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HomeMy WebLinkAboutNordland Construction NW, Inc. - 022420 or PLO c- ,qc)(D CONTRACT JEFFERSON COUNTY,WASHINGTON THIS AGREEMENT,made and entered into this 27% day of FCbrita�' 1 , 2020, between the COUNTY OF JEFFERSON, acting through the Jefferson County Commissioners and the Director of Public Works under and by virtue of Title 36, R.C.W, as amended and Nordland Construction NW, Inc., hereinafter called the Contractor. WITNESSETH: That in consideration of the terms and conditions contained herein and attached and made a part of this agreement, the parties hereto covenant and agree as follows: 1. The Contractor agrees to furnish all labor and equipment and do certain work,to-wit: That the Contractor herein will undertake and complete the following described work: Construction of the Center Road MP 14.61 — 15.01 Resurface and Restore, County Project No. 18020500. This work is to replace the bituminous materials in Center Road in Jefferson County in Quilcene, Washington between the south end of Little Quilcene River bridge and US 101 (approximately 0.35 miles). Work includes removing the existing pavement, shaping and regrading the top of base, placing new base material, placing hot mix asphalt pavement, extending an existing culvert, removing and replacing the asphalt surface of a sidewalk, replacing sections of existing curb and gutter, project temporary traffic control, striping, temporary erosion control, and other work, all in accordance with the Contract Plans, Contract Provisions, and the Standard Specifications. for the total sum of Four Hundred Ninety Eight Thousand, Five Hundred Thirteen and 95/100 dollars ($498,513.95) in accordance with and as described in the attached plans and specifications and the Standard Specifications of the Washington Department of Transportation which are by this reference incorporated herein and made a part hereof. The Contractor shall perform any alteration in or addition to the work provided in this contract and every part thereof. The Contractor shall complete the described work as follows: after the Notice to Proceed is issued,over a period of 25 working days,with a start date of on or after June 15,2020 and a completion date of on or before August 31,2020. The Contractor shall provide and bear the expense of all equipment, work and labor of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in this contract and every part thereof. 2. The County of Jefferson hereby promises and agrees with the Contractor to employ, and does employ the Contractor to furnish the goods and equipment described and to furnish the same according to the attached specifications and the terms and conditions herein contained, and hereby contracts to pay for the same according to the attached specifications and the schedule of unit or itemized prices hereto attached, at the time and in the manner and upon the condition provided for in this contract. The County further agrees to employ the Contractor to perform any alterations in or additions to the work provided for in this contract that may be ordered and to pay for the same under the terms of this contract and the attached specifications at the time and in the manner and upon the conditions provided for in this contract. 3. The Contractor for himself, and for his heirs, executor, administrators, successors, and assigns, does hereby agree to the full performance of all the covenants herein contained upon the part of the Contractor. 4. Prior to commencing work,the Contractor shall obtain at its own cost and expense the following insurance from companies licensed in the State with a Best's rating of no less than A: VII. The Contractor shall provide to the County Risk Manager certificates of insurance with original endorsements affecting insurance required by this clause prior to the commencement of work to be performed. Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 1 of 10 The insurance policies required shall provide that thirty(30)days prior to cancellation, suspension,reduction or material change in the policy,notice of same shall be given to the County Risk Manager by registered mail,return receipt requested, for all of the following stated insurance policies. If any of the insurance requirements are not complied with at the renewal date of the insurance policy, payments to the Contractor shall be withheld until all such requirements have been met,or at the option of the County,the County may pay the renewal premium and withhold such payments from the moneys due The Contractor. All notices shall name the Contractor and identify the agreement by contract number or some other form of identification necessary to inform the County of the particular contract affected. A. Workers Compensation and Employers Liability Insurance. The Contractor shall procure and maintain for the life of the contract, Workers Compensation Insurance, including Employers Liability Coverage, in accordance with the laws of the State of Washington. B. General Liability(1) - with a minimum limit per occurrence of one million dollars ($1,000,000) and an aggregate of not less than two million dollars($2,000,000)for bodily injury, death and property damage unless otherwise specified in the contract specifications. This insurance coverage shall contain no limitations on the scope of the protection provided and indicate on the certificate of insurance the following coverage: 1. Broad Form Property Damage with no employee exclusion; 2. Personal Injury Liability, including extended bodily injury; 3. Broad Form Contractual/Commercial Liability including completed operations(contractors only); 4. Premises-Operations Liability(M&C); 5. Independent Contractors and Subcontractors;and 6. Blanket Contractual Liability. (1)Note: The County shall be named as an additional insured party under this policy. C. Automobile (2) - with a minimum limit per occurrence of $1,000,000 for bodily injury, death and property damage unless otherwise specified in the contract specifications. This insurance shall indicate on the certificate of insurance the following coverage: 1. Owned automobiles; 2. Hired automobiles; and, 3. Non-owned automobiles. (2)Note: The County shall be named as an additional insured party under this policy. Any deductibles or self-insured retention shall be declared to and approved by the County prior to the approval of the contract by the County. At the option of the County, the insurer shall reduce or eliminate deductibles or self- insured retention or The Contractor shall procure a bond guaranteeing payment of losses and related investigations,claim administration and defense expenses. The Contractor shall include all subcontractors as insured under its insurance policies or shall furnish separate certificates and endorsements for each subcontractor. All insurance provisions for subcontractors shall be subject to all of the requirements stated herein. Failure of The Contractor to take out and/or maintain any required insurance shall not relieve The Contractor from any liability under the Agreement, nor shall the insurance requirements be construed to conflict with or otherwise limit the obligations concerning indemnification. It is agreed by the parties that insurers shall have no right of recovery or subrogation against the County (including its employees and other agents and agencies), it being the intention of the parties that the insurance policies so affected shall protect both parties and be primary coverage for any and all losses covered by the above described insurance. It is further agreed by the parties that insurance companies issuing the policy or policies shall have no recourse Construction Contract, Contract F, Version I, Risk Legal Review Date xx/xx/xxxx(TBD) Page 2 of 10 1 against the County (including its employees and other agents and agencies) for payment of any premiums or for assessments under any form of policy. It is further agreed by the parties that any and all deductibles in the above described insurance policies shall be assumed by and be at the sole risk of The Contractor. It is agreed by the parties that judgments for which the County may be liable, in excess of insured amounts provided herein, or any portion thereof, may be withheld from payment due, or to become due, to the Contractor until such time as the Contractor shall furnish additional security covering such judgment as may be determined by the County. The County reserves the right to request additional insurance on an individual basis for extra hazardous contracts and specific service agreements. Any coverage for third party liability claims provided to the County by a"Risk Pool"created pursuant to Ch. 48.62 RCW shall be non-contributory with respect to any policy of insurance the Contractor must provide in order to comply with this Agreement. If the proof of insurance or certificate of coverage indicating the County is an "additional insured"to a policy obtained by the Contractor refers to an endorsement(by number or name)but does not provide the full text of that endorsement,then it shall be the obligation of the Contractor to obtain the full text of that endorsement and forward that full text to the County within 30 days of the execution of this Agreement. The County may, upon the Contractor's failure to comply with all provisions of this contract relating to insurance, withhold payment or compensation that would otherwise be due to the Contractor. 5. The Contractor shall comply with all Federal, State, and local laws and ordinances applicable to the work to be done under this Agreement. This Agreement shall be interpreted and construed in accord with the laws of the State of Washington and venue shall be in Jefferson County, WA. The Contractor shall indemnify and hold the County, and its officers, employees, and agents harmless from and shall process and defend at its own expense, including all costs,attorney fees and expenses relating thereto, all claims, demands, or suits at law or equity arising in whole or in part, directly or indirectly, from the Contractor's negligence or breach of any of its obligations under this Agreement; provided that nothing herein shall require a Contractor to indemnify the County against and hold harmless the County from claims, demands or suits based solely upon the conduct of the County, its officers, employees and agents, and; provided further that if the claims or suits are caused by or result from the concurrent negligence of: (a)the Contractor's agents or employees; and, (b)the County, its officers, employees and agents,this indemnity provision with respect to claims or suits based upon such negligence, and/or the costs to the County of defending such claims and suits, etc., shall be valid and enforceable only to the extent of the Contractor's negligence, or the negligence of the Contractor's agents or employees. Claims against the County shall include, but not be limited to assertions that the use and transfer of any software,book, document, report,film,tape, or sound reproduction of material of any kind, delivered hereunder, constitutes an infringement of any copyright, patent,trademark, trade name, or otherwise results in an unfair trade practice or an unlawful restraint of competition. The Contractor specifically assumes potential liability for actions brought against the County by Contractor's employees, including all other persons engaged in the performance of any work or service required of the Contractor under this Agreement and, solely for the purpose of this indemnification and defense,the Contractor specifically waives any immunity under the state industrial insurance law, Title 51 R.C.W. The Contractor recognizes that this waiver was specifically entered into pursuant to provisions of R.C.W. 4.24.1 15 and was subject of mutual negotiation. 6. The Contractor's relation to the County shall be at all times as an independent Contractor, and nothing herein contained shall be construed to create a relationship of employer-employee or master-servant, and any and all employees of the Contractor or other persons engaged in the performance of any work or service required of the Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 3 of 10 Contractor under this Agreement shall be considered employees of the Contractor only and any claims that may arise on behalf of or against said employees shall be the sole obligation and responsibility of the Contractor. 7. The Contractor shall not sublet or assign any of the services covered by this contract without the express written consent of the County or its authorized representative. Assignment does not include printing or other customary reimbursable expenses that may be provided in an agreement. 8. Nothing in the foregoing clause shall prevent the County, at its option, from additionally requesting that the Contractor deliver to the County an executed bond as security for the faithful performance of this contract and for payment of all obligations of the Contractor. For contracts of$150,000 or less,the County and the Contractor may agree that in-lieu of the Contract Bond; the County will withhold 10% of the Contract amount in accordance with R.C.W 39.08.010. If applicable,the Contractor will indicate this option on Exhibit D. 9. The Contractor will declare a management option of the statutory retained percentage on Exhibit E. nLimited Small Works Project per RCW 39.04.155(3): Performance Bond and Retainage Waived INDEX OF EXHIBITS nExhibit A: Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion X Exhibit B: Certification of Compliance with Wage Payment Statues X Exhibit C: Contract Bond,Jefferson County, Washington nExhibit D: Contractor's Declaration of Option for Contracts for Less Than $150,000 X Exhibit E: Contractor's Declaration of Option for Management of Statutory Retained Percentage Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 4 of 10 IN WITNESS WHEREOF, the Contractor has executed this instrument on the day and year first below written, and the Board of County Commissioners has caused this instrument to be executed by and in the name of said County of Jefferson the day and year first above written. Executed by the Contractor hcuc`� � , 20,•Q0 Contractor: 11 ( nc\ CCi1 r\ i stc \nC-k (Please print) BY: 1-1)0,-,os c))r)y) (Please print) (Signature) The--O(—Cf:"i)? C37 State of Washington, Contractor Registration Number COUNTY OF JEFFERSON BOARD OF COMMISSIONERS _1_(.Kate Dean, i ict 1 "AL /4/' David S Ilivaa District 2 T�V. AIP ' lio'?" erton, District 3 Approved as to form only: P2 C/4',/ ----- /2-f 1--DZ.v Philip C. Hunsucker Date Chief Civil Deputy Prosecutor --------) („2 •/: •2-• Mon emders, P.E. Date Public Works Director/County Engineer Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 5 of 10 EXHIBIT A CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY,AND VOLUNTARY EXCLUSION The Contractor certifies to the best of its knowledge and belief,that it and its principals: (1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (2) Have not within a 3-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity(Federal,State, or local)with commission of any of the offenses enumerated in paragraph(2)of this certification; and (4) Have not within a 3-year period preceding this contract had one or more public transactions (Federal, State, or local)terminated for cause or default. Where the Contractor is unable to certify to any of the statements in this certification, such Contractor shall attach an explanation. t)(fcAflC Co114.CHAC Cd1 nc_. Name of Contractor(Please print) ThCL ta1s � Gli'1 f� PraSiC nL Name and Title of Aut orized R epresentahve(Please print) Signature of Authorize Representative nI am unable to certify to the above statement. An explanation is attached. Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 6 of 10 EXHIBIT B CERTIFICATION OF COMPLIANCE WITH WAGE PAYMENT STATUTES The bidder hereby certifies that,within the three-year period immediately preceding the bid solicitation date(December 18, 2019), the bidder is not a "willful" violator, as defined in R.C.W 49.48.082, of any provision of chapters 49.46, 49.48, or 49.52 R.C.W,as determined by a final and binding citation and notice of assessment issued by the Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Bidder's Business Name Signature of Authorized Official* \V)CMLA caS c\Ohl) I:n Printed Name CDICC\V Title \ILA 1 abaC) KCcC2-Ay cA LaR Date City State Check One: Sole Proprietorship n Partnership _ Joint Ventures Corporation State of Incorporation, or if not a corporation, State where business entity was formed: If a co-partnership, give firm name-binder which business is transacted: A *If a corporation,proposal must be executed in the corporate name by the president or vice-president (or any other corporate officer accompanied by evidence of authority to sign). If a co-partnership,proposal must be executed by a partner. Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 7 of 10 EXHIBIT C Bond No. 0227863 CONTRACT BOND JEFFERSON COUNTY,WASHINGTON KNOW ALL MEN BY THESE PRESENTS: That Nordland Construction Northwest, Inc. ,of 123 Ponderosa PI., Nordland, WA 98358 as Principal,and Berkley Insurance Company , as Surety, are jointly and severally held and bound unto the COUNTY OF JEFFERSON,the penal sum of Four Hundred Ninety Eight Thousand Five Hundred Thirteen&95/1Po1lars ($ 498,513.95 for the payment of which we jointly and severally bind ourselves, or heirs, executors, administrators, and assigns, and successors and assigns,firmly by these presents. The condition of this bond is such that WHEREAS,on the 24th day ofFebruary ,A.D.,20 20 , the said Nordland Construction Northwest,Inc. , Principal herein,executed a certain contract with the County of Jefferson,by the terms,conditions and provisions of which contract the said Nordland Construction Northwest,Inc. , Principal herewith,agrees to furnish all materials and do certain work,to-wit: That the said Principal herein will undertake and complete the following described work: Construction of the Center Road MP 14.61 -15.01 Resurface and Restore,County Project No.18020500 , in Jefferson County, Washington, as per maps, plans and specifications made a part of said contract, which contract as so executed, is hereunto attached,and is now referred to and by this reference is incorporated herein and made a part hereof as full for all purposes as if here set forth at length. NOW THEREFORE,if the Principal herein shall faithfully and truly observe and comply with the terms,conditions and provisions of said contract, in all respects and shall well and truly and fully do and perform all matters and things by the said Principal undertaken to be performed under said contract, upon the terms proposed therein, and within the time prescribed therein, and until the same is accepted, and shall pay all laborers, mechanics, subcontractors and materialmen, and all persons who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work,and shall in all respects faithfully perform said contract according to law,then this obligation to be void,otherwise to remain in full force and effect. WITNESS our hands this 24th day of February ,20 20 Nordland Construction Northwest, Inc. Berkley Insurance Company PRINCIPAL SURETY COMPANY By: By: Byrlflefba Li. Attorney-in-fact Judith C.Kaiser-Smith Address of local office and agent of surety company: PayneWest Insurance,Inc. 501 N Riverpoint Blvd.,Suite 403 Spokane, WA 99202 James Clegg,Agent 509-789-7438 Construction Contract, Contract F, Version I, Risk Legal Review Date xx/xx/xxxx(TBD) Page 8 of 10 No.BI-7801i POWER OF ATTORNEY BERKLEY INSURANCE COMPANY WILMINGTON,DELAWARE NOTICE: The warning found elsewhere in this Power of Attorney affects the validity thereof. Please review carefully. KNOW ALL MEN BY THESE PRESENTS, that BERKLEY INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Delaware,having its principal office in Greenwich, CT,has made,constituted and appointed, and does by these presents make, constitute and appoint: James E. Majeskey II;Judith C. Kaiser-Smith; Thomas V. A. Davis;Shanalee E. Steele;Jaclyn R. Kruse; or Melissa Wolf of Payne West Insurance,Inc. of Spokane, WA its true and lawful Attorney-in-Fact,to sign its name as surety only as delineated below and to execute,seal,acknowledge and deliver any and P all bonds and undertakings, with the exception of Financial Guaranty Insurance, providing that no single obligation shall exceed y Fifty Million and 00/100 U.S. Dollars (U.S.$50,000,000.00), to the same extent as if such bonds had been duly executed and f f acknowledged by the regularly elected officers of the Company at its principal office in their own proper persons. -72This Power of Attorney shall be construed and enforced in accordance with, and governed by, the laws of the State of Delaware, without giving effect to the principles of conflicts of laws thereof. This Power of Attorney is granted pursuant to the following o resolutions which were duly and validly adopted at a meeting of the Board of Directors of the Company held on January 25,2010: r RESOLVED, that, with respect to the Surety business written by Berkley Surety, the Chairman of the Board, Chief E c Executive Officer, President or any Vice President of the Company, in conjunction with the Secretary or any Assistant Secretary are hereby authorized to execute powers of attorney authorizing and qualifying the attorney-in-fact named therein to execute bonds, undertakings, recognizances, or other suretyship obligations on behalf of the Company, and to affix the c corporate seal of the Company to powers of attorney executed pursuant hereto; and said officers may remove any such o attorney-in-fact and revoke any power of attorney previously granted; and further RESOLVED, that such power of attorney limits the acts of those named therein to the bonds, undertakings, recognizances, -_ c or other suretyship obligations specifically named therein, and they have no authority to bind the Company except in the . '�, manner and to the extent therein stated;and further RESOLVED, that such power of attorney revokes all previous powers issued on behalf of the attorney-in-fact named; and -2 further o ^r, RESOLVED, that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any „ power of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligation of the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed. The Company may continue to use for the purposes herein stated the facsimile signature of any F .^ person or persons who shall have been such officer or officers of the Company,notwithstanding the fact that they may have _g ceased to be such at the time when such instruments shall be issued. 1N WITNESS WHEREOF,the Corn y has caused these presents to be signed and attested by its appropriate officers and its �r, corporate seal hereunto affixed this( day of iti L. Attest: :: (thsur kl ance Company (Seal) By f: Ir ederman < Je 1 after o Executive Vice President&Secretary Se i r e •resident -g WARNING: THIS POWER INVALID IF NOT PRINTED ON BLUE"BERKLEY"SECURITY PAPER y STATE OF CONNECTICUT) ) ss: COUNTY OF FAIRFIELD ) Sworn to before me, a Notary Public in the State of Connecticut, this (, day of N2 , (/ , by Ira S. Lederman and Jeffrey M. Rafter who are sworn to me to be the Executive Vice President Secretary, and t Senior Vice President, respectively,of Berkley Insurance Company. MArRiornAr�u�l Icy �t, f CONNECTICUT Q -- MY COMMISSION EXPIRES APRIL 30.2024 otary Public, State of Connecticut .. v CERTIFICATE I,the undersigned,Assistant Secretary of BERKLEY INSURANCE COMPANY,DO HEREBY CERTIFY that the foregoing is a y true, correct and complete copy of the original Power of Attorney;that said Power of Attorney has not been revoked or rescinded and that the authority of the Attorney-in-Fact set forth therein, who executed the bond or undertaking to which this Power of Attorney is attached, is in full force and effect as of this date. Given under my hand and seal of the Company,this 24th day of Feb i / , 7070 . (Seal) / �►� Vincent P.Forte EXHIBIT D CONTRACTOR'S DECLARATION OF OPTION FOR CONTRACTS FOR LESS THAN $150,000 A. A Contract Bond will be provided as required. Date • Signed B. In lieu of providing a Contract Bond,the County will withhold 10%of the Contract amount. Date Signed Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 9 of 10 EXHIBIT E CONTRACTOR'S RACTOR S DECLARATION OF OPTION FOR MANAGEMENT OF STATUTORY RETAINED PERCENTAGE A. I hereby elect to have the retained percentage of this contract held in a fund by the Owner until (30) days following final acceptance of the work. Date `s tt-{\ � � Signed / B. I hereby elect to have the Owner deposit the retained percentage of this contract in an interest bearing account, not subject to withdrawal until after final acceptance of the work. Date Signed C. I hereby elect to have the Owner invest the retained percentage of this contract from time to time as such retained percentage accrues. I hereby designate as the repository for the escrow of said funds. I hereby further agree to be fully responsible for payment of all costs or fees incurred as a result of placing said retained percentage in escrow and investing it as authorized by statute. The Owner shall not be liable in any way for any costs or fees in connection therewith. Date Signed D. I hereby elect to provide a Retainage Bond in accordance with R.C.W 60.28.011. Date Signed Construction Contract, Contract F, Version 1, Risk Legal Review Date xx/xx/xxxx(TBD) Page 10 of 10 �.440 NORDCON-02 MNEIGHBORS -`- ACOREY DATE(MM/DD/YYYY) 44..------ CERTIFICATE OF LIABILITY INSURANCE 2/11/2020 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Spokane Office PHONEFAX Paynewest Insurance,Inc. (A/c,No,Ext):(509)838-3501 (A/c,No):(509)838-3511 501 N.Riverpoint Blvd.,Ste 403 ADDRESS: Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:BITCO General Insurance Corp 20095 INSURED INSURER B: Nordland Construction Northwest,Inc. INSURER C: 123 Ponderosa PI INSURER D: Nordland,WA 98358 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR, INSD WVD (MMIDD/YYYYI (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR CLP 3682173 5/28/2019 5/28/2020 Mai RENTED 300,000 X X PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X 5' LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: WA STOP GAP $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO X X CAP 3682174 5/28/2019 5/28/2020 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY AMAGE AUTOS ONLY AUTOS ONLY (Per accident $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 EXCESS LIAB CLAIMS-MADE CUP2817403 5/28/2019 5/28/2020 AGGREGATE $ 3,000,000 DED X RETENTION$ 10,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITYY/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ FFICER/MEMBER EXCLUDED? N/A Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project No.18020500-Construction of the Center Road MP 14.61-15.01 Resurface and Restore,County Jefferson County is additional insured,for ongoing and completed operations,on a primary/non-contributory basis,including waiver of subrogation,as per the attached forms.30 day notice of cancellation applies per policy forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Jefferson County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O.Box 1220 Port Townsend,WA 98368 AUTHORIZED REPRESENTATIVE I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TMS ENDORSEMENT CHANGES THE POLICY. PLEASE READ R CAREFULLY. LAND IMPROVEMENT CONTRACTORS EXTENDED UABIUTY COVERAGE This endorsement modifies insurance provided under the following: CCIVIVERCIAL GENERAL LIABILITY COVERAGE FORNI It is agreed that the provisions listed below apply only upon the entry of an X in the box next to the caption of such provision. A X Partnership and Joint Venture Extension M. X Construction Project General Aggregate Units B. X Contractors Automatic Additional Insured N. X Fellow Employee Coverage Coverage—Ongoing Operations O. X Property Dan-age to the Named Insured's Work C. X Automatic Waiver of Subrogation P. X Care,Custody or Control D. X Extended Notice of Cancellation, Nonrenewal Q. X Electronic Data Liability Coverage E X Unintentional Failure to Disclose Hazards R X Consolidated Insurance Program Residual F. X Broadened Mobile Equipment Liability Coverage G. X Personal and Advertising Injury-Contractual S. X Automatic Additional Insureds—Managers or Coverage Lessors of Premises H. X Nonemployment Discrimination T. X Automatic Additional Insureds—State or Governmental Agency or Political I. X Liquor Liability Subdivisions—Permits or Authorizations J. X Broadened Conditions U. X Contractors Automatic Additional Insured Coverage—Completed Operations K X Automatic Additional Insureds—Equipment Leases V. X Additional Insured—Engineers, Architects or Surveyors L. X Insured Contract Extension-Railroad Property and Construction Contracts A. PARTNERSI-IP AND JOINT VENTURE EXTENSION The following provision is added to SECTION II-WHO IS AN INSURED : The last full paragraph which reads as follows: No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations is deleted and replaced with the following: With respect to the conduct of any past or present joint venture or partnership not shown as a Named Insured in the Declarations and of which you are or were a partner or member,you are an insured,but only with respect to liability arising out of"your work" on behalf of any partnership or joint venture not shown as a Named Insured in the Declarations, provided no other similar liability insurance is available to you for"your work'in connection with your interest in such partnership or joint venture. GL-3088(09/11) -1- B. CONTRACTORS AUTOMATIC ADDITIONAL INSURED COVERAGE—ONGOING OPERATIONS SECTION II — WHO IS AN INSURED is amended to indude as an additional insured any person or organization who is required by written contract to be an additional insured on your policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions;or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s)at the project(s)designated in the written contract. With respect to the insurance afforded to these additional insureds, the following additional exdusions apply: This insurance does not apply to"bodily injury"or"property damage"occurring after: 1. All work, induding materials, parts or equipment furnished in connection with such work, on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s)at the location of the covered operations has been completed;or 2. That portion of"your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. This insurance is excess of all other insurance available to the additional insured,whether primary,excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Dedarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. C. AUTOMATIC WAIVER OF SUBROGATION Item 8. of SECTION IV- CONNERCIAL GENERAL LABILITY CONDITIONS, is deleted and replaced with the following: 8. Transfer of Fights of Recovery Against Others to Us and Automatic Waiver of Subrogation. a If the insured has rights to recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to in-pair those rights. At our request, the insured will bring"suit" or transfer those rights to us and help us enforce them b. If required by a written contract executed prior to loss, 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"your work"for that person or organization. D. EXTENDED NOTICE OF CANCELLATION,NOIRE EWAL Item A2.b. of the COIMAON POUCY CONDITIONS , is deleted and replaced with the fdlowing: A.2.b. 60 days before the effective date of the cancellation if we cancel for any other reason. Item 9. of SECTION IV- COMVERCIAL (FERAL LABILITY CONDITIONS, is deleted and replaced with the following: 9. WHEN WE DO NOT RENEW GL-3088(09111) -2- a If we choose to nonrenew this policy, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 60 days before the expiration date. b. If we do not give notice of our intent to nonrenew as prescribed in a above, it is agreed that you may extend the period of this policy for a maximum additional sixty(60) days from its scheduled expiration date. Where not otherwise prohibited by law, the existing terms, conditions and rates will remain in effect during that extension period. It is further agreed that so long as it is not otherwise prohibited by law, this one time sixty day extension is the sole remedy and liquidated damages available to the insured as a result of our failure to give the notice as prescribed in 9. a above. E UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Although we relied on your representations as to existing and past hazards, if unintentionally you should fail to disdose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. F. BROADENED MOBILE EQUIPMENT Item 12.b. of SECTION V-DEFINITIONS , is deleted and replaced with the following: 12b. Vehicles maintained for use solely on or next to premises, sites or locations you own, rent or occupy. G. PERSONAL AND ADVERTISING INJURY-CONTRACTUAL COVERAGE Exdusion 2.e. of SECTION I,COVERAGE B is deleted. H. NONELVPLOYNFM DISCRIMNAT1ON Unless"personal and advertising injury'is excluded from this policy Item 14.of SECTION V-DEFINITIONS , is amended to include: "Personal and advertising injury" also means embarrassment or humiliation, mental or emotional distress, physical illness, physical impairment, loss of earning capacity or monetary loss, which is caused by"discrimination." SECTION V-DEFINIT1ONS , is amended to include: "Discrimination" means the unlawful treatment of individuals based on race, color, ethnic origin, age, gender or religion. Item 2.Exdusions of SECTION I,COVERAGE B ,is amended to indude: "Personal and advertising injury" arising out of "discrimination" directly or indirectly related to the past employment, employment or prospective employment of any person or Bass of persons by any insured; "Personal and advertising injury" arising out of "discrimination" by or at your, your agents or your "employees"direction or with your,your agents or your"employees"knowledge or consent; "Personal and advertising injury"arising out of"discrimination" directly or indirectly related to the sale, rental, lease or sub-lease or prospective sale, rental, lease or sub-lease of any dwelling, permanent lodging or premises by or at the direction of any insured;or Fines, penalties, specific performance or injunctions levied or imposed by a governmental entity, or governmental code,law,or statute because of"discrimination." GL-3088(09/11) -3- I. UQUOR LIABILITY Exclusion 2.c. of SECTION I,COVERAGE A , is deleted. J. BROADENED CONDITIONS Items 2.a and 2.b. of SECTION IV- CONNERCIAL GENERAL LIABILITY CONDITIONS, are deleted and replaced with the following: 2. Duties In The Event Of Occurrence,Offense,Oaim Or Suit: a You must see to it that we are notified of an "occurrence" or an offense which may result in a daim as soon as practicable after the "occurrence" has been reported to you, one of your officers or an"employee"designated to give notice to us. Notice should include: (1) How,when and where the"occurrence"or offense took place; (2) The names and addresses of any injured persons and witnesses;and (3) The nature and location of any injury or damage arising out of the"occurrence"or offense. b. If a daim is made or"suit"is brought against any insured,you must: (1) Record the specifics of the daim or "suit" and the date received as soon as you, one of your officers,or an"employee"designated to record such information is notified of it;and (2) Notify us in writing as soon as practicable after you, one of your officers, your legal department or an "employee" you designate to give us such notice learns of the claims or "suit." Item 2.e. is added to SECTION IV-COMVERCIAL GENERAL LIABILITY CONDITIONS : 2.e. If you report an "occurrence" to your workers compensation insurer which develops into a liability daim for which coverage is provided by the Coverage Form,failure to report such"occurrence"to us at the time of "occurrence" shall not be deemed in violation of paragraphs 2.a, 2.b., and 2.c. However, you shall give written notice of this "occurrence" to us as soon as you are made aware of the fact that this"occurrence"may be a liability daim rather than a workers compensation claim K AUTOMATIC ADDITIONAL INSUREDS-EQUIPNENf•LEASES SECTION II - WHO IS AN INSURED is amended to include any person or organization with whom you agree in a written equipment lease or rental agreement to name as an additional insured with respect to liability for"bodily injury',"property damage"or"personal and advertising injury'caused,at least in part,by your maintenance, operation, or use by you of the equipment leased to you by such person or organization,subject to the following additional exdusions. The insurance provided to the additional insured does not apply to: 1. "Bodily injury'or"property damage"occurring after you cease leasing the equipment. 2. "Bodily injury'or"property damage"arising out of the sole negligence of the additional insured. 3. "Property damage"to: a Property owned,used or occupied by or rented to the additional insured;or b. Property in the care, custody or control of the additional insured or over which the additional insured is for any purpose exercising physical control. GL-3088(09/11) -4 This insurance is excess of all other insurance available to the additional insured,whether primary,excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Dedarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. L INSURED CONTRACT DCTENSION-RAILROAD PROPERTY AND CONSTRUCTION CONTRACTS Item 9.of SEC11ON V-DEFIMTIONS ,is deleted and replaced with the following. 9. "Insured Contract"means: a A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an"insured contract"; b. A sidetrack agreement; c. Any easement or license agreement; d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (induding an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury' or "property damage" to a third person or organization. Tort liability means a liability that would be irrposed by law in the absence of any contract or agreement. Paragraph f.does not indude that part of any contract or agreement: (1) That indemnifies an architect,engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports,surveys,field orders,change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage;or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insureds rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, architectural or engineering activities. M CONSTRUCTION PROJECT ORAL AGGREGATE UMTS This modifies SECTION III-UMTS OF INSURANCE A. For all sums which can be attributed only to ongoing operations at a single construction project for which the insured becomes legally obligated to pay as damages caused by an "occurrence" under SECTION I -COVERAGE A, and for all medical expen.,ce caused by accidents under SECTION I - COVERAGE C: GL-3088(09/11) -5- 1. A separate Construction Project General Aggregate Unit applies to each construction project, and that limit is equal to the amount of the General Aggregate Unit shown in the Declarations. 2. The Construction Project General Aggregate Unit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" induded in the "products-completed operations hazard," and for medical expenses under COVERAGE C regardless of the number of: a Insureds; b. Claims made or"suits"brought;or c. Persons or organizations making claims or bringing"suits." 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Construction Project General Aggregate Unit for that construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Construction Project General Aggregate Unit for any other construction project. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Unit shown in the Dedarations, such limits will be subject to the applicable Construction Project General Aggregate Unit. B. For all sums which cannot be attributed only to ongoing operations at a single construction project for which the insured becomes legally obligated to pay as damages caused by an "occurrence" under SECTION I - COVERAGE A, and for all medical experk,co caused by accidents under SECTION I-COVERAGE C : 1. My payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products- Completed Operations Aggregate Unit,whichever is applicable;and 2. Such payments shall not reduce any Construction Project General Aggregate Unit. C. Payments for damages because of "bodily injury" or "property damage" induded in the "products- completed operations hazard"will reduce the Products-Completed Operations Aggregate Unit, and not reduce the General Aggregate Unit nor the Construction Project General Aggregate Unit. D. If a construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E The provisions of SECTION III - UMTS OF INSURANCE not otherwise modified by this endorsement shall continue to be applicable. N. FELLOW ERFLOYEE COVERAGE Exclusion 2.e. Employers Liability of SECTION I, COVERAGE A, is deleted and replaced with the following: 2.e. "Bodily injury"to (1) An"employee"of the insured arising out of and in the course of: (a) Employment by the insured;or (b) Performing duties related to the conduct of the insureds business;or GL-3088(09/11) -6- (2) The spouse, child, parent, brother or sister of that "employee" as a consequence of paragraph(1)above. This exdusion applies: (1) Whether the insured may be liable as an employer or in any other capacity;and (2) To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exdusion does not apply to: (1) Liability assumed by the insured under an"insured contract";or (2) Liability arising from any action or omission of a co-"employee" while that co-"employee" is either in the course of his or her employment or performing duties related to the conduct of your business. Item 2.a(1Xa) of SECTION II-WHO IS AN INSURED , is deleted and replaced with the fdlowing: 2.a.(1Xa) To you, to your partners or members (if you are a partnership or joint venture) or to your members (if you are a limited liability company), or to your "volunteer workers" while performing duties related to the conduct of your business. 0. PROPERTY DAMAGE TO THE NAKED INSURER'S WORK Exclusion I of SECTION I,COVERAGE A. is deleted and replaced with the following: I. Damage to Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products completed operation hazard." This exdusion applies only to that portion of any loss in excess of $50,000 per occurrence if the damaged work and the work out of which the damage ariscs was performed by you. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. P. CARE,CUSTODY OR CONTROL Exclusion 2.j.4 of SECTION I,COVERAGE A is deleted and replaced with the following: 2.j.4 Personal property in the care, custody or control of the insured. However, for personal property in the care, custody or control of you or your"employccs," this exdusion applies only to that portion of any loss in excess of$25,000 per occurrence,subject to the following terms and conditions: (a) The most that we will pay under this provision as an annual aggregate is$100,000, regardless of the number of occurrences. (b) This provision does not apply to "employee" owned property or any property that is missing where there is not physical evidence to show what happened to the property. (c) The aggregate limit for this coverage provision is part of the General Aggregate Unit and SECTION III-UNITS OF INSURANCE is changed accordingly. (d) In the event of damage to or destruction of property covered by this exception, you shall, if requested by us, replace the property or furnish the labor and materials nec. nary for repairs thereto,at actual cost to you,exdusive of prospective profit or overhead charges of any nature. GL-3088(09/11) -7- (e) $2,500 shall be deducted from the total amount of all sums you became obligated to pay as damages on account of damage to or destruction of all property of each person or organization, including the loss of use of that property, as a result of each "occurrence." Our limit of liability under the endorsement as being applicable to each "occurrence" shall be reduced by the amount of the deductible indicated above; however, our aggregate limit of liability under this provision shall not be reduced by the amount of such deductible. The conditions of the policy, induding those with respect to duties in the event of "occurrence," daims or "suit" apply irrespective of the application of the deductible amount. We may pay any part or all of the deductible amount to effect settlement of any claim or"suit" and, upon notification of the action taken, you shall pronptly reimburse us for such part of the deductible amount as has been paid by us. a ELECTRONIC DATA UABILI•IY COVERAGE 1. Exclusion 2.p. Electronic Data of SECTION I, COVERAGE A is deleted and replaced with the following: 2.p. Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data"that does not result from physical injury to tangible property. 2. The following definition is added to SECTION V—DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (induding systems and applications software), hard or floppy disks, CD-ROM.S, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 3. For the purposes of this coverage, the definition of "property damage" in SECTION V — DEFINIIIONS is replaced by the following: "Property damage"means: a Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; b. Loss of use of tangible property that is not physically injured. All such losc of use shall be deemed to occur at the time of the"occurrence"that caused it;or C. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of"electronic data"shall be deemed to occur at the time of the"occurrence"that caused it. For the purposes of this insurance,"electronic data"is not tangible property. R CONSOUDATED INSURANCE PROGRAM RESIDUAL UABILITY COVERAGE Wth respect to"bodily injury', "property damage", or `personal and advertising injury' arising out of your ongoing operations;or operations induded within the"products-completed operations hazard",the policy to which this coverage is attached shall apply as excess insurance over coverage available to`yott under a Consolidated Insurance Program (such as an Owner Controlled Insurance Program or Contractors Controlled Insurance Program). Coverage afforded by this endorsement does not apply to any Consolidated Insurance Program involving a "residential project' or any deductible or insured retention, specified in the Consolidated Insurance Program. The following is added to Section V—Definitions GL-3088(09/11) -8- "Residential project' means any project where 30%or more of the total square foot area of the structures on the project is used or is intended to be used for human residency. This includes but is not limited to single or multifamily housing, apartments, condominiums, townhouses, co-operatives or planned unit developments and appurtenant structures (including pools, hot tubs, detached garages, guest houses or any similar structures). A"residential project"does not indude military owned housing, college/university owned housing or dormitories, long term care fadlities, hotels, motels, hospitals or prisons. All other terms,provisions,exdusions and limitations of this policy apply. S. AUTOMATIC ADDITIONAL INSUREDS-MANAGERS OR LESSORS OR PRENISES SECTION II—WHO IS AN INSURED is amended to include: Any person or organization with whom you agree in a written contract or written agreement to name as an additional insured but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises, designated in the written contract or written agreement, that is leased to you and subject to the following additional exdusions: This insurance does not apply to: 1. Any`occurrence"which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured listed in the written contract or written agreement. This insurance is excess of all other insurance available to the additional insured,whether primary,excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Dedarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be exc cs. T. AUTOMATIC ADDITIONAL INSUREDS — STATE OR GOVEFIMVIENTAL AGENCY OR POLRICAL SUBDMSIONS—PEFINITS OR AUTHORIZATIONS SECTION II — WHO IS AN INSURED is amended to indude any state or governmental agency or subdivision or political subdivision with whom you are required by written contract, ordinance, law or building code to name as an additional insured subject to the following provisions: This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. This insurance does not apply to: 1. `Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government,state or municipality;or 2. "Bodily injury"or"property damage"induded within the"products-completed operations hazard'. This insurance is excess of all other insurance available to the additional insured,whether primary,excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Dedarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. U. CONTRACTORS AUTOMATIC ADDITIONAL INSURED COVERAGE—CONPL ETED OPERATIONS GL-3088(09/11) -9- SEC11ON II —WHO IS AN INSURED is amended to indude as an additional insured any person or organization who is required by written contract to be an additional insured on your policy for completed operations, but only with respect to liability for"bodily injury" or"property damage" caused, in whole or in part, by your work" at the project designated in the contract, performed for that additional insured and induded in the"products-completed operations hazard". This insurance is excess of all other insurance available to the additional insured,whether primary,excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Declarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. V. ADDfi1ONAL INSURED—ENGINEERS,ARCHITECTS OR SURVEYORS SECTION II — WHO IS AN INSURED is amended to indude as an additional insured any architect, engineer or surveyor who is required by written contract to be an additional insured on your policy,but only with respect to liability for"bodily injury", "property damage"or"personal and advertising injury' caused, in whole or in part, 1. Your acts or omissions;or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed by you or on your behalf. This indudes such architect, engineer or surveyor, who may not be engaged by you, but is contractually required to be added as an additional insured to your policy. With respect to the insurance afforded to these additional insureds, the following additional exdusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services,including: 1. The preparing, approving, or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders,designs or specifications;or 2. Supervisory,inspection or engineering services. This insurance is excess of all other insurance available to the additional insured,whether primary,exccs, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Dedarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. GL-3088(09/11) -10- BITCO GENERAL INSURANCE CORPORATION BITCO NATIONAL INSURANCE COMPANY TI-IS EN DORSE7VENT CHANGES THE POLICY. PLEASE READ R CAREFULLY. BROADENED COVERAGE-AUTOMOBILES The following modifies insurance provided under: BUSINESS AUTO COVERAGE FORM Nth respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by this endorsement. 1 - Broad Form Named Insured 11 - Bodily Injury Extension 2- Automatic Waiver of Subrogation 12- Fired Auto Physical Damage 3- Automatic Additional Insured 13 Enhanced Supplementary Payments 4- Primary and Noncontributory-Other Insurance 14- Fellow Employee Coverage for Designated Condition Positions 5- Unintentional Failure to Disdose Hazards 15- Physical Damage—Transportation Expenses 6- Extended Notice of Cancellation, Non-Renewal 16- Rental Reimbursement Coverage 7- When We Do Not Renew 17- Loan/Lease Gap Coverage 8- Notice of Knowledge of Accident or Loss 18- Accidental Air Bag Discharge Coverage 9- Employees as Insured 19- Glass Repair—Waiver of Deductible 10- Employee Fired Autos 1. BROAD FORM NAKED INSURED SECTION II.A 1.-INK)IS AN INSURED -Paragraph d. is added: d. Any organization you newly acquire or fomh, except for a partnership, joint venture or limited liability company, and over which you maintain majority ownership or interest(51%or more)or for which you have assumed the active management, will qualify as a Named Insured if there is no other similar insurance available to that organization. However, coverage under this provision is only afforded until the end of the policy period or the 12-month anniversary of the policy inception date,whichever is earlier. 2. AUTOMAI1C WAIVER OF SU3ROGAI1ON Section IV— Business Auto Conditions, Paragraph A5., Transfer of Fights of Recovery Against Others to Us, is deleted and replaced with the following: a If the insured has rights to recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. b. If required by a written contract executed prior to loss, we waive any right of recovery we may have against any person or organization because of payments we make for damages under this coverage form. AP-0401 (10/17) -1- a AUTOMATIC ADDITIONAL INSURED SECTION II —WHO IS AN INSURED, Paragraph Al, is amended to include as an "insured" any person or organization who is required by written contract or agreement to be an additional insured on your policy, but only with respect to liability arising out of operations performed by you or on your behalf for the additional insured. 4. PRIMARY AND NONCONTRIBUTORY-OTHER INSURANCE CONDITION The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance - Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an"insured"under your policy provided that: 1. Such"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 such"insured". 5. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Although we relied on your representations as to existing and past hazards, if unintentionally you should fail to disdose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. 6. E)CTEM ED NOTICE OF CANCELLATION,NON-RENEWAL The CONIVION POLICY CONDITIONS , Item A2.b. is deleted and replaced with the following: A2.b. 60 days before the effective date of the cancellation if we cancel for any other reason. 7. WHEN WE DO NOT RENEW SECTION IV—BUSINESS AUTO CONDrIIONS ,is amended to add Item B.9.: a If we choose to nonrenew this policy, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 60 days before the expiration date. b. If we do not give notice of our intent to nonrenew as prescribed in a above, it is agreed that you may extend the period of this policy for a maximum additional sixty (60) days from its scheduled expiration date. Where not otherwise prohibited by law, the existing terms, conditions and rates will remain in effect during that extension period. It is further agreed that so long as it is not otherwise prohibited by law, this one-time sixty-day extension is the sole remedy and liquidated damages available to the insured as a result of our failure to give the notice as prescribed in 9.a above. 8. NOTICE OF KNOWLEDGE OF ACCIDENT OR LOSS SECTION IV-BUSINESS AUTO CONDITIONS , Item A2.a is deleted and replaced with the following: 2. Duties in the Event of Accident,Claim Suit or Loss: a You must see to it that we are notified of an "accident", "claim", "suit" or"loss" which may result in a daim as soon as practicable after the"occurrence" has been reported to you, a partner, a member, an officer, or an employee designated to give notice to us. Notice should include: (1) l-bw,when and where the"accident"or"loss"occurred; AP-0401 (10/17) -2- (2) The"insured's"name and address;and (3) To the extent possible, the names and addresses of any injured persons and witnesses. 9. EMPLOYEES AS INSURED The following is added to the Section II -Covered Autos Liability Coverage, Paragraph Al. Who Is An Insured provision: Any"employee"of yours is an"insured"while using a covered"auto"you don't own,hire or borrow in your business or your personal affairs. 10. EMPLOYEE FIRED AUTOS A Changes In Covered Autos Liability Coverage The following is added to the Who Is An Insured Provision: An "employee" of yours is an"insured" 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. B. Changes In General Conditions Paragraph 5.b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph 5.f.of the Other Insurance-Primary And Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Fired 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 an"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". 11. BODILY INJURY EXTENSION SECTION V-DEFINITIONS , Paragraph C. is deleted and replaced by the following: C. "Bodily injury' means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these, at any time. Mental anguish means any type of mental or emotional illness or disease. 12. HIRED AUTO PHYSICAL DAMAGE SECTION III.A4.- Coverage Extensions -Paragraph c.is added: c. Fired Auto Physical Damage If Comprehensive, Specified Causes of Loss or Collision coverage is provided under this policy, then Fired Auto Physical Damage is provided for that coverage part subject to the following: (1) The most we will pay for any one "accident" or "loss" under this Hired Auto Physical Damage Coverage is the lesser of: (a) The any one"Accident"or"Loss"amount of$100,000; (b) The actual cash value;or AP-0401 (10/17) -3- (c) Cost of repair. Our obligation to pay for a loss in c.(1) above will be reduced by a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. The deductible will be waived for"loss"caused by fire or lightning. (2) Subject to paragraph c.(1). above, we will provide coverage equal to the broadest physical damage coverage applicable to any covered"auto"shown in the dedarations. (3) When you are required by written contract to indemnify a lessor for actual financial loss because of loss of use of a hired"auto"resulting from a covered"accident"or"loss",we will cover that financial loss subject to the limit specified in paragraph c.(1). 13. Eli-IANCED SUPPLEMENTARY PAYIVEI'S SECTION II.A2.a COVERAGE EXTENSIONS, Supplementary Payments (2) and (4) are replaced by the following: (2) Up to$2,500 for the cost of bail bonds(including bonds for related traffic laws violations) required because of an"accident"we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the"insured" at our request, induding actual loss of earnings up to$350 a day because of time off from work. 14. FELLOW EMPLOYEE COVERAGE FOR DESIGNATED POSITIONS The Fellow Employee Exclusion contained in Section 11.6.5. does not apply to the following positions or job titles: foreman,supervisor, manager,officer,partner or other senior level"employee". Coverage is excess over all other collectible insurance. 15. PHYSICAL DAMAGE-TRANSPORTATION EXPENSES SECTION III.A4.a Transportation Expenses is replaced by the following: a Transportation Expenses We will pay up to$50 per day to a MEIAMUM of$1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto". We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Cause 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 expirations,when the covered"auto"is returned to use or we pay for its"loss". For autos provided with temporary transportation expense, the following physical damage coverage will apply: (1) The most we will pay for any one"accident"or"loss"under the terrporary transportation expense physical damage coverage is the lessor of: (a) The any one"Accident"or"Loss"amount of$100,000; (b) The actual cash value;or (c) Cost of repair. Our obligation to pay for a loss in a(1)above will be reduced by a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. The deductible will be waived for"loss"caused by fire or lightning. • AP-0401 (10/17) -4- (2) Subject to paragraph a(1). above, we will provide coverage equal to the broadest physical damage coverage applicable to any covered"auto"shown in the declarations. (3) Wien you are required by written contract to indemnify a lessor for actual financial loss because of loss of use of a hired "auto" resulting from a covered "accident" or "loss", we will cover that financial loss subject to the limit specified in paragraph a(1). 16. RENTAL REINBURSENENT COVERAGE SECTION III.A4.-Coverage Extensions -Paragraph d.is added. d. If you carry Comprehensive, Specified Causes of Loss or Collision coverage for the damaged covered "auto" as provided under this policy, then Rental Reimbursement Coverage is provided for that coverage part subject to the following: 1. We will pay for rental reimbursement expenses incurred by you for the rental of an"auto" because of "loss" other than theft, to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. 2. We will only pay 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";or, (b) 30 days. (c) Our payment is limited to the lesser of the following amounts: (1) Necessary and actual expenses incurred;or (2) $50 per day. 17. LOAN/LEASE GAP COVERAGE Physical Darnage Coverage is amended by the addition of the following: In the event of a total "loss" to a covered "auto", we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the loss and the "outstanding balance"of the loan/lease,not to exceed$2,500 for any one vehide or$25,000 annually in aggregate. For the purposes of this endorsement, "outstanding balance" means the amount you we on the loan/lease at the time of loss less any amounts representing taxes, overdue payments, penalties, interest or charges resulting from overdue payments, additional mileage charges, excess wear and tear charges or lease termination fees, costs for extended warranties, credit Life Insurance; Health, Accident or Disability Insurance purchased with the loan or lease;and carry-over balances from previous loans or leases. 18. ACCIDENTAL AIR BAG DISCHARGE COVERAGE SECTION III.B.3.a-Exdusions .This exdusion does not apply to the accidental discharge of an air bag. 19. GLASS REPAIR-WAIVER OF DEDUCTIBLE SECTION III.D-Deductible is replaced with the following: For each covered "auto", our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Dedarations. Any Comprehensive Coverage deductible shown in the Dedarations does not apply to"loss" caused by fire or lightning. The deductible does not apply to glass damage if the glass is repaired rather than replaced. AP-0401 (10/17) -5- Department of Public Works O Consent Agenda Page 1 of 1 Jefferson County Board of Commissioners Agenda Request To: Board of Commissioners Philip Morley, County Administrator From: Monte Reinders P.E., Public Works Director/County Engineer Agenda Date: February 24, 2020 Subject: Execution of Contract with Nordland Construction NW, Inc. for: Center Road MP 14.61 - 15.01 'Resurface and Restore County Project No. 18020500 CRAB Project# 1618-02 Statement of Issue: Execution of contract with Nordland Construction NW, Inc. of Nordland, Washington for their bid amount of $498,513.95 for the above referenced project. Analysis/Strategic Goals/Pro's Et Con's: Center Road between the Little Quilcene River and US 101 has deterioration and damage to the pavement surface and asphalt layers below the surface. This project will remove and replace all asphalt pavement in this section of Center Road. Bids were opened on January 21, 2020. The work was awarded to the lowest responsive bidder, Nordland Construction NW, Inc. on February 3, 2020. Fiscal Impact/Cost Benefit Analysis: The bid amount is $498,513.95. Construction of the road improvements is funded 90% by the County Roads Administration Board - Rural Arterial Program, and 10% by the County Arterial Preservation Program. The sidewalk improvements are funded by $65,000 from the Public Infrastructure Fund. Recommendation: Public Works recommends that the Board execute all three originals of the contract with Nordland Construction NW, Inc. and return two of the contracts to Public Works. Department Contact: Bruce D. Patterson P.E., Project Manager, 385-9160. Reviewed By: • ,A1P/z ///F77 ' P ilip Morley, �o . . or Date CONTRACT REVIEW FORM nt/ -1'/9 ' /l�o? CONTRACT WITH: ed)-N Di d(uct___@'I bi (Contractor/Consultant) CONTRACT FOR: Center Road MP 14.61 - 15.01 Resurface& Restore TERM: Sept 1, 2020 COUNTY DEPARTMENT: Public Works For More Information Contact: Bruce Patterson Contact Phone #: (360)385-9169 DEC 2 0 2019 RETURN TO: Chris Spall RETURN BY: 1/22/2020 (Person in Department) (Date) h 1„ '' • ;,605,389 En_ineers Estimate PROCESS: Exempt from Bid Process ,r-) a..).> _ ,. \"\ Consultant Selection Process a� �o ,- \` Revenue: 180000010.33403.71.2050 RAP Cooperative Purchase y y� 180000010.39700.00.0306 PIF 1• fe . 7 \i ,, Expenditure: 180000010.595 x Competitive Sealed Bid ch rig Funds Required: $71,000 _ Small Works Roster fc, e ) of Matching Funds 1LAPP80000010.33403.72.0000 Vendor List Bid , — RFP orRFQ n Other Step 1: REVIEW •-° ..k ' . Review b ��� y l /� 6, ��/�� Date Revie ed: - APPROVED FORM n Returned-fbr revision(See Comments) Comments Step 2: REVIEW BY PR SCUT . . TTORNEY ,----- Review Review by: _ C - Date Reviewed: / 2 /Lelar7A'''PPROVED AS TO FORM ❑ Retd for revision(See Comments) Comments Step 3: (1f required) DEPARTMENT MAKES REVISIONS AND RESUBMITS TO RISK MANAGEMENT AND PROSECUTING ATTORNEY Step 4: CONTRACTOR/CONSULTANT SIGNS APPROPRIATE NUMBER OF ORIGINALS Step 5: SUBMIT TO BOCC FOR APPROVAL Submit originals and 9 copies of Contract, Review Form,and Agenda Bill to BOCC Office. Place"Sign Here"markers on all places the BOCC needs to sign. MUST be in BOCC Office by 4:30 p.m. TUESDAY for the following Monday's agenda. (This form is to stay with contract throughout the contract review process.)