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13-228.00 Skillings Connolly: Mansfield Connection ROW AcquisitionSUPPLEMENTAL AGREEMENT No. 2 ORGANIZATION AND ADDRESS Skillings Connolly, Inc. PO Box 5080 Lacey, WA 98509 -5080 AGREEMENT NUMBER 13 -008 FEDERAL AID NUMBER CM- 1223(002) PHONE (360) 491 -3399 PROJECT TITLE Mansfield Avenue Connection Project Right of Way Acquisition Services NEW MAXIMUM AMOUNT PAYABLE $81,823.00 DESCRIPTION OF WORK Time Extension Only The Local Agency of the City of Spokane Valley, WA desires to supplement the agreement entered into with Skillings Connolly, Inc. executed on January 24, 2013 and identified as Agreement No. 13 -008. All provisions in the basic agreement remain in effect except as expressly modified by this supplement. The changes to the agreement are described as follows: SECTION 1, SCOPE OF WORK, is hereby changed to read: Unchanged by this Supplemental Agreement. SECTION IV, TIME FOR BEGINNING AND COMPLETION, is amended to change the completion date from December 31, 2013 to December 31, 2014. SECTION V, PAYMENT, shall be amended as follows: Unchanged by this Supplemental Agreement If you concur with this supplement and agree to the changes as stated above, please sign in the appropriate spaces below and return to this office for final action. Signed this1721 `kr- day ofT 013_. By: Skillings Connolly, Inc By: City ofd kane Valley gliZammw Signing Authority Skillings Connolly, Inc. Page 1 of 1 Project No. 13019 City of Spokane Valley Mansfield Avenue Connection Project Right of Way Connection Services Client#:324969 SKILLCON ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYY1) 12/19/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Kibble & Prentice, a USI Co PR 601 Union Street, Suite 1000 Seattle, WA 98101 C•` CT NAME: PAICNN Ext :206 441 4300 ac No: 610462 4528 E-MAIL P I certre com.com uestk ADDRESS: • �I P INSURER(S) AFFORDING COVERAGE NAIC e INSURER A: Travelers Indemnity Co. of Amer 25666 INSURED Skillings Connolly, Inc. 5016 Lacey Blvd. SE Lacey, WA 98503 INSURER B : XL Specialty Insurance Company 37885 INSURER C: Charter Oak Fire Insurance Comp 25615 INSURER D EACH OCCURRENCE INSURER E : X INSURER F : $1 000 000 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM /DD POLICY EXP „ .l a LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR 6806760L011 2/18/2013 12/18/201, EACH OCCURRENCE $1 000 000 X PREMISES eEa ocarrDence $1 000 000 :■ CLAIMS -MADE 1 XI MED EXP (Any one person) $10 000 PERSONAL BADVINJURY $1,000,000 ■ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGO $2,000,000 ■ POLICY X JEC7 ■ LOC $ c AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON OWNED AUTOS BA6752L594 12/18/2013 12/18/201' C o aIIMderD SINGLE LIMIT $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Perecddent) $ X X PROPERTY DAMAGE Per accident $ ■ ■ $ ■ UMBRELLA LIAB EXCESS LIAB ■ OCCUR CLAIMS -MADE EACH OCCURRENCE $ ■ ■ ■ AGGREGATE $ DED ■ RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICEWMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS YN N / A 6806760L011 (WA Stop Gap) 2/18/2013 12/18/201 ' • Wp STATU- x 1� a E.L. EACH ACCIDENT $1 000 000 ECUTIVE E.L. DISEASE - EA EMPLOYEE $1 000 000 below E.L. DISEASE - POLICY LIMIT $1,000,000 B Professional Liability DPR9704780 13/02/2013 03/02/201 ' $1,000,000 per claim $1,000,000 annl aggr. DESCRIPTION OF OPERATIONS /LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space s required) RE: Project No. 10016, City of Spokane Valley On -Call Right -of -Way Acquisition and Appraisal Services. The General Liability policy includes a blanket automatic Additional Insured endorsement that provides Additional Insured status to the Certificate holder, only when there is a written contract or written agreement between the named insured and the certificate holder that requires such status, and only with regard to work performed on behalf of the named insured. CERTIFICATE HOLDER CANCELLATION City of Spokane Valley 11707 East Sprague Avenue, Suite 106 Spokane, WA 99206 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE **war ACORD 25 (2010/05) 1 of 1 #S11448476/M11446994 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PXLZP This page has been left blank intentionally: COMMERICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section II): Any person or organization that you agree in a "contract or agreement requiring insurance" to in- clude as an additional insured on this Coverage Part, but only with respect to liability for "bodily in- jury", "property damage" or "personal injury" caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing opera- tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products- completed operations hazard ". Such person or organization does not qualify as an additional insured for "bodily injury", "property damage" or "personal injury" for which that per- son or organization has assumed liability in a con- tract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which cover- age as an additional insured specifically is added by another endorsement to this Cover- age Part. e. This insurance does not apply to the render- ing of or failure to render any "professional services ". f. The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "contract or agreement requir- ing insurance" to provide for that additional insured, or the limits shown in the Declara- tions for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF CG D3 81 09 07 INSURANCE (Section III) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Cov- erage Part must apply on a primary basis, or a primary and non - contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such addi- tional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance ". But this insur- ance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insur- ance" with such person or organization entered into by you before, and in effect when, the "bodily © 2007 The Travelers Companies, Inc. Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc., with its permission. COMMERICAL GENERAL LIABILITY injury" or "property damage" occurs, or the "per- sonal injury" offense is committed. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement un- der which you are required to include a person or organization as an additional insured on this Cov- erage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal in- jury" is caused by an offense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 © 2007 The Travelers Companies, Inc. CG D3 81 09 07 Includes the copyrighted material of Insurance Services Office, Inc., with its permission.