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16-040.00 All Surface Roofing: Maintenance Facility Roof Repair CONSTRUCTION AGREEMENT All Surface Roofing THIS CONSTRUCTIONAGREEMENT (the "Agreement") is made by and between the City of Spokane Valley,a code City of the State of Washington("City")and All Surface Roofing,("Contractor")jointly referred to as the"Parties". IN CONSIDERATION of the terms and conditions contained herein the Parties agree as follows: 1. Work to Be Performed. Contractor shall do all work and furnish all labor,supervision,tools,materials,supplies and equipment and other items necessary for the construction and completion of the Maintenance Facility Roof Damage Repair Project(the"Work")in accordance with documents described in Exhibit A and in accordance with this Agreement(which are by this reference incorporated herein and made part hereof(the"Contract Documents")),and shall perform any changes in the work in accordance with the Contract Documents. The terms and provisions in this Agreement shall control over any inconsistent or incompatible terms in any other Contract Document. Contractor shall,for the amount set forth in paragraph 4,below,assume and be responsible for the cost and expense of all work required for constructing and completing the Work and related activities provided for in the Contract Documents to City's satisfaction, within the time limits prescribed in the Contract Documents. The City Manager, or designee, shall administer and be the primary contact for Contractor. Upon notice from City, Contractor shall promptly commence work,complete the same in a timely manner,and cure any failure in performance under this Agreement. Unless otherwise directed by City,all work shall be performed in conformance with the Contract Documents,and all City, State and federal standards, codes, ordinances, regulations and laws as now existing or as may be adopted or amended. 2. Time for Performance. Contractor shall commence the Work within 10 days of receipt of a notice to proceed [or execution of this Agreement] and shall complete within 30 days. 3. Liquidated Damages. None 4. Compensation. hi consideration of Contractor performing the Work,City agrees to pay Contractor in accordance with the Contract Documents the sum of$2,047.00,plus Washington State Sales Tax of$ 178.09(if applicable),for a total of$2,225.09,based on the bid submitted by Contractor(Exhibit A),and as may be adjusted in accordance with the Contract Documents. 5.Payment. Contractor may elect to be paid in monthly installments,upon presentation of an application for payment in a form satisfactory to City. Applications for payment shall be sent to the City Finance Department at the below stated address. Pursuant to chapter 60.28 RCW, five percent of the compensation due Contractor shall be retained by City. City reserves the right to withhold payment under this Agreement for that portion of the work(if any)which is determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Contract Documents, City standards, City Code, and federal or state standards. 6. Notice. Notice other than applications for payment shall be given in writing as follows: Construction Agreement Page 1 of 6 TO THE CITY: TO THE CONTRACTOR: Name: Christine Bainbridge, City Clerk Name: All Surface Roofing Phone: (509)921-1000 Phone: 509-315-7136 Address: 11707 East Sprague Ave, Suite 106 Address: P.O. Box 18806 Spokane Valley, WA 99206 Spokane,WA 99228 7. Applicable Laws and Standards. The Parties, in the performance of this Agreement, agree to comply with all applicable federal, state,and local laws, codes and regulations. 8. Certification Regarding Debarment, Suspension, and Other Responsibility Matters — Primary Covered Transactions. A.By executing this Agreement,the Consultant certifies to the best of its knowledge and belief,that it and its principals: 1. Are not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily excluded from covered transactions by any federal department or agency; 2. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission or fraud or a criminal offense in connection with obtaining,attempting to obtain,or performing a public(federal,state,or local)transaction or contract under a public transaction; violation of federal or state antitrust statues or commission of embezzlement,theft,forgery,bribery,falsification or destruction of records,making false statements, or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal,state,or local)with commission of any of the offenses enumerated in paragraph(A)(2)of this certification; and 4. Have not within a three-year period preceding this application/proposal had one or more public transactions(federal, state, or local)terminated for cause or default. B. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this Agreement. 9. Prevailing Wages on Public Works. Contractor, any subcontractor, or other person doing work under this Agreement,shall comply with the requirements of chapter 39.12 RCW,and shall pay each employee an amount not less than the Prevailing Rate of Wage, as specified by the Industrial Statistician of the Washington State Department of Labor and Industries("L&I"). If employing labor in a class not shown,Contractor shall request a determination of the correct wage rate for the class and locality from the Industrial Statistician. Contractor shall provide a copy of any such determinations to City. Before commencing,during,and upon completion of the work,Contractor shall file all forms and pay all fees required by L&I and shall indemnify and hold City harmless from any claims related to its failure to comply with chapter 39.12 RCW. The following information is provided pursuant to RCW 39.12.030: Construction Agreement Page 2 of 6 A. State of Washington prevailing wage rates applicable to this public works project, published by L&I are located at the L&I website address: https://fortress.wa.gov/lni/wagelookup/prvWage lookup.aspx B. This Project is located in Spokane County. C. The effective prevailing wage date is the same date as the bid due date as referenced in the original request for bids and as may be revised by addenda. A copy of the applicable prevailing wage rates is also available for viewing at the offices of City located at 11707 East Sprague,Suite 106,Spokane Valley,WA 99206. Upon request,City will mail a hard copy of the applicable prevailing wages for this project. 10. Relationship of the Parties. It is understood, agreed and declared that Contractor shall be an independent contractor,and not the agent or employee of City,that 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 Contractor. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Contractor. Contractor shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 11. Ownership of Documents. All drawings, plans, specifications, and other related documents prepared by Contractor under this Agreement are and shall be the property of City, and may be subject to disclosure pursuant to chapter 42.56 RCW,or other applicable public record laws. 12. 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 Contractor's records with respect to all matters covered in this Agreement. 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. 13.Warranty. Unless provided otherwise in the Contract Documents,Contractor warrants that all Work and materials performed or installed under this Agreement are free from defect or failure for a period of one year following final acceptance by City, unless a supplier or manufacturer has a warranty for a greater period, which warranty shall be assigned or transferred to City. In the event a defect or failure occurs in work or materials,Contractor shall,within the warranty period, remedy the same at no cost or expense to City. This warranty provision shall not be construed to establish a period of limitation with respect to Contractor's other obligations under this Agreement. 14.Contractor to Be Licensed And Bonded. Contractor shall be duly licensed,registered and bonded by the State of Washington at all times this Agreement is in effect. 15. Contractor to provide performance and payment bonds. Contractor shall provide a payment bond and a performance bond in the full amount of the contract on the City's bond forms. Alternatively,Contractor may elect to have the City retain 50% of the contract amount lieu of providing the City with a payment bond and a performance bond, pursuant to RCW 39.08.010(3). 16.Insurance. Contractor 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 Contractor, its agents,representatives, or employees. Construction Agreement Page 3 of 6 A. Minimum Scope of Insurance. Contractor 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. 2.Commercial general liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, stop gap liability, personal injury and advertising injury, and liability assumed under an insured contract. The commercial general liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. There shall be no endorsement or modification of the commercial general liability insurance for liability arising from explosion,collapse or underground property damage. City shall be named as an insured under Contractor's commercial general liability insurance policy with respect to the work performed for City using ISO Additional Insured endorsement CG 20 10 10 01 and Additional Insured-Completed Operations endorsement CG 20 37 10 01 or substitute endorsements providing equivalent coverage. 3. Workers' compensation coverage as required by the industrial insurance laws of the State of Washington. B. Minimum Amounts of Insurance. Contractor shall maintain the following insurance limits: 1.Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of no less than $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, and no less than a $2,000,000 products-completed operations 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. Contractor's insurance coverage shall be primary insurance with respect to City. Any insurance, self-insurance, or insurance pool coverage maintained by City shall be excess of Contractor's insurance and shall not contribute with it. 2. Contractor shall fax or send electronically in .pdf format a copy of insurer's cancellation notice within two business days of receipt by Contractor. D.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.Best rating of not less than A:VII. E.Evidence of Coverage. As evidence of the insurance coverages required by this Agreement,Contractor shall furnish acceptable insurance certificates to City at the time Contractor returns the signed Agreement, which shall be Exhibit C. The certificate shall specify all of the parties who are additional insureds,and shall 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 City. Construction Agreement Page 4 of 6 Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions, and/or self- insurance. 17.Indemnification and Hold Harmless. Contractor shall,at its sole expense,defend,indemnify and hold harmless City and its officers,agents,and employees,from any and all claims,actions,suits,liability,loss,costs,attorney's fees and costs of litigation, expenses, injuries, and damages of any nature whatsoever relating to or arising out of the wrongful or negligent acts, errors or omissions in the services provided by Contractor, Contractor's agents, subcontractors, subconsultants and employees to the fullest extent permitted by law, subject only to the limitations provided below. Contractor's duty to defend, indemnify and hold harmless City shall not apply to liability for damages arising out of such services caused by or resulting from the sole negligence of City or City's agents or employees. Contractor's duty to defend,indemnify and hold harmless City against liability for damages arising out of such services caused by the concurrent negligence of(a)City or City's agents or employees,and(b)Contractor,Contractor's agents, subcontractors, subconsultants and employees, shall apply only to the extent of the negligence of Contractor, Contractor's agents, subcontractors, subconsultants and employees. Contractor's duty to defend, indemnify and hold City harmless shall include, as to all claims, demands, losses and liability to which it applies,City's personnel-related costs,reasonable attorneys'fees,and the reasonable value of any services rendered by the office of the City Attorney, outside consultant costs, court costs, fees for collection, and all other claim-related expenses. Contractor specifically and expressly waives any immunity that may be granted it under the Washington State Industrial Insurance Act,Title 51 RC W. These indemnification obligations shall not be limited in any way by any limitation on the amount or type of damages,compensation or benefits payable to or for any third party under workers'compensation acts, disability benefit acts, or other employee benefits acts. Provided, that Contractor's waiver of immunity by the provisions of this paragraph extends only to claims against Contractor by City,and does not include,or extend to,any claims by Contractor's employees directly against Contractor. Contractor hereby certifies that this indemnification provision was mutually negotiated. 18. Waiver. No officer, employee, agent or other individual acting on behalf of either party has the power,right or authority to waive any of the conditions or provisions of this 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 of the provisions of this 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. 19. Assignment and Delegation. Neither party shall assign,transfer,or delegate any or all of the responsibilities of this Agreement or the benefits received hereunder without first obtaining the written consent of the other party. 20. Confidentiality. Contractor may, from time to time, receive information which is deemed by City to be confidential. Contractor shall not disclose such information without the prior express written consent of City Construction Agreement Page 5 of 6 or upon order of a Court of competent jurisdiction. 21.Disputes. All disputes arising under or related to this Agreement that cannot be resolved through informal discussion and negotiations shall be resolved by litigation filed in the Superior Court for Spokane County, unless otherwise required by applicable federal or state law. 22. Subcontractor Responsibility. As required by RCW 39.06.020,Contractor shall verify responsibility criteria for each first tier subcontractor and its subcontractors of any tier that hires other subcontractors shall verify responsibility criteria for each of its subcontractors. Verification shall include that each subcontractor,at ' the time of subcontract execution,meets the responsibility criteria listed in RCW 39.04.350(1)and possesses an electrical contractor license,if required by chapter 19.28 RCW,or an elevator contractor license ifrequired by chapter 70.87 RCW. This verification requirement must be included in every subcontract of every tier. 23.Jurisdiction and Venue. This Agreement is entered into in Spokane County,Washington. Venue shall be in Spokane County, State of Washington. 24. Entire Agreement. This 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. 25. Anti-kickback. No officer or employee of City,having the power or duty to perform an 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. 26.Business Registration. Prior to commencement of Work under this Agreement,Contractor shall register with the City as a business. 27.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. 28. Exhibits. Exhibits attached and incorporated into this Agreement are: A. Scope of Work B. Insurance Endorsements J The Parties have executed this Agreement this —7 day of (-)"""1 ,20/C. CITY OF SPOKANE VALLEY: (pntractor: ��-,r - v . P n Owner Oa.rr-r_"' k - w e O U. • arrtE. 11v4i, 4 L i (..4y Atou CVO C R'i we.V ?nes . A S W. APPROVED AS O FORM: — 6 ? Christine Bainbridge,City Clerk i Office the Cityey Construction Agreement Page 6 of 6 All SURFACE ROOFING& John Kidwell COMMERCIALPreesident EAIPhone: 877-723-ROOF Fax: 509-276-7527 WATERPROOFING,INC. jkidwell@a1Isurfaceroofing.com P.Q.Box 18806 Spokane,WA 99228 License:ALLSUSR95ORT CONTRACT NO: C4553B ATTN: Shane Arlt SALESPERSON: Brian Hughes BID TO: Spokane Valley City Hall DATE: 11/17/2015 11707 E Sprague Ave. ste 106 PHONE: 509-315-7136 OFFICE: 877-723-7663 Spokane Valley,WA 99206 FAX: 509-276-7527 BLDG TYPE: Maintenance Garage JOB SITE: 17002 E Euclid, Spokane Valley, WA ALL SURFACE ROOFING&WATERPROOFING,INC.SHALL FURNISH LABOR,MATERIALS AND PERFORM IN A WORKMANSHIP-LIKE MANNER IN STRICT ACCORDANCE WITH THE PLAN AND SPECIFICATIONS AS FOLLOWS: NO WARRANTIES:OWNER UNDERSTANDS THAT THE WORK IS REPAIR WORK, CONSEQUENTLY,CONTRACTOR MAKES NO EXPRESS OR IMPLIED WARRANTIES OR REPRESENTATIONS REGARDING ANY ASPECT OF THE WORK,INCLUDING,BUT NOT LIMITED TO,WORKMANSHIP AND MATERIALS. Repairs to Metal Roofing AS FOLLOWS: • Remove abandoned flue pipe and replace section of metal roofing approx.3'x 6' • On flue that remains,install Z metal at bottom of existing flashing and then coat and seal entire pipe flashing with silicone butter grade. • Minimum charge for bond is$450.00 • Price includes prevailing wage • All Surface Roofing&Waterproofing,Inc.. Leave the job neat and clean of all our material FOR THE SUM OF: $2047.00 Tax Not Included } -1- rrvrrr./1111svr1 IIIrrIU10 rdIXIIJ. rdyee w Vi IU VQle.cr l 1/GV Iv u1.10 r--NI rmye.w to ,u i-" ALLSU-1 OP ID: AT ACCU?LE" DATE(MM1DDIYYYY) ki..,,,-- CERTIFICATE OF LIABILITY INSURANCE 02/11/2016 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NONE CONTACT Anthony Sacco Sacco&Sacco Insurance PHONE FAX Brokers LLCIAIc.No,e>d):916-932-2320 (AIC,No): 916-932-2321 101 Parkshore Drive,Suite 260 ADDRESS:asacco@saccoins.com Folsom,CA 95630 Anthony Sacco INSURER(S)AFFORDING COVERAGE NAIC I INSURER A:Tokio Marine Spec In 23850 INSURED All Surface Roofing INSURER B:Nationwide Mutual Insurance Co 23787 &Waterproofing,Inc. INSURER c:Travelers Prop Casualty Co Ame 25674 P.O. Box 18806 Spokane,WA 99228 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 INS() WVD POLICY NUMBER (MMDDIYYYY) (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X PPK1409912 10/20/2015 10/20/2016 DAMAGETORENTED 300,000 PREMISES(Ea occu«enc�) S MEO EXP(Any one person) $ EXCLUDED PERSONAL&ADV INJURY s 1,000,000 GEM_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG s 2,000,000 OTHER: s AUTOMOBILE LIABILITY COMDINED SINGLE LIMIT s 1,000,000 (Ea accident) B X ANY AUTO ACP7873402565 06/19/2015 06/19/2016 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS NOTON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUS (Per accident) $ UMBRELLA LIAB — OCCUR EACH OCCURRENCE s EXCESS LIAR CLAIMS-MA.DE AGGREGATE S DED RETENTION$ s WORKERS COMPENSATION AFD EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORJPARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S C Equipment Floater QT-660-9894N102-TIL-15 06/19/2015 06/19/2016 Rent/Lsd 100,000 C Intallation Fltr QT-660-9894N102-TIL-15 06/19/2015 06/19/2016 Inst Fltr 350,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Spokane Valley,a code City of the State of Washington is includedasAdditional Insured with respect to General Liability per attached CG 2033 0413&CG 2037 0413 endorsements.Stop Gap Liability applies.Primary wording applies. Re: Maintenance Facility Roof Damage Repair Project CERTIFICATE HOLDER CANCELLATION SPOKVAL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. a code City of the State of AUTHORIZED REPRESENTATIVE Washington /� 11707 East Sprague Ave Ste 106 it k .c-.o 'Spokane Valley,WA 99206 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD I I VIl i.PVtiaV„ ,I,llll/lr. , GA,✓. , C 1.N V, ,V ..n....b,. .,..v,.i v.,...r .i vy.....v. r POLICY NUMBER: PPK1409912 COMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization where required by written contract Information required to complete this Schedule, ii not shown above,will be shown in the Declarations. A. Section II -Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s)or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III- Limits Of Insurance; with respect to liability for 'bodily injury' or If coverage provided to the additional insured is 'property damage"caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement;or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law;and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CO 20 37 0413 ©Insurance Services Office, Inc.,2012 Page 1 of 1 POLICY NUMBER:PP 4 09912 COMMERCIAL GENERAL LIABILITY CG044211 03 THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. STOP GAP - EMPLOYERS LIABILITY COVERAGE ENDORSEMENT - WASHINGTON This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Limits Of Insurance Bodily Injury By Accident 1, 000, 000 Each Accident Bodily Injury By Disease 1, 000,000 Aggregate Limit Bodily Injury By Disease , 1,000, 000 Each Employee (If no entry appears above, the information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) A. The following is added to Section I—Coverages: No other obligation or liability to pay sums COVERAGE—STOP GAP—EMPLOYERS or perform acts or services is covered LIABILITY unless explicitly provided for under Sup- plementary Payments. 1. Insuring Agreement a. We will those sums that the insured b. This insurance applies to "bodily injury by ICY accident"or "bodily injury by disease" only becomes legally obligated by Washington if: Law to pay as damages because of 'bodily injury by accident"or 'bodily injury by dis- (1) The: ease" to your "employee" to which this in- (a) "Bodily injury by accident"or 'bodily surance applies. We will have the right and injury by disease"takes place in the duty to defend the insured against any "coverage territory'; 'Suit" seeking those damages. However, we will have no duty to defend the insured (b) injury by injury accident"or "bodily " arises out of and against any "suit" seeking damages to in the course of the injured "em- which this insurance does not apply. We ployee's"employment by you; and may, at our discretion, investigate any ac- cident and settle any claim or suit" that (c) "Employee", at the time of the injury, may result. But: was covered under a worker's (1) The amount we will pay for damages is compensation policy and subject to a 'Workers compensation law" of limited as described in Section III — Washington;and Limits Of Insurance;and (2) Our right and duty to defend end when (2) The: we have used up the applicable limit of (a) "Bodily injury by accident"is caused insurance in the payment of judgments by an accident that occurs during or settlements under this coverage. the policy period;or CG 04 42 11 03 0 ISO Properties, Inc., 2003 Page 1 of 4 ❑ (b) "Bodily injury by disease" is caused c. Statutory Obligations by or aggravated by conditions of Any obligation of the insured under a employment by you and the injured workers' compensation, disability benefits "employee's" last day of last expo- or unemployment compensation law or any sure to the conditions causing or similar law. aggravating such 'bodily injury by disease" occurs during the policy d. Contractual Liability period. Liability assumed by you under any con- c. The damages we will pay, where recovery tractor agreement. is permitted by law, include damages: e. Violation Of Law (1) For: "Bodily injury by accident"or 'bodily injury (a) Which you are liable to a third party by disease" suffered or caused by any by reason of a claim or "suit"against employee while employed in violation of you by that third party to recover law with your actual knowledge or the ac- the damages claimed against such tual knowledge of any of your "executive third party as a result of injury to officers". your "employee'; f. Termination,Coercion Or Discrimination (b) Care and loss of services; and Damages arising out of coercion, criticism, (c) Consequential "bodily injury by demotion, evaluation, reassignment, disci- accident" or "bodily injury by dis- pline, defamation, harassment, humiliation, ease" to a spouse, child, parent, discrimination against or termination of any brother or sister of the injured "em- "employee", or arising out of other ployee"; employment or personnel decisions con- provided that these damages are the cerning the insured. direct consequence of "bodily injury by g. Failure To Comply With'Workers accident" or "bodily injury by disease" Campensatlon Law" that arises out of and in the course of "Bodily injury by accident"or 'bodily injury the injured "employee's"employment by by disease" to an 'employee" when you you; and are: (2) Because of 'bodily injury by accident" (1) Deprived of common law defenses;or or "bodily injury by disease" to your (2) Otherwise subject to penalty; "employee"that arises out of and in the course of employment, claimed against because of your failure to secure your ob- you in a capacity other than as em- ligations or other failure to comply with any ployer. 'Workers compensation law". 2. Exclusions It Violation Of Age Laws Or Employment Of This insurance does not apply to: Minors a, Intentional Injury "Bodily injury by accident"or 'bodily injury by disease" suffered or caused by any "Bodily injury by accident"or "bodily injury person: by disease" intentionally caused or aggra vated by you,or 'bodily injury by accident" (1) Knowingly employed by you in violation or "bodily injury by disease" resulting from of any law as to age;or an act which is determined to have been (2) Under the age of 14 years, regardless committed by you if it was reasonable to of any such law. believe that an injury is substantially cer- i. Federal Laws tain to occur. Any premium, assessment, penalty, fine, b. Fines Or Penalties benefit, liability or other obligation imposed Any assessment, penalty, or fine levied by by or granted pursuant to: any regulatory inspection agency or au- (1) The Federal Employer's Liability Act (45 thority. USC Section 51-60); (2) The Non-appropriated Fund Instrumen- talities Act(5 USC Sections 8171-8173); Page 2 of 4 0 ISO Properties, Inc., 2003 CG 04 4211 03 ❑ (3) The Longshore and Harbor Workers' No person or organization is an insured with Compensation Act (33 USC Sections respect to the conduct of any current or past 910-950); partnership, joint venture or limited liability (4) The Outer Continental Shelf Lands Act company that is not shown as a Named In- (43 USC Section 1331-1356); sured in the Declarations. (5) The Defense Base Act (42 USC Sec- D. For the purposes of this endorsement, Section ID tions 1651-1654); —Limits Of Insurance, is replaced by the follow- (6) The Federal Coal Mine Health and ing: Safety Act of 1969 (30 USC Sections 1• The Limits of Insurance shown in the Sched- 901 942): ule of this endorsement and the rules below fix the most we will pay regardless of the (7) The Migrant and Seasonal Agricultural number of: Worker Protection Act (29 USC Sec- tions 1801-1872); a. Insureds; (8) Any other workers compensation, b. Claims made or "sults"brought;or unemployment compensation or dis- c. Persons or organizations making claims or ability laws or any similar law;or bringing 'suits". (9) Any subsequent amendments to the 2. The "Bodily Injury By Accident" — Each Acci- laws listed above. dent Limit shown in the Schedule of this en- j. Punitive Damages dorsement is the most we will pay for all dam- ages covered by this insurance because of Multiple, exemplary or punitive damages. "bodily injury by accident" to one or more k. Crew Members "employees"in any one accident. "Bodily injury by accident"or "bodily injury 3. The 'Bodily Injury By Disease" — Aggregate by disease" to a master or member of the Limit shown in the Schedule of this endorse- crew of any vessel or any member of the ment is the most we will pay for all damages flying crew of an aircraft. covered by this insurance and arising out of B. The Supplementary Payments provisions apply to "bodily injury by disease", regardless of the Coverage —Stop Gap Employers Liability as well number of "employees"who sustain "bodily In jury by disease". as to Coverages A and B. C. For the purposes of this endorsement, Section II 4 Subject to Paragraph D.3. of this endorse —Who Is An Insured,is replaced by the following: ment, the "Bodily Injury By Disease" — Each "Employee" Limit shown in the Schedule of this endorsement is the most we will pay for all If you are designated in the Declarations as: damages because of "bodily injury by disease" 1. An individual, you and your spouse are insur- to any one"employee". eds, but only with respect to the conduct of a The limits of the coverage apply separately to business of which you are the sole owner. each consecutive annual period and to any re- 2. A partnership or joint venture, you are an maining period of less than 12 months, starting insured. Your members, your partners, and with the beginning of the policy period shown in their spouses are also insureds, but only with the Declarations, unless the policy period is ex- respect to the conduct of your business. tended after issuance for an additional period of 3. A limited liability company, you are an insured. less than 12 months. In that case, the additional Your members are also insureds, buts only period will be deemed part of the last preceding period for purposes of determining the Limits of with respect to the conduct of your business. Insurance. Your managers are insureds,but only with re- spect to their duties as your managers. 4. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and di- rectors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. CG 04 4211 03 © ISO Properties, Inc., 2003 Page 3 of 4 ❑ .....u..nus...,I ..11114•014 . 44/%11.••• r 6y0 0 V1 ,V LMIC.L/I I ILV IV V1.10 r IVI r ayt.J V r IV E. For the purposes of this endorsement, Condition d. No insured will, except at that insured's 2.—Duties In The Event Of Occurrence, Claim Or own cost, voluntarily make a payment, as- Suit of the Conditions Section IV is deleted and sume any obligation,or incur any expense, replaced by the following: other than for first aid, without our 2. Duties In The Event Of Injury, Claim Or Suit consent. a. You must see to it that we or our agent are F. For the purposes of this endorsement, Paragraph notified as soon as practicable of a"bodily 4.of the Definitions Section is replaced by the fol- injury by accident"or "bodily injury by dis- lowing: ease" which may result in a claim. To the 4. "Coverage territory"means: extent possible, notice should include: a. The United States of America (including its (1) How, when and where the"bodily injury territories and possessions), Puerto Rico by accident" or 'bodily injury by dis- and Canada; ease"took place; b. International waters or airspace, but only if (2) The names and addresses of any in- the injury or damage occurs in the course jured persons and witnesses; and of travel or transportation between any (3) The nature and location of any injury. places included in a. above;or b. If a claim is made or "suit" is brought c. All other parts of the world if the injury or against any insured,you must: damage arises out of the activities of a person whose home is in the territory de- (1) Immediately record the specifics of the scribed in a. above, but who is away for a claim or "suit" and the date received; short time on your business; and Notifyus as soon aspracticable. provided the insured's responsibility to pay (2) damages is determined in the United States You must see to it that we receive written (including its territories and possessions), notice of the claim or "suit" as soon as Puerto Rico,or Canada, in a suit on the merits practicable. according to the substantive law in such c. You and any other involved insured must: territory,or in a settlement we agree to. (1) Immediately send us copies of any G. The following are added to the Definitions Sec- demands, notices, summonses or legal tion: papers received in connection with the 1. Workers Compensation Law" means the injury, clam, proceeding or 'suit'; Workers Compensation Law and any Occupa- (2) Authorize us to obtain records and tional Disease Law of Washington. This does other information; not include provisions of any law providing non-occupational disability benefits. (3) Cooperate with us and assist us, as we 2. "Bodily injury by accident"means bodily injury, may request, in the investigation or setsickness or disease sustained by a person, dement of the claim or defense against including death, resulting from an accident. A the"suit"; disease is not "bodily injury by accident" (4) Assist us, upon our request, in the unless it results directly from "bodily injury by enforcement of any right against any accident". person or organization which may be 3. "Bodily injury by disease" means a disease liable to the insured because of injury sustained by a person, including death. "Bod- to which this insurance may also apply; ily injury by disease" does not include a dis- and ease that results directly from an accident. (5) Do nothing after an injury occurs that H. For the purposes of this endorsement, the defini- would interfere with our right to recover tion of"bodily injury"does not apply. from others. Page 4 of 4 )ISO Properties, Inc., 2003 CG 04 42 11 03 0 r1UI11./VI17U11 I IItIIUIC rd)cIV. rdvc IV VI IV VaIC.L/I 1/LV IV V 1.1V rrvt rave.iv v1 IV PIC-GLN-020 (10/13) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS,4.Other Insurance, and all subparts thereof, as contained in the policy is deleted in its entirely and replaced with the following condition: 4. Other Insurance If all of the other insurance permits contribution by equal shares, we will follow this method unless the insured is required by written contract signed by both parties, to provide insurance that is primary and noncontributory, and the"insured contract"is executed prior to any loss. Where required by a written contract signed by both parties,this insurance will be primary and non-contributing only when and to the extent as required by that contract. However, under the contributory approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains,whichever comes first. If any of the other insurance does not permit contributory by equal shares, we will contribute by limits. Under this method,each insurer's share is based on the ratio of its applicable limit if insurance to the total applicable limits of insurance of all insurers. All other terms, conditions and exclusions under the policy are applicable to this endorsement and remain unchanged. Page 1 of 1 ,vu,.nm�u ,,,,,,u,c I aAly. rUye L UI IU UiRe.0 I ULU IOU I.iw rIVI rdge.L OI IU COMMERCIAL GENERAL LIABILITY CG 20 33 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations when you and such person or This insurance does not apply to: organization have agreed in writing in a contractor agreement that such person or organization be 1. 'Bodily injury", "property damage" or "personal added as an additional insured on your policy. and advertising injury" arising out of the Such person or organization is an additional rendering of, or the failure to render, any insured only with respect to liability for "bodily professional architectural, engineering or injury", "property damage" or "personal and surveying services, including: advertising injury"caused, in whole or in part, by: a. The preparing, approving, or failing to 1. Your acts or omissions;or prepare or approve, maps, shop drawings, 2. The acts or omissions of those acting on your opinions, reports, surveys, field orders, behalf; change orders or drawings and specifications;or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. However, the insurance afforded to such This exclusion applies even if the claims against additional insured: any insured allege negligence or other wrongdoing 1. Only applies to the extent permitted by law;and in the supervision, hiring, employment, training or 2. Will not be broader than that which you are monitoring of others by that insured, if the required by the contract or agreement to "occurrence" which caused the 'bodily injury" or provide for such additional insured. "property damage", or the offense which caused the "personal and advertising injury", involved the A person's or organization's status as an rendering of or the failure to render any additional insured under this endorsement ends professional architectural, engineering or when your operations for that additional insured surveying services. are completed. CG 20 33 04 13 ©Insurance Services Office, Inc.,2012 Page 1 of 2 _....._..__.. ...... , ayc v. w uaw.0 I iuv w v,.is rwi rayo.o vl w 2. "Bodily injury" or "property damage" occurring C. With respect to the insurance afforded to these after: additional insureds, the following is added to a. All work, including materials, parts or 111—Limits Of Insurance: equipment furnished in connection with The most we will pay on behalf of the additional such work, on the project (other than insured is the amount of insurance: service, maintenance or repairs) to be 1. Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured; insured(s) at the location of the covered or operations has been completed;or b. That portion of "your work"out of which the 2. Available under the applicable Limits of Insurance shown in the Declarations; injury or damage arises has been put to its intended use by any person or organization whichever is less. other than another contractor or This endorsement shall not increase the subcontractor engaged in performing applicable Limits of Insurance shown in the operations for a principal as a part of the Declarations. same project. Page 2 of 2 ©Insurance Services Office, Inc.,2012 CG 20 33 0413 ALL SURFACE ROOFING&WATERPROOFING INC https://secure.lni.wa.gov/verify/Details/IiabilityCertificate.aspx?UB... hr; STATE of WASHINGTON Department of Labor& Industries Certificate of Workers' Compensation Coverage February 24, 2016 WA UBI No. 602 546 881 L&I Account ID 103,561-00 Legal Business Name ALL SURFACE ROOFING & WATERPROOFING INC Doing Business As ALL SURFACE ROOFING & WATERPRO Workers' Comp Premium Status: Account is current. Estimated Workers Reported Quarter 4 of Year 2015"21 to 30 (See Description Below) Workers" Account Representative Collections Dialer Unit, 800-301-1826- Email: dialercollections@Lni.wa.gov Licensed Contractor? Yes License No. ALLSUSR950RT License Expiration 01/31/2018 What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RCW 51.12.050 and 51.16.190). 1 of 1 2/24/2016 1:03 PM