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HomeMy WebLinkAboutAG 20-976 - MILES RESOURCES, LLC RETURN TO: PW ADMIN EXT: 2700 ID#: 3953
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/Div: PUBLIC WORKS 1 qapial Projects
2. ORIGINATING STAFF PERSON:J oh n Mulkey EXT: 261-3668 3. DATE REQ.By 8/13/21
3. TYPE OF DOCUMENT(CHECK ONE):
[3 CONTRACTOR SELECTION DOCUMENT(E.G.,RFB,RFP,RFQ)
[3 PUBLIC WORKS CONTRACT U SMALL OR LIMITED PUBLIC WORKS CONTRACT
[3 PROFESSIONAL SERVICE AGREEMENT E3 MAINTENANCE AGREEMENT
[3 GOODS AND SERVICE AGREEMENT [3 HUMAN SERVICES/CDBG
[3 REAL ESTATE DOCUMENT [I SECURITY DOCUMENT(E.G.BOND RELATED DOCUMENTS)
0 ORDINANCE [3 RESOLUTION
0 CONTRACT AMENDMENT(AG#):20-976 0 INTERLOCAL
0 OTHER Chan 0 Order 2
4. PROJECT Mm,,: SW 320th Street Preservation Project
5. NAME OF CONTRACTOW-Miles Resources
ADDRESS:400 Va Llpy_Ay ,NE Puyallup, WA 98372 TELI,THONE:253-383-3585
E-MAii.: Brqtj,sghWz milleggsources,com FAX:
z SIGNATURE NAME� B raid2emy M riffith VP/GM
..Ly
6. EXHIBITS AND ATTACHMENTS:0 SCOPE,WORK OR SERVICES 0 COMPENSATION [I INSURANCE REQUIREMENTS/CERTIFICATE 0 ALL OTHER
REFERENCED EXHIBITS [I PROOF OF AUTHORITY TO SIGN [3 REQUIRED LICENSES 0 PRIOR CONTRACT/AMENDMENTS
CFW LICENSE#09-10441 -00 Bl-,,EXP. 12/31/, 10/31/21 UBI#602�-870-34-9- .,EXP. 12131 M
7. TERM: COMMENCEMENT DATE: 12/28/2020 COMPLETION DATE: Upon Completion 49 WD
8. TOTAL COMPENSATION:$_T,§97.60 this C01639,950,5,8.Tqtl,all __ (INCLUDE EXPENSES AND SALES TAX,IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE-ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: 13 YES 0 NO IF YES,MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED: [a YES 0 NO IF YES,$_ PAID BY: 0 CONTRACTOR 13 CITY
RETAINAGE: RETAINAGE AMOUNT: Fed Aid -None -Ei RETAINAGE AGREEMENT(SEE CONTRACT) OR [i RETAINAGE BOND PROVIDED
n PURCHASING: PLEASE CHARGE To: c36214-26500
9. DOCUMENT/CONTRACT REVIEW INITIAL/DATE REVIEWED INITIAL DATE APPROVED
11 PROJECT MANAGER JRM-7-28-21_....
N DIVISION MANAGER SLH M'921
I DEPUTY DIRECTOR DSW SIT21
A DIRECTOR DSW I.,EJ 811 0121
o RISK MANAGEMENT (IF APPLICABLE)
A LAW DEPT KVA 8/9/2021
- ................................
10. COUNCIL APPROVAL(IF APPLICABLE) SCHEDULED COMMITI EE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
11. CONTRACT SIGNATURE ROUTING
ci SENT TO VENDOR/CONTRACTOR DATE SENT:,"I....... DATE REC'D;— ,,, ............
• ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE,LICENSES,EXHIBITS
• CREATE ELECTRONIC REMINDERINOTIFICATION FOR I MONTH PRIOR TO EXPIRATION DATE
(INCLUDE DEPT.SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.)
INITIAL/DATE SIGNED
• FINANCE DEPARI'MENT
• LAW DEPT
• SIGNATORY(MAYOR ORLIRIc'-_10I�I1_�
• CITY CLERK ilk
c
• ASSIGNED AG# AG#
Ei SIGNED Copy RETURNED DATE SENT:
COMMENTS:
EXECUTE ORIGINALS_.
CITY OF FEDERAL WAY
CONTRACT CA 'GE ORDER AOREENET
_ 214 _ AG#20-976 2
PROJECT NUMBER AGREEMENT NUMBER N 1 N E ORDER NUMtff
W 320TH STREET PRESERVATION PROJECT ..*__ MILES RESOURCES, LLC.
PRo RESTiT LE �.�._._.
CONI°R ACTOr
SUMMARY OF PROPOSED CHANGES:
This Change Order covers the work changes summarized below:
1. Per FWD 4, City policy has changed to require steel posts instead of wood posts for
signs.This FWD directs Miles Resources LLC to use steel posts in lieu of wooden posts.
Payment is for the lump sum cost to replace all wood sign posts with steel posts.
Create new Bid Item No. 58, Steel Sign Posts. Unit Cost will be$1,200 per Lump Sum.
Quantity is 1, per Lump Sum.
2. When the contractor installed the non-slip coating on utilities in sidewalks they noted
detectable warnings were missing from two pedestrian refuge islands,and the contract
did not provide for their installation. Director approved replacement by Vanguard.
Payment is for the lump sum cost to replace detectable warning strips for two pedestrian
crossings.
Create new Bid Item No. 59, Detectable Warning Replacement. Unit Cost will be
$6,697.60 per Lump Sum. Quantity is 1, per Lump Sum.
The time provided for completion in the Contract is
® Unchanged
❑ Increased by_.Working Day(s)
❑ Decreased by. .... Working Day(s)
This Document shall become an Amendment to the Contract and all provisions of the Contract not amended
herein will apply to this Change Order.
Will this change affect expiration or extent of Insurance coverage? ❑ Yes ® No
If"Yes"Will the Policies Be Extended? ❑ Yes ❑ No
CHANGE ORDER AGREEMENT Rcv. 8/19
MODIFICATIONS TO UNIT PRICES:
PREVIOUS REVISED
ITEM NO. ITEM i0TY UNIT PRICE UNIT PRICE ADD OR
DELETETHESE ITEMS ARE APPROXIMATE OR ESTIMATED QUANTITIES INVOLVED IN THIS
CHANGE!
ITEM NO. ITEM OTY UNIT PRICE ADD OR DELETE
58 STEEL SIGN POSTS 1 $1,200.00 ADD $1,200.00
59 DETECTABLE WARNING
REPLACEMENT 1 $6,697.60 ADD$6,697.60
TOTAL NET CONTRACT: NCREASE$'7I397.60
�� DECREASE$
DEPARTMENT RECAP TO DATE:
ORIGINAL CONTRACT AMOUNT 56 288 05
PREVIOUS CHANGE ORDERS $ 43
764 9
THIS CHANGE ORDER $— 7, ,97.60
NEW CONTRACT AMOUNT $ 34 950 58
STATEMENT:
Payment for the above work will be in accordance with applicable portions of the standard specifications,and
with the understanding that all materials, workmanship and measurements shall be in accordance with the
provisions of the standard specifications, the contract plans,and the special provisions governing the types of
construction. The execution of this Change Order shall constitute full satisfaction and a waiver of any and all
claims by the Contractor arising out of, or relating in any way to, the Work identified, to be performed, or
r„le�ed pursuant to Change Order except as specifically described in this Change Order.
CON A,,TOR' SjGNATURE DATE
PUILI OIIS DIRECTDR _.
DATE ....
CHANGE ORDER AGREEMENT Rem /19
RETURN TO: PW ADMIN EXT: 2700 ID#: 3901
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/Div: PUBLIC WORKS/ Captial Projects
................. .................
2. ORIGINATING STAFF PERSON: John Mulkey EXT: 261-3668 - 3. DATE REQ. By:4/20/21
3. TYPE OF DOCUMENT(CHECK ONE):
[3 CONTRACTOR SELECTION DOCUMENT(E.G.,RFB,RFP,RFQ)
[3 PUBLIC WORKS CONTRACT [3 SMALL OR LIMITED PUBLIC WORKS CONTRACT
[3 PROFESSIONAL SERVICE AGREEMENT [3 MAINTENANCE AGREEMENT
[3 GOODS AND SERVICE AGREEMENT 13 HUMAN SERVICES/CDBG
o REAL ESTATE DOCUMENT [3 SECURITY DOCUMENT(E.G.BOND RELATED DOCUMENTS)
[3 ORDINANCE [3 RESOLUTION
0 CONTRACT AMENDMENT(AG#):20-1976 0 INTERLOCAL
0 OTHER Change Order 1 � ... ....
4. PROJECT NAM ': SW 320th Street Preservation Project ....................
5. NAME OF CONTRACTOR. Miles Resources
I ...........
ADDRESS: 400 Valley Ave-..NE. PL,IyallUf), WA 98372 TELFT11ONE,: 253-383-3585
E-MAIL: Betsuiz rrfl(q� .......... AX ..........IT
.ft sresources.com F .
SIGNATURErt
NAMEch: Bradley Griffith VP/GM, ...........
6. EXHIBITS AND ATTACHMENTS:0 SCOPE,WORK OR SERVICES G3 COMPENSATION [3 INSURANCE REQUIREMENTS/CERTIFICATE 0 ALL OTHER
REFERENCED EXHIBITS D PROOF OF AUTHORITY TO SIGN [3 REQUIRED LICENSES [3 PRIOR CON'l I�ACIIAMEN DM ENTS
CFW LICENSE#09-104415-00 13111,EXP. 12/31/ 10/31/21 UBI 9 602-870-349 EX 11, 1,2/31421
.............
7. TERM: COMMENCEMENT DATE.- 12/28/2020 COMPLETION DATE:, Upon Completion 49 WD
...........Upon.-.--
8. TOTAL COMPENSATION:$43,764.93 this CO/$627,052.98 Total (INCLUDE EXPENSES AND SALES TAX,IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE-ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: 13 YES [a NO IF YES,MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED: 0 YES 63 NO IF YES,$ PAID BY: 0 CONTRACTOR 13 CITY
RETAWAGE: RETAMAGE AMOUNT: Fed Aid -None o RETAINAGE AGREEMENT(SEE CONTRACT) OR o RETAfNAGE BOND PROVIDED
i!i PURCHASING: PLEASE CHARGE TO: c36214-26500
..........
9. DOCUMENT/CONTRACT REVIEW INITIAL/DATE R r--m EW ED INITIAL DATE APPROVED
A PROJECT MANAGER JRM-4-6-21
11 DIVISION MANAGER SLH 4-7-2021
A DEPUTY DIRECTOR EJW 4/7/2021 .................
I DIRECTOR EJW 4/8/2021
Ei RISK MANAGEMENT (IF APPLICABLE) ..........----
I LAW DEPT ER 4/8/2021 ..............
10. COUNCIL APPROVAL(IF APPLICABLE) N/A SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
11. CONTRACT SIGNATURE ROUTING
M SENT TO VENDOR/CONTRACTOR DATE SENT: 4 113/2021 DATE REC,D:412012021
* ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE,LICENSES,EXHIBITS
* CREATE ELECTRONIC REMINDER/NOTIFICATION FOR I MONTH PRIOR TO EXPIRATION DATE
(INCLUDE DEPT.SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.)
INITIAL DATE SIGNED
Ei FINANCE DEPARTMENT
Ei LAW DEPT
Ei SIGNATORY(MAYOR OR DIRECTOR) l use
Ei CITY CLERK
Ei ASSIGNED AG 9 AG#
o SIGNED Copy RETURNED DATE SENT:
COMMENTS:
EXECUTE ORIGINALS
........................
........................................
.............. ............. .............
1/2020
F FEDERAL V4J'AY
i
214 AG#20-976 1
y PROJECT NUMBER _ AGREEMENT NUMBER _ CHANGEORDERNUMBER EFFECTIVEDATE
SW 320TH STREET PRESERVATION PROJECT MILES RESOURCES LLCa
_ PROJECTTITLE _ CONTRACTOR
SUMMARY OF PROPOSED CHANGES:
This Change Order covers the work changes summarized below:
Remove trees and roots in planter and sidewalk areas along SW 320th Street as noted in the
attached tree removal list per the attached bid from Miles Resources, LLC.
Create new bid item No. 56,Tree and Root Removal. Unit Cost will be$39,092.70 per Lump
Sum, quantity will be 1, per Lump Sum.
Adjust time related bid items, BI 4 and BI 5 for added time to the contract of 4 working days.
Create new bid item 57, Replace Through Curb Inlet. Unit Cost will be $1,500, per Each,
Quantity will be 2, per Each. No bid item provided but one called out for replacement and
second added in curb replacement area.
The time provided for completion in the Contract is
❑ Unchanged
N Increased by 4 Working Day(s)
❑ Decreased by_ Working Day(s)
This Document shall become an Amendment to the Contract and all provisions of the Contract not amended
herein will apply to this Change Order.
Will this change affect expiration or extent of Insurance coverage? ❑ Yes N No
If"Yes"Will the Polii s Bp1 Yes No
MODIFICATIONS TO UNIT PRICES.
PREVIOUS REVISED
ITEM NO,ITEM OTY UNIT PRICE UtilljIIICE.ADD OR DELETIr'
4 TRAFFIC CONTROL SUPERVISOR 1 $25,600.00 $27,875.56 $2,275.56
5 PROJECT TEMPORARY TRAFFIC
CONTROL 1 $2,775.00 $3,021.67 $246.67
CHANGE E AGREEMENT Rev. 8/19
THESE ITEMS ARE APPROXIMATE OR ESTIMATED QUANTITIES INVOLVED IN THIS CHANGE:
ITEM NO, ITEM QU UNIT PRICE AID12 Q8 12ELEIE
4 TRAFFIC CONTROL
SUPERVISOR 1 $27,875.56 ADD$2,275.56
5 PROJECT TEMPORARY
TRAFFIC CONTROL 1 $3,021.67 Add $246.67
56 TREE AND ROOT REMOVAL 1 $39,092.70 ADD$39,092.70
57 REPLACE THROUGH CURB
INLET 2 $1,075.00 ADD$2,150.00
TOTAL NET CONTRACT: INCREASE$43,764.93 J DECREASE$
DEPARTMENT RECAP TO DATE:
ORIGINAL CONTRACT AMOUNT $ 583, 8&05'
PREVIOUS CHANGE ORDERS $ 0.00
THIS CHANGE ORDER $ 43,764.93
NEW CONTRACT AMOUNT $ 632,0 i2.98
STATEMENT:
Payment for the above work will be in accordance with applicable portions of the standard specifications,and
with the understanding that all materials, workmanship and measurements shall be in accordance with the
provisions of the standard specifications, the contract plans, and the special provisions governing the types of
construction. The execution of this Change Order shall constitute full satisfaction and a waiver of any and all
claims by the Contractor arising out of, or relating in any way to, the Work identified, to be performed, or
eted'pursuant to Change rd'er,except as specifically described in this Change Order,
CON RACTOR" GNATURE DATE
PUBLIC W R S DIRECTOR DATE
CHANGE ORDER AGREEMENT 2 Rev. 8/19
MILES RESOURCES LLC
400 Valley Avenue NE Phone: (253)383-3585
Puyallup,WA 98372 Fax: (253)572-8648
WA. Contractor IJC. #MILESRL897RK
To: City Of Federal Way Contact: John Mulkey
Address: P.O. Box 9718 Phone: (253)835-2526
Federal Way,WA 98063-9718 Fax: (253)835-2709
Project Name: 320th Street Tree Removal Bid Number:
Project Location: City Of Federal Way Bid Date: 3/10/2021
Miles Resources is pleased to offer the following quotation for the above referenced project.Our proposed scope of work is as follows:
Item# Item Description Estimated Quantity Unit Unit Price Total Price
1 Remove 16 Trees&Restoration 1.00 LS $39,092.70 $39,092.70
Total Bid Price: $39,092.70
Notes:
• This quote is valid for 45 days.An Intent to Award or a Subcontract must be received within 45 days of Bid Submittal.
• This proposal is subiect to approved subcontract and mutually aqreed to schedule.
Payment Terms:
Terms: Net 30 days from date of invoice
. _.... ......
ACCEPTED: CONFIRMED:
The above prices,specifications and conditions are satisfactory and MILES RESOURCES LLC
are hereby accepted.
Buyer:
Signature: Authorized Signature:
Date of Acceptance: Estimator: Brett Schultz
253-307-4935 brett.schultz@milesresources.com
Page 1 of 1
SW 320t" St 2021 Preservation Project
TREE REMOVAL LIST
1) Sta 19+90 Lt Tree, Stump&Root Removal
2) Sta 19+50 Lt Tree,Stump&Root Removal
3) Sta 16+30 Lt Tree,Stump & Root Removal
4) Sta 15+90 Lt Tree,Stump & Root Removal
5) Sta 15+50 Lt Tree,Stump& Root Removal
6) Sta 13+90 Lt Tree, Stump & Root Removal
7) Sta 33+50 Lt Tree, Stump& Root Removal
8) Sta 34+65 Lt Tree,Stump&Root Removal
9) Sta 11+30 Rt Tree,Stump& Root Removal
10) Sta 13+00 Rt Tree,Stump& Root Removal
11) Sta 15+40 Rt Tree,Stump& Root Removal
12) Sta 17+00 Rt Tree,Stump& Root Removal
13) Sta 17+75 Rt Tree,Stump& Root Removal
14) Sta 19+75 Rt Tree,Stump& Root Removal
15) Sta 24+00 Rt Tree,Stump& Root Removal
16) Sta 21+00 Lt Tree,Stump&Root Removal
MILES RESOURCES LLC
400 Valley Avenue NE Phone: (253)383-3585
Puyallup,WA 98372 Fax: (253)572-8648
WA. Contractor LIC. #MILESRL897RK
To: City Of Federal Way Contact: Jacob Williams
Address: P.O. Box 9718 Phone: (253)835-2526
Federal Way,WA 98063-9718 Fax: (253)835-2709
Project Name: SW 320th Street Through Curb Inlet Quote Bid Number:
Project Location: Bid Date:
Miles Resources is pleased to offer the following quotation for the above referenced project.Our proposed scope of work is as follows:
Item# Item trescription Estimated Quantity Unit Unit Price Total Price
1 Through Curb Inlet 2.00 EACH $1,075.00 $2,150.00
Total Bid Price: $2,150.00
Notes:
• This quote is valid for 45 days.An Intent to Award or a Subcontract must be received within 45 days of Bid Submittal.
• This proposal is subiect to approved subcontract and mutually aqreed to schedule.
Payment Terms:
Terms: Net 30 days from date of invoice
ACCEPTED: CONFIRMED:
The above prices,specifications and conditions are satisfactory and MILES RESOURCES LLC
are hereby accepted.
Buyer:
Signature: Authorized Signature:
Date of Acceptance: . Estimator: Brett Schultz
253-307-4935 brett.schultz@milesresources.com
Page 1 of 1
RETURN TO: PW ADMIN EXT: 2700 ID#: 3791 / 3828
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT/][)IV: PUBLIC WORKS/Capital Projects
ORIGINATING STAFF PERSON: John Mulkey EXT: 261-3668 3. DATE REQ. B,,: 11/18/2020
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 RFB 20-008
I. PROJECT NAME: SW 320th Street Preservation Project
c. NAMEOFCONTRACTOR: Miles Resources, LLC
ADDRESS: 400 Valle Ave NE Puyallup, WA 98372 TELEPHONE: 253-383-3585
E-MAIL: Brett.schulzCo)milesresources.com FAX:
SIGNATURENAME: Bradley Griffith TITLE:VP/GM
i. EXHIBITS AND ATTACHMENTS:® SCOPE,WORK OR SERVICES m COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHEF
REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
CFW LICENSE#09-104415-00 BL,EXP. 12/31/ 10/31/21 UBI#602-870-349 ,EXP. 12/12/21
TERM: COMMENCEMENT DATE: Upon Execution COMPLETION DATE: Upon Completion 45 WD
i. TOTAL COMPENSATION:$583,288.05 (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: ❑YE :ed 9X)na#eYES,$ PAID BY: ®CONTRACTOR ❑CITY
RETAINAGE: RETAINAGE AMOUNT: RETAINAGE AGREEMENT(SEE CONTRACT) OR ❑RETAINAGE BOND PROVIDED
O PURCHASING: PLEASE CHARGE TO: c36214-26500
I. DOCUMENT/CONTRACT REVIEW INITIAL/DATE REVIEWED INITIAL/DATE APPROVED
8 PROJECT MANAGER JRM-8-14-2020 JRM 11-4-2020
II DIVISION MANAGER SLH 8/14/2020 SLH 11/5/2020
8 DEPUTY DIRECTOR DSw e/1712020
6 DIRECTOR 'W DSW 11/17/2020
❑ RISK MANAGEMENT (IF APPLICABLE)
6 LAW DEPT DK 08-25-2020 ER reviewed 11/10/2020
0. COUNCIL APPROVAL(IF APPLICABLE) SCHEDULED COMMITTEE DATE: 11/2/2020 COMMITTEE APPROVAL DATE: 11/2/2020
SCHEDULED COUNCIL DATE: 11/17/2020 COUNCIL APPROVAL DATE:
1. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE,LICENSES,EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE
(INCLUDE DEPT.SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.)
INITIAL/DATE SIGNED
❑ FINANCE DEPARTMENT
LI LA DEPT Z ft 7O
q0WGNATORY(MAYOR OR DIRECTOR)
ElCITY CLERK
❑ ASSIGNED AG# G
El SIGNED COPY RETURNED ED E SENT:
:OMMENTS:
;XECUTE" 1 "ORIGINALS
THIS IS THE'CONFORMED"SET,NO CHANGES CAN BE MADE TO THE BODY OF THE BID DOCUMENTS EXCEPT FOR CONTRACTOR NAME AND VALUE
1/2020
CONFORMED
PUBLIC WORKS CONTRACT
THIS PUBLIC WORKS CONTRACT ("Contract") is dated effective this day of L C"(72020 and
is made by and between the City of Federal Way, a Washington municipal corporation ("City or Owner"), and
Miles Resources, LLC, a Washington Limited Liability Company ("Contractor"), for the project known as SW
320th Street Preservation (the"Project").
A. The City desires to retain an independent contractor to furnish all labor and materials necessary to perform
work necessary to complete the Project; and
B. The Contractor has the requisite skill and experience to perform such work.
NOW, THEREFORE, the parties ("Parties") agree to the following terms and conditions:
1. SERVICES BY CONTRACTOR
Contractor shall perform all Work and furnish all tools, materials, supplies, equipment, labor and other
items incidental thereto necessary for the construction and completion of the Project. Contractor shall perform
the Work in a manner consistent with accepted practices for other properly licensed contractors and in
accordance with and as described in the Contract Documents, which Work shall be completed to the City's
satisfaction, within the time period prescribed by the City and pursuant to the direction of the Mayor or his or her
designee.
2. TERM
2.1 This Contract shall commence on the effective date of this Contract and continue until the Project is
formally accepted as complete by the City Council, Notice of Project Completion is filed with State agencies, and
all bonds for the Project are released by the City.
2.2 The Contractor must complete the Work in accordance with the number of Working Days for the
Project as identified in the Contract Documents. With regard to obtaining Substantial Completion and the
Completion Date by the Contractor, time is of the essence. In the event the Work is not substantially completed
within the time specified in the Contract Documents, Contractor agrees to pay to the City liquidated damages in
the amount set forth in the Contract Documents. The parties acknowledge that delays inconvenience the public
and cost taxpayers undue sums of money, adding time needed for administration, inspection, and supervision of
the Project and diverting City resources from other projects and obligations.
2.3 If the Contractor is unreasonably delayed by others, notification shall be made in writing to the
Engineer in accordance with the Contract Documents. Any request for a time extension or additional
compensation (including expectancy or consequential damages) allegedly resulting from such delay shall be
made in accordance with the procedures of the Contract Documents. Failure to follow the notice procedures in
the Contract Documents is a full and complete waiver of Contractor's right to additional time, money, damages,
or other relief (including expectancy or consequential damages) as a result of the event or condition giving rise
to such request.
3. COMPENSATION
3.1 In consideration of the Contractor performing the Work, the City agrees to pay the Contractor an
amount not to exceed Five Hundred Eighty-Three Thousand Two Hundred Etghty-Eicalit and 05/100 Dollars ($
583.288.05), which amount shall constitute full and complete payment by the City ("Total Compensation"). The
Contractor shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a result
of the performance and payment of this Contract.
3.2 The City shall pay the Contractor for Work performed under this Contract as detailed in the Bid
Proposal, which is incorporated herein and made a part hereof by this reference, and as detailed in the Contract
Documents. The City shall have the right to withhold payment to the Contractor for any of the Work not
completed in a satisfactory manner, in the City's sole and absolute discretion, which shall be withheld until such
CITY OF FEDERAL WAY SW 320TH STREET PRESERVATION
PROJECT
RFB-22 PROJECT#214/ RFB#20-008
CFW RFB VERSION 2020-JUN
CONFORMED
time as Contractor modifies or repairs the Work so that the Work is acceptable to the City. Payment to the
Contractor for partial estimates, final estimates, and retained percentages shall be subject to controlling laws.
3.3 In addition to the requirements set forth in the Contract Documents, the Contractor shall maintain
Project cost records by cost codes and shall contemporaneously segregate and separately record, at the time
incurred, all costs (1) directly associated with each work activity, (2) directly or indirectly resulting from any
event, occurrence, condition, or direction for which Contractor seeks an adjustment in Contract price Contract
time, or related to any other Claim or protest. Any work performed for which Contractor intends to seek an
adjustment in Contract Price or Contract Time, or related to any other Claim or protest, shall be recorded on the
same day the work is performed and kept separate so as to distinguish it from Contract Work.
4. INDEPENDENT CONTRACTOR
4.1 It is the intention and understanding of the Parties that the Contractor shall be an independent
contractor and that the City shall be neither liable nor obligated to pay Contractor sick leave, vacation pay or any
other benefit of employment, nor to pay any social security or other tax which may arise as an incident of
employment. The Contractor shall not conduct itself as nor claim to be an officer or employee of the City. The
Contractor shall pay all income and other taxes due. Industrial or any other insurance that is purchased for the
benefit of the City, regardless of whether such may provide a secondary or incidental benefit to the Contractor,
shall not be deemed to convert this Agreement to an employment contract. It is recognized that Contractor may
or will be performing professional services during the Term for other parties; provided, however, that such
performance of other services shall not conflict with or interfere with Contractor's ability to perform the Services.
Contractor agrees to resolve any such conflicts of interest in favor of the City. Nothing contained in this Contract
shall create a contractual or direct relationship with or a cause of action in favor of a Subcontractor or third party
against the City, or by the Contractor against the Engineer, or against any of their agents, employees,
engineers, or consultants.
4.2 If the Contractor is a sole proprietorship or if this is a contract with an individual, the contractor
agrees to notify the City and complete any required form if the Contractor retired under a State of Washington
retirement system and agrees to indemnify any losses the City may sustain through the Contractor's failure to
do so.
5. INDEMNIFICATION
5.1 Contractor Indemnification.
5.1.1 The Contractor shall indemnify, defend, and hold the City, its elected officials, officers, employees,
agents, consultants, and volunteers (collectively "the Indemnified Parties") harmless from any costs or losses,
and pay and damages or judgments, related to any claim brought by any person employed in any capacity by
the Contractor or subcontractor or supplier (of any tier) performing the Work, with respect to the payment of
wages, salaries, or other compensation or benefits including but not limited to benefits such as medical, health,
retirement, vacation, sick leave, etc.
5.1.2. To the fullest extent permitted by law, the Contractor shall defend, release, indemnify, and hold
harmless the City and the Indemnified Parties for, from, and against any and all claims, demands, losses, costs,
damages, suits, actions, expenses, fines, penalties, response costs, and liabilities (including costs and all
attorney and expert fees and internal personnel costs of investigation) of whatsoever kind or nature to the extent
arising from, resulting from, connected with, or incident to the Contractor's performance or failure to perform this
Contract or the Work or its breach of this Contract; provided, however, that if the provisions of RCW 4.24.155
apply to the Work and any injuries to persons or property arising out of the performance of this Contract are
caused by or result from the concurrent negligence of the Contractor or its subcontractors, agents, employees,
or anyone for whom they are legally liable, and an Indemnified Party, the indemnification and defense
obligations under this Section 5.1.2 apply only to the extent of the negligence of the Contractor, its
subcontractors, agents, employees, and anyone for whom they are legally liable.
5.1.3 Contractor specifically assumes potential liability for actions brought by the Contractor's own
employees or former employees against any Indemnified Party, and for that purpose Contractor waives any
immunity that may be granted to it under the Washington State Industrial Insurance Act, Title 51 RCW.
CITY OF FEDERAL WAY SW 320TH STREET PRESERVATION
PROJECT
RFB-23 PROJECT#214/ RFB#20-008
CFW RFB VERSION 2020-JUN
CONFORMED
Contractor's indemnification shall not be limited in any way by any limitation on the amount of damages,
compensation or benefits payable to or by any third party under workers' compensation acts, disability benefit
acts or any other benefits acts or programs. Provided, however, the Contractor's waiver of immunity by the
provisions of this paragraph extends only to claims against the Contractor by any Indemnified party, and does
not include, or extend to, any claims by the Contractor's employee directly against the Contractor. The
Contractor recognizes that this waiver was specifically entered into.
5.2 Contractor Release. Any deviation, alteration, variation, addition, or omission in the Work by
Contractor from the Contract Documents shall preclude Contractor from bringing any Claim or request for
additional time or compensation on the basis of an alleged defect or error in the Contract Documents related to
or arising, in any way, from that deviation, alteration, variation, addition, or omission. The Contractor further
warrants that any alteration, variation, deletion, or omission fully complies with or exceeds all requirements of
the Contract Documents and assumes all risk thereof.
5.3 Survival. The provisions of this Section shall (1) survive the expiration or termination of this Contract
with respect to any event occurring prior to such expiration or termination, final payment hereunder, and any
applicable statute of repose with respect to claims, fines, costs or damages brought or made against any
Indemnified Party; (2) shall not be limited by RCW 4.16326(g); and (3) are in addition to any other rights or
remedies which the City and/or any of the Indemnified Parties may have by law or under this Contract.
5.4 Offset. In the event of any claim or demand made against any Indemnified Party hereunder, the City
may, in its sole discretion, reserve, retain or apply any monies due to the Contractor under the Contract or any
other agreement or contract with the City for the purpose of resolving such claims; provided, however, that the
City may, in the City's sole discretion, release such funds if the Contractor provides the City with adequate
assurance of the protection of the City's and the other Indemnified Parties interests.
5.5 The Contractor shall ensure that each Subcontract includes a provision requiring each
Subcontractor to indemnify and defend the City and the Indemnified Parties in the same manner, to the same
extent, and for the same duration as Contractor agrees to indemnify and defend the City and the Indemnified
Parties in this Section 5.
6. OWNERSHIP OF DOCUMENTS
All originals and copies of work product, including plans, sketches, layouts, designs, design
specifications, records, files, computer disks, magnetic media, all finished or unfinished documents or material
which may be produced or modified by Contractor while performing the Work, whether or not required to be
furnished to the City, shall become the property of the City, shall be delivered to the City at its request, and may
be used by the City without restriction.
7. PATENTS, COPYRIGHTS. AND RIGHTS IN DATA
7.1 Any patentable result or material suitable for copyright arising out of this Contract shall be owned by
and made available to the City for public use, unless the City shall, in a specific case where it is legally
permissible, determine that it is in the public interest that it not be so owned or available.
7.2 The Contractor agrees that the ownership of any plans, drawings, designs, specifications, computer
programs, technical reports, operating manuals, calculations, notes and other work submitted or which is
specified to be delivered under this Contract, whether or not complete (referred to in this subsection as "Subject
Data"), is hereby irrevocably transferred and assigned to the City and shall be vested in the City or such other
local, state or federal agency, if any, as may be provided by separate contract with the City. The Contractor shall
execute and deliver such instruments and take such other action(s) as may be requested by the City to perfect
or protect the City's rights to such Subject Data and work product, and to perfect the assignments and transfers
contemplated in Sections 6 and 7.
7.3 All such Subject Data furnished by the Contractor pursuant to this Contract, other than documents
exclusively for internal use by the City, shall carry such notations on the front cover or a title page (or in such
case of maps, in the same block) as may be requested by the City. The Contractor shall also place their
CITY OF FEDERAL WAY SW 320TH STREET PRESERVATION
PROJECT
RFB-24 PROJECT#214/ RFB#20-008
CFW RFB VERSION 2020-JUN
CONFORMED
endorsement on all Subject Data furnished by them. All such identification details shall be subject to approval by
the City prior to printing.
7.4 The Contractor shall ensure that substantially the foregoing paragraphs in Sections 6 and 7 are
included in each subcontract for the work on the Project.
8. GENERAL PROVISIONS
8.1 Entire Contract. The Contract Documents contain all of the agreements of the Parties with respect to
any matter covered or mentioned in this Contract and no prior agreements or understandings pertaining to any
such matters shall be effective for any purpose. In entering into this Contract, neither party has relied upon any
statement, estimate, forecast, projection, representation, warranty, action or agreement of the other party except
for those expressly contained in the Contract Documents.
8.2 Documents. The documents incorporated by reference, as if fully set forth in this Contract, are the
Advertisement for Bids, the Instructions to Bidders and Checklists, the Contractor's Bid Proposal (including all
forms and supplemental information listed on the Bidders Checklist), the Contract Documents (including Project
Plans, Specifications, and all Appendices, Amendments, and Supplemental Reports & Information), the Contract
Provisions (including all forms and supplemental information listed on the Contract Checklist), the version of the
Washington State Standard Specifications for Road, Bridge, and Municipal Construction identified herein, and
any other documents provided to bidders and/or referenced in or referred to by the Contract Documents.
8.3 Modification. No provisions of this Contract, including this provision, may be amended or added to
except by agreement in writing signed by the Parties or their respective successors in interest in accordance
with the Contract Documents.
8.4 Change Orders. In addition to its rights under the Contract Documents, the City may unilaterally
issue a Change Order at any time making changes within the general scope of the Contract, without invalidating
the Contract and without providing notice to sureties. The City's issuance of a unilateral Change Order shall not
be construed as a waiver of any rights afforded the City, including its right to reject a prior protest or request for
change or Claim due to untimeliness or the Contractor's failure to fully comply with the requirements of the
Contract Documents, or to void the unilateral Change Order due to unilateral mistake, misrepresentation, or
fraud.
8.5 Total Cost Method /Claims. In no event shall a Total Cost Method or a modified Total Cost Method
be used by the Contractor to calculate any adjustments to the Contract price. For the purpose of this provision,
any cost method, or variety of cost methods, using the difference between the actual cost of the Work and the
Bid or Contract price of the Work to calculate any additional compensation or money owed to the Contractor
shall be considered a Total Cost Method. In addition, the City shall not be responsible for, and the Contractor
shall not be entitled to, any compensation for unallowable costs. Unallowable costs include, but are not limited
to: (i) interest or attorneys' fees, except as mandated by statute; (ii) Claim preparation or filing costs; (iii) the
costs of preparing notices or protests; (iv) lost profits, lost income, or lost earnings; (v) costs for idle equipment
when such equipment is not at the Site, has not been employed in the Work, or is not scheduled to be used at
the Site; (vi) claims consulting costs; (vii) expert fees and costs; (viii) loss of other business; and/or(ix) any other
special, consequential, expectancy, incidental, or indirect damages incurred by the Contractor, Subcontractors,
or suppliers.
8.6 Warranties and Guarantees. In addition to the requirements of the Contract Documents, the
Contractor warrants that all portions of the Work that will be covered by a manufacturer's or supplier's guarantee
or warranty shall be performed in such a manner so as to preserve all rights under such guarantees or
warranties. If the City attempts to enforce a claim based upon a manufacturer's or supplier's guarantee or
warranty and such manufacturer or supplier refuses to honor such guarantee or warranty based, in whole or in
part, on a claim of defective installation by the Contractor or a Subcontractor, the Contractor shall be
responsible for any resulting loss or damage, and repairs, incurred by the City as a result of the manufacturer's
or supplier's refusal to honor such guarantee or warranty. This obligation survives termination of this Contract.
CITY OF FEDERAL WAY SW 320TH STREET PRESERVATION
PROJECT
RFB-25 PROJECT#214/ RFB#20-008
CFW RFB VERSION 2020-JUN
CONFORMED
8.7 Full Force and Effect. Any provision of this Contract, which is declared invalid, void or illegal, shall in
no way affect, impair, or invalidate any other provision hereof and such other provisions shall remain in full force
and effect.
8.8 Ass g ment. The Contractor shall not transfer or assign, in whole or in part, any or all of its
obligations and rights hereunder without the prior written consent of the City. In the event the City consents to
any such assignment or transfer, such consent shall in no way release the Contractor from any of its obligations
or liabilities under this Contract.
8.9 Successors In Interest. Subject to the preceding Subsection, this Contract shall be binding upon and
inure to the benefit of the Parties' successors in interest, heirs and assigns.
8.10 Time Limitation and..Venue. For the convenience of the parties to the Contract it is mutually agreed
by the parties that any claims, causes of action, or disputes which the Contractor has against the City arising
from the Contract shall be brought within the following time period: (i) 180 calendar days from the date of
Substantial Completion for those claims, causes of action, or disputes arising prior to the date of Substantial
Completion, and (ii) 180 calendar days from the date of Final Acceptance of the Contract by the City for those
claims, causes of action, or dispute arising after the date of Substantial Completion. It is further agreed that the
venue for any claim, cause of action, or dispute related to this Contract shall be King County, Washington, which
shall have exclusive jurisdiction over any such case, controversy, or dispute. The parties understand and agree
that the Contractor's failure to bring suit within the time period provided, shall be a complete bar to any such
claims or causes of action. It is further mutually agreed by the parties that when any claims, causes of action, or
disputes which the Contractor asserts against the City arising from the Contract are filed with the City or initiated
in court, the Contractor shall permit the City to have timely access to any records deemed necessary by the City
to assist in evaluating the claims, action, or dispute.
8.11 No Waiver. Failure of the City to declare any breach or default immediately upon occurrence
thereof, or delay in taking any action in connection with, shall not waive such breach or default. Failure of the
City to declare one breach or default does not act as a waiver of the City's right to declare another breach or
default.
8.12 Sole Authority/Discretiun/Judgi-nent. Where the Contract Documents provide the City or its
Engineer with "sole" authority, discretion, or judgment, such authority, discretion, or judgment shall be
considered unconditional and absolute.
8.13 Governing Law. This Contract shall be made in and shall be governed by and interpreted in
accordance with the laws of the State of Washington.
8.14 Authority. Each individual executing this Contract on behalf of the City and Contractor represents
and warrants that such individuals are duly authorized to execute and deliver this Contract on behalf of the
Contractor or City.
8.15 Engineer. The Engineer is the City's representative who directly supervises the engineering and
administration of a construction Contract. The Engineer's authorities, duties, and responsibilities are limited to
those specifically identified in the Contract Documents. Designation of an individual or entity as the Engineer for
the Project is solely to identify the representative of the City as the entity to act as the Engineer as described in
the Contract Documents. Using the term "engineer' does not imply that such entity or person is a licensed
professional engineer or an engineering company and does not import any additional obligations upon the
actions of the Engineer that may govern licensed professional engineers when performing engineering services.
The Engineer for this Project is designated as: John Mulkey, P.E., Senior Capital Engineer
8.16 Notices. Any notices required to be given to Contractor or to the Engineer shall be delivered to the
Parties at the addresses set forth below. Any notices may be delivered personally to the addressee of the
CITY OF FEDERAL WAY SW 320TH STREET PRESERVATION
PROJECT
RFB-26 PROJECT#214/RFB#20-008
CFW RFB VERSION 2020-JUN
CONFORMED
notice or may be deposited in the United States mail, postage prepaid, to the address set forth herein. Any
notice so posted in the United States mail shall be deemed received three (3) days after the date of mailing.
CONTRACTOR: Miles Resources, LLC
Attn: Bradley Griffith
400 Valley Ave NE
Puyallup, WA 98372
ENGINEER City of Federal Way
Attn: John Mulkey P.E., Senior Capital Engineer
33325 8th Ave S
Federal Way, WA 98003
8.17 Captions. The respective captions of the Sections of this Contract are inserted for convenience of
reference only and shall not be deemed to modify or otherwise affect in any respect any of the provisions of this
Contract.
8.18 Performance. Time is of the essence of this Contract and each and all of its provisions in which
performance is a factor. Adherence to completion dates is essential to the Contractor's performance of this
Contract.
8.19 Compliance with Ethics Code. If a violation of the City's Ethics Resolution No. 91-54, as amended,
occurs as a result of the formation and/or performance of this Contract, this Contract may be rendered null and
void, at the City's option.
9. PERFORMANCE/PAYMENT BOND
Pursuant to RCW 39.08.010, the Contractor's payment and performance bonds must be conditioned
upon: (i) faithful performance of all of the provisions of the Contract, including warranty obligations; (ii) the
payment of all laborers, mechanics, Subcontractors, and Suppliers, and all persons who supply such persons
with provisions or supplies in carrying out the Work; and (iii) payment of any taxes, liabilities, increases, or
penalties incurred on the Project under Titles 50, 51, and 82 RCW which may be due on (a) projects referred to
in RCW 60.28.011(1)(b), and (b) projects for which the bond is conditioned on the payment of such taxes,
liabilities, increases, or penalties. Contractor's obligations under this Contract shall not be limited to the dollar
amount of the bond.
DATED the day and year set forth above.
CITY OF FEDERAL WAY SW 320TH STREET PRESERVATION
PROJECT
RFB-27 PROJECT#214/ RFB#20-008
CFW RFB VERSION 2020-JUN
CONFORMED
CITY FE RAL WAY: CONTRAC Z
reil, Mayor Signature ofi h rized lhdividual
325 8th Avenue South [ ,I
Federal Way, WA 98003-6325 C C1 Ulu Pik�j deq f-
Printed Name of Authorized Individual
ATTEST: LOO _
''l 1 � U D ,�J r�V St,eetAddrel� e• ��
to ha► e 'ourtney, CMC, City Clerk I
APP OVE AS TO FO M: Cit ate i
Y. � P
J. Ryan Call, City Attorney
NOTARY OF CONTRACTOR'S SIGNATURE:
STATE OF WASHINGTON )
Q COUNTY OFT / -( )) ss.
On this da p sonally appeared before me Y i C rl � [ 1 t� to me known to be
the I � rP t(-I of YY11�b" �.11 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 he/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 I`r�'I { day of KQA14rn o-e r 2G_
C�' �k�o' —
? !G
(typed/printed name f notary)
Notary Public in and for the State of Washington.
}�, E ,�• +fir My commission expires I ' 1(1--7-1
R
111
00
00
4 - r00
i CP PUB0r-Jj 0
PIS
CITY OF FEDERAL WAY SW 320TH STREET PRESERVATION
PROJECT
RFB-28 PROJECT#214/ RFB#20-008
CFW RFB VERSION 2020-JUN
l:U1Nr UK rViK1J
Bond No.023216546
PERFORMANCE AND PAYMENT BOND
SW 320TH STREET PRESERVATION PROJECT
The City of Federal Way ("City") has awarded to Miles Resources, LLC ("Principal"), a contract for the
construction of the above referenced project, and said Principal is required to furnish a bond for performance of
all obligations under the Contract and for payment in accord with Chapter 39.08 Revised Code of Washington
(RCW)and (where applicable) Chapter 60.28 RCW.
The Principal, and Liberty Mutual Insurance Company {"Surety"), a corporation organized under the'laws of the
State of Massachusetts and licensed to do business in the State of Washington as surety and
named in the current list of "Surety Companies Acceptable in Federal Bonds" as published in the Federal
Register by the Audit Staff Bureau of Accounts, U.S. Treasury Dept., are jointly and severally held and firmly
bound to the City of Federal Way, in the sum of Five Hundred Eighty-Three Thousand Two Hundred Eithy_Eight
and 051100 US Dollars{$583,288.05)Total Contract Amount,subject to the provisions herein.
This bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors,
or assigns shall:
1) Well and faithfully perform all of the Principal's obligations under the Contract and fulfill all terms
and conditions of all duly authorized modifications, additions, and changes to said Contract that may
hereafter be made, at the time and in the manner therein specified; and if such performance
obligations have not been fulfilled; this bond shall remain in force and effect;and
2} Pay all persons in accordance with Chapters 39.08, 39.12, and 60.28 RCW including all workers,
laborers, mechanics, subcontractors, and materialmen, and all person who shall supply such
contractor or subcontractor with provisions and supplies for the carrying on of such work, and all
taxes incurred on said Contract under Titles 50 and 51 RCW and all taxes imposed on the Principal
under Title 82 RCW; and if such payment obligations have not been fulfilled, this bond shall remain
in full force and effect.
The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the
Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract shall
in any way affect its obligation on this bond, and waives notice of any change, extension of time, alteration or
addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes
to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall
automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such
increased obligation.
This bond shall be signed by duly authorized officers and will only be accepted if accompanied by a fully
executed, original power of attorney for the office executing on behalf of the surety.
PRINCIPA lies edources, LC SURETY: Liberty Mutual Insurance Company ikct.0p .
Principal turd Date Surety Signature
Brad &rJ FAf 1_1 Aiiceon A.Kellner . � "1�."
PrWed Warne Printed Name
i u,. I(LSI G I nt Attomey-in-Fact
Tide Tifle
CITY OF FEDERAL WAY SW 320TH STREET PRESERVATION
PROJECT
RFB-32 PROJECT#2141 RFB 920-008
CFW RFB VERSION 2020-JUN
LOCAL OFFICEIAGENT OF SURETY;
Propel Insurance
Name
601 Union Street,Suite 3400
Sneer Address
Seattle,WA 98101
city, State, Zip
(206)6764200
Telephone
BOND NO.: 023216W
APPROVED AS TO FORM: �L�^�i I" 7 yr
J. Ryan Call, City Attorney
CITY OF FEDERAL WAY SW 320TH STREET PRESERVATION
PROJECT
RFB-33 PROJECT 9214/RFB 020-008
CFW RFB VERSION 2020-JUN
This Power of Attorney linits;the acts of those named herein,and they have no authority to
bind the Company except in the rranner and to the aftl herein staked.
Libe Liberty Mutual Insurance Company
mutum. The Ohio Casualty Insurance Company Cero'liicake Na 8204061 -023049
SURETY WestAmedcan Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS:That The Oho Ca-,:mlty Irswwm Carrpory Is a of the State of New i Orrpslhi.4 diEt
Liberty M�tuai Insurance Carp@N is a corpora'don dLAy crga61:,Td L9 ri*iays d the Stake of Massachisem,and Carpary is a corporatian dsr4y urga6zeJ
underb-Lelaw ufftStM ofb-Tara[tnerein cdleLtveiy,-@lled ti e CorrpaTies j,p,rsuarttoard byaL#mrh yheMnsetfitrth does i-�ram corrthae and appoirf,__�
AlieeonA.KelM,Alyssa I.L2n,Amelia G.Burrill,Annelies M.Richie,Brandon K.Biah BrentE.Heileser> Carley Espiritu,Chriswoher l(inyonn,Cynchi3 L.jal,
Diane M.Harding E[hvard5ims_Eric A.ZirrrTierman Erica E.Mosioy,Heather L.AIIM Hoilj AIbei,%Jacob T.Haddock,jan>es B.Binder,jarnia L. MarquEs,
Katharine .5N der,K yI ej oseph H ow4 TerdeCanard
all of the city of Tacorre stake Of WA each it clMdLoli it tt-j2re be n xim than are rarre�its me and la4Ld YdaT ey-irn-factw rralcp-
eaecuh!,seat ac and on betlalf as suety and as its artand deed ary ardalf Lr&nnaldrgs,bards,reccgr arres andother surety cbliliors,in Rnwrice
of these preserts and shall be as bir ft upon the Con parses as if try have been duly signed bj the phesldert and attested by the secretary of the Con parses in their awn pvper
fWAM
IN WITNESS WHEREOF,this Power ofAttorney has been subscribed by an aLtharized olflmoroAdal Ofthe Ccrrparies and the caporaake se6ls ofthe Corrpanies have been afford
therealths 28th ray of 1 Uy 2020
Liberiyr MlAel Insurance Conpary
ry trist►,� 'tvv( INS& imsu/? The Ohio CasrelgrlrsuranceConWry
qua°aywn�rgn -�?4aprok�r y� WastAm3ican Insurance COrrpwy -
Y � 1912 � 0 d � 1919� 4 s 1991 0
yJ,}
ct+vy�db y� harwrya ts3 hvnuMrAa By:
C 7 * 1 `�d * k M ►
Lo David Mt Caney,Assistarc5areiary
70 its Stale of PENPSYLVANQA Ss
:' Carly of M ONTGOMERY
v3Onthis 28th dayof July 2020 Lefbre rrepers llyappearc!DmAdMCarey,Wbaciananledge NffmlftobetheAss6VrtSecrE4aryafLiberlyMAnllmurance��
'ro Corrpany,The Ohio CasLoly Ccurpary,and WestArmrican ksuiame Corr:iarry,old got he,as such being ardhorized soto do,execute the Taregdng irstrur ertforthe piposes a)
therein curtained by sigrirg cis bar !Vtihe cr Fnrrn by lin-Feiras a 64 audxwLzed d"ncer. ULU
E
cur IN WITNESS WHEREOF,I have lraeurlm srbsvibed rry rare and alfoued rry nolo seal at IGng of Pnssia,PerrsyWria,on the day and yeariirrst ab we vwritken ECL
In �
Mi•,I
`' jE'� COMMONWEALTH OF PENNUYLVANLA 'Q�
C? µ ��t p Notarial Seal C
C) Teresa Pastella,Notary Puck C/ i �• l0'.
Upper MenonTwp Montgomery County By: _�:!-�.�'="�' 11ta, E
>_. a My Commission Expires Mardi 28,2021 •'
eirs@ d'aS�ita, ry 1"LU[c o 10
try ti, Mrmher,r=pnn,,�v r' .__. _��of Nokarre. Q—O
fCi rL AI�y � E2 O
Ths Posner of Anotney is niDde and execIABd prsuzi t to and icy+aWmrity of the Vi losarg Rplaz and Auttxxi-t8VkA a of The Ohio Casualty Insurance Carpery, LibeMl VI UL al�rn
•G irisurariceCurrtp V,ardWestArn riranlnsuarxe ConrpanyWl,,dq msdtfi xis am rrminfJ1 fw:e and Fiectrwd'rg as fL b/s: 0 C)
.51 ARTICLE N'OFFICERS:Section 12 PawerofAtlornq. 42
Any Officer or other Official of the Clorpoizab atdWzed for that purpose in whirl by the Chairrmn or the Presider*and subject to such Grritaion as the Chairmn or the'Z5.0
L, President may presaft shall appoi t such atmmeWr>fact as Tray be necessary to act in behalf of the Corporation to ralte,eaeci de seat aclvhovkdge and deliver as surety >�
any and all vide aldrgs,bonds,rec*anes and Ocher surely obligations.Such amorneys-in-face;subject to the limitations set forth in their respecifue pwas of attorney,s4i I
o have fill power to bird the Corporation by their sWet re and execution of any such irstrurrents and to attach thereb the seal of the Corporation When so[xe=er4 such E cc
cV
z u instnirerts sh d be as binding as if signed by the President and attested tD by the Secretary Any pallier or auth orV Warted tD ary restive or atffrr`-y-irrfact r#V-a, V)
prrwisiors Ofthis article may be revdaed atary*ye bythhe Board,the ChaRmn the President or bythe olrrar ordkers grartng such pwserora to ft. d
ARTICLE XM-Execution of Contracts:Section S.Surely Bonds and Undertaldrtgs. cQ
Any officer cif the Carrpany aLOnh led fartlhat purpose in widTg by ttx cttairran or tte prim'beM and suo ectto such Iir rttat om as the ctairrren or the p-eslderht tray prescribe,i—
sllall appdnt such almrri s-ln-fa-,,as rruy be reressary to act in beidf of the Corrmry to rmIse,s--ecw_te,seal,aclmovrlecge and cielhw as sugj ary 2.rd ail uxierolGr>:
berms,recogm2artces and Wu sLmy odfp-Vom.Swhatt ±rs-in-factsut1 ea tott�,1irrimfllom satforttt 1n 1tririTaspertve poiAes of amorrney,slaif i>ave.lull pck r to lkrxi tte
Co,-rrpany lay ti-,,-�rsigrst,aE and exf-,Wff x-I©f ary such j,Elm rrlvras ar>._l tD attach li-�E nebti-e seal of Te CoT{ony, n so exec:d sLx:h instrarr rz sha'sl ba as?�rdrig as ff
s��d IVfhe prresic�-rtand-ncsTd tythE'sceru2ry.
Certificate of Designation-The President of the Carrpery,aetirg pistenttoIke Bybavrs afthe Corpery,authorizes David M Carey,Assistant Secretary to appoutsuch atlon ys 4ni-
factasraybenecessarytoactonbehaffafthheCorrparyiDrrde,eeMseataci,rvr,ic-rgeanddefinerassi ttaryandallurdertakhr bonds,magazances and Wwsurety
oblig�.
Au,tdnortzation-By u1ar trrous carsert afthe Corrpany/s Board of Direcmrs,the Carrpary concerts tbatfarsirrife or rrecharically mproducedsigrahie of ary ass6tilrtsecretary of the
CwW y,%hn rew appearing upon a certified copy of any power of athlnM issued by the Company in corrnedton Wth suety,bonds,shall be vaNd and iirndrg upon the Carrpary with
the sameforce and ekdasthhoLghnanllafiyabed
L Renee C.Lien&e n the udersigred Assislart Secretiry,The Ohio Casu*Insurance Corrparry,Liberty MAA Insurance Co rpary,and west American Insurance corrpary do
herebl certify ibat the original power of atmM of vthich the foregdrg Is a AA he and correct copyr of the Parer ofAbxW executed by said Corpark%is In fill Torre and effect and
has notbeen revoWd
IN TESTR OW WHEREOF,I toe he eLrto set rry tend and affixed the seals of said Crrrparies this ten, day Of November , 2020
41NSu y11 IN q INSUq
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LMS-12873 LMIC OCIC WAIC Multi Co 12n9
AUTHORIZATION TO ACT ON BEHALF OF
MILES RESOURCES,LLC
A WASHINGTON LIMITED LIABILITY COMPANY
WHEREAS,Miles Resources,LLC(the"Company")is a Washington limited liability company
organized for purposes of(among other things)managing and operating business assets used in connection
with the Company's construction,paving and related activities;
WHEREAS,all authority to operate the business and affairs of the Company is vested in one or
more mangers,and the managers of the company are Walt Miles,Lisa Kittilsby,and Tim Kittilsby
(hereinafter the"Managers");
WHEREAS,the Mangers of the company intend to delegate certain authority relating to the day-
to-day operations of the company to the individuals identified below;
NOW THEREFORE,be it resolved as follows:
RESOLVED,that the Managers hereby delegate a portion of their authority to the"Operations
Managers:of the Company named below;
RESOLVED,that each of the Operations Managers,acting individually,shall have the power and
authority to manage the day-to-day business of the company. Without limiting the generality of the
foregoing,the Operations Managers shall have the power and authority to negotiate and enter into contracts
on behalf of the Company,sign documents relating to such contracts,and to engage in any other acts
related to the Company's day-to-day operations;
RESOLVED,that Angela Reis is hereby removed as Operations Mangers of the company.
For the purpose of execution of the Authorization,a facsimile or electronically scanned signature
shall have the same force and effect as an original signature. This Agreement may be executed in one or
more counterparts,all of which shall be considered one and the same Agreement.
SIGNED and EFFECTIVE this I" day of Auguste 2018
MILES RESOURCES,LLC OPERATIONS MANAGERS
/,��-I--2- , (,�V/ _. ./
By: Walt Miles Br die •ifF h
Its: Manager and Member General Man gei10 erations Manager
A7A r
By: Lisa Kittilsby Krystal Amos
Its: Manager and Member Controller/Operations Manager
By: Tim Kittilsby
Its: Manager
11/4/2020 Corporations and Charities System
Ii+,r'SS�I� i frl ias and Charities Filing System
BUSINESS INFORMATION
Business Name:
MILES RESOURCES LLC
UBI Number:
602 870 349
Business Type:
WA LIMITED LIABILITY COMPANY
Business Status:
ACTIVE
Principal Office Street Address:
400 VALLEY AVE NE,PUYALLUP,WA,98372-2516,UNITED STATES
Principal Office Mailing Address:
400 VALLEY AVE NE,PUYALLUP,WA,98372-2516,UNITED STATES
Expiration Date:
10/31/2021
Jurisdiction:
UNITED STATES,WASHINGTON
Formation/Registration Date:
10/06/2008
Period of Duration:
PERPETUAL
Inactive Date:
Nature of Business:
CONSTRUCTION
REGISTERED AGENT INFORMATION
Registered Agent Name:
TIMOTHY KITTILSBY
Street Address:
400 VALLEY AVE NE,PUYALLUP,WA,98372-2516,UNITED STATES
Mailing Address:
400 VALLEY AVE NE,PUYALLUP,WA,98372-2516,UNITED STATES
GOVERNORS
Title Governors Type Entity Name First Name Last Name
https://ccfs.sos.wa.gov/#/BusinessSearch/Businessinformation 1/2
11/4/2020 Corporations and Charities System
Title Governors Type Entity Name First Name Last Name
GOVERNOR INDIVIDUAL TIM KITTILSBY
GOVERNOR INDIVIDUAL LISA KITTILSBY
GOVERNOR INDIVIDUAL WALT MILES
Back
Filing History Name History Print Return to Business Search
https:Hccfs.sos.wa.gov/#/BusinessSearchBusinessinformation 2/2
Client#: 17793 MILESAND
DATE(MM/DD/YYYY)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 1 10/21/2020
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 Sharnel Di Vona
NAME:
Prop
PHONE 800
933 FAX
Taco Insurancecomer l©DRassxtSha nel9DOonaQpropelinsurance.coml 866577-1326
JAfC,No Tacoma Commercial Insurance ADDRESS;
1201 Pacific Ave, Suite 1000
INSURER(S)AFFORDING COVERAGE NAIC#
Tacoma,WA 98402 INSURER A:Alaska National Insurance Company 38733
INSURED INSURER B:Sirius International Insurance Corp
Miles Resources LLC Continental Casualty Company 20443
INSURER C: Y P Y
400 Valley Ave NE
INSURER D
Puyallup,WA 98372
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 CONTRACTOR 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.
INSFr ADDLISUSR, POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR yyVD POLICY NUMBER (MM/DD/YYYY) IMWDWYYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY 20DLS11734 4/01/2020 04/01/2021 EACH OCCURRENCE $1,000,000
CLAIMS-MADE Xi OCCUR DAMAGE ( RENTED
PREMISESS RENT occurrence) $100,000
X BI/PD Ded: $1,000 MED EXP(Any one person $5,000
X CG0001 04/13 PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY JECOT 1 X] LOC PRODUCTS-COMP/OPAGG $2,000,000
OTHER: _ _ COMBINED SINGLE LIMIT $
A
AUTOMOBILE LIABILITY 20DAT11734 4/01/2020 04/01/2021 �Ea accident $1,000,000
X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
X AUTOS ONLY X AUTOS ONLY Per accident
X CA0020 10/13 $
A � UMBRELLA LIAB X OCCUR 20DLU11734 4/01/2020 04/01/2021 EACH OCCURRENCE s5,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,000
DED X RE?ENTON T-510,00D $
A WORKERS COMPENSATION SPTERTU20DLS11734 4/01/2020 04/01/2021�- — orH-
AND EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
N (WA STOP GAP ONLY) E.L.EACH ACCIDENT $1,000 000
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory In NH) i� E.L.DISEASE-EA EMPLOYEEI$1,000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
D
B Pollution w/Mold CPL00011321 04/01/2020 04/01/2021 $3,000,000/$25,000 ded.
C Leased/Rented Eq 6080724344 4/01/2020 04/01/2021 $800,000(L/R eq)
C Inst. Floater 6080724344 4/01/2020 04/01/2021 $100,000 I.F.
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
RE: 20151 SW 320th Street Preservation Project,RFB#20-008, Project#214.
Additional Insured Status-applies per attached form(s).
CERTIFICATE HOLDER CANCELLATION
City of Federal Way SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Y Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
33325 8th Ave South ACCORDANCE WITH THE POLICY PROVISIONS.
Federal Way,WA 98003
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
#S4338315/M4084914 KTROO
This page has been left blank intentionally.
JIF Alaska National
INSURANCE COMPANY
BLANKET ADDITIONAL INSURED — AUTOMATIC STATUS IF REQUIRED BY WRITTEN CONTRACT
(CONTRACTORS)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:.
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Additional Premium: included
1. The following is added to SECTION II — WHO IS (2) If the "written contract requiring insurance"
AN INSURED: specifically requires you to provide
additional insured coverage to that person
Any person or organization that: for injury or damage that is caused, in
whole or in part, by the acts or omissions
a. You agree in a "written contract requiring of you or your subcontractor, that person
insurance" to include as an additional insured or organization is an additional insured
on this Coverage Part; and only if the injury or damage is caused, in
whole or in part, by the acts or omissions
b. Has not been added to this policy as an of you or your subcontractor in the
additional insured for the same project by the performance of "your work" to which the
attachment of an endorsement under this "written contract requiring insurance"
Coverage Part which includes such person or applies" or
organization in the endorsement's schedule;
'(3)If neither Paragraph (1) nor (2) above
is an insured, but: applies that person or organization is only
an additional insured if, and only to the
c. Only with respect to liability for "bodily injury", extent that, the injury or damage is caused
"property damage" or"personal and advertising by negligent acts or omissions of you or
injury"; and your subcontractor in the performance of
"your work" to which the "written contract
d. Only as described in Paragraph (1), (2) or (3) requiring insurance" applies. The person or
below, whichever applies: organization does not qualify as an
additional insured with respect to injury or
(1) If the "written contract requiring insurance" damage caused in whole or in part by
specifically requires you to provide independent negligent acts or omissions of
additional insured coverage to that person such person or organization.
for injury or damage that arises out of"your
work", that person or organization is an
additional insured only if the injury or
damage arises out of "your work" to which
the "written contract requiring insurance"
applies;
ANIC GL 1218 05 18 Page 1 of 3
41%V Alaska National
INSURANCE COMPANY
2. If the"written contract requiring insurance" contains (1) The preparing, approving, or failing to
a specific requirement that you procure completed prepare or approve, maps, shop drawings,
operations coverage or coverage within the opinions, reports, surveys, field orders or
"products-completed operations hazard" for the change orders, or the preparing,
additional insured, then the insurance provided to approving, or failing to prepare or approve,
the additional insured covers "bodily injury" or drawings and specifications; and
"property damage"that occurs within the"products-
completed operations hazard" at the level specified (2) Supervisory, inspection, architectural or
in Paragraph 1.d.(1), 1.d.(2), or 1.d.(3), whichever engineering activities.
applies. However, even if completed operations
coverage or coverage within the "products- 4. The insurance provided to the additional insured by
completed operations hazard" is required by the this endorsement is excess over any valid and
"written contract requiring insurance", such collectible other insurance, whether primary,
coverage is available to the additional insured only excess, contingent or on any other basis, that is
if the "bodily injury" or "property damage" occurs available to the additional insured. However, if the
prior to the end of the time period during which you "written contract requiring insurance" specifically
are required by the "written contract requiring requires that this insurance apply on a primary
insurance" to provide such coverage or the basis or a primary and non-contributory basis, this
expiration date of the policy, whichever comes first. insurance is primary to other insurance available to
the additional insured under which that person or
3. The insurance provided to the additional insured by organization qualifies as a named insured, and we
this endorsement is limited as follows: will not share with that other insurance. But the
insurance provided to the additional insured by this
a. If the Limits of Insurance of this Coverage Part endorsement still is excess over any valid and
shown in the Declarations exceed the collectible other insurance, whether primary,
minimum limits of liability required by the excess, contingent or on any other basis, that is
"written contract requiring insurance", the available to the additional insured when that
insurance provided to the additional insured person or organization is an additional insured, or
will be limited to such minimum required limits is any other insured that does not qualify as a
of liability. For the purposes of determining named insured, under such other insurance.
whether this limitation applies, the minimum
limits of liability required by the "written 5. As a condition of coverage provided to the
contract requiring insurance"will be considered additional insured by this endorsement:
to include the minimum limits of liability of any
Umbrella or Excess liability coverage required a. The additional insured must give us written
for the additional insured by that "written notice as soon as practicable of an
contract requiring insurance". This "occurrence" or an offense which may result in
endorsement will not increase the limits of a claim. To the extent possible, such notice
insurance described in Section III — Limits Of should include:
Insurance.
(1) How, when and where the "occurrence" or
b. The insurance provided to the additional offense took place;
insured does not apply to "bodily injury",
"property damage", or "personal and (2) The names and addresses of any injured
advertising injury" arising out of an architect's, persons and witnesses; and
engineer's, or surveyor's rendering of or failure
to render any professional services including: (3) The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
ANIC GL 1218 05 18 Page 2 of 3
JIF Alaska National
IN S U AANCE COMPANY
b. If a claim is made or "suit" is brought against 6. The following is added to the DEFINITIONS
the additional insured, the additional insured Section:
must:
"Written contract requiring insurance" means that
(1) Immediately record the specifics of the part of any written contract or agreement for
claim or"suit" and the date received; and construction services under which you are required
to include a person or organization as an additional
(2) Notify us as soon as practicable. insured on this Coverage Part, provided that the
"bodily injury" and "property damage" occurs, and
The additional insured must see to it that we the "personal and advertising injury" is caused by
receive written notice of the claim or "suit' as an offense committed, during the policy period and:
soon as practicable.
a. After the signing and execution of the contract
c. The additional insured must immediately send or agreement by you; and
us copies of all legal papers received in
connection with the claim or "suit', cooperate b. While that part of the contract or agreement is
with us in the investigation or settlement of the in effect.
claim or defense against the "suit", and
otherwise comply with all policy conditions.
d. The additional insured must tender the defense
and indemnity of any claim or "suit" to any
provider of other insurance which would cover
the additional insured for a loss we cover
under this endorsement. However, this
condition does not affect whether the
insurance provided to the additional insured by
this endorsement is primary to other insurance
available to the additional insured which covers
that person or organization as a named
insured as described in Paragraph 3. above.
This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date
issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is
required only when this endorsement is issued subsequent to commencement of the policy.
Endorsement Effective 4-1-2020 Policy No. 20D LS 11734
Insured Miles Sand &Gravel Endorsement No.
Countersigned By
Includes copyrighted material of the Insurance Services Office, Inc., with its permission.
ANIC GL 1218 05 18 Page 3 of 3
This page has been left blank intentionally.
J%r Alaska National
INSURANCE COMPANY
CONTRACTORS' GENERAL LIABILITY ENHANCEMENT ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Coverage afforded under this extension of coverage endorsement does not apply to any person or organization
covered as an additional insured on any other endorsement now or hereafter attached to this Coverage Part.
SCHEDULE OF COVERAGES ARE SUMMARIZED BELOW
1. Miscellaneous Additional Insureds 14. In Rem Actions
8 additional insured extensions.
1. MISCELLANEOUS ADDITIONAL INSUREDS
Primary and Noncontributory Insurance
Section II Who Is An Insured is amended to
2. Damage To Premises Rented to You include as an additional Insured any person or
Limit increased to$500,000. organization described in Paragraphs 2.a.
through 2.h. below whom you are required to add
3. Medical Payments as an additional insured on this policy under a
Limits increased to $15,000. written contract or written agreement. However,
Reporting period increased to three years from the written contract or written agreement must be:
the date of accident.
1. Currently in effect or becoming effective
4. Non-owned Watercraft during the term of this policy; and
Increased to 50 feet.
2. Executed prior to the "bodily injury",
6. Supplementary Payments "property damage" or"personal injury and
Cost of bail bonds increased to$10,000. advertising injury", but
Daily loss of earnings increased to $500,
Only the following persons or organizations
6. Newly Formed Or Acquired Organizations are additional insureds under this
Coverage extended to the end of the policy period endorsement and coverage provided to such
or the next anniversary of this policy's effective additional insureds is limited as provided
date. herein:
7. Liberalization Clause a. State or Governmental Agency or
Subdivision or Political Subdivi-
8. Unintentional Failure To Disclose Hazards sions
9. Notice of Occurrence Any state or governmental agency or
subdivision or political subdivision
10. Broad Knowledge of Occurrence that has issued a permit in
connection with operations performed
11. Bodily Injury-Extension of Coverage by you or on your behalf and that you
are required by any ordinance, law or
12. Expected Or Intended Injury building code to include as an
Reasonable force - bodily injury or property additional insured on this coverage
damage. part is an additional insured, but only
with respect to liability for "bodily
13. Blanket Waiver of Subrogation injury", "property damage", "personal
Waiver of subrogation where required by written and advertising injury" arising out of
contract or written agreement. such operations.
ANIC GL 1187 07 16 Page 1 of 6
`] Alaska rational
INSURANCE COMPANY
The insurance provided to such state e. Owners or Other Interests From
or political subdivision does not apply Whom Land Has Been Leased
to any "bodily injury", "property
damage" or"personal and advertising An owner or other interest from whom
injury" arising out of operations land has been leased by you but only
performed for that state or political with respect to liability arising out of
subdivision. the ownership, maintenance or use of
that specific part of the land leased to
b. Controlling Interest you and subject to the following
additional exclusions:
Any persons or organizations with a
controlling interest in you but only This insurance does not apply to:
with respect to their liability arising
out of: (1) Any "occurrence" which takes
place after you cease to lease
(1) Their financial control of you, or that land; or
(2) Premises they own, maintain or (2) Structural alterations, new con-
control while you lease�or occupy struction or demolition operations
these premises. performed by or on behalf of
such additional insured.
This insurance does not apply to
structural alterations, new construc- f. Co-owner of Insured Premises
tion and demolition operations
performed by or for such additional A co-owner of a premises co-owned
insured. by you and covered under this
insurance but only with respect to the
c. Managers or Lessors of Premises co-owners liability as co-owner of
such premises.
A manager or lessor of premises but
only with respect to liability arising out g. Lessor of Equipment
of the ownership, maintenance or use
of that specific part of the premises Any person or organization from
leased to you and subject to the whom you lease equipment. Such
following additional exclusions: person or organization is an
additional insured only with respect to
This insurance does not apply to: their liability for "bodily injury",
"property damage" or "personal and
(1) Any "occurrence" which takes Advertising injury" caused, in whole
place after you cease to be a or in part, by your maintenance, oper-
tenant in that premises; or ation or use of equipment leased to
you by such person or organization.
(2) Structural alterations, new con- A person's or organization's status as
struction or demolition operations an additional insured under this
performed by or on behalf of endorsement ends when their written
such additional insured. contract or written agreement with
you for such leased equipment ends.
d. Mortgagee, Assignee or Receiver
With respect to the insurance
A mortgagee, assignee or receiver afforded these additional insureds,
but only with respect to their liability the following additional exclusions
as mortgagee, assignee, or receiver apply:
and arising out of the ownership,
maintenance, or use of a premises by This insurance does not apply:
you.
(1) To any "occurrence" which takes
This insurance does not apply to place after the equipment lease
structural alterations, new construc- expires; or
tion or demolition operations
performed by or for such additional
insured.
ANIC GL 1187 07 16 Page 2 of 6
Alaska National
INSURANCE COMPANY
(2) To "bodily injury", "property additional insured. However,
damage", or "personal and even if coverage within the
advertising injury" arising out of "products-completed operations
the sole negligence of such hazard" is required by the written
additional insured. contract, such coverage is
available to the additional insured
h. Owners, Lessees or Contractors only if the "bodily injury" or
"property damage"occurs prior to
(1) Such person or organization is an the end of the time period during
additional insured for "bodily which you are required by the
injury", "property damage" and written contract to provide such
"personal and advertising injury" coverage or the expiration date of
if, and only to the extent that, the the policy, whichever comes first.
injury or damage is caused by
negligent acts or omissions of Any insurance provided to an additional
you or your subcontractor in the insured designated under Paragraphs 2.a.
performance of "your work" to through 2.g. above does not apply to "bodily
which the written contract injury' or "property damage" included within
applies. This person or organi- the products-completed operations hazard."
zation does not qualify as an
additional insured with respect to Primary And Noncontributory Insurance
injury or damage caused in whole
or in part by independent The following is added to the Other Insurance
negligent acts or omissions of Condition and supersedes any provision to the
such person or organization. contrary:
(2) However, this insurance does not This insurance is primary to and will not seek
apply to "bodily injury", "property
damage" or "personal and contribution from any other insurance available to
advertising injury" arising out of an additional insured under your policy provided
an architect's, engineer's, or that:
surveyor's rendering of or failure
to render any professional (1) The additional insured is a
services including: Named Insured under such other
insurance; and
i. the preparing, approving, or
failing to prepare or approve (2) You have agreed in writing in a
maps, drawings, opinions, contract or agreement that this
reports, surveys, change insurance would be primary and
orders, design or would not seek contribution from
specifications; and any other insurance available to
the additional insured.
ii. supervisory, inspection, or Section III -Limits of Insurance, the following is
engineering services. added:
(3) The insurance provided to this With respect to the insurance afforded to the
additional insured, does not additional insureds described in Paragraphs a.
cover "bodily injury" or "property through h. above, the most we will pay on behalf
damage' caused by your of such additional insured is the amount of
negligent acts and omissions in
the performance of "your work" Insurance:
that occurs within the "products- (1) Required by the contract or
completed operations hazard",
unless the written contract agreement; or
contains a specific requirement
(2) Available under the applicable
that you procure completed
o Limits of Insurance shown in the
operations coverage or coverage
within the "products-completed Declarations;
operations hazard" for the
whichever is less.
ANIC GL 1187 07 16 Page 3 of 6
Alaska National
INSURANCE COMPANY
This provision shall not increase the applicable 4. NON-OWNED WATERCRAFT
Limits of Insurance shown in the Declaration.
A. If endorsement CG 21 09, CG 21 10, CG 24
2. Damage To Premises Rented to You 50, or CG 24 51 is attached to the policy,
Paragraph A. 2. g. (2) (b) is replaced by the
SECTION III — LIMITS OF INSURANCE, following:
Paragraph 6. is replaced by the following:
(b) A watercraft that you do not
6. Subject to Paragraph 5. above, the own that is:
Damage to Premises Rented to You Limit
is the most we will pay under Coverage A (i) Less than 50 feet long:
for damages because of "property and
damage" to any one premises, while
rented to you, or in the case of damage (ii) Not being used to carry
by fire, while rented to you or temporarily persons or property for a
occupied by you with permission of the charge.
owner.
B. If Paragraph A. does not apply, Paragraph g.
If a limit is shown for Damage to Premises (2) of 2. EXCLUSION under SECTION I —
Rented to You the most we will pay under COVERAGES, COVERAGE A — BODILY
Coverage A for damages because or "property INJURY AND PROPERTY DAMAGE
damage" to any one premises is the Limit shown LIABILITY is replaced by the following:
in the Declarations or $500,000, whichever is
greater. (2) A watercraft that you do not own
that is:
3. MEDICAL PAYMENTS
(a) Less than 50 feet long; and
A. Section III—Limits of Insurance, Paragraph
7. is replaced by the following (b) Not being used to carry
persons or property for a
7. Subject to Paragraph 5. above the charge.
Medical Expense Limit is the most we will
pay under Coverage C for all medical 5. SUPPLEMENTARY PAYMENTS
expenses because of "bodily injury"
sustained by any one person. A. Under Section I -Supplementary Payments
- Coverage A and B, Paragraph 1.b., the
If a limit is shown for Medical Expense in limit of$250 shown for the cost of bail bonds
the Declarations the most we will pay is replaced by $10,000;
under Coverage C for all medical
expenses because of "bodily injury" B. In Paragraph 1.d., the limit of$250 shown for
sustained by any one person is the Limit daily loss of earnings is replaced by$500.
shown in the Declarations or $15,000,
whichever is greater. 6. NEWLY FORMED OR ACQUIRED
ORGANIZATIONS
B. This provision 5. (Medical Payments) does
not apply if Section I - Coverage C Medical Paragraph 3.a. of Section II -Who Is An Insured
Payments is excluded either by the is deleted and replaced by the following:
provisions of the Coverage Part or by
endorsement. Coverage under this provision is afforded only
until the end of the policy period or the next
C. Paragraph 1.a.(3)(b) of Section I -Coverage anniversary of this policy's effective date after you
C - Medical Payments, is replaced by the acquire or form the organization, whichever is
following: earlier.
(b) The expenses are incurred
and reported to us within
three years of the date of the
accident; and
ANIC GL 1187 07 16 Page 4 of 6
fir Alaska National
I N SURANCE COMPANY
7. LIBERALIZATION CLAUSE 10. BROAD KNOWLEDGE OF OCCURRENCE
If we adopt a change in our forms or rules which The following is added to Paragraph 2. of Section
would broaden coverage for contractors under IV - Commercial General Liability Conditions -
this endorsement without an additional premium Duties in The Event of Occurrence, Offense,
charge, your policy will automatically provide the Claim or Suit:
additional coverages as of the date the revision is
effective in your state. You must give us or our authorized representative
notice of an "occurrence", offense, claim, or"suit"
8. UNINTENTIONAL FAILURE TO DISCLOSE only when the "occurrence", offense, claim or
HAZARDS "suit' is known to:
SECTION IV — COMMERCIAL GENERAL (1) You, if you are an individual;
LIABILITY CONDITIONS — Paragraph 6. —
Representations is replaced by the following: (2) A partner, if you are a
partnership;
6. Representations
(3) An executive officer or the
By accepting this policy, you agree: employee designated by you to
give such notice, if you are a
a. The statements in the Declarations are corporation; or
accurate and complete; (4) A manager, if you are a limited
b. Those statements are based upon liability company.
representations you made to us; and 11. EXPANDED BODILY INJURY
c. We have issued this policy in reliance Section V - Definitions, the definition of "bodily
upon your representations. injury" is changed to read:
The unintentional omission of, or "Bodily injury" means bodily injury, sickness or
unintentional error in, any information you disease sustained by a person, including death,
provided to us which we relied upon in humiliation, shock, mental anguish or mental
issuing this policy will not prejudice your injury by that person at any time which results as
rights under this insurance. However, this a consequence of the bodily injury, sickness or
provision does not affect our right to collect disease.
additional premium or to exercise our rights of
cancellation or nonrenewal in accordance 12. EXPECTED OR INTENDED INJURY
with applicable laws and regulations.
Exclusion a. of Section I - Coverage A - Bodily
9. NOTICE OF OCCURRENCE Injury and Property Damage Liability is
replaced by the following:
The following is added to Paragraph 2. of Section
IV - Commercial General Liability Conditions - a. "Bodily injury" or "property damage"
Duties In The Event of Occurrence, Offense, expected or intended from the
Claim or Suit: standpoint of the insured. This
exclusion does not apply to "bodily
Your rights under this Coverage Part will not be injury" or"property damage" resulting
prejudiced if you fail to give us notice of an from the use of reasonable force to
"occurrence", offense, claim or "suit" and that protect persons or property.
failure is solely due to your reasonable belief that
the "bodily injury" or "property damage" is not
covered under this Coverage Part. However, you
shall give written notice of this "occurrence",
offense, claim or "suit" to us as soon as you are
aware that this insurance may apply to such
"occurrence", offense, claim or"suit."
ANIC GL 1187 07 16 Page 5 of 6
JV Alaska National
INSURANCE COMPANY
13. BLANKET WAIVER OF SUBROGATION However, this waiver applies only when you have
agreed in writing to waive such rights of recovery
The Transfer Of Rights Of Recovery Against in a contract or agreement, and only if the
Others To Us Condition (Section IV - contract or agreement:
Commercial General Liability Conditions) is
amended by the addition of the following: 1. Is in effect or becomes effective during
the term of this policy; and
We waive any right of recovery we may have
against any person or organization because of 2. Was executed prior to loss.
payments we make for injury or damage arising
out of: 14. IN REM ACTIONS
1. Your ongoing operations; or Any action in rem against any vessel owned,
operated by or for, or chartered by or for you will
2. "Your work" included in the "products- be treated in the same manner as though the
completed operations hazard." action were in personam against you.
This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date
issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is
required only when this endorsement is issued subsequent to commencement of the policy.
Endorsement Effective Policy No.
Insured Endorsement No.
Countersigned By
Includes copyrighted material of Insurance Services Office, Inc., with its permission
ANIC GL 1187 07 16 Page 6 of 6
JW Alaska National
INSURANCE COMPANY
MOTOR CARRIER COVERAGE ENHANCEMENT ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following-
MOTOR CARRIER COVERAGE FORM
(The entries required to complete this endorsement will be shown below or on the"schedule of coverages".)
Various provisions in this endorsement restrict 6. TRANSPORTATION EXPENSES —
coverage. Read the entire policy carefully to INCREASED TO $200 PER
determine rights, duties, and what is and is not DAY/MAXIMUM OF$1,500
covered. 7. LOSS OF USE EXPENSES (HIRED,
Throughout this policy, the words"you" and "your' RENTED OR BORROWED) INCREASED
refer to the Named Insured shown in the TO$200 PER DAY/MAXIMUM OF$1,500
Declarations. The words"we", "us",and"our"refer 8. AIRBAG COVERAGE
to the company providing this insurance.
9. FUEL IN VEHICLE COVERAGE-$2,500
Other words and phrases that appear in quotation 10. FIRE EXTINGUISHER RECHARGE
marks have special meaning. Refer to SECTION
VI— DEFINITIONS in the Motor Carrier Coverage COVERAGE
Form. 11. AUTO LOAN/LEASE GAP COVERAGE -
The coverages provided by this endorsement $2,500
apply per "accident" and, unless otherwise 12. PERSONAL PROPERTY COVERAGE
specified,are subject to all of the terms,conditions, FOR DRIVER-$1,000
exclusions and deductible provisions of the policy 13. TELEMATICS EQUIPMENT COVERAGE
to which it is attached. -$2,500
Below is a summary of the changes made by this 14. "DOWNTIME LOSS" AND RENTAL
endorsement to the MOTOR CARRIER REIMBURSEMENT COVERAGE - $150
COVERAGE FORM. This summary is for PER DAY, 30 DAY MAXIMUM
convenience only. Refer to the specific language for complete details. 15. SINGLE PHYSICAL DAMAGE DEDUCT-
1. EMPLOYEE AS INSURED (HIRED AUTO ISLE PER LOSS
— LESS THAN 10,000 POUNDS GVW) 16. DEDUCTIBLE ON GLASS BREAKAGE
2. "BLANKET" ADDITIONAL INSURED AS WAIVED IF GLASS REPAIRED RATHERTHAN REPLACED
REQUIRED BY WRITTEN CONTRACT
17. TRANSFER OF RIGHTS OF RECOVERY
3. COST OF BAIL BONDS — INCREASED AGAINST US (WAIVER OF SUBROGA-
TION)
4. REASONABLE EXPENSES INCURRED 18. UNINTENTIONAL FAILURE TO DIS-
BY THE INSURED — INCREASED TO CLOSE HAZARDS
$500 PER DAY
5. TOWING AND LABOR COSTS - $2,500 19. OTHER INSURANCE CHANGES
PER DISABLEMENT SUBJECT TO 20. BODILY INJURY INCLUDES MENTAL
$5,000 ANNUAL AGGREGATE ANGUISH
ANIC CA 1220 01 19 Page 1 of 5
4fJr Alaska National
INSURANCE COMPANY
SECTION II — COVERED AUTO LIABILITY SECTION IV — PHYSICAL DAMAGE COVERAGE,
COVERAGE, Paragraph A.1. Who Is An Insured is Paragraph AA.a. — Transportation Expenses is
amended to include: deleted and replaced by the following:
f. Any "employee" of yours while operating a. Transportation Expenses
an "auto" with a gross vehicle weight of We will pay up to $200 per day to a
less than 10,000 pounds hired or rented maximum of $1,500 for temporary
under a contract or agreement in an transportation expense incurred by you
"employee's" name, with your permission, because of the total theft of a covered
while performing duties related to the "auto"that is 20,000 lbs. of Gross Vehicle
conduct of your business. Weight. We will pay only for those
g. Any person or organization for whom you covered "autos"for which you carry either
have agreed in writing to provide Comprehensive or Specified Causes of
insurance such as is afforded by this Loss Coverage. We will pay for temporary
Coverage Form, but only with respect to transportation expenses incurred during
liability arising out of the ownership, the period beginning 48 hours after the
maintenance or use of"autos"covered by theft and ending, regardless of the policy's
this policy. expiration, when the covered "auto" is
SECTION II — COVERED AUTO LIABILITY returned to use or we pay for its"loss".
COVERAGE, Paragraph A.2.a. (2) —Supplementary SECTION IV — PHYSICAL DAMAGE COVERAGE,
Payments is replaced by the following: Paragraph A.4.b.—Loss of Use Expenses is replaced
(2) Up to$5,000 for the cost of bail bonds by the following:
(including bonds for related traffic law b. Loss of Use Expenses—Hired, Rented,
violations) required because of an or Borrowed Automobiles
"accident" we cover. We do not have We will pay expenses for which an
to furnish these bonds. "insured" becomes legally responsible for
SECTION II — COVERED AUTO LIABILITY loss of use of a vehicle hired, rented or
COVERAGE, Paragraph A.2.a. (4)—Supplementary borrowed without a driver under a written
Payments is replaced by the following: rental contract.or agreement. We will pay
(4) All reasonable expenses incurred by for loss of use expenses if caused by:
the"insured" at our request, including (1) Other than Collision, only if the
actual loss of earnings up to $500 a Declarations indicate that Compre-
day because of time off from work. hensive Coverage is provided for the
2. Towing vehicle withdrawn from service.
We will pay up to$2,500 for towing and labor (2) Specified Causes of Loss only if the
costs each time a covered "auto" is disabled. Declarations indicate that Specified
However, the labor must be performed at the Causes of Loss Coverage is provided
place of disablement. for the vehicle withdrawn from service.
The most we will pay fortowing and labor costs (3) Collision only if the Declarations
is$5,000 in any one policy year. indicate that Collision Coverage is
SECTION II — COVERED AUTO LIABILITY provided for the vehicle withdrawnfrom service.
COVERAGE, Exclusion B.S. is amended to add: However the most we will pay for any
This exclusion does not apply if the "bodily expenses for loss of use is$200 per day, to a
injury results from the use of a covered auto" maximum of$1,500.
you own or hire. Such coverage as is afforded
by this provision is excess over any other
collectible insurance.
ANIC CA 1220 01 19 Page 2 of 5
AV Alaska National
INSURANCE COMPANY
Section IV—PHYSICAL DAMAGE COVERAGE 9. Driver's Personal Property
The following are added to A. Coverage: We will pay up to$1,000 for loss or damage to
5. Airbag Coverage personal property or effects of any driver of a
We will pay the cost to repair, replace,or reset covered "auto" while contained in that "auto"
an airbag that inflates for any reason other and caused by:
than as a result of a collision if the Declarations a. Fire, lightning or explosion;
indicate that the covered "auto" has b. Windstorm, hail or earthquake;
Comprehensive Coverage or Specified
Causes of Loss Coverage. c. Flood;
6. Fuel in Vehicle d. Mischief or vandalism;
We will pay up to $2,500 for the actual loss e. The sinking, burning, collision or
sustained as a result of loss of fuel in a derailment of any conveyance
covered "auto", used to operate the "auto", transporting the covered"auto";
caused by a covered loss to the covered f. The covered "auto's" collision with
"auto." No deductible applies to this coverage. another object; or
7. Fire Extinguisher Recharge g. The covered"auto's"overturn.
We will pay the cost to recharge or replace, We will not pay for loss or damage to coins,
whichever is less, fire extinguishers kept in currency, securities or contraband.
your covered "autos" that are intentionally Exclusions 2.c.,2.e.and 21 of Section IV,B.,
discharged in an attempt to extinguish a fire. Physical Damage Coverage do not apply to
No deductible applies to this coverage. this coverage.
8. Auto Loan/Lease Gap Coverage This coverage is excess over any other
In the event of a total"loss"to a covered"auto" collectible insurance. No deductible applies to
for which we pay under the policy's Physical this coverage.
Damage Coverage, we will pay any unpaid 10. Telematics Equipment Coverage
amount due on the lease or loan for that"auto,"
less: We will pay up to$2,500 for loss or damage to
a. The amount paid under the policy's "telematics" equipment in a covered "auto"
Physical Damage Coverage and any: caused by a covered cause of "loss". This
coverage applies whether or not the
(1) Overdue lease/loan pay- equipment is permanently installed in, or
ments at the time of the"loss"; mounted on, the covered"auto."
(2) Financial penalties imposed Exclusions 2.c.,2.e.and 2.f.of Section IV,B.,
under a lease for excessive Physical Damage Coverage do not apply to
use, abnormal wear and tear this coverage.
or high mileage; No deductible applies to this coverage.
(3) Security deposits not returned 11. Downtime Loss and Rental Reimburse-
by the lessor; ment Coverage
(4) Costs for extended war- We will pay any resulting"downtime loss"and
ranties, Credit Life Insurance, rental reimbursement expense you sustain as
Health, Accident or Disability a result of a covered physical damage"loss"to
Insurance purchased with the a covered"auto"up to a maximum of$150 per
loan or lease; and day for a maximum of 30 days for the same
(5) Carry-over balances from physical damage loss, subject to the following
previous loans or leases. limitations:
The most we will pay as a result of any one
"loss"is$2,500.
ANIC CA 1220 01 19 Page 3 of 5
JW Alaska National
INSURANCE COMPANY
a. We will cover"downtime loss" and rental organization is waived prior to the"accident"or
reimbursement expenses beginning the the "loss" under a contract with that person or
sixth day after: organization.
(1) We have given you our agreement to SECTION V — MOTOR CARRIER CONDITIONS —
pay for repairs to a covered"auto"and Paragraph B.2. —Concealment, Misrepresentation Or
you have given the repair facility your Fraud is amended by adding Unintentional Failure to
authorization to make the repairs; or Disclose Hazards at the end of Paragraph B.2. as
(2) The date you first reported the "loss" follows:
to us if we have declared your auto a Unintentional Failure to Disclose Hazards
total "loss"; and If you unintentionally fail to disclose any
b. Coverage for "downtime loss" and rental hazards existing at the inception date of your
reimbursement will end when any of the policy, we will not deny coverage under this
following occur: Coverage Form because of such failure.
(1) You have a spare or reserve "auto" However, this provision does not affect our
available to you to continue your right to collect additional premium or exercise
operations. our right of cancellation or non-renewal.
(2) You purchase a replacement"auto." SECTION V — MOTOR CARRIER
CONDITIONS — B. General Conditions 5.
(3) Repairs to your covered "auto" have Other Insurance — Primary and Excess
been completed by the repair facility Insurance Provisions—f. is replaced by the
and the"auto"has been determined to following:
be road-worthy. f. For Hired Auto Physical Damage
(4) You reach the 30 days of maximum Coverage, the following are deemed to be
coverage. covered"autos"you own:
Coverage for "downtime loss" and rental (1) Any covered "auto" you lease, hire,
reimbursement is excess over any other rent, or borrow; and
insurance coverage available. (2) Any covered"auto"" hired or rented by
SECTION IV—PHYSICAL DAMAGE COVERAGE your "employee" under a contract in
D. Deductible is replaced by the following: that individual "employee's" name,
For each covered"auto", our obligation to pay with your permission,while performing
for, repair, or replace damaged or stolen duties related to the conduct of your
property will be reduced by the applicable business.
deductible shown in the Declarations. Any However, any"auto" that is leased, hired,
Comprehensive Coverage deductible shown rented or borrowed with a driver is not a
in the Declarations does not apply to "loss" covered"auto".
caused by fire or lightning. SECTION VI — DEFINITIONS — Paragraph C. —
However, if more than one covered "auto" is "Bodily injury" is replaced by the following:
involved in the same loss, only one deductible
will apply to the loss. If the deductible amounts C. "Bodily injury" means bodily injury, sickness or
vary, the largest deductible will apply. disease sustained by a person including death or
No deductible applies to glass breakage if the mental anguish resulting from any of these.Mental anguish means any type of mental or
glass is repaired rather than replaced. emotional illness or disease.
SECTION V — MOTOR CARRIER CONDITIONS,
Paragraph A. 5. — Transfer of Rights of Recovery
Against Others To Us is amended to include:
5. Transfer of Rights of Recovery Against
Others to Us
This condition does not apply to any person(s)
or organization(s) to the extent that
subrogation against that person or
ANIC CA 1220 01 19 Page 4 of 5
Ar Alaska MUonal
INSURANCE COMPANY
SECTION VI — DEFINITIONS — the following are T. 'Business Income"means:
added: 1. Net Income (net profit or loss before income
S. "Downtime Loss" means actual loss of"business taxes) that would have been earned or
income" for the period of time that a covered incurred; and
"auto": 2. Continuing normal operating expenses,
1. is out of service for repair or replacement as a including payroll.
result of a covered physical damage loss; and U. "Telematics equipment"means:
2. is in the custody of a repair facility if not a total Equipment, devices, or software, used in vehicle
"loss." telematics systems.
This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date
issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required
only when this endorsement is issued subsequent to commencement of the policy.
Endorsement Effective Policy No.
Insured Endorsement No.
Countersigned By
Includes copyrighted material of the Insurance Services Office, Inc., with its permission.
ANIC CA 1220 01 19 Page 5 of 5
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