Loading...
09-020.00 Century West: Transportation Planning SvcsT AGREEMENT FOR PROFESSIONAL SERVICES Contract #09 -001 Century West Engineering Corporation Transportation Planning Services THIS AGREEMENT is made by and between the City of Spokane Valley, a code City of the State of Washington, hereinafter "City" and Century West Engineering Corporation, hereinafter "Contractor," jointly referred to as "parties." IN CONSIDERATION of the terms and conditions contained herein the parties agree as follows: 1. Work to Be Performed The Consultant will provide all labor, services and material to satisfactorily complete the attached Scope of Services. A. Administration The City Manager or designee shall administer and be the primary contact for Consultant. Prior to commencement of work, Consultant shall contact the City Manager or designee to review the Scope of Work, schedule and date of completion. Upon notice from the City Manager or designee, Consultant shall commence work, perform the requested tasks in the Scope of Work, stop work and promptly cure any failure in performance under this agreement. B. Representations The City has relied upon the qualifications of the Consultant in entering into this agreement. By execution of this agreement, Consultant represents it possesses the ability, skill and resources necessary to perform the work and is familiar with all current laws, rules and regulations which reasonably relate to the Scope of Work. No substitutions of agreed upon personnel shall be made without the written consent of the City. Consultant shall be responsible for the technical accuracy of its services and documents resulting therefrom, and City shall not be responsible for discovering deficiencies therein. Consultant shall correct such deficiencies without additional compensation except to the extent such action is directly attributable to deficiencies in City furnished information. C. Modifications The City may modify this agreement and order changes in the work whenever necessary or advisable. The Consultant will accept modifications when ordered in writing by the City Manager or designee. Compensation for such modifications or changes shall be as mutually agreed between the parties. The Consultant shall make such revisions in the work as are necessary to correct errors or omissions appearing therein when required to do so by the City without additional compensation. 2. Term of Contract This agreement shall be in full force and effect upon execution and shall remain in effect until December 31, 2009. Either party may terminate this agreement by ten days written notice to the other party. In the event of such termination, the City shall pay the Consultant for all work previously authorized and satisfactorily performed prior to the termination date. 3. Compensation The City agrees to pay the Consultant on a time and materials basis up to an amount not exceeding $50,000 in accordance with the attached Schedule of Fees and as full compensation for everything done under this Agreement. 4. Pa,_ nt . The Consultant shall be paid monthly upon presentation of an invoice to the City. Contract #09 -001- Transportation Planning Services — Century West Engineering Corporation - #4 Page 1 of 7 C09 -020 r t Applications for payment shall be sent to the City Clerk at the below stated address. The City reserves the right to withhold payment under this agreement which is determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Scope of Work, City Standards, City ordinances and federal or state standards. 5. Notice Notice shall be given in writing as follows: TO THE CITY: TO THE CONTRACTOR: Christine Bainbridge, City Clerk Dennis D. Fuller, P.E. (509)921 -1000 (509) 838 -3810 11707 East Sprague Ave, Suite 106 1825 N. Hutchinson Road, 2 Floor Spokane Valley, WA 99206 Spokane Valley, WA 99212 6. Auolicable Laws and Standards The parties, in the performance of this agreement, agree to comply with all applicable Federal, State, local laws, ordinances, and regulations. 7. Relationship of the Parties It is understood, agreed and declared that the Consultant shall be an independent Consultant and not the agent or employee of the City, that the City is interested in only the results to be achieved, and that the right to control the particular manner, method and means in which the services are performed is solely within the discretion of the Consultant Any and all employees who provide services to the City under this agreement shall be deemed employees solely ofthe Consultant. The Consultant shall be solely responsible for the conduct and actions of all its employees under this agreement and any liability that may attach thereto. 8. Ownership of Documents All drawings, plans, specifications, and other related documents prepared by the Consultant under this agreement are and shall be the property of the City, and may be subject to disclosure pursuant to RCW 42.56 or other applicable public record laws. 9. Records The City or State Auditor or any of their representatives shall have full access to and the right to examine during normal business hours all of the Consultant's records with respect to all matters covered in this contract. Such representatives shall be permitted to audit, examine and make excerpts or transcripts from such records and to make audits of all contracts, invoices, materials, payrolls and record of matters covered by this contract for a period of three years from the date final payment is made hereunder. 10. Insurance The Consultant shall procure and maintain for the duration of the agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, its agents, representatives, or employees. No Limitation. Consultant's maintenance of insurance as required by the agreement shall not be construed to limit the liability of the Consultant to the coverage provided by such insurance, or otherwise limit the City's recourse to any remedy available at law or in equity. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non - owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. Contract #09-001- Transportation Planning Services — Century West Engineering Corporation - #4 Page 2 of 7 2. Commercial General Liability insurance shall be written on ISO occurrence form CO 00 01 and shall cover liability arising from premises, operations, independent contractors and personal injury and advertising injury. The City shall be named as an insured under the Consultant's Commercial General Liability insurance policy with respect to the work performed for the City. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. 4. Professional Liability insurance appropriate to the Consultant's profession. B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. 3. Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability, Professional Liability and Commercial General Liability insurance: 1. The Consultant's insurance coverage shall be primary insurance as respect the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Consultant's insurance and shall not contribute with it 2. Cancellation of Consultant's insurance shall be governed by either: a. the policy shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty days prior written notice by certified mail, return receipt requested, has been given to the City, or b. the Consultant shall provide at least 30 days prior written notice by certified mail, return receipt requested of a cancellation. D. Acceptability ofInsurers Insurance is to be placed with insurers with a current AM Best rating of not less than ANIL E. Evidence of Coverage. As evidence of the insurance coverages required by this contract, the Consultant shall furnish acceptable insurance certificates to the City at the time the Consultant returns the signed contract. The certificate shall specify all of the parties who are additional insureds, and will include applicable policy endorsements, and the deduction or retention level. Insuring companies or entities are subject to City acceptance. If requested, complete copies of insurance policies shall be provided to the City. The Consultant shall be Contract #09 -001- Transportation Planning Services — Century West Engineering Corporation - #4 Page 3 of 7 a financially responsible for all pertinent deductibles, self-insured retentions, and/or self - insurance. 11. Indemnification and Hold Harmless The Consultant shall defend, indemnify and hold the City, its officers, officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees, arising out of or in connection with the performance ofthis agreement, except for injuries and damages caused by the sole negligence of the City. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115 then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence ofthe Consultant and the City, its officers, officials, employees, and volunteers, the Consultant's liability hereunder shall be only to the extent ofthe Consultant's negligence. It is further specifically and expressly understood that the indemnification provided herein constitutes the Consultant's waiver of immunity under Industrial Insurance. Title 51 RCW, solely for the purposes of this indemnification. This waiver has been mutually negotiated by the parties. The provisions ofthis section shall survive the expiration or termination of the agreement. 12. ]Naive r. No officer, employee, agent or other individual acting on behalf of either party has the power, right or authority to waive any ofthe conditions or provisions ofthis agreement. No waiver in one instance shall be held to be waiver of any other subsequent breach or nonperformance. All remedies afforded in this agreement or by law, shall be taken and construed as cumulative, and in addition to every other remedy provided herein or by law. Failure of either party to enforce at any time any ofthe provisions ofthis agreement or to require at any time performance by the other party of any provision hereof shall in no way be construed to be a waiver of such provisions nor shall it affect the validity of this agreement or any part thereof. 13. Assignment and Delegation Neither party shall assign, transfer or delegate any or all ofthe responsibilities ofthis agreement or the benefits received hereunder without first obtaining the written consent of the other party. 14. Subcontracts Except as otherwise provided herein, the Consultant shall not enter into subcontracts for any ofthe work contemplated under this agreement without obtaining prior written approval of the City. 15. Confidentiality Consultant may, from time to time, receive information which is deemed by the City to be confidential. Consultant shall not disclose such information without the express written consent of the City or upon order of a Court of competent jurisdiction. 16. Jurisdiction and Venue This agreement is entered into in Spokane County, Washington. Venue shall be in Spokane County, State of Washington. 17. Cost and Attorney's Fees In the event a lawsuit is brought with respect to this agreement, the prevailing party shall be awarded its costs and attorney's fees in the amount to be determined by the Court as reasonable. Unless provided otherwise by statute, Consultant's attorney fees payable by the City shall not exceed the total sum amount paid under this agreement. 18. Entire Agreement This written agreement constitutes the entire and complete agreement between the parties and supercedes any prior oral or written agreements. This agreement may not be changed, modified or altered except in writing signed by the parties hereto. 19. Anti- kickback No officer or employee of the City, having the power or duty to perform an Contract #09 -001- Transportation Planning Services — Century West Engineering Corporation - #4 Page 4 of 7 official act or action related to this agreement shall have or acquire any interest in this agreement, or have solicited, accepted or granted a present or future gift, favor, service or other thing of value from any person with an interest in this agreement. 20. Business Registration Prior to commencement of work under this agreement, Consultant shall register with the City as a business. 21. Severability If any section, sentence, clause or phrase of this agreement should be held to be invalid for any reason by a court of competent jurisdiction, such invalidity shall not affect the validity of any other section, sentence, clause or phrase of this agreement. 22. Exhibits Exhibits attached and incorporated into this agreement are: 1. Scope of Work 2. Schedule of Fees 3. Insurance Certificates IN WITNESS WHEREOF, the p; 2009. CITY OF EO VALLEY: David Mercier, City Manager uties have executed this agreement this day of Consult Jy' C -lwner Tax ID ID No. _ RE DACTED ATTEST APPROVED AS TO FORM: Christine Bainbridge, City Clerk Office of e City Atto y rha'ssbe0ecnuredacted dment contains confidential tax information and pursuant to RCW 82.32.330. You may petition for a review of our findings pertaining to any redacted or withheld documents pursuant to Spokane Valley Municipal Code (SVMC) 2.75.080; and obtain judicial review pursuant to RCW 42.56350. Contract #09 -001- Transportation Planning Services — Century West Engineering Corporation - #4 Page 5 of 7 Exhibit 1 Scope of Work Transportation Planning Services Background and Purpose The City of Spokane Valley currently has a vacant, part-time (0.4 FTE) Senior Engineer (Planning/Grants) position. This position assists the Senior Capital Projects Engineer with the development of the Six Year Transportation Improvement Program (TIP) and the development of state and federal grant applications for street capital projects. Rather than filling this position with a part-time employee, the City desires to contract with a qualified consultant to provide transportation planning support services. Transportation Planning Services Consultant support services entail the designation of an engineer with transportation planning experience to work with city staff and provide day - today support in the development of the city's TIP and street project grant applications. The type of support services includes, but is not limited to, the following: Six -Year TO Development of the Amended 2009 TIP and the 2010 -2015 Six Year TIP Project List: including review of the following: • volume /capacity ratios based on Spokane regional traffic models • number, location, and type of collisions/injuries/fatalities • existing and forecast intersection levels of service • existing pavement conditions • increased areas of development and re- development within the city and in areas adjacent to the city • adjacent jurisdiction street projects that cross city boundaries • proposed street maintenance activities • full-width paving associated with Spokane County's STEP Six Year TIP Develop planning -level cost estimates including: Cost Estimates: • description of proposed improvements • number of proposed lanes • proposed intersection improvements • pedestrian/bicycle improvements • ADA requirements • drainage facilities • project limits maps • project estimate • right -of -way acquisition costs • other appropriate items Six Year TIP Review project selection criteria of local, state, and federal grant programs; Funding identify grant funding program(s) for each project. Grant programs shall include, Proposals: but not be limited to, the following: WA State Transportation Improvement Board (TIB) Corridor Completion Initiative (CCI) Urban Arterial Program (UAP, previously AIP) Urban Corridor Program (UCP, previously TPP) Sidewalk Program (SP, previously PSMP) Contract #09 -001- Transportation Planning Services — Century West Engineering Corporation - #4 Page 6 of 7 FA • Freight Mobility /Strategic Investment Board (FMSIB) • Federal Aid Program Bridge (BR) Surface Transportation Program (STP) Congestion Management/Air Quality Funds (CMAQ) Transportation Enhancement Program Emergency Relief Intersection and Corridor Safety • WSDOT Safe Routes to School Program Pedestrian and Bicycle Safety Program Regional Mobility Grant Program • Spokane Transit Authority (STA) Bus relaxed street improvements • Community Development Block Grants (CDBG) Low - Moderate Income area improvements • Washington Utilities and Transportation Commission (WUTC) Grade Crossing Protective Fund Also help identify potential funding partners such as adjacent jurisdictions and/or private developers. Six Year TIP Develop the Six Year TIP Report consisting of: Report • project phases (PE, RW, and Cl) • sorted by year • identifying major funding source(s) • include necessary information for STIP software. Grant Assist in the preparation of state and federal grant applications including Applleations: information such as: • existing structural pavement condition • existing and proposed levels of service (LOS) • existing and proposed traffic volumes • system continuity • project funding • alternative mode accessibility • transportation concurrency • economic growth and development • urban accident analysis /annual benefit • public support/participation • environmental enhancements/historical preservation • freight mobility • GMA information/support Contract #08 -012 - Transportation Planning Services —Century West Engineering Corporation Page 7 of 7 Cllent#• 47497 4CENTWES - ACORD CERTIFICATE OF LIABILITY INSURANCE 0810110 D° "'"' r ' PRODUCER Hilb Rogal & Hobbs CALIC#OD36842 503 972 -197? 5100 SW Macadam Avenue, Suite 270 Portland, OR 97239 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED CENTURY WEST ENGINEERING CORPORATION 6650 SW REDWOOD LANE #300 PORTLAND, OR 97224 INSURER A. Hartford Casualty Insurance Company 29424 INSURER B TWIN CITY FIRE INS CO 29459 INSURER C Lexington Insurance Company 19437 INSURER o HARTFORD UNDERWRITERS INS CO 30104 INSURER E $1.000.000 COVERAGES 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS NSR POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER A GENERAL LIABILITY 52SOAPR2754 08/01/08 08/01/09 EACH OCCURRENCE $1.000.000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $300 OOO CLAIMS MADE a OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1.000,000 GENERAL AGGREGATE s2,000,000 PRODUCTS - COMP /OP AGG g = 00 = 0 000 GENT AGGREGATE LIMIT APPLIES PER POLICY PRO- LOC D AUTOMOBILE LIABILITY X ANYAUTO 52UECUM6899 08/01/08 08/01/09 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per Dom) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per acddent) $ X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE (Per acddent) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY AGG $ ANY AUTO $ A EXCESSIUMBREw► LIABILITY 52SBAPR2754 08/01/08 08/01/09 EACH OCCURRENCE $5 000 000 X OCCUR F-1 CLAIMS MADE AGGREGATE s5,000,000 $ EDUCTIBLE F $ x D RETENTION $10000 KE B WORRS COMPENSATION AND 52WECN09327 10/01/08 10/01/09 WC LIMM OTH- EMPLOYM LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICEWMEMBER EXCLUDED? EL EACH ACCIDENT $500,000 EJ- DISEASE - EA EMPLOYEE $500,000 ff yas, describe under SPECIAL PROVISIONS below EL DISEASE -POLICY LIMIT $500,000 C OTHER Professional 7876046 04/15/08 04/15/09 $1,000,000 Per Claim Liability $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 10 days notice of cancellation applies for non payment of premium. Re: All operations Certificate holder is included as Additional Insured, with respects to general liability, where required by written contract Subject to policy terms, conditions and exclusions. Cell AIIJilLoLl City of Spokane Valley 11707 East Sprague Avenue Suite 106 Spokane, WA 99206 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _30 _ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR AGQRD Z5 (ZUU11U5) 1 of 2 #M598358 4RJAC 0 ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon ACORD 25-S (2001108) 2 of 2 #M598358 11 ^ ./Gant#: 47497 4CENTWEf ACORD CEK IFICATE OF LIABILITY INSURANCE 04/151 09 PRODUCER Willis of Oregon, Inc. CALIC#0464609 503 972 -1977 ( 5100 SW Macadam Avenue, Suite 270 Portland, OR 97239 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC 0 INSURED Century West Engineering Corporation 6650 SW Redwood Lane #350 Portland, OR 97224 INSURER A. Hartford Casualty Insuran 29424 INSURER B Twin City Fire ins Co 29459 INSURER C Lexington Insurance Company 19437 INSURER D Hartford Underwriter Ins 30104 INSURER E- 08/01108 COVERAGES 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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INOR LTR g TYPE OF INSURANCE POLICY NUMBER DA C EF POLICY MMI p LIMITS A GENERAL LIABILITY 52SBAPR2754 08/01108 08/01/09 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $300,000 CLAIMS MADE OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1 QQQ QQQ GENERAL AGGREGATE $2 000 000 GENT- AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP /OP AGG s2,000,000 POLICY ECT LOC D AUTOMOBILE LIABILITY ANY AUTO 62UECUMS899 08/01/08 08/01/09 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY AGG $ ANY AUTO $ A EXCESSIUMBRELLA LIABILITY 52SBAPR2754 08/01/08 08/01/09 EACH OCCURRENCE $5,000,000 X OCCUR Fi CLAIMS MADE AGGREGATE $5.000.000 $ $ DEDUCTIBLE $ X RETENTION $10,000 B WORKERS COMPENSATION AND 52WECN09327 10/01/08 10/01/09 wC LIMff 0TH - EMPLOYERS' LIABILITY ANY PROPRIETORMARTNERIEXECUTIVE E-L EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE S500 9 000 OFFICERIMEMBER EXCLUDED? if yes describe under SP CIAL PROVISIONS bebw E.L. DISEASE - POUCY LIMIT $500,000 C OTHER Professional 7881645 04/15/09 04/15/10 $1,000,000 Per Claim Liability $2,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Re: All operations Certificate holder is Included as Additional Insured, with respects to general liability, where required by written contract. Subject to policy terms, conditions and exclusions. 10 days notice of cancellation applies for non payment (See Attached Descriptions) City of Spokane Valley 11707 East Sprague Avenue Suite 106 Spokane, WA 99206 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -1Q_ DAYS WRITTEN N: TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR AUTHORIZED RE I ACORD 25 (2001108) 1 of 3 #S630409/M630383 4MVAN 0 ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon ACORD 25-S (2001108) 2 of 3 OS630409IM630383 r 4 � DE , (C-ontin,ued - from Ps!-e of prennium. IN AMS 25 .3 (2001108). _ 3,- 3 - #S630409IM630381