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HomeMy WebLinkAboutAG 21-067 - METRO GLASS CO., INCRETURN TO: Mary Jaenicke EXT: 6901 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT./DIV: Park 2. ORIGINATING STAFF PERSON: Derreck Presnell EXT: 6959 3. DATE REQ. BY. 4/9/21 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT 19 SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL ❑ OTHER 5. PROJECT NAME: PAEC Sneeze Guard 6. NAME OF CONTRACTOR: Metro Glass Co., Inc. ADDRESS: 1120 SW16TH #4, Renton WA 98057 TELEPHONE 425-226-9510 E-MAI L: lisa@metmglassco corn FAX: 425-264-4528 SIGNATURE NAME: Lisa Roh fina TITLE Estimator 7. EXHIBITS AND ATTACHMENTS: A SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: upon signing COMPLETION DATE: 7/31121 9. TOTAL COMPENSATION $ 3,662.00 + $369.86 = $4,031.86 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES A No IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ®YES ®NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED © PURCHASING: PLEASE CHARGE TO: 001-7100-331-576-80-480 , COVID-19 code #267662 10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED ❑ PROJECT MANAGER ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ❑ LAW ER 4/2/2021 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D: ❑ 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 I DATE SIGNED ❑ LAW DEPARTMENT +�BfGNATORY (MAYOR OR DIRECTOR) © CITY CLERK ❑ ASSIGNED AG# A -- COMMENTS: 2/2017 LIMITED PUBLIC WORKS CONTRACT FOR PAEC SNEEZE GUARD This limited public works contract ("Contract") is dated effective this �1.L_ day of Aofi 1 20 11 and is made by and between the City of Federal Way, a Washington municipal corporation ("City" or "Owner"), and Metro Glass Co. Inc., a State of Washington Corporation ("Contractor"). A. The City desires to retain an independent contractor to furnish all labor and materials necessary to perform work at the Performing Arts & Events Center located at 31510 Pete von Reichbauer Way S., Federal Way, Washington ('Property"); and B. The Contractor has the requisite skill and necessary experience to perform such work. NOW, THEREFORE, the Parties ("Parties") agree to the following terms and conditions: 1. SERVICES BY CONTRACTOR 1.1 Description of Work. 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 work, more particularly described as the PAEC Sneeze Guard project, in Exhibit "A" attached hereto and incorporated by this reference, ("Work"), and in accordance with and as described in the Contract Documents, which include without limitation, this Contract, Contract Change Order Agreement attached as Exhibit `B," Notice to Labor Unions attached as Exhibit "C," Certificate(s) of Insurance Form attached hereto as Exhibit "D," Prevailing Wage Rates attached as Exhibit "B," Title VI Assurances attached hereto as Exhibit "F," and all other Appendices attached hereto and incorporated by this reference, (collectively 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. 1.2 Completion Date. The Work shall be commenced within five (5) days of receipt by the Contractor of the City's Notice to Proceed. The Work shall be completed on or before the 31st day of July, 2021. In the event the Work is not completed within the time specified, Contractor agrees to pay to the City liquidated damages in the amount set forth in the formula included in Section 1.3 of this Contract. The Work shall not be deemed completed until the City has accepted the Work. 1.3 Liquidated Damages. Time is of the essence of the Contract. Delays inconvenience the traveling public, obstruct traffic, interfere with and delay commerce, and increase risk to Highway users. Delays also cost tax payers undue sums of money, adding time needed for administration, engineering, inspection, and supervision. Accordingly, the Contractor agrees: 1 /2020 1. To pay liquidated damages in the amount of $200.00 for each working day beyond the number of working days established for Physical Completion, and 2. To authorize the Engineer to deduct these liquidated damages from any money due or coming due to the Contractor. When the Contract Work has progressed to the extent that the Contracting Agency has full use and benefit of the facilities, both from the operational and safety standpoint, all the initial plantings are completed and only minor incidental Work, replacement of temporary substitute facilities, plant establishment periods, or correction or repair remains to physically complete the total Contract, the Engineer may determine the Contract Work is substantially complete. The Engineer will notify the Contractor in writing of the Substantial Completion Date. For overruns in Contract time occurring after the date so established, liquidated damages shown above will not apply. For overruns in Contract time occurring after the Substantial Completion Date, liquidated damages shall be assessed on the basis of direct engineering and related costs assignable to the project until the actual Physical Completion Date of all the Contract Work. The Contractor shall complete the remaining Work as promptly as possible. Upon request by the Engineer, the Contractor shall furnish a written schedule for completing the physical Work on the Contract. Liquidated damages will not be assessed for any days for which an extension of time is granted. No deduction or payment of liquidated damages will, in any degree, release the Contractor from further obligations and liabilities to complete the entire Contract. 1.4 Performance Standard. Contractor shall perform the Work in a manner consistent with accepted practices for other properly licensed contractors, performed to the City's satisfaction, within the time period prescribed by the City. 1.5 Compliance with Laws. Contractor shall perform the Work in accordance with all applicable federal, state and City laws, including, but not limited to all City ordinances, resolutions, standards or policies, as now existing or hereafter adopted or amended, and obtain all necessary permits and pay all permits, inspection or other fees, at its sole cost and expense. 1.6 Change Orders. The City may, at any time, without notice to sureties, order changes within the scope of the Work. Contractor agrees to fully perform any such alterations or additions to the Work. All such change orders shall be in the form of the Contract Change Order Agreement attached hereto as Exhibit `B," which shall be signed by both the Contractor and the City, shall specifically state the change of the Work, the completion date for such changed Work, and any increase or decrease in the compensation to be paid to Contractor as a result of such change in the Work. Oral change orders shall not be binding upon the City unless confirmed in writing by the City. if any change hereunder causes an increase or decrease in the Contractor's cost of, or time required for, the performance or any part of the Work under this Contract, an equitable adjustment will be made and the Contract modified in writing accordingly. 2 1/2020 If the Contractor intends to assert a claim for an equitable adjustment hereunder, it shall, within five (5) days after receipt of a written change order from the City or after giving the City the written notice required above, as the case may be, submit to the City a written statement setting forth the general nature and monetary extent of such claim; provided the City, in its sole discretion, may extend such five (5) day submittal period upon request by the Contractor. The Contractor shall supply such supporting documents and analysis for the claims as the City may require determining if the claims and costs have merit. No claim will be allowed for any costs incurred more than five (5) days before the Contractor gives written notice as required. No claim by the Contractor for an equitable adjustment hereunder will be allowed if asserted after final payment under this Contract. 1.7 Work and Materials Omitted. The Contractor shall, when directed in writing by the City, omit work, services and materials to be furnished under the Contract and the value of the omitted work and materials will be deducted from the Total Compensation and the delivery schedule will be reviewed if appropriate. The value of the omitted work, services and materials will be a lump sum or unit price, as mutually agreed upon in writing by the Contractor and the City. If the parties cannot agree on an appropriate deduction, the City reserves the right to issue a unilateral change order adjusting the price and the delivery schedule. 1.8 Utility Location. Contractor is responsible for locating any underground utilities affected by the Work and is deemed to be an excavator for purposes of Chapter 19.122 RCW, as amended. Contractor shall be responsible for compliance with Chapter 19.122 RCW, including utilization of the "one call" locator system before commencing any excavation activities. 1.9 Air Environment. Contractor shall fully cover any and all loads of loose construction materials including without limitation, sand, dirt, gravel, asphalt, excavated materials, construction debris, etc., to protect said materials from air exposure and to minimize emission of airborne particles to the ambient air environment within the City of Federal Way. 2. TERM This Contract shall commence on the effective date of this Contract and continue until the completion of the Work, which shall be no later than the 31st day of July 2021, and the expiration of all warranties contained in the Contract Documents ("Term"). 3. WARRANTY 3.1 Requisite Skill. The Contractor warrants that it has the requisite skill to complete the Work, and is appropriately accredited and licensed by all applicable agencies and governmental entities, including, but not limited to being registered to do business in the City of Federal Way by obtaining a City of Federal Way business registration. Contractor represents that it has visited the site and is familiar with all of the plans and specifications in connection with the completion of the Work. 3 1 /2020 3.2 Defective Work. The Contractor shall, at its sole cost and expense, correct all Work which the City deems to have defects in workmanship and material discovered within one (1) year after the City's final acceptance of the Work. 4. COMPENSATION 4.1 Total Compcnsation. In consideration of the Contractor performing the Work, the City agrees to pay the Contractor a fixed fee equal to Three Thousand Six Hundred Sixty -Two and No/100 Dollars ($3,662.00), and Washington State sales tax equal to Three Hundred Sixty - Nine and 86/100 Dollars ($369.86), for a total amount not to exceed Four Thousand Thirty -One and 86/100 Dollars ($4,031.86), which amount shall constitute full and complete payment by the City. 4.2 Contractor Responsible for Taxes. Except as otherwise provided in Section 4.1 hereof, 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. 4.3 Nonpayment. 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 discretion, which shall be withheld until such time as Contractor modifies or repairs the Work so that the Work is acceptable to the City. 4.4 Method of Palmicnt. Payment by the City for the Work will only be made after the Work has been completed, a voucher or invoice is submitted in the form specified by the City, and such invoice is approved by the appropriate City representative. Payment shall be made within thirty (30) days of receipt of such invoice or voucher unless otherwise set forth in the Bid Form. The Contractor's acceptance of such payment for the Work shall constitute full compensation for the performance of the Work. Invoices shall be submitted, in duplicate to: City of Federal Way ATTN: Accounts Payable 33325 8th Avenue South Federal Way, WA 98003-6325 Duplicate invoices shall be furnished to: City of Federal Way ATTN: Derreck Presnell 33325 8th Avenue South Federal Way, WA 98003-6325 5. EQUAL OPPORTUNITY EMPLOYER In all Contractor services, programs or activities, and all Contractor hiring and employment made possible by or resulting from this Contract, there shall be no discrimination by 4 1/2020 Contractor or by Contractor's employees, agents, subcontractors or representatives against any person because of sex, age (except minimum age and retirement provisions), race, color, creed, national origin, marital status or the presence of any disability, including sensory, mental or physical handicaps, unless based upon a bona fide occupational qualification in relationship to hiring and employment. This requirement shall apply, but not be limited to the following: employment, advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. Contractor shall comply with and shall not violate any of the terms of Chapter 49.60 RCW, Title VI of the Civil Rights Act of 1964, the Americans With Disabilities Act, Section 504 of the Rehabilitation Act of 1973, 49 CFR Part 21, 21.5 and 26, or any other applicable federal, state, or local law or regulation regarding non- discrimination. Contractor shall post a notice to Labor Unions or other employment organizations, attached hereto as Exhibit "C," as required by Section 202 of Executive Order 11246. Any material violation of this provision shall be grounds for termination of this Contract by the City and, in the case of the Contractor's breach, may result in ineligibility for further City agreements. If this project involves federal funds including USDOT funds administered by WSDOT, the contractor agrees to the clauses contained in Exhibit F. 6. INDEPENDENT CONTRACTOR/CONFLICT OF INTEREST 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 pay all income and other taxes as due. Industrial or any other insurance 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 Contract to an employment contract. It is recognized that Contractor may or will be performing work during the Term for other parties; provided, however, that such performance of other work shall not conflict with or interfere with the Contractor's ability to perform the Work. Contractor agrees to resolve any such conflicts of interest in favor of the City. 7. TERMINATION Prior to the expiration of the Term, this Contract may be terminated immediately, with or without cause by the City. 8. INDEMNIFICATION 8.1 Contractor Indemnification. The Contractor agrees to indemnify, defend and hold the City, its elected officials, officers, employees, agents, and volunteers harmless from any and all claims, demands, losses, actions and liabilities (including costs and all attorney fees) to or by any and all persons or entities, including, without limitation, their respective agents, licensees, or representatives, arising from, resulting from, or connected with this Contract to the extent caused. by the negligent acts, errors or omissions of the Contractor, its partners, shareholders, agents, employees, or by the Contractor's breach of this Contract. Contractor waives any immunity that may be granted to it under the Washington State Industrial Insurance Act, Title 51 RCW. 5 1/2020 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. 8.2 City_ Indemnification. The City agrees to indemnify, defend and hold the Contractor, its officers, directors, shareholders, partners, employees, and agents harmless from any and all claims, demands, losses, actions and liabilities (including costs and attorney fees) to or by any and all persons or entities, including without limitation, their respective agents, licensees, or representatives, arising from, resulting from or connected with this Contract to the extent solely caused by the negligent acts, errors, or omissions of the City, its employees or agents. 8.3 Survival. The provisions of this Section shall survive the expiration or termination of this Contract with respect to any event occurring prior to such expiration or termination. 9. INSURANCE 9.1 Minimum Limits. The Contractor agrees to carry as a minimum, the following insurance, in such forms and with such carriers who have a rating, which is satisfactory to the City: (1) , Workers' compensation and employer's liability insurance in amounts sufficient an pursut to the laws of the State of Washington; (2) Commercial general liability insurance with combined single limits of liability not less than $2,000,000 for bodily injury, including personal injury or death, products liability and property damage. (3) Automobile liability insurance with combined single limits of liability not less than $1,000,000 for bodily injury, including personal injury or death and property damage. (4) If any structures are involved in the Contract, the Contractor shall maintain an "All Risk Builder's Risk 2 form at all times in an amount no less than the value of the structure until final acceptance of the project by the City. 9.2 Endorsements. Each insurance policy shall contain, or be endorsed to contain, the following provisions: (1) The City, its officers, officials, employees, volunteers and agents shall each be named as additional insured. (2) Coverage may not be terminated or reduced in limits except after thirty (30) days prior written notice by certified mail, return receipt requested, to the City. (3) Coverage shall be primary insurance as respects the City, its officials, employees 6 1 /2020 and volunteers. Any insurance or self-insurance maintained by the City, its officials, employees or volunteers shall be in excess of Contractor's insurance. (4) Coverage shall apply to each insured separately against whom claim is made or suit is brought. (5) Coverage shall be written on an "occurrence" form as opposed to a "claims made" or "claims paid" form. 9.3 Verification. Contractor shall furnish the City with certificates of insurance evidencing the coverage required by this Section, attached hereto as Exhibit "D" and incorporated by this reference. The City reserves the right to require complete certified copies of all required insurance policies, at any time. 9.4 Subcontractors. Contractors shall include all subcontractors as additional insured under its policies or shall furnish separate certificates for each subcontractor. All coverage for subcontractors shall be subject to all of the requirements stated herein. 9.5 Deductibles and Self Insured Retentions. Any deductibles or self -insured retentions must be disclosed by Contractor and approved in writing by the City. At the option of the City, Contractor shall either reduce or eliminate such deductibles or self -insured retentions or procure a bond guaranteeing payment for any amounts not covered by the insurance by reason of such deductibles or self -insured retentions. 9.6 Asbestos Abatement or Hazardous Materials. If asbestos abatement or hazardous materials work is performed, Contractor shall review coverage with the City's Risk Manager and provide scope and limits of coverage that are appropriate for the scope of Work and are satisfactory to the City. Contractor shall not commence any Work until its coverage has been approved by the Risk Manager. 9.7 Termination. The Contractor's failure to provide the insurance coverage required by this Section shall be deemed to constitute non -acceptance of this Contract by the Contractor and the City may then award this Contract to the next lower bidder. The provisions of this Section shall survive the expiration or termination of this Contract with respect to any event occurring prior to such expiration or termination. 10. SAFETY Contractor shall take all necessary precautions for the safety of employees on the work site and shall comply with all applicable provisions of federal, state and municipal safety and health laws and codes, including without limitation, all OSHA/WISHA requirements, Safety and Health Standards for Construction Work (Chapter 296-155 WAC), General Safety and Health Standards (Chapter 296-24 WAC), and General Occupational Health Standards (Chapter 296-62 WAC). Contractor shall erect and properly maintain, at all times, all necessary guards, barricades, signals and other safeguards at all unsafe places at or near the Work for the protection 7 1/2020 of its employees and the public, safe passageways at all road crossings, crosswalks, street intersections; post danger signs warning against known or unusual hazards and do all other things necessary to prevent accident or loss of any kind. Contractor shall protect from damage all water, sewer, gas, steam or other pipes or conduits, and all hydrants and all other property that is likely to become displaced or damaged by the execution of the Work. The Contractor shall, at its own expense, secure and maintain a safe storage place for its materials and equipment and is solely responsible for the same. 11. PREVAILING WAGES 11.1 Wages of Employees. This Contract is subject to the minimum wage requirements of Chapter 39.12 of the Revised Code of Washington, as now existing or hereafter amended or supplemented. In the payment of hourly wages and fringe benefits to be paid to any of Contractor's laborers, work persons and/or mechanics, Contractor shall not pay less than the "prevailing rate of wage" for an hour's work in the same trade or occupation in the locality within the State of Washington where such labor is performed, as determined by the Industrial Statistician of the Department of Labor and Industries of the State of Washington, which "prevailing rates of wage" are attached hereto as Exhibit "E" and incorporated herein by this reference. Prevailing wages paid pursuant to this Agreement shall be the prevailing wage rates, which are in effect on the date when the bids, proposals, or quotes were required to be submitted to the City. 11.2 Exemptions to Prevailing Wage. The prevailing wage requirements of Chapter 39.12 RCW, and as required in this Contract do not apply to: (1) Sole owners and their spouses; (2) Any partner who owns at least 30% of a partnership; and (3) The President, Vice President and Treasurer of a corporation if each one owns at least 30% of the corporation. 11.3 Reporting Requirements. Contractor shall comply with all reporting requirements of the Department of Labor and Industries of the State of Washington. Upon the execution of this Contract, Contractor shall complete and file a Statement of Intent to Pay Prevailing Wages with the Department of Labor and Industries. Upon completion of the Work, Contractor shall complete and file an Affidavit of Wages Paid with the Department of Labor and Industries. Contractor shall deliver copies of both the Statement of Intent to Pay Prevailing Wages and the Affidavit of Wages Paid, certified by the Department of Labor and Industries, to the City. 11.4 Disputes. In the event any dispute arises as to what are the prevailing rates of wages for work of a similar nature and such dispute cannot be resolved by the City and the Contractor, the matter shall be referred for arbitration to the Director of the Department of Labor and Industries of the State of Washington and the decision therein shall be final and conclusive and binding on all parties involved in the dispute. 1 /2020 12. FAILURE TO PAY SUBCONTRACTORS In the event the Contractor shall fail to pay any subcontractors or laborers, or fail to pay for any materials or any insurance premiums, the City may terminate this Contract and/or the City may withhold from the money which may be due the Contractor an amount necessary for the payment of such subcontractors, laborers, materials or insurance premiums. 13. 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 shall become the property of the City and shall be delivered to the City at its request. 14. CONFIDENTIALITY Any records, reports, information, data or other documents or materials given to or prepared or assembled by the Contractor under this Contract will be kept as confidential and shall not be made available to any individual or organization by the Contractor without prior written approval of the City. 15. BOOKS AND RECORDS The Contractor agrees to maintain books, records, and documents which sufficiently and properly reflect all direct and indirect costs related to the performance of this Contract and such accounting procedures and practices as may be deemed necessary by the City to assure proper accounting of all funds paid pursuant to this Contract. These records shall be subject at all reasonable times to inspection, review or audit by the City, its authorized representative, the State Auditor, or other governmental officials authorized by law to monitor this Contract. 16. CLEAN UP At any time ordered by the City and immediately after completion of the Work, the Contractor, shall, at its own expense, clean up and remove all refuse and unused materials of any kind resulting from the Work. In the event the Contractor fails to perform the necessary clean up, the City may, but in no event is it obligated to, perform the necessary clean up and the costs thereof shall be immediately paid by the Contractor to the City and/or the City may deduct its costs from any remaining payments due to the Contractor. 17. CONTRACTOR AND SUBCONTRACTOR RESPONSIBILITY: 17.1 Contractor Verification. The Contractor verifies that it has a certificate of registration with the State of Washington; has a current state unified business identifier number; is not disqualified from bidding on any public works contract under RCW 39.06.010 or 39.12.065 (3); has industrial insurance as required by Title 51 RCW, if applicable; has an employment security department number as required in Title 50 RCW, if applicable; has a state 9 1 /2020 excise tax registration number as required in Title 82 RCW, if applicable; possesses a valid electrical contractor license as required by chapter 19.28 RCW, if applicable; and possesses an elevator contractor license as required by chapter 70.87 RCW, if applicable. 17.2 Subcontractor Contracts. The Contractor shall include the language of this section in each of its first tier subcontracts, and shall require each of its subcontractors to include the same language of this section in each of their subcontracts, adjusting only as necessary the terms used for the contracting parties. Upon request of the Owner, the Contractor shall promptly provide documentation to the Owner demonstrating that the subcontractor meets the subcontractor responsibility criteria below. The requirements of this section apply to all subcontractors regardless of tier. 17.3 Subcontractor Verification. At the time of subcontract execution, the Contractor shall verify that each of its first tier subcontractors meets the following bidder responsibility criteria: Have a current certificate of registration in compliance with chapter 18.27 RCW, which must have been in effect at the time of subcontract bid submittal; Have a current Washington Unified Business Identifier (UBI) number; Not be disqualified from bidding on any public works contract under RCW 39.06.010 or 39.12.065 (3); Have Industrial Insurance (workers' compensation) coverage for the subcontractor's employees working in Washington, as required in Title 51 RCW, if applicable; A Washington Employment Security Department number, as required in Title 50 RCW, if applicable; A Washington Department of Revenue state excise tax registration number, as required in Title 82 RCW, if applicable; An electrical contractor license, if required by Chapter 19.28 RCW, if applicable; An elevator contractor license, if required by Chapter 70.87 RCW. 18. GENERAL PROVISIONS 18.1 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. 18.2 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. 18.3 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. 18.4 Assignment. 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. 18.5 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. 10 1/2020 18.6 Attorney Fees. In the event the City or the Contractor defaults on the performance of any terms in this Contract, and the Contractor or City places the enforcement of the Contract or any part thereof, or the collection of any monies due, or to become due hereunder, or recovery of possession of any belongings, in the hands of an attorney, or file suit upon the same, each Party shall pay all its own attorneys' fees, costs and expenses. The venue for any dispute related to this Contract shall be King County, Washington. 18.7 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. 18.8 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. 18.9 Authori . 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. 18.10 Notices..Any notices required to be given by the City to Contractor or by the Contractor to the City shall be delivered to the Parties at the addresses set forth below. Any notices may be delivered personally to the addressee of the 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. 18.11 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. 18.12 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. 18.13 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. 18.14 Conflicting Provisions. In the event of a conflict between the terms and provisions of any of the Contract Documents, the Mayor or his or her designee shall issue an interpretation of the controlling document, which interpretation shall be final and binding. DATED the day and year set forth above. 11 1/2020 APPROVED AS TO FORM: ±E-L� J. Ryan Call, City Attorncy CITY OF FEDERAL WAY: errejrr, Mayor 25 8th Avenue South ederal Way, WA 98003-6325 ATTEST: ,44haFnie Courtney, CMC, it Clerk 12 1 /2020 METRO GLASS CO., Its: STATE OF WASHINGTON ) ) ss. COUNTY OF Y1 oa (Address) q 9j os Z UYZS zZ(a q 5(0 (Phone) On this day personally appeared before me 1`�Ao v% GY0uL4j � to me known to be the 1� of 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 kL day of n)r , k , 20_7_1 ,, �\\\k►►111111 _r �-�SEY CO 11+1 =" 20114579 p .o`g4�6 10 �j'11 'jr 0WASN P`T (typed/printed name of notary) Notary Public in and for the State of Washington. My commission expires - 31- Z-A 13 1 /2020 EXHIBIT -A SCOPE OF WORK 1. Install sneeze guard, to run full length of counter top. 2. Glass specification: 3/8" clear glass with flat polished edges. 3. Satin anodized post for a height of 33" (at post). 4. Gap between counter top and bottom of glass to be 12" to allow for items to be passed through (drinks to be served). 5. All labor to be compensated at prevailing wage rate. 14 1 /2020 �� CD CD _ m (j) � . 59 r �— � m g �v5 u, 118 Y i� (A) /1 V1 1 T a F Is g a m < O0ZO Ommz � c — m m £ { M o n n { C7 - n c 5 0 1 D m cn � a o 1 U) O c s rrq �$ Z _ v g13� m � O O Z � v Ix 1 ! s f PAEC couNTERRaass , o PM VGV RWAv r1J'll Memo GLASS COMPANY. INC. „aoaw,MnMIA.. PANTCN. WA OW {� < FEDERAL WAY. WA RA NWNE NWJ9U1610 FAX 46,M 167E LOLL METRO GLASS JDBR 21014 WACCNTRACTORt.: MERROGC,NMW � ITE, r�lT�Y6�fYTI� CW 81/T �NV,I CLsraY[n *G v�pW ^OLD [Lu5 ti �TI I 4 Hu" L P 'F O Y fit F ®I a< E s F PAEC i W � COUNTER CAASSBALWER METRO GLASS COMPANY, INC. „m SW,A N 2 S e_ � 37510 PE"fE VON REICIBAUER WAY 6OUTN 1@I1Q1, WA Mon F S I FEDERAL WAY, WA PHONE � Msl5,0 FAX AYwlEl�62� MEMO Q AS3 A00/ 21014 WA CANTWTOM 0 METRDGC,MMW PROJECT NUMBER PROJECT TITLE EXHIBIT B CONTRACT CHANGE ORDER AGREEMENT CHANGE ORDER NUMBER EFFECTIVE DATE SUMMARY OF PROPOSED CHANGES: CONTRACTOR The time provided for completion in the Contract is ❑ Unchanged ❑ Increased ❑ Decreased by Calendar Days. 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 PRICE CHANGE LUMP SUM: INCREASE $ UNIT PRICE: DECREASE$ THE ITEMS ARE APPROXIMATE OR ESTIMATED QUANTITIES INVOLVED IN THIS CHANGE ITEM NO. ITEM QTY. UNIT PRICE ADD OR DELETE TOTAL NET CONTRACT: INCREASE $ DECREASE$ 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. DEPARTMENT RECAP TO DATE: ORIGINAL CONTRACT AMOUNT $ PREVIOUS CHANGE ORDERS $ THIS CHANGE ORDER $ *ADJUSTMENTS $ NEW CONTRACT AMOUNT $ CONTRACTOR'S SIGNATURE DATE DIRECTOR'S SIGNATURE DATE 15 1 /2020 ADJUSTMENTS CHANGE ORDER ESTIMATE IS HEREBY INCREASED DECREASED PAY THIS ADJUSTED AMOUNT: DIRECTOR'S SI6NATURE DATE 16 1 /2020 EXHIBIT C NOTICE TO LABOR UNIONS -OR OTHEREMPLOYMENTORGANIZATIONS - NONDISCRIMINATION IN EMPLOYMENT TO: \ Sj) ' K' lr l 0A D "O-A O -� p G%_ i v\jtXC O V 1 i Ed_ T►ragA e I (Name of Union or Organization) The undersigned currently holds contract(s) with C' ,.1 hC , involving funds or credit of the City of Federal Way, Washington, or (a) subcontract(s) with a prime contractor holding such contract(s). You are advised that, under the provisions of the above contract(s) or subcontract(s) and in accordance with Section 202 of Executive Order 11246 dated September 24, 1965, the undersigned is obliged not to discriminate against any employee or applicant of employment because of race, color, creed or national origin. This obligation not to discriminate in employment includes, but is not limited to, the following: EMPLOYMENT, UPGRADING, TRANSFER OR DEMOTION RECRUITMENT AND ADVERTISING RATES OF PAY OR OTHER FORMS OF COMPENSATION SELECTION FOR TRAINING INCLUDING APPRENTICESHIP, LAYOFF OR TERMINATION This notice is furnished to you pursuant to the provisions of the above contract(s) or subcontractor(s) and Executive Order 11246. Copies of this Notice will be posted by the undersigned in conspicuous places available to employees or applicants for employment. �AehrD C119,SS Co) lnc. (Contractor or subcontractor) u-ILA -21E Date 17 1 /2020 EXHIBIT D CERTIFICATE OF INSURANCE (SEE ATTACHED). 18 1 /2020 Page 1 of 4 State of Washington Department of Labor & Industries Prevailing Wage Section - Telephone 360-902-5335 PO Box 44540, Olympia, WA 98504-4540 Washington State Prevailing Wage The PREVAILING WAGES listed here include both the hourly wage rate and the hourly rate of fringe benefits. On public works projects, worker's wage and benefit rates must add to not less, than this total. A brief description of overtime calculation requirements are provided on the Benefit Code Key. Journey Level Prevailing Wage Rates for the Effective Date: 4/6/2021 County Trade ^ Job Classification Wage Holiday Overtime Note *Risk Class: King Laborers Air, Gas Or Electric Vibrating Screed $52.39 7A 4V 8Y View King Laborers Airtrac Drill Operator $54.01 7A 4V 8Y View King Laborers Ballast Regular Machine $52.39 7A 4V 8Y View i King Laborers Batch Weighman $44.40 7A 4V 8Y View King Laborers Brick Pavers $52.39 7A 4V 8Y View; King Laborers Brush Cutter $52.39 7A 4V 8Y View. King Laborers Brush Hog Feeder $52.39 7A 4V 8Y View King Laborers Burner $52.39 7A 4V 8Y View King Laborers Caisson Worker $54.01 7A 4V 8Y View. King Laborers Carpenter Tender $52.39 7A 4V 8Y View King Laborers Cement Dumper -paving $53.351 7A 4V 8Y View' King Laborers Cement Finisher Tender $52.39 7A 4V 8Y View King Laborers Change House Or Dry Shack $52.39 7A 4V 8Y View King Laborers Chipping Gun (30 Lbs. And Over) $53.35 7A 4V 8Y View King Laborers Chipping Gun (Under 30 Lbs. ) $52.39 7A 4V 8Y View Ming Laborers Choker Setter $52.39 7A 4V 8Y View King Laborers Chuck Tender $52.39 7A 4V 8Y View! King Laborers Clary Power Spreader $53.35 7A 4V 8Y View King Laborers Clean-up Laborer $52.39 7A 4V 8Y View:, King Laborers Concrete Dumper/Chute Operator $53.35 7A 4V 8Y View King Laborers Concrete Form Stripper $52.39 7A 4V 8Y View King Laborers Concrete Placement Crew $53.35 7A 4V 8Y View King Laborers Concrete Saw Operator/Core Driller $53.35 7A 4V 8Y View' King Laborers Crusher Feeder $44.40 7A 4V 8Y View King Laborers Curing Laborer $52.391 7A 4V 8Y View htinc•//cPrnrP. lni wn onv/waaPlnnlrnn/ 4/60071 Page 2 of 4 King Laborers Demolition: Wrecking Et Moving (Intl. Charred Material) $52.39 7A 4V 8Y View King Laborers Ditch Digger $52.39 7A 4V BY View King Laborers Diver $54.01 7A 4V 8Y View King Laborers Drill Operator (Hydraulic, Diamond) $53.35 7A 4V 8Y View King Laborers Dry Stack Walls $52.39 7A 4V 8Y View King Laborers Dump Person $52.39 7A 4V 8Y View , King Laborers Epoxy Technician $52.39 7A 4V 8Y View King Laborers Erosion Control Worker $52.39 7A 4V 8Y View King Laborers Faller Et Bucker Chain Saw $53.35 7A 4V 8Y View King Laborers Fine Graders $52.39 7A 4V 8Y View ' King Laborers Firewatch $44.40 7A 4V 8Y View'. Ming Laborers Form Setter $52.39 7A 4V 8Y View King Laborers Gabian Basket Builders $52.39 7A 4V 8Y View King Laborers General Laborer $52.39 7A 4V 8Y View King Laborers Grade Checker Et Transit Person $54.01 7A 4V 8Y View'; King Laborers Grinders $52.39 7A 4V 8Y View King Laborers Grout Machine Tender $52.391 7A 4V 8Y View King Laborers Groutmen (Pressure) Including Post Tension Beams $53.35 7A 4V 8Y View King Laborers Guardrail Erector $52.39 7A 4V 8Y View King Laborers Hazardous Waste Worker (Level A) $54.01 7A 4V 8Y View. King I Laborers Hazardous Waste Worker (Level B) $53.35 7A 4V 8Y View, King Laborers Hazardous Waste Worker (Level C) $52.39 7A 4V 8Y View King Laborers High Scaler $54.01 7A 4V 8Y View. King Laborers Jackhammer $53.35 7A 4V 8Y View Ming Laborers Laserbeam Operator $53.35 7A 4V 8Y View King Laborers Maintenance Person $52.39 7A 4V 8Y View King Laborers Manhole Builder-Mudman $53.35 7A 4V 8Y View King Laborers Material Yard Person $52.39 7A 4V 8Y View King Laborers Motorman -Dinky Locomotive $53.35 7A 4V 8Y View. King Laborers lShotcrete, Nozzleman (Concrete Pump, Green Cutter When Using Combination Of High Pressure Air Et Water On Concrete Et Rock, Sandblast, Gunite, Water Blaster, Vacuum Blaster) $53.35 7A 4V 8Y View' King Laborers Pavement Breaker $53.35 7A I 4V 8Y View King Laborers Pilot Car $44.40 7A 4V 8Y View, httnc•//ePrnrP lni urn onvharavPlnnlnin/ 4/Fi WOW Page 3 of 4 King Laborers Pipe Layer Lead $54.01 7A 4V BY View King Laborers Pipe Layer/Tailor $53.35 7A 4V 8Y View King Laborers Pipe Pot Tender $53.35 7A 4V 8Y View King Laborers Pipe Reliner $53.35 7A 4V 8Y View King Laborers Pipe Wrapper $53.35 7A 4V BY View King Laborers Pot Tender $52.39 7A 4V 8Y View King Laborers Powderman $54.01 7A 4V 8Y View King Laborers Powderman's Helper $52.39 7A 4V 8Y View King Laborers Power Jacks $53.35 7A 4V 8Y View; King Laborers Railroad Spike Puller - Power $53.35 7A 4V 8Y View i King Laborers Raker - Asphalt $54.01 7A 4V BY View: King Laborers Re-timberman $54.01 7A 4V 8Y View King Laborers Remote Equipment Operator $53.35 7A 4V BY View King Laborers Rigger/Signal Person $53.35 7A 4V 8Y View King Laborers Rip Rap Person $52.39 7A 4V 8Y View King Laborers Rivet Buster $53.35 7A 4V 8Y View King Laborers Rodder $53.35 7A 4V 8Y View King Laborers Scaffold Erector $52.39 7A 4V 8Y View King Laborers Scale Person $52.39 7A 4V 8Y View King Laborers Sloper (Over 20") $53.35 7A 4V 8Y View King Laborers Sloper Sprayer $52.39 7A 4V 8Y View; King Laborers Spreader (Concrete) $53.35 7A 4V 8Y View': King Laborers Stake Hopper $52.39 7A 4V 8Y View King Laborers _ Stock Piler $52.39 7A 4V 8Y View King Laborers Swinging Stage/Boatswain Chair $44.40 7A 4V BY View King Laborers Tamper Ft Similar Electric, Air Et Gas Operated Tools $53.35 7A 4V 8Y View, King Laborers Tamper (Multiple Ft Self- propelled) $53.35 7A 4V 8Y View King Laborers Timber Person - Sewer (Lagger, Shorer Et Cribber) $53.35 7A 4V 8Y View, King Laborers Toolroom Person (at Jobsite) $52.39 7A 4V 8Y View King Laborers Topper $52.39 7A 4V 8Y View King Laborers Track Laborer $52.39 7A 4V 8Y View. King Laborers Track Liner (Power) $53.35 7A 4V 8Y View King Laborers Traffic Control Laborer $47.48 7A 4V 9C View King Laborers Traffic Control Supervisor $50.31 7A 4V 9C View' King Laborers Truck Spotter $52.39 7A 4V BY View King Laborers Tugger Operator $53.35 7A 4V 8Y View' King Laborers Tunnel Work -Compressed Air Worker 0-30 psi $129.67 7A 4V 9B View King Laborers Tunnel Work -Compressed Air Worker 30.01-44.00 psi $134.70 7A 4V 9B View httnc•//aPrnre lni wn anv/wnoPlnnknn/ 4/600?1 Page 4 of 4 King LaLorErsTunnel Work -Compressed Air Worker 44.01-54.00 psi $138.38 7A 4V 9B View King Laborers Tunnel Work -Compressed Air Worker 54.01.60.00 psi $144.08 7A — 4V — 9B — View King Laborers Tunnel Work -Compressed Air Worker 60.01-64.00 psi $146.20 7A 4V 9B View j I King Laborers Tunnel Work -Compressed Air Worker 64.01-68.00 psi $151.30 7A 4V 9B View King Laborers Tunnel Work -Compressed Air Worker 68.01-70.00 psi $153.20 7A 4V 9B View ! f King Laborers Tunnel Work -Compressed Air Worker 70.01-72.00 psi $155.20 7A 4V 9B View , ! King Laborers Tunnel Work -Compressed Air Worker 72.01-74.00 psi $157.20 7A 4V 9B View King Laborers Tunnel Work-Guage and Lock Tender $54.11 $54.11 7A 7A 4V 4V 8Y 8Y View View King Laborers Tunnel Work -Miner King Laborers Vibrator $53.351 7A 4V 8Y View King Laborers Vinyl Seamer $52.39 7A 4V 8Y View King Laborers Watchman $40.36 7A 4V 8Y View King Laborers Welder Well Point Laborer $53.35 $53.35 7A 7A 4V 4V 8Y 8Y View View King Laborers King ILaborers Window Washer/Cleaner $40.36 7A 4V 8Y View bans - //secure.l n i _wa . gov/wagel cinkun/ 4/6/2021 EXHIBIT F - - TITLE VI ASSURANCES During the performance of this contract, the contractor/consultant, for itself, its assignees and successors in interest (hereinafter referred to as the "contractor") agrees as follows: 1. Compliance with Regulations The contractor shall comply with the Regulations relative to non-discrimination in federally assisted programs of United States Department of Transportation (USDOT), Title 49, Code of Federal Regulations, part 21, as they may be amended from time to time, (hereinafter referred to as the Regulations), which are herein incorporated by reference and made a part of this contract. 2. Non-discrimination The contractor, with regard to the work performed by it during the contract, shall not discriminate on the grounds of race, color, sex, or national origin in the selection and retention of sub -contractors, including procurement of materials and leases of equipment. The contractor shall not participate either directly or indirectly in the discrimination prohibited by Section 21.5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix B of the Regulations. 3. Solicitations for Sub -contracts, Including Procurement of Materials and Equipment In all solicitations either by competitive bidding or negotiations made by the contractor for work to be performed under a sub -contract, including procurement of materials or leases of equipment, each potential sub -contractor or supplier shall be notified by the contractor of the contractor's obligations under this contract and the Regulations relative to non-discrimination on the grounds of race, color, sex, or national origin. 4. Information and Reports The contractor shall provide all information and reports required by the Regulations or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by the contracting agency or the appropriate federal agency to be pertinent to ascertain compliance with such Regulations, orders and instructions. Where any information required of a contractor is in the exclusive possession of another who fails or refuses to furnish this information, the contractor shall so certify to WSDOT or the USDOT as appropriate, and shall set forth what efforts it has made to obtain the information. 20 1 /2020 5. Sanctions for Non-compliance the -event -of the -contractor's non -compliance -with the non-discrimination provisions of - this contract, the contracting agency shall impose such contract sanctions as it or the USDOT may determine to be appropriate, including, but not limited to: Withholding of payments to the contractor under the contract until the contractor complies, and/or; Cancellation, termination, or suspension of the contract, in whole or in part 6. Incorporation of Provisions The contractor shall include the provisions of paragraphs (1) through (5) in every sub- contract, including procurement of materials and leases of equipment, unless exempt by the Regulations, or directives issued pursuant thereto. The contractor shall take such action with respect to any sub -contractor or procurement as the contracting agency or USDOT may direct as a means of enforcing such provisions including sanctions for non-compliance. Provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a sub -contractor or supplier as a result of such direction, the contractor may request WSDOT enter into such litigation to protect the interests of the state and, in addition, the contractor may request the USDOT enter into such litigation to protect the interests of the United States. 21 1 /2020 5T�pe u STATE-0E—WAS H I N G-TOINI BUSINESS LICENSING SERVICE Thank you for filing online Our processing time generally takes up to 10 business days. Some endorsements may take more time for state or city approval. You will receive your business license with approved endorsements in the mail. An updated business license will be mailed to you when additional endorsements are approved_ Confirmation Number: 0-019-281-934 Filing Date and Time: 03/26/2021 07:28:34 AM Payment Method: ACH Debit/E-Check Business Entity Information Entity Type: Corporation Name of Entity: METRO GLASS CO., INC. AccountlD: 600405200-001-0001 Firm Name: METRO GLASS CO., INC. Endorsement(s) Applied For Begin 03/26/2021 Non -Resident Fee Type Begin BLS Processing Fee 03/26/2021 End Count 03/31/2022 1 End Count 1 Fee $81.00 $81.00 Fee $0.00 $0.00 Grand Total: $81.00 txLOW4 f'!coRo. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 04/13/2021 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER WA#877030 1-206-343-2323 rONTACI Matt Benoit NAME: AssuredPartners of Washington, LLC PHONEWC'FRJC N END: 206-343-4174 AssuredPartners of Wash. Ins. Agency, LLC CA Lic OX61066 E-MAIL 1325 Fourth Avenue, Suite 2100 ADDRESS: matt.benoit@assuredpartnp-ra.com Seattle, WA 98101 INSURERS AFFORDING COVERAGE I NAIC # ALASXA NATL INS CO 38733 INSURED INSURER B : Metro Glass Company, Inc. INSURER C 1120 SW 16th, Suite A-4 INSURERD: _ INSURER E. Renton, WA 98057 INSURER F. rnVGoeccc CFRTIFICATF NIIMRFR• 61939327 RFVLRION Nl1MRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS I.TR TYPE OF INSURANCE POLICY NUMBER MMIDOfYYYY fA ID A X COMMERCIALGENERAL LIABILITY X X 20FPS08425 06/15/20 06/15/21 EACHOCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR -DAMAGE TO PREMISES [Ea occurrence)$ 500,000 X MED EXP JAny one person) $ 15,000 WA Stop Gap PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 POLICYUPERO. LlLOC $ OTHER: A AUTOMOBILE LIABILITY X X 20FAS08425 06/15/20 06/15/21 CEaOMaocSINldnt E,,tIS E LIMIT $ 1,000,000 _ BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY AUTOS ONLY $ $ BODILY INJURY (Per accident) PROPERTY DAMAGE Per acciden $ X $1,000cx $1,000 Col A UMBRELLALIAB OCCUR X X 20FLU08425 06/15/20 06/15/21 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE M DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ OFFI CER/M EMBER EXCLUDED? (Mandatory In NH) NIA 20FPS08425 WA Stop Gap 06/15/20 06/15/21 TH STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Re: Federal Way PAEC The following are additional insured as required per contract: City of Federal Way; its officers, officials, employees, volunteers, and agents; and any others as required by written contract. This insurance is primary and non-contributory with a waiver of subrogation when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Federal Way THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. p0 BOX 9718 AUTHORIZED REPRESENTATIVE Federal Way, WA 98063 I USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD colinmeding 61939327 JV Alaska !National INSURANCE COMPANY BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Various provisions in this endorsement restrict SECTION IV — Business Auto Conditions, coverage. Read the entire policy carefully to Paragraph A. 5. — Transfer of Rights of Recovery determine rights, duties, and what is and is not Against Others To Us is amended to include: covered. Throughout this policy, the words "you" and "your" refer to the Named Insured shown in the Declarations. The words "we", "us", and "our" refer to the company providing this insurance. Other words and phrases that appear in quotation marks have special meaning. Refer to SECTION V — DEFINITIONS in the Business Auto Coverage Form. The coverages provided by this endorsement apply per "accident" and, unless otherwise specified, are subject to all of the terms, conditions, exclusions and deductible provisions of the policy, to which it is attached. SECTION II — COVERED AUTO LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured is amended to include: d. Any "employee" of yours while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. e. Any person or organization for whom you have agreed in writing to provide insurance such as is afforded by this Coverage Form, but only with respect to liability arising out of the ownership, maintenance or use of "autos" covered by this policy. If such person or organization has other insurance then this insurance is primary to and we will not seek contribution from the other insurance. 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 organization is waived prior to the "accident" or the "loss" under a contract with that person or organization. SECTION II — COVERED AUTO LIABILITY COVERAGE, Paragraph A.2.a. (2) — Supplementary Payments is replaced by the following: (2) Up to $10,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. SECTION II — COVERED AUTO LIABILITY COVERAGE, Paragraph A.2.a. (4) — Supplementary Payments is replaced by the following: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. ANIC CA 1150 10 13 Page 1 of 4 Ar Alaska National INSURANCE COPANY SECTION II — COVERED AUTO LIABILITY COVERAGE, Paragraph A.2.c. — Voluntary Property Damage is added as follows: c. Voluntary Property Damage At your written request, we may make a voluntary payment for Property Damage caused by an "insured", but without liability to a third party, up to $25,000. We will not make a Voluntary Property Damage payment to anyone who is an "insured" under this policy. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph A.2. — Towing is replaced by the following: Towing We will pay up to $500 for towing and labor costs incurred each time a covered "auto" that is a: a. Private passenger; b. Truck; c. Pick-up truck; d. Panel ; or e. Van type vehicle under 20,000 lbs. of Gross Vehicle Weight is disabled. However, the labor must be performed at place of disablement. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph A.3. — Glass Breakage — Hitting a Bird or Animal — Falling Objects or Missiles is replaced by the following: Glass Breakage — Hitting a Bird or Animal — Falling Objects or Missiles If you carry Comprehensive Coverage for the damaged covered "auto", we will pay the following under Comprehensive Coverage: a. Glass Breakage; b. "Loss" caused by hitting a bird or animal; and c. "Loss" caused by falling objects or missiles. However, you have the option of having glass breakage caused by a covered "auto's" collision or overturn considered a "loss" under Collision Coverage. Glass Repair —Waiver of Deductible No deductible applies to glass breakage, if the glass is repaired rather than replaced. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph AA.a. — Transportation Expenses is replaced by the following: a. Transportation Expenses We will pay up to $200 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" that is a: (1) Private passenger; (2) Truck; (3) Pick-up truck; (4) Panel; or (5) Van type vehicle under 20,000 lbs. of Gross Vehicle Weight. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". ANIC CA 1150 10 13 Page 2 of 4 JW Alaska ift0onal SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph AA.b. — Loss of Use Expenses is replaced by the following: b. Loss of Use Expenses — Hired, Rented, or Borrowed Automobiles We will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle hired, rented or borrowed without a driver under a written rental contract or agreement. We will pay for loss of use expenses, if caused by: (1) Other than Collision, only if the Declarations indicate that Comprehensive Coverage is provided for the vehicle withdrawn from service. (2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for the vehicle withdrawn from service. (3) Collision only if the Declarations indicate that Collision Coverage is provided for the vehicle withdrawn from service. However, the most we will pay for any expenses for loss of use is $200 per day, to a maximum of $1,500. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph AA.c. — Non -Transportation Loss of Use Expenses is added as follows: c. Non -Transportation Loss of Use Expenses We will pay up to $2,000 for non - transportation expense incurred by you, because of "loss" to a covered "auto", if caused by: (1) Other than Collision, only if the Declarations indicate that Comprehensive Coverage is provided for the "auto" withdrawn from service; (2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for the "auto" withdrawn from service; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for the "auto" withdrawn from service. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph AAA. — Airbag Coverage is added as follows: d. Airbag Coverage We will pay for the cost to repair, replace, or reset an airbag that inflates for any reason other than as a result of a collision, if the Declarations indicate that the covered "auto" has Comprehensive Coverage or Specified Causes of Loss Coverage. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph AA.e. — Rental Reimbursement Coverage is added as follows: e. Rental Reimbursement Coverage We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto" that is a: (1) Private Passenger; (2) Truck; (3) Pick-up truck; (4) Panel; or (5) Van type vehicle under 20,000 lbs. of Gross Vehicle Weight. Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. ANIC CA 1150 10 13 Page 3 of 4 Alaska National INSURANCE COMPANY (1) We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a) The number of days reasonably required to repair or replace the covered "auto". (b) 30 days. (2) This coverage does not apply while there are spare or reserve "autos" available to you for your operations. (3) The Rental Reimbursement Coverage described above does not apply to a covered "auto" that is described or designated as a covered "auto" on Rental Reimbursement Coverage Form CA 99 23. SECTION IV — BUSINESS AUTO CONDITIONS — Paragraph B.2. — Concealment, Misrepresentation Or Fraud is amended by adding Unintentional Failure to Disclose Hazards at the end of Paragraph B.2. as follows: Unintentional Failure to Disclose Hazards If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. SECTION IV — BUSINESS AUTO CONDITIONS — Paragraph B.5.b. — Other Insurance is replaced by the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent, or borrow; and (2) Any covered "auto"" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". SECTION V — DEFINITIONS — Paragraph C. — "Bodily injury" is replaced by the following: C. "Bodily injury" means bodily injury, sickness or disease sustained by a person including death or mental anguish resulting from any of these. Mental anguish means any type of mental or emotional illness or disease 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 Insured Countersigned By Policy No. 20FAS08425 Endorsement No. C Insurance Services Office, Inc., 2009 ANIC CA 1150 10 13 Page 4 of 4 JV Al Kaska Ab ional IN S 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 8 additional insured extensions. Primary and Noncontributory Insurance 2. Damage To Premises Rented to You Limit increased to $500,000. 3. Medical Payments Limits increased to $15,000. Reporting period increased to three years from the date of accident. 4. Non -owned Watercraft Increased to 50 feet. S. Supplementary Payments Cost of bail bonds increased to $10,000. Daily loss of earnings increased to $500. 6. Newly Formed Or Acquired Organizations Coverage extended to the end of the policy period or the next anniversary of this policy's effective date. 7. Liberalization Clause 8. Unintentional Failure To Disclose Hazards 9. Notice of Occurrence 10. Broad Knowledge of Occurrence 11. Bodily Injury - Extension of Coverage 12. Expected Or Intended Injury Reasonable force - bodily injury or property damage. 13. Blanket Waiver of Subrogation Waiver of subrogation where required by written contract or written agreement. 14. In Rem Actions 1. MISCELLANEOUS ADDITIONAL INSUREDS Section II Who Is An Insured is amended to include as an additional Insured any person or organization described in Paragraphs 2.a. through 2.h. below whom you are required to add as an additional insured on this policy under a written contract or written agreement. However, the written contract or written agreement must be: 1. Currently in effect or becoming effective during the term of this policy; and 2. Executed prior to the "bodily injury", "property damage" or "personal injury and advertising injury", but Only the following persons or organizations are additional insureds under this endorsement and coverage provided to such additional insureds is limited as provided herein: a. State or Governmental Agency or Subdivision or Political Subdivi- sions Any state or governmental agency or subdivision or political subdivision that has issued a permit in connection with operations performed by you or on your behalf and that you are required by any ordinance, law or building code to include as an additional insured on this coverage part is an additional insured, but only with respect to liability for "bodily injury", "property damage", "personal and advertising injury" arising out of such operations. ANIC GL 1187 07 16 Page 1 of 6 JV Ahmka IN"IM" j INSURAfNCE C❑MPANY 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 "personai 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. AN IC GL 1187 07 16 Page 2 of 6 a Alaska1 INSURANCE COMPANY (2) To "bodily injury", "property damage", or "personal and advertising injury" arising out of the soie negligence of such additional insured. h. Owners, Lessees or Contractors (1) Such person or organization is an additional insured for "bodily injury", "property damage" and "personal and advertising injury" if, and only to the extent that, the injury or damage is caused by negligent acts or omissions of you or your subcontractor in the performance of "your work" to which the written contract applies. This person or organi- zation does not qualify as an additional insured with respect to injury or damage caused in whole or in part by independent negligent acts or omissions of such person or organization. (2) However, this insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services including: i. the preparing, approving, or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, design or specifications; and ii. supervisory, inspection, or engineering services. (3) The insurance provided to this additional insured, does not cover "bodily injury" or "property damage" caused by your negligent acts and omissions in the performance of "your work" that occurs within the "products - completed operations hazard", unless the written contract contains a specific requirement that you procure completed operations coverage or coverage within the "products -completed operations hazard" for the additional insured. However, even if coverage within the "producis-completed operations hazard" is required by the written contract, such coverage is available to the additional insured only if the "bodily injury' or "property damage" occurs prior to the end of the time period during which you are required by the written contract to provide such coverage or the expiration date of the policy, whichever comes first. Any insurance provided to an additional insured designated under Paragraphs 2.a. through 2.g. above does not apply to "bodily injury' or "property damage" included within the products -completed operations hazard." Primary And Noncontributory Insurance The following is added to the Other Insurance Condition and supersedes any provision to the contrary: This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Section III - Limits of Insurance, the following is added: With respect to the insurance afforded to the additional insureds described in Paragraphs a. through h. above, the most we will pay on behalf of such additional insured is the amount of insurance: (1) Required by the contract or agreement; or (2) Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. ANIC GL 1187 07 16 Page 3 of 6 JWAIaskaftbonal INSURANCE COMPANY This provision shall not increase the applicable Limits of Insurance shown in the Declaration. 2. Damage To Premises Rented to You SECTION III — LIMITS OF INSURANCE, Paragraph S. is replaced by the following: 6. Subject to Paragraph S. above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner. If a limit is shown for Damage to Premises Rented to You the most we will pay under Coverage A for damages because or "property damage" to any one premises is the Limit shown in the Declarations or $500,000, whichever is greater. 3. MEDICAL PAYMENTS A. Section III — Limits of Insurance, Paragraph 7. is replaced by the following: 7. Subject to Paragraph 5. above the Medical Expense Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person. If a limit is shown for Medical Expense in the Declarations the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person is the Limit shown in the Declarations or $15,000, whichever is greater. B. This provision 5. (Medical Payments) does not apply if Section I - Coverage C Medical Payments is excluded either by the provisions of the Coverage Part or by endorsement. C. Paragraph 1.a.(3)(b) of Section 1 - Coverage C - Medical Payments, is replaced by the following: (b) The expenses are incurred and reported to us within three years of the date of the accident; and 4. NON -OWNED WATERCRAFT A. If endorsement CG 21 09, CG 21 10, CG 24 50, vi CG 24 51 is ailached to the porky, Paragraph A. 2. g. (2) (b) is replaced by the following: (b) A watercraft that you do not own that is: (i) Less than 50 feet long: and (ii) Not being used to carry persons or property for a charge. B. If Paragraph A. does not apply, Paragraph g. (2) of 2. EXCLUSION under SECTION I — COVERAGES, COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: (2) A watercraft that you do not own that is: (a) Less than 50 feet long; and (b) Not being used to carry persons or property for a charge. S. SUPPLEMENTARY PAYMENTS A. Under Section I - Supplementary Payments - Coverage A and B, Paragraph 1.b., the limit of $250 shown for the cost of bail bonds is replaced by $10,000; B. In Paragraph 1.d., the limit of $250 shown for daily loss of earnings is replaced by $500. 6. NEWLY FORMED OR ACQUIRED ORGANIZATIONS Paragraph 3.a. of Section II - Who Is An Insured is deleted and replaced by the following: Coverage under this provision is afforded only until the end of the policy period or the next anniversary of this policy's effective date after you acquire or form the organization, whichever is earlier. ANIC GL 1187 07 16 Page 4 of 6 a JW ; I INSURANCE 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 LIABILITY CONDITIONS — Paragraph 6. — Representations is replaced by the following: 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. The unintentional omission of, or unintentional error in, any information you provided to us which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable laws and regulations. 9. NOTICE OF OCCURRENCE The following is added to Paragraph 2. of Section IV - Commercial General Liability Conditions - Duties In The Event of Occurrence, Offense, Claim or Suit: Your rights under this Coverage Part will not be prejudiced if you fail to give us notice of an "occurrence", offense, claim or "suit" and that 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." (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) An executive officer or the employee designated by you to give such notice, if you are a corporation; or (4) A manager, if you are a limited liability company. 11. EXPANDED BODILY INJURY Section V - Definitions, the definition of "bodily injury' is changed to read: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury by that person at any time which results as a consequence of the bodily injury, sickness or disease. 12. EXPECTED OR INTENDED INJURY Exclusion a. of Section I - Coverage A - Bodily Injury and Property Damage Liability is replaced by the following: a. "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. ANIC GL 1187 07 16 Page 5 of 6 Alaska National INS U R A N C C CC) M PAN Y 13. BLANKET WAIVER OF SUBROGATION The Transfer Of Rights Of Recovery Against Others To Us Condition (Section iV - Commercial General Liability Conditions) is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of: 1. Your ongoing operations; or 2. "Your work" included in the "products - completed operations hazard." However, this waiver applies only when you have agreed in writing to waive such rights of recovery in a contract or agreement, and only if the oontraci or agreement: 1. Is in effect or becomes effective during the term of this policy; and 2. Was executed prior to loss. 14. IN REM ACTIONS Any action in rem against any vessel owned, operated by or for, or chartered by or for you will be treated in the same manner as though the 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. 20FPS08425 Includes copyrighted material of Insurance Services Office, Inc., with its permission ANIC GL 1187 07 16 Page 6 of 6 4/19/2021 METRO GLASS CO INC Labor & Industries (https:lllnl.wa.agn) METRO GLASS CO INC Owner or tradesperson PO BOX 738 ...................... .......... Principals RENTON, WA 98057 GROUWS, CHARLES HANSON, PRESIDENT KIN-226-95 KING County GROUWS, STEVEN CHARLES, VICE PRESIDENT GROUWS, RYAN ALBERT, SECRETARY URPMAN, ROY E, PRESIDENT (End: 02/01/2013) Doing business as METRO GLASS CO INC WA UBI No. Business type 600 405 200 Corporation License Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Construction Contractor Active Meets current requirements. License specialties GLAZING/GLASS License no. METROGC184MW Effective — expiration 07116/1982— 03/01/2023 Bond CBIC $6,000.00 Bond account no. SC4410 Received by L&I Effective date 12/12/2001 11/18/2001 Expiration date Until Canceled Insurance Alaska National Insurance Co $1,000,000.00 Policy no. 20FPS08425 Received by L&I Effective date 06/11/2020 06/15/2020 Expiration date 0611512021 -GROUWS, STEVEN CHARLES, VICE PRESIDENT -GROUWS, RYAN ALBERT, SECRETARY •URPMAN, ROY E, PRESIDENT (End: 02/01/2013) Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I fax debts are recorded for this contractor license during the previous 6 year period, but some debts may be recorded by other agencies. License Violations No iicense violations during the previous 6 year period. I Certifications & Endorsements OMWBE Certifications https://secure.ini.wa.gov/verify/Detaii.aspx?UBI=600405200&LIC=METROGC164MW&SAW= 1 /2 4/19/2021 METRO GLASS CO INC No active certifications exist for this business. Apprentice Training Agent Registered training agent. Check Workers' Comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID Account is current. 3",929-00 Doing business as METRO GLASS CO INC Estimated workers reported Quarter 4 of Year 2020 "7 to 10 Workers" L&I account contact T4 / CASSANDRA SMITH (360)9025632 - Email: SMCA235@lni.wa.gov Public Works Requirements Verify the contractor is eligible to perform work on public works projects Required Training— Effective July 1. 2019 Exempt from this requirement. Contractor Strikes No strikes have been issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace Safety & Health Check for any past safety and health violations found on jobsites this business was responsible for. No inspections during the previous 6 year period. https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=600405200&LIC=METROGC184MW&SAW= 2/2