HomeMy WebLinkAboutAG 17-007 - Federal Way Historical SocietyRETURN TO: EXT:
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV: Pt it 6GS
2. ORIGINATING STAFF PERSON: e-.71.--1. c r '7fl EXT: 6 c /O 3. DATE REQ. BY:
4. TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT(AG #): ❑ INTERLOCAL
❑ OTHER
5. PROJECT NAME: 179 / ,) 161-,-,„...;‘, a C. I G7�
6. NAME OF CONTRACTOR: F ' 1- A71ii%C..}c ,roar. -4
ADDRESS:
E -MAIL:
SIGNATURE NAME:
prodC•e%.,.. rr ,., ,STcc /L.t 404tx 341
TELEPHONE
FAX:
TITLE
7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE ❑ ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS
8. TERM: COMMENCEMENT DATE: 04‘ 10 2'j��- COMPLETION DATE: C6
9. TOTAL COMPENSATION $ (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE BY (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
❑ PURCHASING: PLEASE CHARGE TO:
10. DOOUMENT /CONTRACT REVIEW
Cpl PROJECT MANAGER
❑ DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE) l 7-(2c, �(
❑ LAW � � l io�� J ?, �3
11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: / iJ /) (/ COUNCIL APPROVAL DATE: 111
12. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: /5/,, DATE REC'D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
INITIAL / DA E SIGNED
WC 111o(H
INITIAL / DATE REVIEWED
9/8/4
INITIAL / DATE APPROVED
COMMENTS:
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❑ LAW DEPARTMENT
❑ CHIEF OF STAFF
❑ SIGNATORY (MAYOR OR DIRECTOR)
❑ CITY CLERK 90, _
❑ ASSIGNED AG# AGPV jl -001-
❑ SIGNED COPY RETURNED DATE SENT: CA -11-11
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MEMORANDUM OF UNDERSTANDING
BETWEEN
THE HISTORICAL SOCIETY OF FEDERAL WAY
AND
THE CITY OF FEDERAL WAY, WASHINGTON
FOR
ELECTRICAL, PLUMBING AND INSULATION IMPROVEMENTS
THIS MEMORANDUM OF UNDERSTANDING ( "MOU ") is made this j O day of
201a by and between the undersigned representatives of the City of Federal Way, a Washington
municipal corporation ( "City "), and The Historical Society of Federal Way, a Washington nonprofit
corporation ( "Society ").
WHEREAS, the City and the Historical Society of Federal Way have had a lease agreement for the
Steel Lake Annex "House" Building in good standing for several years.
WHEREAS, the City is supportive of the Historical Society of Federal Way's desire to make
improvements to the electrical, plumbing and insulation to the building at their cost.
WHEREAS, this MOU will help the Historical Society of Federal Way secure grant funding to pay
for these improvements.
WHEREAS, these improvements will help ensure the building is in good repair and condition going
forward.
WHEREAS, all improvements made will be permitted with the community development department
and all work will be performed by licensed contractors and all City laws and codes will be followed
according to the lease agreement in place.
NOW, THEREFORE, in consideration of the mutual agreements and covenants contained herein
and for other good and valuable consideration, the receipt and sufficiency of which hereby are
acknowledged, it is mutually agreed and covenanted, by and between the parties to this Agreement, as
follows:
1. Scope of Work for Improvements. The improvements to be undertaken by the Society under this
Agreement shall be limited to the following items of work:
a. Install new water supply piping with new material meeting current plumbing codes to
replace the existing galvanized steel piping system. The existing galvanized steel piping
system will be abandoned in place. The new piping will supply hot and cold water (with
new angle stops and supply lines) to the lavatory basin and toilet in each of the three
bathrooms, the sink in the kitchen, the laundry tub in the basement utility room, the
make -up water supply for the hot water furnace, the domestic hot water heater, and the
two exterior hose bibbs. The locations of these supply points are shown in the schematic
plans entitled "Plumbing Facilities" (one plan for each floor) that are attached hereto and
incorporated herein. Water supply to the neighboring "barn" structure will be
reconnected inside the subject "house" building. To the extent possible, existing
plumbing fixtures shall be reused, including lavatory basins, toilets, sinks, and faucets.
The water supply to the shower in the 2'd floor bathroom and to the clothes washing
machine facilities in the basement will be discontinued. The original plumbing drain
system (consisting of cast iron soil pipe and galvanized steel pipe) is excluded from this
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scope of work. The low- pressure pipe network for the hot water heating system
(consisting of steel pipe) is excluded from this scope of work.
b. Install new wiring with new material meeting current electrical code to supply electrical
service to the lighting fixtures and convenience wall outlets throughout the building. The
locations of these service points are shown in the schematic plans entitled "Electrical
Lighting" (one plan for each floor) and "Electrical Outlets" (one plan for each floor) that
are attached hereto and incorporated herein. New electrical circuits will originate at the
electrical circuit - breaker panels that exist in the Robinson Room in the basement. The
electrical connection to the neighboring "barn" structure will be reconnected inside the
subject "house" building. To the extent practicable, new wire will be routed within
ceilings and walls; otherwise, new wire will be enclosed within races or conduit mounted
to the exposed surfaces of ceilings and walls. New wiring will not be installed for the hot
water furnace, the domestic hot water heater, or for the electrical kitchen range space. To
the extent possible, existing fluorescent and incandescent light fixtures will be reused.
Switches and duplex wall outlets and covers will be replaced and upgraded to current
standards.
c. Remove the existing contaminated insulation material in the attic space, decontaminate
the attic space, and install new material after the specified plumbing and electrical
improvements are completed within the attic space. Potential points of entry by rodents
into the attic space will be closed to the extent practicable. The new insulation material
will meet or exceed the insulation value of the existing material in the attic.
d. Repair openings, or "windows," that are cut into the ceilings and walls in order to route
new piping and wire within the affected ceilings and walls. The repairs will include
installation of shcctrock material, mudding and taping, and repainting as necessary.
2. Conditions. All alterations to the Scope of Work must be approved by the City in writing. All
alterations or improvements to the premises undertaken by the Society shall be constructed at the
Society' s expense, and the Society agrees to bear full responsibility for insuring all construction on
the premises is undertaken and conducted in a safe and professional manner, and all alterations and
improvements shall be of high quality construction. The Society agrees it will not allow any liens to
attach to the premises as a result of any construction performed on the premises. The Society further
agrees to hold the City harmless from any and all claims, including costs, attorney's fees and
expenses arising in any way from any construction on the premises, unless specifically agreed to
otherwise in writing signed by the City prior to construction or addition of any alterations or
improvements to the premises. All alterations and improvements shall become property of the City
upon termination or expiration of the agreement.
3. City's Responsibility. The City will waive all permitting fees for these improvements.
4. Historical Society of Federal Way Responsibilities. The Society is solely responsible for obtaining
bids, hiring contractors and obtaining applicable City permits. The Society is responsible for costs
associated with any improvements.
5. Term. The term of this MOU shall commence upon the effective date written above and shall
continue until the completion of all obligations under this MOU.
6. Indemnification. The Historical Society of Federal Way shall indemnify and hold harmless the City
and its officers, boards, commissions, employees, agents, attorneys, and contractors from and against
any and all liability, damages, and claims, (including, without limitation, reasonable fees and
expenses of attorneys, expert witnesses and consultants), which may be asserted by reason of any act
2
or omission of the Society, its employees, agents, or contractors, which may arise out of this MOU.
The provisions of this section shall survive the expiration or termination of this MOU.
7. Insurance. The Society agrees to carry as a minimum the following insurance in such forms and
with such carriers who have a rating that is satisfactory to the City:
a. Commercial general liability insurance with combined single limits of liability not less than
$2,000,000 for bodily injury including personal injury or death, products liability and property
damage; and
b. Automobile liability insurance coverage on all owned, non- owned, hired and leased vehicles with
a minimum combined single limits in the minimum amounts required to drive under Washington
State law per accident for bodily injury, including personal injury or death, and property damage.
The Society's maintenance of insurance as required by the MOU shall not be construed to limit the
liability of the Society to the coverage provided by such insurance, or otherwise limit the City's
recourse to any remedy available at law or in equity. Any insurance, self - insurance, or insurance pool
coverage maintained by the City shall be excess of the Society's insurance and shall not contribute
with it.
The City shall be named as additional insured on all commercial general liability insurance policies.
Concurrent with the execution of this Agreement, the Society shall provide certificates of insurance
for all commercial general liability policies attached hereto as Exhibit "A" and incorporated by this
reference. At City's request, the Society shall furnish the City with copies of all insurance policies
and with evidence of payment of premiums or fees of such policies. If the Society's insurance
policies are "claims made," the Society shall be required to maintain tail coverage for a minimum
period of three (3) years from the date this MOU is actually terminated.
8. This MOU contains all of the agreements of the City and the Society with respect to any matter
covered or mentioned in this MOU.
IN WITNESS WHEREOF, the City and the Society have executed this Memorandum of Understanding
as of the day and year first written above by their duly authorized representatives.
3
CITY OF FEDERAL WAY: ATTEST:
Jo
utton
Aral
1 .s I.
erector
APPRO ! ED AS TO FORM:
City Attorney, /4G-iiv►� .1714wie,- l
HISTORICAL SOCIETY OF FEDERAL WAY:
Diana Noble - Gulliford, President
1600 B SW Dash Pt. Road #125
Federal Way, WA 98023
STATE OF WASHINGTON )
) ss.
COUNTY OF
y lerk, Stephanie Co ; , CMC
On this day personally appeared before me Diana Noble - Gulliford, to me known to be the
President of the Historical Society of Federal Way that executed the foregoing instrument, and
acknowledged the said instrument to be the free and voluntary act and deed of said corporation,
for the uses and purposes therein mentioned, and on oath stated that she was authorized to
execute said instrument and that the seal affixed, if any, is the corporate seal of said corporation.
GIVEN my hand and official seal this \ 0 day of .370-r u , 20 V.
Notary's signature csv-a. Prbe....A---c-
Notary's printed name jor‘Zo. kr-o c)-
Notary Public in and for the State of Washington
My Commission Expires 1 0 —11— a01 ".
TONIA PROCTOR
NOTARY PUBLIC
STATE OF WASHINGTON
COMMISSION EXPIRES
TOBER 11 2017
4
Non Profit Insurance Program
CERTIFICATE OF COVERAGE
HistSFW4Revised
ISsue Date: 01 /12/2017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUE A CONTRACT
BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTAT IVE OR PRODUCER, AND THE CERT IFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ics) must be endorsed. If SUBROGRATION IS WAIVED, subject to the terms and conditions of
the policy, certain coverage may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Clear Risk Solutions
451 Diamond Drive
Ephrata, WA 98823
INSURED
Historical Society of Federal Way
1600 B SW Dash Point Rd, #125
Federal Way, WA 98023
COVERAGES
COMPANIES AFFORDING COVERAGE
GENERAL LIABILITY
American Alternative Insurance Corporation
AUTOMOBILE LIABILITY
American Alternative Insurance Corporation
PROPERTY
American Alternative Insurance Corporation, et al.
MISCELLANEOUS PROFESSIONAL LIABILITY
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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.
TYPE OF INSURANCE
GENERAL LIABILITY
POLICY NUMBER POLICY EFF POLICY EXP DESCRIPTION
DATE DATE
LIMITS
COMMERCIAL GENERAL LIABILITY N1- A2- RL- 0000013.08
OCCURRENCF FORM
INCLUDES STOP GAP
LIABILITY IS SUBJECT 10
AUTOMOBILE LIABILITY
06/01/2016
A $50,000 SIR PAYABLE FROM PROGRAM FUNDS)
ANY AUTO
(LIABILITY IS SUBJECT TO
PROPERTY
06/01/2018 PER OCCURRENCE
PER MEMBER AGGREGATE
PRODUCT -CO MP /OP
PERSONAL & ADV. INJURY
ANNUAL POOL AGGREGATE
$5,000,000
$10,000,000
$5,000,000
55,000,000
550,000,000
N1- A2- RL- 0000013 -08 06/01/2016
A $50,000 SIR PAYABLE FROM PROGRAM FUNDS)
06/01/2018 COMBINED SINGLE LIMIT $5,000,000
ANNUAL POOL AGGREGATE NONE
N1- A2- RL•0000013.08 06/01/2016
(PROPERTY IS SUBJECT TO A 550,000 SIR PAYABI F FROM PROGRAM FUNDS)
MISCELLANEOUS PROFESSIONAL LIABILITY
06/01/2018 ALL RISK PER OCC EXCL EQ & FI
EARTHQUAKE PER OCC
FLOOD PER OCC
ANNUAL POOL AGGREGATE
$75,000,000
$1,000,000
$1,000,000
NONE
(LIABILITY IS SUBJECT TO A SIR PAYABLE FROM PROGRAM FUNDS)
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / SPECIAL ITEMS
Regarding space leased at 2645 South 312th Street, Federal Way. City of Federal Way is named as Additional Insured regarding
this lease only and is subject to policy terms, conditions, and exclusions. Additional Insured endorsement is attached.
06/01/2016
06/01/2018 PER CLAIM
ANNUAL POOL AGGREGATE
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
WITH THE P011 CY PROVISIONS.
CERTIFICATE HOLDER
AUTHORIZED REPRESENTATIVE
City of Federal Way
3325 8th Avenue S
Federal Way, WA 98003
3204824
AMERICAN ALTERNATIVE
INSURANCE COMPANY
ADDITIONAL INSURED — DESIGNATED PERSON OR ORGANIZATION
(GENERAL LIABILITY)
Named Insured
Non Profit Insurance Program (NPIP)
Policy Number
N 1- A2 -RL- 0000013 -05
Endorsement Effective
6/1/2016
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
This endorsement modifies insurance provided under the following:
GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above.
Schedule
Person or Organization (Additional Insured): As Per Schedule on file with Clear Risk Solutions, Underwriting Administrator
City of Federal Way
3325 8th Avenue S
Federal Way, WA 98003
Regarding space leased at 2645 South 312th Street, Federal Way. City of Federal Way is named as Additional Insured regarding
this lease only and is subject to policy terms, conditions, and exclusions. Additional Insured endorsement is attached.
A. With respects to the General Liability Coverage Part only, the definition of Insured in the Liability Conditions, Definitions
and Exclusions section of this policy is amended to include as an insured the Person or Organization shown in the above
Schedule. Such Person or Organization is an Insured only with respect to liability for Bodily Inlury, Property Damage, or
Personal and Advertising injury caused in whole or in part by your acts or omissions or the acts or omissions of those
acting on your behalf:
1. In performance of your ongoing operations; or
2. In connection with your premises owned or rented to you.
B. The Limits of Insurance applicable to the additional Insured are those specified in either the:
1. Written contract or written agreement; or
2. Declarations for this policy,
whichever is Tess. these Limits of Insurance are inclusive and not in addition to the Limits Of Insurance shown in the Declarations.
An other terms and conditions remain unchanged.
RL 2163 12/12
3204825
Includes copyrighted material of the Insurance Services Office, Inc., with its permission.
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