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14-180.00 Inland Asphalt: 2014 Stormwater Utility Small Works Projects Contract THIS AGREEMENT,made and entered into this 22-44 day of Saipt , 2014, between the City of Spokane Valley under and by virtue of Title 35 RCW, as amended and Inland Asphalt Company 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: Stormwater Utility 2014 Small Works Projects,Package 2 SVPW Contract #14-051 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. (p ILA-18� V. The project was awarded for the bid amount of$152,077.00_. 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 September 2 2 ,2014. Date Al Hughbanks Printed Name Chief Esti' .tor Title / i t Signa City of Spok e Valley fib( 7.;1.2.("7 P ted ame Ce i4' A Titl- AZIA f ignature Revised 6.19.13 Siiole �rValley BOND NO: 9170316 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 INLAND ASPHALT COMPANY (Contractor), as Principal, a contract for the construction of the project designated as Stormwater Small Works 2014,Package 2, Project No. (Project #14-051) 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 FIDELITY AND DEPOSIT COMPANY OF MARYLAND (Surety),a corporation organized under the laws MARYLAND 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$152,077.00 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. INLAND • 'H;LT au FIDELITY AND DEPOSIT COMPANY OF MARYLAND PRIN' i' .11 i�I r .' i ) SUR TY/ / �, 1/���1 a 1 d / 09/22/2014 Principal Sig Date urety Signature / Date Al Hugh an'4. LISA HALL Printed Name Printed Name Chief Estimator ATTORNEY-IN-FACT Title Title Name,address,and telephone of local office/agent of Surety Company is: . TINA DAVIS 15 W.SOUTH TEMPLE, STE. 700 SALT LAKE CITY, UT 84101 Spokane .s0Valley BOND NO: 9170316 CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to INLAND ASPHALT COMPANY (Contractor), as Principal, a contract for the construction of the project designated as Stormwater Small Works 2014,Package 2, Project No. 14-051 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 FIDELITY AND DEPOSIT COMPANY OF MARYLAND (Surety),a corporation,organized under the laws of MARYLAND 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$152,077.00 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. INLAND ' ,,T T '' FIDELITY AND DEPOSIT COMPANY OF MAR AND P' i , o litii, S • � / /,L���I1t\- . Q Z Z 14- 40_ 04m,,� _. .. 2/2014 Principal Sifir ate Surety Signature Date Al HughLISA HALL Printed Name Printed Name Chief Estimator ATTORNEY-IN-FACT Title Title Name,address,and telephone of local office/agent of Surety Company is: TINA DAVIS 15 W.SOUTH TEMPLE, STE. 700 SALT LAKE CITY, UT 84101 SURETY ACKNOWLEDGMENT STATE OF UTAH } COUNTY OF SALT LAKE } SS On this 22ND day of SEPTEMBER, 2014, before me personally came LISA HALL to me known, who, being by me duly sworn, did depose and say that she is an Attorney-In-Fact of FIDELITY AND DEPOSIT COMPANY OF MARYLAND the corporation described in and which executed the within instrument; that she knows the corporate seal of said corporation, that the seal affixed to the within instrument is such corporate seal, and that she signed the said instrument and affixed the said seal as Attorney-In-Fact of the Board of Directors of said corporation and by authority of this office under the Standing Resolut' ns thereof. .)• T�'' Notary'�blic' I 4, OmeC,'3C .�-O-----{y(i----------. 1 9 6�: '! NOtary Public t 41 � +c� CommissianNumbar6-9659 1 i Y l Y Commiusion Exp:0:59 �v'r'. +h`1:=.�,.�d � phos 1 Nr. 'lao.! ' Novanibor 30,2096 1 a , Ns State St 6 of Utah 1 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the ZURICH AMERICAN INSURANCE COMPANY,a corporation of the State of New York,the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY,a corporation of the State of Maryland,and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by THOMAS O. MCCLELLAN, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies,which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof,do hereby nominate,constitute,and appoint Tina DAVIS,Lisa HALL and Lindsey PLATTNER,all of Salt Lake City,Utah, EACH its true and lawful agent and Attorney-in-Fact,to make,execute, seal and deliver,for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York,New York.,the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V,Section 8,of the By-Laws of said Companies,and is now in force. IN WITNESS WHEREOF,the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND,this 24th day of July,A.D.2014. I ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND c atut4 as ttuos,% s�r��Ns e p �S 8BAL _t of ' teM u ma BY: *Citar2---„ ,..._g el. ff./1K4-0( Assistant Secretary Vice President Michael McKibben Thomas O.McClellan State of Maryland City of Baltimore On this 24th day of July,A.D.2014,before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,THOMAS O. MCCLELLAN,Vice President,and MICHAEL MCKIBBEN,Assistant Secretary,of the Companies,to me personally known to be the individuals and officers described in and who executed the preceding instrument,and acknowledged the execution of same,and being by me duly sworn,deposeth and saith, that he/she is the said officer of the Company aforesaid,and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies,and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my Official Seal the day and year first above written. tt01.1:..1:,....s.' G 92titAt;_D. 00,,,,,-(2 .,:„v.:.0t,,c...44- Maria D.Adamski,Notary Public My Commission Expires:July 8,2015 1 POA-F 020-8022W EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V,Section 8,Attorneys-in-Fact. The Chief Executive Officer,the President,or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys-in-fact with authority to execute bonds, policies, recognizances, stipulations,undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto;and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate;and I do further certify that Article V,Section 8,of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attomey...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President,Secretary, or Assistant Secretary of the Company,whether made heretofore or hereafter,wherever appearing upon a certified copy of any power of attorney issued by the Company,shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 22NDday of SEPTEMBER ,2014 ft" to". = UALltN 199171 9� Nr Gerald F.Haley,Vice President _ Certificate of Insurance CERTIFICATE INSURANCE POLICISSUED AS A MATTER OF Y AND DOES NOT AMEND,INFORMATION. XTEND,OR ALTER THE COVERAGE AFFORDED BYN YOU Y THE POLICIES LISTED BELOW. THIS CERTIFICATE IS NOT AN This is to Certify that NWelikk Inland Asphalt Company 7 lik e NAME CPM Development Corporation dba ADDRESS V\%t Li ePO Box 3366 OF INSURED I Spokane, WA 99220-3366 I rfrMutual® is,at the issue date of this certificate,insured by the Company under the policy(ies)listed below.The insurance afforded by the listed policy(ies)is subject to all their terms,exclusions and Conditions and is not altered by any rec,uirement,term or condition of any contract or other document with respect to which this certificate may be issued. 1 EXP DATE 0 CONTINUOUS TYPE OF POLICY ❑EXTENDED POLICY NUMBER LIMIT OF LIABILITY El POLICY TERM WA7-C8D-004095-024 COVERAGE AFFORDED UNDER WORKERS 9/1/2015 WC LAW OF THE FOLLOWING EMPLOYERS LIABILITY COMPENSATION WC7-C81-004095-014 STATES: ALL STATES EXCLUDING Bodily Injury by Accident MONPOLISTICS STATES AND $1,000,000 Each Accident NY Bodily Injury by Disease $1,000,000 Policy Limit OR,WI Bodily Injury by Disease $1,000,000 Each Person General Aggregate-Other than Products/Completed Operations GENERAL LIABILITY 9/1/2015 TB2-C81-004095-114' $2,000,000 -Per project aggregate included Products/Completed Operations Aggregate 21 OCCURRENCE $2,000,000 0 CLAIMS MADE Bodily Injury and Property Damage Liability $2,000,000 Per Occurrence RETRO DATE Personal Injury • Included* Per Person/Organization Other Other Included in BI/PD Liability FIRE DAMAGE$100,000;PER PROJECT AGGREGATE Each Accident-Single Limit AUTOMOBILE 9/1/2015 AS2-C81-004095-124 $2,000,000 B.I.And P.D.Combined LIABILITY Comp Ded$10,000 Each Person 10 OWNED El NON-OWNED Coll Ded$10,000 Each Accident or Occurrence El HIRED Each Accident or Occurrence ETHER Excess Workers' 9/1/2015 EW7-68N-004095-344 SIR 250,000;EXCESS WC 250,000,000(INCLUDES WA STOP Compensation&Employers' GAP)EL$750,000 Liability ADDITIONAL COMMENTS RE: Stormwater Utility 2014 Small Works Projects,Package 2 City of Spokane Valley is named as additional insured with respect to the above referenced project. Coverage is primary and non-contributory. lithe certificate expiration date is continuous or extended term,you will be notified if coverage is terminated or reduced before the certificate expiration date. SPECIAL NOTICE-OHIO:ANY PERSON WHO,WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER,SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD. IMPORTANT NOTICE TO FLORIDA POLICYHOLDERS AND CERTIFICATE HOLDERS:IN THE EVENT YOU HAVE ANY QUESTIONS OR NEED INFORMATION ABOUT THIS CERTIFICATE FOR ANY REASON,PLEASE CONTACT YOUR LOCAL SALES PRODUCER WHOSE NAME AND TELEPHONE NUMBER APPEARS IN THE LOWER RIGHT HAND CORNER OF THIS CERTIFICATE.THE APPROPRIATE LOCAL SALES OFFICE MAILING ADDRESS MAY ALSO BE OBTAINED BY CALLING THIS NUMBER. Liberty Mutual Insurance Group NOTICE OF CANCELLATION:(NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: City of Spokane Valley 7Aaf. A,,Qt.,,r . -E.112.0.04';t6)4,_"11707 E. Sprague, Suite 106 Stanley S.Esposito Jr. 3 Spokane Valley,WA 99206 Pittsburgh/0387 AUTHORIZED REPRESENTATIVE Bx 12 Federal Street,Ste.310 Pittsburgh PA 15212-5706 412-231-1331 9/29/14 OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 Liberty �► Mutual. INSURANCE Liberty Mutual Group 157 Berkeley Street • Boston,MA 02116 Tel: (617)654-4096 Fax: (857)224- August 21 2014 Re: Oldcastle Inc.,Oldcastle Materials,Inc.,CPM Development Corporation,Eugene Sand Construction, Inc.,Interstate Concrete and Asphalt Co. Policy#TB2-C81-004095-114,AS2-C81-004095-124,WA7-C8D-004095-024,WC7-C81-004095-024, EW7-68N-004095-344 To Whom It May Concern: Please accept this letter as confirmation that these customers have renewed with Liberty Mutual Insurance and coverage continues under the attached expiring endorsements. We will release the renewal endorsements for the current policy period of 9/1/14—9/1/15 within 30 days at which time,we will provide you copies of the endorsements for your file. Endorsements: WC 00 03 13- Waiver of Our Right to Recover from Others Endorsement CG 20 10 04 13—Additional Insured—Owners.Lessees or Contractors CO 20 37 04 13—Additional Insured—Owners,Lessees or Contractors—Completed Operations CO 24 04 05 09-Waiver of our Right to Recover From Others Endorsement LD 24 10 07 13 -Primary and Non Contributory-Scheduled Additional Insured AC 84 23 08 11 —Designated Insured—Noncontributing CA 04 44 10 13—Waiver of Transfer of Rights of Recovery against Other to US(Waiver of Subrogation) CA 20 48 10 13—Designated Insured I hope this will suffice for verification purposes. If you have any questions,please contact me at 617-654-4096. Regards, .Natalie O'Brien Natalie O'Brien Underwriting Technical Specialist Helping people live safe,more secure lives. Certificate of Insurance THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION.ONLY AND CONFERS NO RIGHT UPON YOU THE CERTIFICATE HOLDER.THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND.EXTEND,OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. This is to Certify that OW e't Inland Asphalt Company —1 111, AL.NAME AND Libe CPM Development Corporation dba •�� PO Box 3366 ADDRESS I OF INSURED Spokane, WA 99220-3366 P, � Mutual® is,at the issue date of this certificate,insured by the Company under the policy(ies)listed below.The insurance afforded by the listed policy(ies)is subject to all their terms,exclusions and Conditions and is nol altered by any rec,uirement,tenn or condition of any contract or other document with respect to which this certificate may be issued. 1 EXP DATE 0 CONTINUOUS TYPE OF POLICY ❑EXTENDED POLICY NUMBER LIMIT OF LIABILITY 0 POLICY TERM WA7-C8D-004095-025 COVERAGE AFFORDED UNDER WORKERS 9/1/2016 WC7-C81-004095-015 WC LAW OF THE FOLLOWING EMPLOYERS LIABILITY COMPENSATION STATES: ALL STATES EXCLUDING Bodily Injury by Accident MONPOLISTICS STATES AND $1,000,000 Each Accident NY Bodily Injury by Disease 1 OR,WI $1,000,000 Policy Limit Bodily Injury by Disease $1,000,000 Each Person General Aggregate-Other than Products/Completed Operations GENERAL LIABILITY 9/1/2016 TB2-C81-004095-115 $2,000,000 -Per project aggregate included Products/Completed Operations Aggregate El OCCURRENCE $2,000,000 ❑CLAIMS MADE Bodily Injury and Property Damage Liability $2,000,000 Per Occurrence RETRO DATE Personal Injury Included* Per Person/Organization Other Other Included in SI/PD Liability FIRE DAMAGE$100,000;PER PROJECT AGGREGATE AUTOMOBILE 9/1/2016 AS2-C81-004095-125 $2,000,000 InLimit Ad PD.Combined LIABILITY Comp Ded$10,000 Each Person Q OWNED 0 NON-OWNED Coll Ded$10,000 Each Accident or Occurrence 0 HIRED Each Accident or Occurrence OTHER Excess Workers' 9/1/2016 EW7-68N-004095-345 SIR 250,000;EXCESS WC 250,000,000(INCLUDES WA STOP Compensation&Employers' GAP)EL$750,000 Liability ADDITIONAL COMMENTS RE: Stormewater Utility 2014 Small Works Projects,Package 2 City of Spokane Valley is named as additional insured with respect to the above referenced project. Coverage is primary and non-contributory. •If the certificate expiration date is continuous or extended term,you will be notified if coverage is terminated or reduced before the certificate expiration date. SPECIAL NOTICE-OHIO:ANY PERSON WHO,WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER.SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD. IMPORTANT NOTICE TO FLORIDA POLICYHOLDERS AND CERTIFICATE HOLDERS:IN THE EVENT YOU HAVE ANY QUESTIONS OR NEED INFORMATION ABOUT THIS CERTIFICATE FOR ANY REASON.PLEASE CONTACT YOUR LOCAL SALES PRODUCER WHOSE.NAME AND TELEPHONE NUMBER APPEARS IN THE LOWER RIGHT HAND CORNER OF THIS CERTIFICATE.THE APPROPRIATE LOCAL SALES OFFICE MAILING ADDRESS MAY ALSO BE OBTAINED BY CALLING THIS NUMBER. Liberty Mutual Insurance Group NOTICE OF CANCELLATION:(NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMI'ANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: City of Spokane Valley 11707 E. Sprague Ave.,Suite 106 s 0� � Stanley S.Esposito Jr. !E—' Spokane Valley,WA 99206 Pittsburgh/0387 AUTHORIZED REPRESENTATIVE cE,_ I I 12 Federal Street,Ste.310 Pittsburgh PA 15212-5706 412-231-1331 10/6/15 OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 POLICY NUMBER:TB2-C81-004095-1 15 COMVERCIAL GENERAL LIABILITY CG 2010 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to 1. All work, including materials, parts or include as an additional insured the person(s) or equipment ment furnished in connection with such organization(s) shown in the Schedule, but only with work, on the project (other than service, respect to liability for 'bodily injury", "property maintenance or repairs)to be performed by or damage" or "personal and advertising injury" on behalf of the additional insured(s) at the caused,in whole or in part.by: location of the covered operations has been 1. Your acts or omissions;or completed;or 2. The acts or omissions of those acting on your 2. That portion of "your work" out of which the behalf; injury or damage arises has been put to its in the performance of your ongoing operations for intended use by any person or organization the additional insured(s) at the location(s) ether than another contractor or subcontractorengaged in performing operationsa designated above. for a principal as a part of the same project. However. C. With respect to the insurance afforded to these 1. The insurance afforded to such additional additional insureds, the following is added to insured only applies to the extent permitted by Section III—Limits Of Insurance: law;and If coverage provided to the additional insured is 2. If coverage provided to the additional insured is required by a contract or agreement, the most we required by a contract or agreement, the will pay on behalf of the additional insured is the insurance afforded to such additional insured will amount of insurance: not be broader than that which you are required 1. Required by the contract or agreement;or by the contract or agreement to provide for such additional insured. 2. Available under the applicable Limits of B. With respect to the insurance afforded to these Insurance shown in the Declarations; additional insureds, the following additional whichever is less. exclusions apply: This endorsement shall not increase the This insurance does not apply to "bodily injury" or applicable Limits of Insurance shown in the "property damage" occurring after. Declarations. SCHEDULE Name Of Additional Insured Person(s) Location(s)Of Covered Operations Or Organization(s): Any owner,lessee,or contractor for whom you have Any location listed in such agreement agreed in writing prior to a loss to provide liability insurance Information required to complete this Schedule,if not shown above, will be shown in the Declarations. CG 2010 0413 ®Insurance Services Office,Inc.,2012 Page 1 of 1 Policy Number TB2-C81-004095-115 issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY—SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Person or Organization: Where required by written contract prior to a loss If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person or organization shown in the Schedule that is an additional insured on this policy, this policy will apply solely on the basis required by such written agreement If the applicable written agreement does not specify on what basis the liability Insurance will apply,this Insurance shall be excess over any other valid and collectible insurance available to the additional insured,whether such Insurance is on an excess,contingent or primary basis.Condition 4 Other Insurance of Section IV is revised accordingly. LD 2410 0713 ®2013 Liberty Mutual Insurance.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.,with its permission.