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14-146.00 Halme Construction: SE Yardley Stormwater Retrofits Contract 7 THIS AGREEMENT, made and entered into this day of dr — 2014, between the City of Spokane Valley under and by virtue of Title 35 RCW, a amended and Halme Construction, 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: I. The Contractor shall do all work and furnish all tools, materials, and equipment for: SE Yardley Stormwater Retrofits SVPW Contract# 14-041 in accordance with and as described in the project plans and specification, and the standard specification of the Washington State of Department of Transportation which are by this reference incorporated herein and made part hereof and, shall perform any changes in the work in accord with the Contract Documents. 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 these Contract Documents except those items mentioned therein to be furnished by the City of Spokane Valley. II. The City of Spokane Valley hereby promises and agrees with the Contractor to employ, and does employ the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with the project plans and specification and the terms and conditions herein contained and hereby contracts to pay for the same according to the referenced specifications and the schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this contract. III. The Contractor for himself/herself, and for his/hers heirs, executors, administrators, successors, and assigns, does hereby agree to full performance of all covenants required of the Contractor in the contract. IV. It is further provided that no liability shall attach to the City of Spokane Valley by reason of entering onto this contract, except as provided herein. V. The project was awarded for the bid amount of$704,727.75. IN WITNESS WHEREOF, the Contractor has executed this instrument, on the day and year first below written and the City of Spokane Valley has caused this instrument to be executed by and in the name of the said City of Spokane Valley the day and year first above written. Executed by Contractor August 21 , 2014. Date Jason Halme Printed Name Vice President Title Signature City of Spokane Valley /frf i c, J/at ccc Printed Name 6-07 ,144fA,tlei".rt— le 0 Signature . . », , /N„ Spokane 40jValley Valley BOND NO: 106109280 CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Halme Construction, Inc., (Contractor), as Principal, a contract for the construction of the project designated as SE Yardley Stormwater Retrofits, Project No. 0192, in Spokane Valley, Washington, and said Principal is required under the terms of the Contract to furnish a performance bond in accordance with chapter 39.08 Revised Code of Washington (RCW). The Principal, and Travelers Casualty and Surety Company (Surety), a corporation, organized under the laws of Connecticut and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accounts, U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley, as Obligee, in the sum of$704,727.75 total Contract amount (including Washington State sales tax),subject to the provisions herein. This performance bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all the terms and conditions of all duly authorized modifications, additions, and changes to said Contract that may hereafter be made, at the time and in the manner therein specified; shall warranty the work as provided in the Contract and shall indemnify and hold harmless the Obligee from any defects in the workmanship and materials incorporated into the work for the period identified in the Contract; and if such performance obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time,alteration or addition to the terms of the Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond, and waives notice of any change, extension of time, alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts, and shall be signed by the parties' duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. Halme Construction, Inc. Travelers Casualty and Surety Company PRINCIPAL 38103 Halme Drive East; Davenport,WA 99122 SURETY One Tower Square; Hartford, CT 06183 08/26/2014 08/26/2014 Principal ' nature Date Surety Sig ure Date lasnn alms Shelly Donovan Printed Name Printed Name Vice President Attorney In Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: PayneWest Insurance, Inc.; 7903 E. Broadway Ave., Spokane Valley,WA 99212 (509) 455-6767 Revised 1.14 13 Spokane hMalley� BOND NO: 106109280 CONTRACTOR'S PAYMENT BOND(NON-FEDERALLY FUNDED PROJECT) to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Halme Construction, Inc., (Contractor), as Principal, a contract for the construction of the project designated as SE Yardley Stormwater Retrofits, Project No. 0192, in Spokane Valley,Washington, and said Principal is required under the terms of the Contract to furnish a payment bond in accordance with chapter 39.08 Revised Code of Washington(RCW). The Principal, and Travelers Casualty and Surety Company (Surety), a corporation organized under the laws Connecticut and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds" as published in the Federal Register by the Audit Staff Bureau of Accounts, U.S.Treasury Dept., are jointly and severally held and firmly bound to the City of Spokane Valley, as Obligee, in the sum of$704,727.75 total Contract amount (including Washington State sales tax),subject to the provisions herein. This payment bond shall become null and void, if and when the Principal, its heirs,executors,administrators, successors, or assigns shall pay all persons in accordance with chapters 39.08 and 39.12 RCW, including all workers, 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 indemnify and hold harmless the Obligee from all loss, cost or damage which Obligee may suffer by reason of the failure of Principal to make such required payments; and if such payment obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change,extension of time,alteration or addition to the terms of the Contract, the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond, except as provided herein, and waives notice of any change, extension of time, alteration or addition to the terms of the Contract or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts, and shall be signed by the parties' duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. Halme Construction, Inc. Travelers Casualty and Surety Company PRINCIPAL38103 Halme Drive East; Davenport,WA 99122 SURETY One Tower Square; Hartford, CT 06183 08/26/2014 08/26/2014 Principal Si nature Date Surety Sig re Date Jason Halme Shelly Donovan Printed Name Printed Name Vice President Attorney In Fact Title Title Name,address, and telephone of local office/agent of Surety Company is: PayneWest Insurance, Inc.; 7903 E. Broadway Ave.,Spokane Valley,WA 99212 (509)455-6767 Revised 1 14.13 WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER POWER OF ATTORNEY TRAVELERSJJ Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company Attorney-In Fact No. 225464 Certificate No. 005629658 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company,St. Paul Guardian Insurance Company, St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint Judith A.Rapp,James E.Majeskey II,Judith C.Kaiser-Smith,Shawn M.Wilson,Nicholas W.Paget,and Shelly Donovan of the City of Spokane Valley ,State of Washington ,their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of,guaranteeing the fidelity of persons,guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions orproceedings allowed by law. \ , .:' " .l tt.,, •'. .�.,`ate>'" , 'IN WITNESS WHEREOF,the Companies have caused this instrument•to be signed.and thein 6th corporate seals to be hereto affixed,this day of September 2013 ern`%,." \,:: �� � 4 Farmington Casualty Company f."f .� ,-.19 ' ' St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance`Com anY,fat' Travelers Casualty and Surety Company n Y Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company I4_ 0/.5144, en Y4IN &` t`44/i„y JyF\0.E MIN:\ cx Jp+1'”ryg�q D, C n m �:`OaPORAlf°I^i a' I: .°: : NRDfii i',SEAL 0sp EG Af o'.•.•. ..:a 1S•...... ,..0 si F,a O. +'' ANt State of Connecticut By: //r / City of Hartford ss. Robert L.Raney, enior Vice President On this the 6th day of September 2013 before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. lltrk In Witness Whereof,I hereunto set my hand and official seal. `` _ �W w" C My Commission expires the 30th day of June,2016. n At/6LO * Marie C.Tetreault,Notary Public . , mss 58440-8-12 Printed in U.S.A. WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance.Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,which resolutions are now in full force and effect,reading as follows: RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED,that any bond,recognizance,contract of indemnity,or writing obligatory in the nature of a bond,recognizance,or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,any Vice President, any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I,Kevin E.Hughes,the undersigned,Assistant Secretary,of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity Guaranty Company do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companiesrwhich is force and effect and has not been revoked. � • -. 26th August 14 IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the ssedals of said Companies this day of g ,20 14. icy Kevin E.Hughes,Assistant Sec tary ASV 4Y1:/w hORE.6'yGa � a .H n�N.✓sG✓y ..._ Aho Nmwen, tY/WON C IN , as� 1, aa.;;, 0P+.IN `s 4sLp 9 8 8 77E "1"4TED 04-7 ti m1 p - e+ e:`paoarf+nF HAMM). 3 ‘ t 1951 �,S,EAL 1f vSEALa. CONN. Attoe skFANcf Pc4a . To verify the authenticity of this Power of Attorney,call 1-800-421-3880 or contact us at www.travelersbond.com.Please refer to the Attorney-In-Fact number,the above-named individuals and the details of the bond to which the power is attached. WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER ` �...miN HALMCON-01 DARRE ACORE,' DATE(MM/DD/YYYY) 4,..._.---- CERTIFICATE OF LIABILITY INSURANCE 8/20/2014 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 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 Valley Office PHONE FAX Paynewest Insurance,Inc. (A/c,No.Ext):(509)455-6767 (A/C,No): E-MAIL 7903 E.Broadway ADDRESS: Spokane,WA 99212 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Charter Oak Fire Insurance Co INSURED INSURERS:Travelers Indemnity 25658 Halme Construction,Inc INSURER C:Travelers Property Casualty Co of America 25674 38103 Halme Dr.E INSURER D:Travelers Indemnity of America 25666 Davenport,WA 99122 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 EFF POLICY EXP W /YLIMITS LTR INSD VD POLICY NUMBER (MM/DD/YYYY) (MM/DDYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X CO527D1655 12/31/2013 12/31/2014 PREMISES(DAMAGE TOEa RENT occuEDrrence) $ 300,000 MED EXP(Any one person) $ 5,000 X 5,000 Ded PD PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: _GENERAL AGGREGATE $ 2,000,000 POLICY X jECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: WA Stop Gap $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) _ B X ANY AUTO _ X 810527D1655 12/31/2013 12/31/2014 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $HIRED AUTOS AUTOS (Per accident) X -0-Deductible $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 7,000,000 C EXCESS LIAB CLAIMS-MADE X CUP527D1655 12/31/2013 12/31/2014 AGGREGATE $ 7,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/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 $ D Installation Floater 6605007X721 12/31/2013 12/31/2014 Any One Location 600,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Travelers Indimnity Co of America:#25666,A+XV The Travelers Indemnity Co:#25658,A+XV Charter Oak Fire Insurance Co:#25615,A+XV Travelers Property Casualty Co of America:#25674,A+XV RE:SVPW Contract#14041-SE Yardley Stormwater Retrofits The City of Spokane Valley is an additional insured per policy form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1 Cityof Spokane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1 p ACCORDANCE WITH THE POLICY PROVISIONS. 11707 E Sprague Suite 106 Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for"bodily injury", requiring insurance" specifically requires you "property damage" or"personal injury"; and to provide such coverage for that additional insured, and then the insurance provided to b) If, and only to the extent that, the injury or the additional insured applies only to such damage is caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring insur- requiring insurance" applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to the independent acts earlier. or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the additional insured for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the "written contract requiring insurance", the in- "written contract requiring insurance" specifically surance provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that "written contract requiring in- this insurance is primary to "other insurance" surance". This endorsement shall not in- available to the additional insured which covers crease the limits of insurance described in that person or organization as a named insured Section III— Limits Of Insurance. for such loss, and we will not share with that b) "other insurance". But the insurance provided to The insurance provided to the additional in- the additional insured by this endorsement still is sured does not apply to "bodily injury", "prop- excess over anyvalid and collectible "other in- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any surance", whether primary, excess, contingent or on any other basis, that is available to the addi- professional architectural, engineering or sur- tional insured when that person or organization is veying services, including: an additional insured under such "other insur- i. The preparing, approving, or failing to ance". prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement: ders or change orders, or the preparing, approving, or failing to prepare or ap- a) The additional insured must give us written prove, drawings and specifications; and notice as soon as practicable of an "occur- rence" or an offense which may result in a ii. Supervisory, inspection, architectural or engineering activities. claim. To the extent possible, such notice should include: CG D2 46 08 05 ©2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" any provider of"other insurance"which would or offense took place; cover the additional insured for a loss we ii. The names and addresses of any injured cover under this endorsement. However, this persons and witnesses; and condition does not affect whether the insur- ance provided to the additional insured by iii. The nature and location of any injury or this endorsement is primary to "other insur- damage arising out of the "occurrence" or ance" available to the additional insured offense. which covers that person or organization as a b) If a claim is made or "suit" is brought against named insured as described in paragraph 3. the additional insured, the additional insured above. must: 5. The following definition is added to SECTION V. i. Immediately record the specifics of the —DEFINITIONS: claim or"suit" and the date received; and "Written contract requiring insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement The additional insured must see to it that we under which you are required to include a in- receive written notice of the claim or"suit" as person or organization as an additional soon as practicable. sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- c) The additional insured must immediately curs and the "personal injury" is caused by an send us copies of all legal papers received in offense committed: connection with the claim or "suit", cooperate a. After the signing and execution of the with us in the investigation or settlement of contract or agreement by you; the claim or defense against the "suit", and otherwise comply with all policy conditions. b. While that part of the contract or d) The additional insured must tender the de- agreement is in effect; and fense and indemnity of any claim or "suit" to c. Before the end of the policy period. Page 2 of 2 ©2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 COMMERCIAL GENERAL LIABILITY POLICY NUMBER: ISSUE DATE: - - THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED.PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Project Designated Project(s): General Aggregate(s): A. For all sums which the insured becomes legally 3. Any payments made under COVERAGE A. obligated to pay as damages caused by "occur- for damages or under COVERAGE C. for rences" under COVERAGE A. (SECTION I), and medical expenses shall reduce the Desig- for all medical expenses caused by accidents un- nated Project General Aggregate Limit for der COVERAGE C (SECTION I), which can be that designated "project". Such payments attributed only to operations at a single desig- shall not reduce the General Aggregate Limit nated "project" shown in the Schedule above: shown in the Declarations nor shall they re- 1. A separate Designated Project General Ag- duce any other Designated Project General gregate Limit applies to each designated "pro- Aggregate Limit for any other designated ject", and that limit is equal to the amount of "project" shown in the Schedule above. the General Aggregate Limit shown in the 4. The limits shown in the Declarations for Each Declarations, unless separate Designated Occurrence, Damage To Premises Rented Project General Aggregate(s) are sched- To You and Medical Expense continue to uled above. apply. However, instead of being subject to 2. The Designated Project General Aggregate the General Aggregate Limit shown in the Limit is the most we will pay for the sum of all Declarations, such limits will be subject to the damages under COVERAGE A., except applicable Designated Project General Ag- damages because of "bodily injury" or "prop- gregate Limit. erty damage" included in the "products- B. For all sums which the insured becomes legally completed operations hazard", and for medi- obligated to pay as damages caused by "occur- cal expenses under COVERAGE C, regard- rences" under COVERAGE A. (SECTION I), and less of the number of: for all medical expenses caused by accidents un- a. Insureds; der COVERAGE C. (SECTION I), which cannot be attributed only to operations at a single desig- b. Claims made or"suits" brought; or nated "project" shown in the Schedule above: c. Persons or organizations making claims or bringing "suits". CG D2 11 01 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 COMMERCIAL GENERAL LIABILITY 1. Any payments made under COVERAGE A. vided, any payments for damages because of for damages or under COVERAGE C. for "bodily injury" or "property damage" included in medical expenses shall reduce the amount the "products-completed operations hazard" will available under the General Aggregate Limit reduce the Products-Completed Operations Ag- or the Products-Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gregate Limit, whichever is applicable; and gate Limit nor the Designated Project General 2. Such payments shall not reduce any Desig- Aggregate Limit. nated Project General Aggregate Limit. E. For the purposes of this endorsement the Defini- C. Part 2. of SECTION III— LIMITS OF INSURANCE tions Section is amended by the addition of the is deleted and replaced by the following: following definition: 2. The General Aggregate Limit is the most we "Project" means an area away from premises will pay for the sum of: owned by or rented to you at which you are per- forming operations pursuant to a contract or a. Damages under Coverage B; and agreement. For the purposes of determining the b. Damages from "occurrences" under applicable aggregate limit of insurance, each COVERAGE A (SECTION I) and for all "project" that includes premises involving the medical expenses caused by accidents same or connecting lots, or premises whose con- under COVERAGE C (SECTION I) which nection is interrupted only by a street, roadway, cannot be attributed only to operations at waterway or right-of-way of a railroad shall be a single designated "project" shown in the considered a single "project". SCHEDULE above. F. The provisions of SECTION III — LIMITS OF D. When coverage for liability arising out of the INSURANCE not otherwise modified by this en- "products-completed operations hazard" is pro- dorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG D2 11 01 04 HALME CONSTRUCTION INC Page 1 of 1 SLUE OFWASHINGION Department of Labor& Industries Certificate of Workers' Compensation Coverage August 27, 2014 WA UBI No. 601 553 217 L&I Account ID 831,273-01 Legal Business Name HALME CONSTRUCTION INC Doing Business As HALME CONSTRUCTION INC Workers'Comp Premium Status: Account is current. Estimated Workers Reported Quarter 2 of Year 2014"31 to 50 (See Description Below) Workers" Account Representative TO/GARY HONC (360)902-4823- Email: HONC235@Ini.wa.gov Licensed Contractor? Yes License No. HALMECI061R7 License Expiration 11/15/2015 What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RCW 51.12.050 and 51.16.190). https://secure.lni.wa.gov/verify/Details/liabilityCertificate.aspx?UBI=6015 53217&LIC=H... 8/27/2014