT The following is added to SECTION II — WHO IS The following is added to SECTION II — WHO IS AN INSURED: AN INSURED: Any person or organization that is a premises Any person or organization that is an equipment owner, manager or lessor and that you have lessor and that you have agreed in a written con- agreed in a written contract or agreement to in- tract or agreement to include as an insured on elude as an additional insured on this Coverage this Coverage Part is an insured, but only with re- Part is an insured, but only with respect to liability spect to liability for "bodily injury", "property dam- for "bodily injury", "property damage", "personal age", "personal injury"or"advertising injury"that: injury" or"advertising injury' that: a. Is "bodily injury" or "property damage" that a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- injury" caused by an offense that is commit- ted, subsequent to the execution of that con- ted, subsequent to the execution of that con tract or agreement; and tract or agreement; and b. Arises out of the ownership, maintenance or b. Is caused, in whole or in part, by your acts or use of that part of any premises leased to omissions in the maintenance, operation or use of equipment leased to you by such you. equipment lessor. The insurance provided to such premises owner, The insurance provided to such equipment lessor manager or lessor is subject to the following pro- is subject to the following provisions: visions: a. The limits of insurance provided to such a. The limits of insurance provided to such equipment lessor will be the minimum limits premises owner, manager or lessor will be which you agreed to provide in the written the minimum limits which you agreed to pro- contract or agreement, or the limits shown on vide in the written contract or agreement, or the Declarations,whichever are less. the limits shown on the Declarations, which- ever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or b. The insurance provided to such premises "property damage" that occurs, or "personal owner, manager or lessor does not apply to: injury" or "advertising injury" caused by an of- (1) Any "bodily injury" or "property damage" fense that is committed, after the equipment that occurs, or"personal injury" or "adver- lease expires. tising injury" caused by an offense that is c. The insurance provided to such equipment committed, after you cease to be a tenant lessor is excess over any valid and collectible in that premises; or other insurance available to such equipment (2) Structural alterations, new construction or lessor, whether primary, excess, contingent demolition operations performed by or on or on any other basis, unless you have behalf of such premises owner, lessor or agreed in the written contract or agreement manager. that this insurance must be primary to, or c. The insurance provided to such premises non-contributory with, such other insurance, owner, manager or lessor is excess over any in which case this insurance will be primary valid and collectible other insurance available to, and non-contributory with, such other in- to such premises owner, manager or lessor, surance. whether primary, excess, contingent or on I. BLANKET ADDITIONAL INSURED — STATES any other basis, unless you have agreed in OR POLITICAL SUBDIVISIONS — PERMITS the written contract or agreement that this in- surance must be primary to, or non- The following is added to SECTION II — WHO IS contributory with, such other insurance, in AN INSURED: which case this insurance will be primary to, Any state or political subdivision that has issued a and non-contributory with, such other insur- permit in connection with operations performed by ance. you or on your behalf and that you are required Page 4 of 6 ©2011 The Travelers Indemnity Company.All rights reserved. CG D3 16 11 11 COMMERCIAL GENERAL LIABILITY by any ordinance, law or building code to include (ii) A manager of any limited liability as an additional insured on this Coverage Part is company; or an insured, but only with respect to liability for (iii) An executive officer or director of "bodily injury", "property damage", "personal in- any other organization; jury" or "advertising injury" arising out of such op- erations. that is your partner, joint venture member or manager; or The insurance provided to such state or political (b) Any "employee" authorized by such subdivision does not apply to: partnership, joint venture, limited li- a. Any "bodily injury," "property damage," "per- ability company or other organization sonal injury" or "advertising injury" arising out to give notice of an "occurrence" or of operations performed for that state or po- offense. litical subdivision; or (3) Notice to us of such "occurrence" or of an b. Any "bodily injury" or "property damage" in- offense will be deemed to be given as cluded in the "products-completed operations soon as practicable if it is given in good hazard". faith as soon as practicable to your work- J. KNOWLEDGE AND NOTICE OF OCCUR- ers' compensation insurer. This applies RENCE OR OFFENSE only if you subsequently give notice to us The following is added to Paragraph 2., Duties In of the "occurrence" or offense as soon as The Event of Occurrence, Offense, Claim or practicable after any of the persons de Suit, of SECTION IV — COMMERCIAL GEN- scribed in Paragraphs e. (1) or (2) above ERAL LIABILITY CONDITIONS: discovers that the "occurrence" or offense may result in sums to which the insurance e. The following provisions apply to Paragraph provided under this Coverage Part may a. above, but only for the purposes of the in- apply. surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. However, if this Coverage Part includes an en- of Section II—Who Is An Insured: dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution (1) Notice to us of such "occurrence" or of- costs arising out of a discharge, release or es- fense must be given as soon as practica- cape of"pollutants" which contains a requirement ble only after the "occurrence" or offense that the discharge, release or escape of "pollut- is known by you (if you are an individual), ants" must be reported to us within a specific any of your partners or members who is number of days after its abrupt commencement, an individual (if you are a partnership or this Paragraph e. does not affect that require- joint venture), any of your managers who ment. is an individual (if you are a limited liability company), any of your "executive offi- K. UNINTENTIONAL OMISSION cers" or directors (if you are an organiza- The following is added to Paragraph 6., Repre- tion other than a partnership,joint venture sentations, of SECTION IV — COMMERCIAL or limited liability company) or any "em- GENERAL LIABILITY CONDITIONS: ployee" authorized by you to give notice The unintentional omission of, or unintentional of an "occurrence"or offense. error in, any information provided by you which (2) If you are a partnership, joint venture or we relied upon in issuing this policy will not preju- limited liability company, and none of your dice your rights under this insurance. However, partners, joint venture members or man- this provision does not affect our right to collect agers are individuals, notice to us of such additional premium or to exercise our rights of "occurrence" or offense must be given as cancellation or nonrenewal in accordance with soon as practicable only after the "occur- applicable insurance laws or regulations. rence" or offense is known by: L. BLANKET WAIVER OF SUBROGATION (a) Any individual who is: The following is added to Paragraph 8., Transfer (i) A partner or member of any part- Of Rights Of Recovery Against Others To Us, nership or joint venture; of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: CG D3 16 11 11 CO 2011 The Travelers Indemnity Company.All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- 3. "Bodily injury" means bodily injury, mental ment to waive that insured's right of recovery anguish, mental injury, shock, fright, disability, against any person or organization, we waive our humiliation, sickness or disease sustained by right of recovery against such person or organiza- a person, including death resulting from any tion, but only for payments we make because of: of these at any time. a. "Bodily injury" or "property damage" that oc- N. CONTRACTUAL LIABILITY— RAILROADS curs; or 1. The following replaces Paragraph c. of the b. "Personal injury" or "advertising injury" definition of "insured contract" in the DEFINI caused by an offense that is committed; TIONS Section: subsequent to the execution of that contract or c. Any easement or license agreement: agreement. 2. Paragraph f.(1) of the definition of "insured M. AMENDED BODILY INJURY DEFINITION contract" in the DEFINITIONS Section is de- leted. The following replaces the definition of "bodily injury" in the DEFINITIONS Section: Page 6 of 6 ©2011 The Travelers Indemnity Company.AD rights reserved. CG D3 16 11 11 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights. duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF B. BLANKET ADDITIONAL INSURED USE — INCREASED LIMIT C. EMPLOYEE HIRED AUTO I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES— INCREASED LIMIT D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS — INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO — LIMITED WORLDWIDE COV- LOSS ERAGE— INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED this insurance applies and only to the extent that The following is added to Paragraph A.1., Who Is person or organization qualifies as an "insured" An Insured, of SECTION II —COVERED AUTOS under the Who Is An Insured provision contained LIABILITY COVERAGE: in Section II. Any organization you newly acquire or form dur C. EMPLOYEE HIRED AUTO ing the policy period over which you maintain 1. The following is added to Paragraph A.1., 50% or more ownership interest and that is riot Who Is An Insured, of SECTION II — COV- separately insured for Business Auto Coverage. ERED AUTOS LIABILITY COVERAGE: Coverage under this provision is afforded only un- An "employee" of yours is an "insured" while til the 180th day after you acquire or form the or- operating an "auto" hired or rented under a ganization or the end of the policy period, which- contract or agreement in an "employee's" ever is earlier. name, with your permission, while performing duties related to the conduct of your busi- B. BLANKET ADDITIONAL INSURED ness. The following is added to Paragraph c. in A.1.. 2. The following replaces Paragraph b. in B.5., Who Is An Insured, of SECTION II — COVERED Other Insurance. of SECTION IV — BUSI- AUTOS LIABILITY COVERAGE: NESS AUTO CONDITIONS: Any person or organization who is required under b. For Hired Auto Physical Damage Cover- a written contract or agreement between you and age, the following are deemed to be cov- that person or organization, that is signed and ered "autos" you own: executed by you before the "bodily injury" or (1) Any covered "auto" you lease, hire, "property damage" occurs and that is in effect rent or borrow; and during the policy period, to be named as an addi- (2) Any covered "auto" hired or rented by tional insured is an "insured" for Covered Autos your "employee" under a contract in Liability Coverage, but only for damages to which an "employee's" name, with your CA T3 53 02 15 O 2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto"that is leased, hired, of the United States of America. Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (i) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set- tle any such claim or "suit" and keep The following is added to Paragraph Al... Who Is us advised of all proceedings and ac- An Insured, of SECTION II —COVERED AUTOS tions. LIABILITY COVERAGE: (ii) Neither you nor any other involved Any "employee" of yours is an "insured" while us- "insured" will make any settlement ing a covered "auto" you don't own, hire or borrow without our consent. in your business or your personal affairs. (iii) We may, at our discretion, participate E. SUPPLEMENTARY PAYMENTS — INCREASED in defending the "insured" against, or LIMITS in the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2). "suit". of SECTION II — COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in- we cover. We do not have to furnish sured" pays with our consent. but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4). graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE— INDEMNITY BASIS within the limit described in Para- The following replaces Subparagraph (5) in Para- graph C.. Limits Of Insurance. of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to (5) Anywhere in the world, except any country or make such payments ends when we jurisdiction while any trade sanction, em- have used up the applicable limit of bargo, or similar regulation imposed by the insurance in payments for damages. United States of America applies to and pro settlements or defense expenses. hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re- and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees". country outside the United States, its ter- partners (if you are a partnership), members ritories and possessions. Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 ©2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO You agree to maintain all required or (2) In or on your covered "auto". compulsory insurance in any such conn- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered "auto". local law. Your failure to comply with No deductibles apply to this Personal Property compulsory insurance requirements will not invalidate the coverage afforded by coverage. this policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following is added to Paragraph B.3.. Exclu- had you complied with the compulsory in- Bions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE: (d) It is understood that we are not an admit- Exclusion 3.a. does not apply to "loss" to one or ted or authorized insurer outside the more airbags in a covered "auto" you own that in- United States of America, its territories flate due to a cause other than a cause of "loss" and possessions, Puerto Rico and Can- set forth in Paragraphs A.1.b. and A.1.c., but ada. We assume no responsibility for the only: furnishing of certificates of insurance, or a. If that "auto" is a covered "auto" for Compre- for compliance in any way with the laws hensive Coverage under this policy; of other countries relating to insurance. b. The airbags are not covered under any war- G. WAIVER OF DEDUCTIBLE— GLASS rarity; and The following is added to Paragraph D., Deducti- c. The airbags were not intentionally inflated. ble. of SECTION III — PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any COVERAGE: one "loss". No deductible for a covered "auto" will apply to L. NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage if the glass is repaired rather than LOSS replaced. The following is added to Paragraph A.2.a., of H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF SECTION IV— BUSINESS AUTO CONDITIONS: USE—INCREASED LIMIT Your duty to give us or our authorized representa- The following replaces the last sentence of Para- tive prompt notice of the "accident" or "loss" ap- graph A.4.b., Loss Of Use Expenses, of SEC- plies only when the "accident" or "loss" is known TION III—PHYSICAL DAMAGE COVERAGE: to: However, the most we will pay for any expenses (a) You (if you are an individual); for loss of use is $65 per day, to a maximum of (b) A partner(if you are a partnership); $750 for any one "accident". (c) A member (if you are a limited liability corn- !. PHYSICAL DAMAGE — TRANSPORTATION pany); EXPENSES— INCREASED LIMIT (d) An executive officer, director or insurance The following replaces the first sentence in Para- manager (if you are a corporation or other or- graph A.4.a., Transportation Expenses, of ganization); or SECTION III — PHYSICAL DAMAGE COVER- (e) Any "employee" authorized by you to give no- AGE: tice of the "accident" or"loss". We will pay up to $50 per day to a maximum of M. BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense in- The following replaces Paragraph A.5., Transfer curred by you because of the total theft of a coy- Of Rights Of Recovery Against Others To Us, ered "auto" of the private passenger type. of SECTION IV — BUSINESS AUTO CONDI- J. PERSONAL PROPERTY TIONS: The following is added to Paragraph A.4., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for "loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or"loss", provided that the "accident" or"loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 02015 The Travelers Indemnity Company.All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract, prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col- The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud. of cancellation or non-renewal. SECTION IV— BUSINESS AUTO CONDITIONS: Page 4 of 4 2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 2. The following is added to Paragraph B.5., Other 1. The following is added to Paragraph A.1.c., Who Insurance of SECTION IV — BUSINESS AUTO Is An Insured, of SECTION II — COVERED CONDITIONS: AUTOS LIABILITY COVERAGE: Regardless of the provisions of paragraph a. and Any person or organization who is required under paragraph d. of this part 5. Other Insurance, this a written contract or agreement between you and insurance is primary to and non-contributory with that person or organization, that is signed and applicable other insurance under which an addi- executed by you before the "bodily injury" or tional insured person or organization is the first "property damage" occurs and that is in effect named insured when the written contract or during the policy period, to be named as an addi- agreement between you and that person or or- tional insured is an "insured" for Covered Autos ganization, that is signed and executed by you Liability Coverage, but only for damages to which before the "bodily injury" or "property damage" this insurance applies and only to the extent that occurs and that is in effect during the policy pe- person or organization qualifies as an "insured" nod, requires this insurance to be primary and under the Who Is An Insured provision contained in SECTION II. non-contributory. CA T4 74 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.with its permission. This page has been left blank intentionally. 3/15/2019 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=253 Consumer tools Agent and Company Lookup Orders Independent Review Decisions CHARTER OAK FIRE INSURANCE COMPANY THE Change History I Licensing I Appointments I Complaints I Orders I National Info I Ratings I Tax Filings Back to Search General information Contact information Name:CHARTER OAK FIRE INSURANCE COMPANY THE Registered address Mailing address Corporate family group:TRAVELERS GRP 0 ONE TOWER SQUARE ONE TOWER SQUARE Organization type: PROPERTY HARTFORD,CT 06183-9070 HARTFORD,CT 06183-9070 Doing Business As(DBA):Unavailable Telephone Telephone WAOIC:253 860-277-0111 860-277-0111 NAIC:25615 Status:ACTIVE Admitted date:01/02/1936 Ownership type: STOCK Company change history View changes Types of coverage authorized to sell 0 Insurance types Casualty Marine Ocean Marine Pro• rty Surety Vehicle !•u.gw.i�spy Agents and agencies that represent this company (Appointments) View agents View agencies Company complaint history 0 ...... .......................... View complaints Orders issued since 2010 View orders •,q Premium tax filings by tax year o 2018, 2017 2016 2015 201.4 r kas si se 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. oo< •op 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 tBCAx Duff and Phelps RateiS s https://fortress.wa.gov/oiciconsumertoolkit/Company/CompanyProfile.aspx?WAOIC=253 1/2 3/15/2019 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=253 Dieel&mer:links to external or third party websites are provided solely for visitors'convenience.links you take to other sites are done so at your own risk and our office accepts no Iiablkty for any external linked sites or their content.Be aware that not all financial rating companies use the same rating processes. https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx7WAOIC=253 2/2 3/15/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=002516&PPP= w 11a Co' Los&Retirement Home&Aum Health 6 Danlahty Olher the Events 76 Charter Oak Fire Insurance Company Follow IM Print this gage (a member of Travelers Group) AM Bast 5:002518 NAIC It 25615 FEIN a:06.0291290 Address: One Tower Square Phone: 880.277-0111 Hartford,CT 06183 Fax: 860.277.7002 UNITED STATES Web: www.travelers.com Best's Credit Ratings Financial Strength Rating View Definition Long-Tenn Issuer Credit Rating View Definition Rating: A••(Superior) Long-Term: aa• Affiliation Code: g(Group) Outlook: Stable Financial Size Category: XV($2 Billion or greater) Action: Affirmed Outlook: Stable Effective Date: October 31,2018 Action: Affirmed Initial Rating Date: April 18.2005 Effective Date: October 31,2018 Initial Rating Date: June 30,1936 u Denotes under Review Best's Rsung Licensing: Licensed Territory:(Current since 12120/2001).The company is licensed In the District of Columbia,Puerto Rico,AL,AK,AZ,AR. 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,TX,UT,VT,VA,WA,WV,WI and WY. Total Assets DPW-Top Lines of Business 3945,000.00 S935,OW.00I �MIE � 5995.1100.00 I I • ::::::i ;111 lir"! ' �.. �. s.,t10o.00 .., 80.87% 5915.000.00' ill , 1. I, �■ 5910,000.00 I1 ;' I' Ft II —Commercial Multiple Peril 5905000.00 —Wallets'Compensation 2010 2011 20r0 2015 2014 —Auto(Commercial) —Omer Liability IOccvrrancol —Data Veers —Hnmrgwners Multiple Peril Company Attributes Industry: Insurance Business: Property/Casually Business Status: In Business Entity: Operating Company Consolidated Type: Affiliated Single Company Organization Type: Stock Statement Type: NAIC PC Lest Statement: 3rd Quarter 2018 http://consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=002516&PPP= 1 3/15/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=002516&PPP= Top Line(s)of Business leased upon Direct Premiums Written) Top States)of Business leased upon Direct Premiums Written) 1.Commercial Multiple Peril(View Definition) 1.New York 2.Workers'Compensation(View oefinklon) 2.New Jersey 3.Auto(Commercial)Mew Definition) 3.Texas 4.Other Liability(Occurrence)lvisw Desninon I 4.Florida 5.Homeowners Mutiple Pen)View Dereeson I 5.Illinois http://consumers.ambest.com/CompanyProf)le.aspx?BL=36&ambnum=002516&PPP= 2/5 3/15/2019 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1320 Consumer tools Agent and Company Lookup Orders Independent Review Decisions TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Change History I Licensing I Appointments I Complaints I Orders I National Info I Ratings I Tax Filings Back to Search General information Contact information Name:TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Registered Mailing address Corporate family group:TRAVELERS GRP e address ONE TOWER SQUARE Organization type: PROPERTY ONE TOWER SQ HARTFORD,CT 06183 Doing Business As(DBA): Unavailable HARTFORD,CT 06183 Telephone Telephone WAOIC: 1320 p 860-027-7011 NAIC:25674 860-027-7011 Status:ACTIVE Admitted date: 10/11/1974 Ownership type: STOCK Ybacv,in top Company change history e Ir View changes Types of coverage authorized to sell r Insurance types !Casualty Marine Ocean Marine Property Surety Vehicle NO to log Agents and agencies that represent this company (Appointments) View agents View agencies Company complaint history o View complaints 1'Nsits w Orders issued since 2010 No orders are found 5e.k c to,r Premium tax filings by tax year 2018 2017 2016 2015 2014 es zap National information on insurance companies Want more information about this company?The NAIC'sConsumer 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. t sack m rop 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 Poops Carp [Moody s Investors Service https:l/fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1320 1/2 3/15/2019 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1320 Fitch IBCA Duff and Phelps Ratites Disclaimer:Links to external or third party websites are provided solely for visitors'convenience.Links you take to other sites are done so at your own risk and our office accepts no liability for any external linked sites or their content.Be aware that not all financial rating companies use the same rating processes. bei to rap https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1320 2/2 3/15/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=004461&PPP= '..�" 0J Lrfe 8 Rebrament Home a Auto Health a Disability Other Lite Events 76 Travelers Property Casualty Co of Amer Fetbsu j Pnntlhisoag0 (a member of Travelers Group) AM Best 8 004461 NAIC a'.26674 FEIN a'36.2718165 Address: One Tower Square Phone: 860-277-0111 Hartford,CT 06183 Fax: 880-277-7002 UNITED STATES Web: www.bavelers.com Best's Credit Ratings Financial Strength Rating View Definition Long-Term Issuer Credit Rating View Definition Rating: A+.(Superior) Long-Term: axe Affiliation Code: g(Group) Outlook: Stable Financial Size Category: XV($2 Billion or greater) Action: Affirmed Outlook: Stable Effective Date: October 31,2018 Action: Affirmed Initial Rating Date: April 18,2005 Effective Date: October 31,2018 Initial Rating Date: June 30,1972 u Gables Under Review Best's Rating Licensing: Licensed Territory:(Current since 11/0512018).The company is licensed in the Oislnd of Columbia.Northern Mariana Islands. Puerto Rico,U,S,Virgin Islands and all states. Total Assets DPW•Top Linea of Business 5940.000.00 5920,000.00 _ aMI G 5900.080.00 E 568000000 1MH ! I • 5860,000.00 5840,000.00 atzo.000.00' ' l ' 19.03% . RI 5800.000.00 I .. 111.p i t 3780,000.00 " �� "I I —Workers'Compensation tare tote tote 2015 2014 —Other Liability(Occurrence) —Commercial Multiple Peril Dale Years —Auto(Commercial)—Inland Manna Company Attributes Industry: Insurance Business: Property/Casually Business Status: In Business Entity: Operating Company Consolidated Type: Affiliated Single Company Organization Type: Stock Statement Type: NAIC PC Last Statement: 3rd Quarter 2018 http://consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=004461&PPP= • 1/5 3/15/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=004461&PPP= Top Line(s)of Business(based upon Drent Premmms carmen) Top State(s)of Business (based upon Direct Premiums carmen) L Workers'Compensation Mow Domino.) 1.California 2.Other Liability(Occurrence)(View Dennitron) 2.New York 3.Commercial Multiple Peril(View Definition) 3.New Jersey 4.Auto(Commercial)(View Definition) 4.Illinois 5.Inland Marine Mew Definition I 5.Pennsylvania http://consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=004461&PPP= 2/5 3/15/2019 Carriers I Surplus Lines Association of Washington Documents I Membership I Calendar of Events I FAQs I Contact Us SEARCH About Us I News I Filing Information I Brokerage Firms I Carriers I SLIP I Laws 8 Regulations I Education I Links I Manual Home > Carriers Carrier Requirements Carriers List of Active Carriers Inclusion on this list does not indicate that the carrier meets the requirement as an appropriate insurer.The Surplus Line Broker is solely responsible for determining the qualifications of each carrier.Being on this list means the carrier is recognized by the Surplus Line Association of Washington and filings by brokers for the carrier will be accepted for examination. Search By Insurer Name or City: westchester Search Insurer Name Address City S... WESTCHESTER SURPLUS LINES INSURANCE COMPANY 436 WALNUT STREET PHILADELPHIA PA O1-1 of 1 items About Us I News I Filing Information I Brokerage Firms I Carriers I SLIP I Laws&Regulations I Education I Links I Manual Hume I Documents I Membership I Calendar of Events I FADs I Contact Us Copyright©2019 Surplus Line Association of Washington,All Rights Reserved.I RSS http://www.surpluslines.org/carriers/ 1/1 3/15/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=004433&PPP= filer co Lite&Retirement Horn,6 Auto Health 6 Disability Other Lite Events 76 snares Westchester Surplus Lines Insurance Co F060W 4 Print lhts pegg (a member of Chubb INA Group) AM Beata:004433 NAIC If 10172 FEIN#:58-2139927 Address: P.O.Box 1000 Phone: 215.640-1000 Philadelphia,PA 19106 Fax: UNITED STATES Web: www.chubb.com Best's Credit Ratings Financial Strength Rating View Definition Long-Term Issuer Credit Rating View Definition Rating: A++(Superior) Long-Term: aa+ Affiliation Coda: g(Group) Outlook: Stable Financial Size Category: XV($2 Billion or greater) Action: Affirmed Outlook: Stable Effective Date: December 13,2018 Action: Affirmed Initial Rating Date: August 16,2005 Effective Date: December 13,2018 Initial Rating Date: June 30.1972 u Denotes Under Review Best's Rating Licensing: Licensed Territory:(Current since 11/27/2018),It is authorized as a Domestic Surplus Lines Insurer in Georgia.II also operates on a surplus lines or non-admitted basis In the District of Columbia,Guam,Northern Mariana islands,Puerto Rico,U.S.Virgin Islands.AL.AK.AZ.AR. CA.CO.CT,DE,FL,Hl,ID,IL.IN,IA,KS.KY.LA.ME.MD,MA,MI,MN.MS,MO,MT,NE,NV,NH.NJ.NM,NY,NC,ND,OH,OK,OR,PA,RI, SC.SD.TN.TX.UT.VT.VA.WA.WV.WI and WY. Total Assets DPW•Top Lines of Business 5400000.00--- 5350.000.00 � kYS300,000I s=fir . .00®1 li i9 6 E•E ' u, 1 ... 550.000.00 111 $D.ou I. III' 20ts 2017 rare 2015 tote —Alen Lines—Omer Liadaty(Occurrence) —Fire—Other Lability IClams-madel Data Yeats —Products LiabiHy Company Attributes Industry: Insurance Business: Property/Casually Business Status: In Business Entity: Operating Company Consolidated Typo: Affiliated Single Company Organization Type: Stock Statement Type: NAIC PC Last Statement: 3rd Quarter 2018 http://consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=004433&PPP= 1/5 3/15/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=004433&PPP= Top Line(s)of Business(tanned upon Deed Premiums Written) Top Stats(s)of Buslnsss (ossed upon Direct Premiums Wnn.n) 1.Allied Lines 1Vaw Definition) 1.Honda 2.Other liability(Occurrence)(View Definition) 2.Texas 3.Fire(View Definitwn I 3.California 4.Other Liability(Claims-made)(View Definition 1 4.New York 5.Products Liability(Mow Definition) 5.Louisiana http://consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=004433&PPP= 2/5 3/15/2019 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1323 Consumer tools Agent and Company Lookup Orders Independent Review Decisions TRAVELERS INDEMNITY COMPANY THE Chane History I Licensing I Appointments I Complaints I Orders I National Info I Ratings I Tax Filings -Back to Search General information Contact information Name:TRAVELERS INDEMNITY COMPANY THE Registered address Mailing address Corporate family group:TRAVELERS GRP 0 ONE TOWER SQUARE ONE TOWER SQUARE Organization type: PROPERTY HARTFORD,CT 06183-9070 HARTFORD,CT 06183-9070 Doing Business As (DBA): Unavailable Telephone Telephone WAOIC: 1323 860-277-0111 860-277-0111 NAIC:25658 Status:ACTIVE Admitted date: 11/27/1916 Ownership type:STOCK Company change history I View changes Types of coverage authorized to sell 0 Ilnsurance types Casualty Marine Ocean Marine Property Surety _.-- VehIcle axk q top Agents and agencies that represent this company (Appointments) 0 ......... .................................... IView agents_ View agencies earl ry top Company complaint history e _....................... View complaints Orders issued since 2010 No orders are found S lack to top Premium tax filings by tax year o 2018 2017 2016 2015 2014 n Eack.to tot National information on insurance companies Want more information about this company?The NAIC's Consumer information(OS)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. ^ha.lo!en 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-Ratin-s Standard and,poor s Cork Moody's Investors Service Fitch IBCA,Duff and Phelps Ratlnos https://fortress,wa.gov/oic/consumertoolkiUCompany/CompanyProfile.aspx?WAOIC=1323 1/2 3/15/2019 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1323 Dlaelalm.,:Links to external or third-party websites are provided solely for visitors convenience.Links you take to other sites are done so at your own risk and our ORice accepts no liability for any external linked Sites or their content.Be aware that not all financial rating companies use the same rating processes. S tori m'n0 https://fortress.wa.gov/oic/consumertoolkit/Company/CompanyProfile.aspx?WAOIC=1323 2/2 3/15/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=002520&PPP= Ili IOWo GO .---- Lae&Retirement Home a Auto Health 8 OisaNllly Other Life Events 76 Travelers Indemnity Company Follow * Printlhis nage (a member of Travelers Group) AM Best a:002520 NAIC it 25658 FEIN a:080568050 Address: One Tower Square Phone: 860-277-0111 Hartford,CT 06183 Fax: 860-277-7002 UNITED STATES Web: www.lravelers.com Best's Credit Ratings Financial Strength Rating View Definition Long-Term Issuer Credit Rating View Definition Rating: A++(Superior) Long-Term: aa+ Affiliation Code: g(Group) Outlook: Stable Financial Size Category: XV($2 Billion or greater) Action: Affirmed Outlook: Stable Effective Date: October 31,2018 Action: Affirmed Initial Rating Date: April 18,2005 Effective Date: October 31,2018 Initial Rating Date: June 30.1922 u Denotes Under Review Best's Rating Licensing: Licensed Territory:(Current since 10/0512017),The company is licensed in the District of Columbia.Guam.Puerto Rico,U.S.Virgin Islands and all states. Total Assets DPW-Top Lines of Business 821.800,000.00— --I-- $21.600.000.00 s Imoi— " ` .. Y 821,400,000.00 im.. 151 $21.200.600.00- u , 7 7Y■il: Ism1 � 121.000.000.00 t t �- a 18.42% $20,800,000.00 1 S 1�_i -' ' i i s2o.eoo,0aa.o0 t �C ! $ . t1 �-s fr i —workers'Compensation 020.400.000.00 I I 1 , § : 1 --Other Liability IOccunence) 2018 2017 21116 2015 2014 —Auto(Commercial) —Commercial Multiple Pent—Anted Lines —Data Years —Fire Company Attributes Industry: Insurance Business: Property/Casually Business Status: In Business Entity: Operating Company Consolidated Type: Affiliated Single Company Organization Type: Stock Statement Type: NAIC PC Last Statement: 3rd Quarter 2018 http://consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=002520&PPP= 1/5 3/15/2019 consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=002520&PPP= Top Line(s)of Business(based won Direct Premiums wnaenl Top State(s)of Business (based upon Direct Premiums Wndenl 1.Workers'Compensation(view Defimdon) 1.New York 2.Other Liability(Occurrence)(View Definition) 2.Massachusetts 3.Auto(Commercial)(Mew Definition) 3.Texas 4.Commercial Multiple Peril(View Definition) 4.New Jersey 5.Allied Lines(View Definition) 5.Pennsylvania http://consumers.ambest.com/CompanyProfile.aspx?BL=36&ambnum=002520&PPP= 2/5 Escrow No. h7 Z9 Z i Agency City of Auburn 25 W. Main, Auburn WA 98001-4998 Contract No. 19-03 ESCROW AGREEMENT TO: (Bank Name,Address,Phone) Col um 1_ Qein 719 Ce_ , WA elblo4- The Undersigned, Transportation Systems, Inc., 6917 166th Avenue East, Sumner, WA 98390, herein referred to as the Contractor, has directed the City of Auburn, hereinafter referred to as the Agency, to deliver to you its warrants which shall be payable to you and the Contractor jointly. Such warrants are to be held and disposed of by you in accordance with the following instructions and upon the terms and conditions hereinafter set forth. INSTRUCTIONS 1. Warrants or checks made payable to you and the Contractor jointly upon delivery to you shall be endorsed by you and forwarded for collection. The moneys will then be used by you to purchase, as directed by the Contractor, bonds or other securities chosen by the Contractor and approved by the Agency. Attached is a list of such bonds, or other securities approved by the Agency. Other bonds or securities, except stocks may be selected by the Contractor, subject to express written approval of the Agency. Purchase of such bonds or other securities shall be in a form which shall allow you alone to reconvert such bonds or other securities into money if you are required to do so by the Agency as provided in paragraph 4 of this Escrow Agreement. 2. When and as interest on the securities held by you pursuant to this agreement accrues and is paid, you shall collect such interest and forward it to the Contractor at its address designated in the first paragraph unless otherwise directed by the Contractor. 3. You are not authorized to deliver to the Contractor all or any part of the securities held by you pursuant to this agreement (or moneys derived from the sale of such securities, or the negotiation of the Agency's warrants)except in accordance with written instructions from the Agency. Compliance with such instructions shall relieve you of any further liability related thereto. The estimated completion date on the contract underlying this Escrow Agreement is July 12, 2019. 4. In the event the Agency orders you to do so in writing, you shall, within thirty-five (35) days of receipt of such order, reconvert into money the securities held by you pursuant to this agreement and return such money together with any other moneys held by you hereunder, to the Agency. 5. The Contractor agrees to pay you as compensation for your services hereunder as follows: Payment of all fees shall be the sole responsibility of the Contractor and shall not be deducted from any property placed with you pursuant to this agreement until and unless the Agency directs the release to the Contractor of the securities and moneys held hereunder whereupon you shall be granted a first lien upon such property released and shall be entitled to reimburse yourself from such property for the entire amount of your fees as provided for herein above. On the event that you are made a party to any litigation with respect to the property held by you hereunder, or in the event that the conditions of this escrow are not promptly fulfilled or that you are required to render any service not provided for in these instructions, or that there is any assignment of the interests of this escrow or any modification hereof, you shall be entitled to reasonable compensation for such extraordinary services from the Contractor and reimbursement from the Contractor for all costs and expenses, including attorney fees occasioned by such default, delay, controversy or litigation. 6. This agreement shall not be binding until executed by the Contractor and the Agency and accepted by you. 7. This instrument contains the entire agreement between you, the Contractor and the Agency with respect to this escrow and you are not a party to nor bound by any instrument or agreement other than this; you shall not be required to take notice of any default or any other matter nor be bound by nor required to give notice or demand, nor required to take any action whatever except as herein expressly provided; you shall not be liable for any loss or damage not caused by your own negligence or willful misconduct. 8. The forgoing provisions shall be binding upon the assigns, successors, personal representatives and heirs of the parties hereto. The undersigned have read and hereby approve the instructions as given above governing the administration of this escrow and do hereby execute this agreement on this 15 day of Alta(c 1-�, , 2019. Transportation Systems, Inc City of Auburn (Contractor) (Agency) n By '9 Bye �/, / �.04fi .2zA-0-(-- (Signatu ) (Finance Dir J tor, Shelley Coleman) (Na ) (Title) The above escrow instructions received and accepted this 13 day of , 2019. By (Authorized Bank Officer) C it/LA-dAti1 (Name) (Title) Securities Authorized by Agency: 1) Bills, certificates, notes or bonds of the United States; 2) Other obligations of the United States or its agencies; 3) Obligation of any corporation wholly-owned by the government of the United States; 4) Indebtedness of the Federal National Mortgage Association; 5) Time deposits in commercial banks; and 6) Savings deposits in commercial banks. REF. ENG-093, Revised 11/17 • CITY OF AUBURN PUBLIC WORKS DEPARTMENT ADDENDUM NO. 1 DATE: February 4, 2019 Project Number CP1815,Contract No. 19-03 2018 Citywide ADA and Sidewalk Improvements Project Bid Opening Date: February 7, 2019 11:00 AM PT The following revisions, additions, and/or deletions are hereby made a part of the specifications and plans of the above-named contract and shall be taken into consideration by the bidder in submitting their bid: BID PROPOSAL PACKAGE: 1. REPLACE the entire Original Bid Proposal Package with the attached Revised Bid Proposal Package. The following is a summary of changes to the Original Bid Proposal Package: a. The unit of measure has changed from Square Feet(SF)to Linear Feet(LF)for Bid Item 48 (Plastic Stop Line) on Page 4 of the Proposal Form. b. The quantity has changed from 80 Linear Feet (LF)to 40 Linear Feet(LF)for Bid Item 48 (Plastic Stop Line) on Page 4 of the Proposal Form. c. The quantity has changed from 400 Square Feet(SF)to 200 Square Feet(SF)for Bid Item 49 (Plastic Crosswalk Line) on Page 4 of the Proposal Form. d. The name for Bid Item 50 (Remove Plastic Stop Line) on Page 4 has been changed from "Remove Plastic Stop Line"to"Removing Plastic Line". e. The unit of measure has changed from Square Feet(SF)to Linear Feet(LF)for Bid Item 50 (Removing Plastic Line) on Page 4 of the Proposal Form. f. The quantity has changed from 61 Linear Feet(LF)to 40 Linear Feet(LF)for Bid Item 50 (Removing Plastic Line) on Page 4 of the Proposal Form. g. The unit of measure has changed from Linear Feet (LF)to Square Feet(SF)for Bid Item 73 (Plastic Crosswalk Line) on Page 6 of the Proposal Form. h. The quantity has changed from 328 Square Feet(SF) to 610 Square Feet(SF)for Bid Item 73 (Plastic Crosswalk Line) on Page 6 of the Proposal Form. i. The name for Bid Item 74 (Removing Plastic Stop Line) on Page 6 has been changed from "Removing Plastic Stop Line"to"Removing Plastic Line". j. The name for Bid Item 75 (Removing Crosswalk Line) on Page 6 has been changed from "Removing Crosswalk Line"to"Removing Plastic Crosswalk Line". k. The unit of measure has changed from Linear Feet (LF)to Square Feet (SF)for Bid Item 75(Removing Plastic Crosswalk Line) on Page 6 of the Proposal Form. I. The quantity has changed from 328 Square Feet(SF) to 610 Square Feet (SF)for Bid Item 75 (Removing Plastic Crosswalk Line) on Page 6 of the Proposal Form. # , . PART 2: TECHNICAL SPECIAL PROVISIONS: 1. REVISE the first paragraph in Section 8-20.3(14)1 (Video Detection System)to read: When traffic video detection is shown in the Plans, the Contractor shall provide and install a fully functional Econolite Vision video detection camera system per Section 9-29.23(Video Detection Cameras). A complete video detection system shall include, but not limited to, cameras, housing, mounts, auxiliary equipment, and all required mounting hardware, cables, connectors, and wiring. CONTRACT PLANS: 1. Sheet number 6 (Vehicle Camera Detection Plan): a. REVISE Construction Note No. 1 to read: 1 0 Install new vantage vector vehicle detection camera as specified in 8-20.3(14)1 of the special provisions. Contractor shall coordinate installation of video detection camera equipment in the cabinet with manufacturer. Contractor is responsible for all connections and terminals. By signing the space provided in the"Receipt of Addenda" section of the"Bid Proposal", bidders certify and acknowledge receipt of Addendum No. 1 and to due consideration thereof in preparing and submitting the"Bid Proposal". Failure to acknowledge receipt of this Addendum on the"Bid Proposal" may be considered an irregularity in the"Bid Proposal". Prepared By: Rev'-wed B : � f z y , �� ('' .// zlq f l q / / Project M nager Date neer of Record Date Approved • > 2/1/A2 Jacob Sweeting, City Engineer/Asst. Director of Engineering Services CITY OF AUBURN PUBLIC WORKS DEPARTMENT ADDENDUM NO. 2 DATE: February 5, 2019 Project Number CP1815, Contract No. 19-03 2018 Citywide ADA and Sidewalk Improvements Project Bid Opening Date: February 7, 2019 11:00 AM PT The following revisions, additions, and/or deletions are hereby made a part of the specifications and plans of the above-named contract and shall be taken into consideration by the bidder in submitting their bid: DESIGN CLARIFICATION: 1. On sheet 5(Repair Plan)of the Contract Plans for Site 6, the existing 8"diameter cast iron water main is approximately 35 feet east of the existing water meter boxes. 2. On sheet 5 (Repair Plan)of the Contract Plans for Site 9, the 12" diameter ductile iron water main is approximately 10 feet west of the existing fire hydrants. By signing the space provided in the"Receipt of Addenda" section of the"Bid Proposal", bidders certify and acknowledge receipt of Addendum No. 2 and to due consideration thereof in preparing and submitting the"Bid Proposal". Failure to acknowledge receipt of this Addendum on the"Bid Proposal" may be considered an irregularity in the"Bid Proposal". Prepared By: Reviewed By: 2/5A, Pro'ec nager Dat J i ineer of Re ord Date Approved By: Jacob Sweeting, .E. City Engineer/Asst, Director of Engineering Services CITY OF AUBURN CONTRACT CHANGE ORDER AGREEMENT NO. 1 Contract No.: Contract 19-03 Project Name: CP1815,2018 Citywide ADA&Sidewalk Improvements Contractor: Transportation Systems, Inc. 6917 166th Avenue East Sumner,WA 98390 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, measurements and unit bid prices 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: Below are additional compensation for the redesign of the storm drainage system at Site#4(9th St.SE&H St. SE)and 5 working days is added to the Contract for the additional work. The additional work will be paid for by the following added pay items and the various pay items in the Contract: 1. ADD pay item CO1-1 (Type 1 Catch Basin with Vaned Grate)to the Contract,which shall be full payment for all costs for material, equipment and labor to furnish and install the catch basin and grate as described in Section 7-05(Manholes, Inlets, Catch Basins, and Drywells)and at the location as shown in the attached plan. 2. ADD pay item CO1-2 (Storm Inlet with Solid Cover)to the Contract,which shall be full payment for all costs for material, equipment and labor to furnish and install the storm inlet as described in Section 7-05(Manholes, Inlets, Catch Basins, and Drywells)and at the location as shown in the attached plan. . 3. ADD pay item CO1-3(Connect to Existing Pipe)to the Contract,which shall be full payment for all costs for material, equipment and labor to connect to existing storm line as described in Section 7-05(Manholes, Inlets, Catch Basins,and Drywells)and at the location as shown in the attached plan. . 4. ADD pay item CO1-4(12-inch Diam.ADS HP Storm Dual Wall PP Pipe with Waterstop Connector)to the Contract,which shall be full payment for all costs for material,equipment and labor to install the storm pipe as described in Section 7-04 (Storm Sewers)as recommended by the manufacturer and at the location as shown in the attached plan. . 5. ADD pay item CO1-5(Additional Mobilization)to the Contract,which shall be full pay for all equipment mobilization, miscellaneous traffic control,temporary sheeting, and all miscellaneous items needed to get the added drainage work done as shown in the attached plan.. 6. INCREASE Contract unit quantity for pay item#8(Removal of Concrete or Asphalt Pavement). 7. INCREASE Contract unit quantity for pay item#11 (Remove Pipe). 8. INCREASE Contract unit quantity for pay item#15(Commercial HMA). 9. INCREASE Contract unit quantity for pay item#21 (Pipe Zone Bedding). 10. INCREASE Contract unit quantity for pay item#22(Select Trench Backfill). The Contract time is extended by 5 working days. Sec. Quantity Unit Price Total Price Item Sch. No. Item Description (+1-) Units ($) (+/-) CO1-1 A 7-05 Type 1 Catch Basin with Vaned Grate 2 EA 1,800.00 $ 3,600.00 C01-2 A 7-05 Storm Inlet with Solid Cover 1 EA 1,600.00 $ 1,600.00 C01-3 A 7-05 Connect to Existing Pipe 2 EA 600.00 $ 1,200.00 12-inch Diam. ADS HP Storm Dual Wall PP Pipe with Waterstop CO1-4 A 7-04 Connector 46 LF 63.00 $ 2,898.00 C01-5 A 1-09 Additional Mobilization 8500 LS 1.00 $ 8,500.00 4 A 1-10 Traffic Control Labor- Flagging 80 HR 45.00 $ 3,600.00 8 A 2-02 Removal of Concrete or Asphalt Pavement 15 SY 12.00 $ 180.00 11 A 2-02 Remove Pipe 5 LF 38.00 $ 190.00 15 A 5-04 Commercial HMA 6 TN 200.00 $ 1,200.00 21 A 7-08 Pipe Zone Bedding 15 TN 60.00 $ 900.00 22 A 7-08 Select Trench Backfill 15 TN 50.00 $ 750.00 Subtotal $ 24,618.00 Washington State Sales Tax(10%)on applicable items $ - ENG-028, Revised 01/19 Page 1 of 2 CITY OF AUBURN CONTRACT CHANGE ORDER AGREEMENT NO. 1 Contract No.: Contract 19-03 Project Name: CP1815,2018 Citywide ADA&Sidewalk Improvements TOTAL $ 24,618.00 Base Amount Total incl.Tax 1. Total Cost this C/O $ 24,618.00 $ 24,618.00 2. Total Cost Previous C/O $ - $ - 3. Original Contract Amount $ 451,184.00 $451,184.00 4. Revised Contract Amount $ 475,802.00 $475,802.00 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. All other terms and conditions of the Contract remain unchanged. Counterparts: This agreement may be executed in multiple counterparts, each of which shall be one and the same Agreement and shall become effective when one or more counterparts have been signed by each of the parties and delivered to the other party. Contractor: 1211-4(4---) Date Project Manager: �. 7 z9 Date City Engineer: �1/u, 7/709Date Approved by: • 1`3(.l ayor Auburn Date Approved as to form: ���{ City • •rney ate ENG-028, Revised 01/19 Page 2 of 2 . CITY OF AUBURN CONTRACT CHANGE ORDER AGREEMENT NO. 2 Contract No.: Contract 19-03 Project Name: CP1815, 2018 Citywide ADA& Sidewalk Improvements Contractor: Transportation Systems, Inc. 6917 166th Avenue East Sumner, WA 98390 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, measurements and unit bid prices for the type of construction involved shall be in accordance with the contract documents of the above named project unless stated otherwise Summary of Proposed Changes: 1. A total of 8 working days are added to the Contract for the following unforeseen work to be paid by utilizing existing Contract Bid Items: 4/16/2019-Time spent re-digging conduit at Site 9, 4/24/2019 through 4/25/2019-Waiting for inline valve to be fixed by City Maintenance&Operations staff at Site 9, 4/26/2019 and 4/29/2019-Time spent repairing a defective fire hydrant at Site 9, 5/13/2019 through 5/14/2019-Removal of direct bury CenturyLink wires wrapped around a tree to be removed at Site 7, and 6/5/2019- Removal of direct bury CenturyLink wires wrapped around a tree to be removed at Site 5. 2. For the purpose of settlement of an ongoing dispute, both parties agree to add 10 no cost working days to the Contract in exchange for the force account work listed below: D St. NE and 9th/10th St. NE -installation of the pedestrian push button extension arm at the NW corner -adjustment of the junction boxes at the NE, NW and SW corner -landscaping restoration (Otto Luken shrubs) H St. SE and 9th St. SE -reparation of the damaged irrigation system 28th ST NE-West of I St. NE -partial removal of obstructed root system -partial payment to repair the damaged irrigation system that were not possible to protect By signing this change order,the Contractor agrees and certifies that the 10 added working days constitutes the final settlement to the Contractor and no additional compensation will be made for any of the Work described above. The Contract time is extended by 18 working days. Sec.No. Item Description Quantity Unit Price Total Price Item Sch. (+/-) Units ($) (+/-) N/A $ - Subtotal $ - Washington State Sales Tax(10%) on applicable items $ - TOTAL $ - Base Amount Total incl. Tax 1. Total Cost this C/O $ - $ - 2. Total Cost Previous C/O $ 24,618.00 $ 24,618.00 3. Original Contract Amount $ 451,184.00 $ 451,184.00 4. Revised Contract Amount $ 475,802.00 $ 475,802.00 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. All other terms and conditions of the Contract remain unchanged. Counterparts: This agreement may be executed in multiple counterparts, each of which shall be one and the same Agreement and shall become effective when one or more counterparts have been signed by each of the parties and delivered to the other party. ENG-028, Revised 01/19 Page 1 of 2 CITY OF AUBURN CONTRACT CHANGE ORDER AGREEMENT NO. 2 Contract No.: Contract 19-03 Project Name: CP1815, 2018 Citywide ADA& Sidewalk Improvements Contractor: 7�1-��/91,�G'� ' Date F /A-a4", Project Manager: c //9/2o Date City Engineer: , ,SJ ti v t ✓ ///ti/L' Date Approved by: \ 4 - 4 11 `6 lb Mayo ity of Au•urn Date Approved as to form: \()Q.., -, City Attorney Date ENG-028, Revised 01/19 Page 2 of 2