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15-036.00 Power City Electric: CenterPlace Lounge Electrical CONSTRUCTION AGREEMENT Power City Electric THIS CONSTRUCTIONAGREEMENT (the "Agreement") is made by and between the City of Spokane Valley, a code City of the State of Washington ("City") and Power City Electric, ("Contractor") jointly referred to as the"Parties". 1N CONSIDERATION of the terms and conditions contained herein the Parties agree as follows: 1. Work to Be Performed. Contractor shall do all work and furnish all labor, supervision,tools,materials, supplies and equipment and other items necessary for the construction and completion of the CenterPlace Lounge Electrical Project (the "Work") in accordance with documents described in Exhibit 1 and in accordance with this Agreement(which are by this reference incorporated herein and made part hereof(the "Contract Documents")), and shall perform any changes in the work in accordance with the Contract Documents. The terms and provisions in this Agreement shall control over any inconsistent or incompatible terms in any other Contract Document. Contractor shall, for the amount set forth in paragraph 4,below, assume and be responsible for the cost and expense of all work required for constructing and completing the Work and related activities provided for in the Contract Documents to City's satisfaction, within the time limits prescribed in the Contract Documents. The City Manager,or designee,shall administer and be the primary contact for Contractor. Upon notice from City,Contractor shall promptly commence work,complete the same in a timely manner,and cure any failure in performance under this Agreement. Unless otherwise directed by City,all work shall be performed in conformance with the Contract Documents, and all City,State and federal standards,codes,ordinances,regulations and laws as now existing or as may be adopted or amended. 2. Time for Performance. Contractor shall commence the Work within 10 days of receipt of a notice to 8N' proceed and shall complete the Work by April'17,2015. Mt� 3. Liquidated Damages. TIME IS OF THE ESSENCE FOR THIS CONTRACT. Delays cause inconvenience to the residents of City and cost taxpayers undue sums of money, adding time needed for administration,engineering,inspection and supervision. It is impractical for City to calculate the actual cost of delays. Accordingly, Contractor agrees to pay liquidated damages for failure to achieve Substantial Completion (as defined in the Contract Documents) which shall be in the amount of$100 per day. These liquidated damages are not a penalty, but are fixed and agreed upon by and between Contractor and City because of the impracticability and difficulty of fixing and ascertaining the actual damages that City would sustain in the event that the Work is not completed in accordance with the Contract Documents. Liquidated damages may be retained by City and deducted from payments otherwise due to the Contractor. 4. Compensation. In consideration of Contractor performing the Work, City agrees to pay Contractor in accordance with the Contract Documents the sum of$1,906.63,plus Washington State Sales Tax of$165.88, for a total of$2,072.51,based on the bid submitted by Contractor,and as may be adjusted in accordance with the Contract Documents. 5.Payment. Contractor may elect to be paid in monthly installments,upon presentation of an application for payment in a form satisfactory to City. Applications for payment shall be sent to the City Finance Department Construction Agreement Page 1 of 6 at the below stated address. Pursuant to Chapter 60.28 RCW, five percent of the compensation due Contractor shall be retained by City. City reserves the right to withhold payment under this Agreement which is determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Contract Documents,City standards, City Code, and federal or state standards. 6. Notice. Notice other than applications for payment shall be given in writing as follows: TO THE CITY: TO THE CONTRACTOR: Name: Christine Bainbridge, City Clerk Name: Power City Electric Phone: (509)921-1000 Phone: (509) 535-8500 Address: 11707 East Sprague Ave, Suite 106 Address: 3327 E. Olive Spokane Valley,WA 99206 Spokane,WA 99202 7.Applicable Laws and Standards. The Parties,in the performance ofthis Agreement,agree to comply with all applicable federal, state, and local laws, codes and regulations. 8. Certification Regarding Debarment, Suspension, and Other Responsibility Matters — Primary Covered Transactions. A.By executing this Agreement,the Consultant 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 three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission or 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 statues 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(A)(2)of this certification;and 4. Have not within a three-year period preceding this application/proposal had one or more public transactions(federal, state, or local)terminated for cause or default. B. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this Agreement. 9.Prevailing Wages on Public Works. Contractor,any subcontractor,or other person doing work under this Agreement, shall comply with the requirements of RCW 39.12,and shall pay each employee an amount not less than the Prevailing Rate of Wage, as specified by the Industrial Statistician of the Washington State Department of Labor and Industries("L&P'). If employing labor in a class not shown,Contractor shall request a determination of the correct wage rate for the class and locality from the Industrial Statistician. Contractor shall provide a copy of any such determinations to City. Construction Agreement Page 2 of 6 Before commencing,during,and upon completion of the work,Contractor shall file all forms and pay all fees required by L&I and shall indemnify and hold City harmless from any claims related to its failure to comply with RCW 39.12. The following information is provided pursuant to RCW 39.12.030: A. State of Washington prevailing wage rates applicable to this public works project, published by L&I are located at the L&I website address: https://fortress.wa.gov/lni/wagelookup/prvWagelookup.aspx B. This Project is located in Spokane County. C. The effective prevailing wage date is the same date as the bid due date as referenced in the original request for bids and as may be revised by addenda. A copy of the applicable prevailing wage rates is also available for viewing at the offices of City located at 11707 East Sprague, Suite 106,Spokane Valley,WA 99206. Upon request,City will mail a hard copy of the applicable prevailing wages for this project. 10.Relationship of the Parties. It is understood,agreed and declared that Contractor shall be an independent contractor,and not the agent or employee of City,that City is interested in only the results to be achieved,and that the right to control the particular manner,method and means in which the services are performed is solely within the discretion of Contractor. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Contractor. Contractor shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 11.Ownership of Documents. All drawings,plans,specifications,and other related documents prepared by Contractor under this Agreement are and shall be the property of City, and may be subject to disclosure pursuant to RCW 42.56 or other applicable public record laws. 12.Records. The City or State Auditor or any of their representatives shall have full access to and the right to examine during normal business hours all of Contractor's records with respect to all matters covered in this Agreement. Such representatives shall be permitted to audit,examine and make excerpts or transcripts from such records and to make audits of all contracts,invoices,materials,payrolls and record of matters covered by this contract for a period of three years from the date final payment is made hereunder. 13.Warranty. Unless provided otherwise in the Contract Documents,Contractor warrants that all Work and materials performed or installed under this Agreement are free from defect or failure for a period of one year following final acceptance by City,unless a supplier or manufacturer has a warranty for a greater period,which warranty shall be assigned or transferred to City. In the event a defect or failure occurs in work or materials, Contractor shall, within the warranty period, remedy the same at no cost or expense to City. This warranty provision shall not be construed to establish a period of limitation with respect to Contractor's other obligations under this Agreement. 14.Contractor to Be Licensed And Bonded. Contractor shall be duly licensed,registered and bonded by the State of Washington at all times this Agreement is in effect. 15. Insurance. Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the Construction Agreement Page 3 of 6 performance of the work hereunder by Contractor, its agents,representatives,or employees. A. Minimum Scope of Insurance. Contractor shall obtain insurance of the types described below: 1.Automobile liability insurance covering all owned,non-owned,hired,and leased vehicles. Coverage shall be written on Insurance Services Office(ISO)form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2.Commercial general liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises,operations,independent contractors,products- completed operations,stop gap liability,personal injury and advertising injury,and liability assumed under an insured contract. The commercial general liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. There shall be no endorsement or modification of the commercial general liability insurance for liability arising from explosion,collapse or underground property damage. City shall be named as an insured under Contractor's commercial general liability insurance policy with respect to the work performed for City using ISO Additional Insured endorsement CG 20 10 10 01 and Additional Insured-Completed Operations endorsement CG 20 37 10 01 or substitute endorsements providing equivalent coverage. 3.Workers' compensation coverage as required by the industrial insurance laws of the State of Washington. B. Minimum Amounts of Insurance. Contractor shall maintain the following insurance limits: 1.Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of$1,000,000 per accident. 2.Commercial general liability insurance shall be written with limits no less than$1,000,000 each occurrence, $2,000,000 general aggregate, and a $2,000,000 products-completed operations aggregate limit. C. Other Insurance Provisions. The insurance policies are to contain, or be endorsed to contain,the following provisions for automobile liability, professional liability and commercial general liability insurance: 1. Contractor's insurance coverage shall be primary insurance with respect to City. Any insurance, self-insurance, or insurance pool coverage maintained by City shall be excess of Contractor's insurance and shall not contribute with it. 2. Contractor shall fax or send electronically in .pdf format a copy of insurer's cancellation notice within two business days of receipt by Contractor. D.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.Best rating of not less than A:VII. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, Contractor shall furnish acceptable insurance certificates to City at the time Contractor returns the signed Agreement. The certificate shall specify all of the parties who are additional insureds,and will Construction Agreement Page 4 of 6 include applicable policy endorsements,and the deduction or retention level. Insuring companies or entities are subject to City acceptance. If requested, complete copies of insurance policies shall be provided to City. Contractor shall be financially responsible for all pertinent deductibles,self-insured retentions, and/or self-insurance. 16.Indemnification and Hold Harmless. Contractor shall,at its sole expense,defend,indemnify and hold harmless City and its officers, agents, and employees, from any and all claims, actions, suits, liability, loss, costs,attorney's fees and costs of litigation,expenses,injuries,and damages of any nature whatsoever relating to or arising out of the wrongful or negligent acts,errors or omissions in the services provided by Contractor, Contractor's agents, subcontractors, subconsultants and employees to the fullest extent permitted by law, subject only to the limitations provided below. Contractor's duty to defend,indemnify and hold harmless City shall not apply to liability for damages arising out of such services caused by or resulting from the sole negligence of City or City's agents or employees. Contractor's duty to defend,indemnify and hold harmless City against liability for damages arising out of such services caused by the concurrent negligence of(a) City or City's agents or employees, and(b)Contractor, Contractor's agents, subcontractors, subconsultants and employees, shall apply only to the extent of the negligence of Contractor,Contractor's agents, subcontractors, subconsultants and employees. Contractor's duty to defend,indemnify and hold City harmless shall include,as to all claims,demands,losses and liability to which it applies,City's personnel-related costs,reasonable attorneys'fees,and the reasonable value of any services rendered by the office of the City Attorney,outside consultant costs,court costs,fees for collection, and all other claim-related expenses. Contractor specifically and expressly waives any immunity that may be granted it under the Washington State Industrial Insurance Act,Title 51 RCW. These indemnification obligations shall not be limited in any way by any limitation on the amount or type of damages, compensation or benefits payable to or for any third party under workers' compensation acts, disability benefit acts, or other employee benefits acts. Provided, that Contractor's waiver of immunity by the provisions of this paragraph extends only to claims against Contractor by City,and does not include,or extend to,any claims by Contractor's employees directly against Contractor. Contractor hereby certifies that this indemnification provision was mutually negotiated. 17. Waiver. No officer, employee, agent or other individual acting on behalf of either party has the power, right or authority to waive any of the conditions or provisions of this Agreement. No waiver in one instance shall be held to be waiver of any other subsequent breach or nonperformance. All remedies afforded in this Agreement or by law, shall be taken and construed as cumulative, and in addition to every other remedy provided herein or by law. Failure of either party to enforce at any time any of the provisions of this Agreement or to require at any time performance by the other party of any provision hereof shall in no way be construed to be a waiver of such provisions nor shall it affect the validity of this Agreement or any part thereof. 18. Assignment and Delegation. Neither party shall assign, transfer, or delegate any or all of the responsibilities of this Agreement or the benefits received hereunder without first obtaining the written consent of the other party. 19. Confidentiality. Contractor may,from time to time,receive information which is deemed by City to be confidential. Contractor shall not disclose such information without the prior express written consent of City or upon order of a Court of competent jurisdiction. Construction Agreement Page 5 of 6 20.Disputes. All disputes arising under or related to this Agreement that cannot be resolved through informal discussion and negotiations shall be resolved by litigation filed in the Superior Court for Spokane County, unless otherwise required by applicable federal or state law. 21. Subcontractor Responsibility. As required by RCW 39.06.020, Contractor shall verify responsibility criteria for each first tier subcontractor and its subcontractors of any tier that hires other subcontractors shall verify responsibility criteria for each of its subcontractors. Verification shall include that each subcontractor,at the time of subcontract execution,meets the responsibility criteria listed in RCW 39.04.350(1)and possesses an electrical contractor license,if required by chapter 19.28 RCW,or an elevator contractor license if required by chapter 70.87 RCW. This verification requirement must be included in every subcontract of every tier. 22.Jurisdiction and Venue. This Agreement is entered into in Spokane County,Washington. Venue shall be in Spokane County, State of Washington. 23. Entire Agreement. This Agreement constitutes the entire and complete agreement between the parties and supercedes any prior oral or written agreements. This Agreement may not be changed,modified or altered except in writing signed by the Parties. 24. Anti-kickback. No officer or employee of City, having the power or duty to perform an official act or action related to this Agreement shall have or acquire any interest in this Agreement, or have solicited, accepted or granted a present or future gift, favor, service or other thing of value from any person with an interest in this Agreement. 25.Business Registration. Prior to commencement of Work under this Agreement,Contractor shall register with the City as a business. 26.Severability. If any section,sentence,clause or phrase of this Agreement should be held to be invalid for any reason by a court of competent jurisdiction,such invalidity shall not affect the validity of any other section, sentence, clause or phrase of this Agreement. 27. Exhibits. Exhibits attached and incorporated into this Agreement are: 1. Scope of Work 2. Insurance Endorsements �7 cl( The Parties have executed this Agreement this /Q day of March, 2015. CITY IF SPOKANE VALLEY: Contractor: POWER CITY ELECTRIC, INC. ,,,,,tv / .... _ .... Tike Jac s tn,City Manager =Mr an Aga, President ATTEST: APPROVED AS TO FORM: Aglifr A. ( / f rn Christine Bainbridge,City Clerk f Office City A oey Construction Agreement Page 6 of 6 EXHIBIT 1, I. RECEIVED E. 3327 OLIVE --, .. - JA 21 2015 SPOKANE, WA 99202 — PHONE: (509)1 535-8 PARKS&RECREATION DEPS FAX (509) 535-4665500 PROPOSAL PROPOSAL SUBMITTED TO DATE City of Spokane Valley 1/16/2015 STREET JOB NAME 2426 N.Discovery Place Install four additional circuits in kitchen CITY,STATE,AND ZIP CODE JOB LOCATION Spokane Valley,WA 99206 2426 N.Discovery Place ATTN: PHONE: Brian Moat (509)720-5406 SCOPE: Provide and install all electrical appurtenances for the addition of four 120V circuits and receptacles in the kitchen of the facility,project breakdown are as follows: 1. Remove current circuit feeding the refrigerator off of circuit 33 and refeed with dedicated circuit from panel P3. 2. Pull four 20A 120V circuits up from panel P3 & mechanical panel to kitchen area using existing raceways to the junction box above the ceiling. 3. Take three circuits down from junction box and supply three duplex receptacles mounted below the counter of the bar in the kitchen,all raceways will be surface mounted. 4. This proposal is based off of being able to pull additional circuits from the kitchen area down to the first floor electrical panels thru existing raceways,if this is not possible proposed cost will have to be adjusted before work will be continued. Base Bid: $1,906.63+Taxes INCLUSIONS: • Labor,material,tools& equipment • Electrical permit EXCLUDES: • Patching walls, floor or structure • Moving equipment or furniture • Overtime hours • Sales Tax This proposal is based upon a mutually agreed upon subcontract and schedule. This proposal is good for 30 days unless specified otherwise. Terry Farmer, Small Works Department Proposal Acceptance: Authorized Customer Signature Printed Name Date "Complimentary design assistance, scope/budget development,and estimates for electrical systems are proprietary not intended to be shared without the expressed permission of Power City Electric" Spokane jValley'' BOND NO: 106252021 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 Power City Electric, Inc. (Contractor), as Principal, a contract for the construction of the project designated as*(PROJECT NAME), Project No. (Project #) 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). *CenterPlace Lounge Electrical Project The Principal, and Travelers Casualty and Surety Company of America (Surety), a corporation organized under the laws CT 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$2,072.51 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. Travelers Casualty and Surety Company PRINCIPAL(CONTRACTOR) Power City Electric, Inc. SU'1 TY of America 3/17/2015 /,��;'•i(._. IAA 3/17/2015 Principa bignatu Date urety igna' re 1 Date Dan Aga Kathy Gurley Printed Name Printed Name President Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: Wells Fargo Insurance Services USA, Inc. 601 W. Main, Suite 1400 Spokane,WA 99201 509-358-3800 Updated 1.14.2013 ♦ Spokane _ Va11e y BOND NO: 106252021 CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley,Washington,in Spokane County,has awarded to Power City Electric, Inc. (Contractor), as Principal, a contract for the construction of the project designated as*(PROJECT NAME), Project No. (Project #) 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). *CenterPlace Lounge Electrical Project The Principal, and Travelers Casualty and Surety Company of America (Surety), a corporation, organized under the laws of CT 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$ 2,072.51 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. Travelers Casualty and Surety Company PRINCIPAL(CONTRACTOR)Power City Electric, Inc. SU• TY of America 3/17/2015 O' : I / 3/17/2015 Principal "� ature Date S rety Signa 4 Date Dan Aga Kathy Gurley _— Printed Name Printed Name President Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: Wells Fargo Insurance Services USA, Inc. 601 W. Main, Suite 1400 Spokane,WA 99201 509-358-3800 Updated 1.14.2013 WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER �- POWER OF ATTORNEY TRAVELERSJ 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. 228487 Certificate No. 0 0 6 0 6 1 4 5 2 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 Chris Larson,George C.Schroeder,Wm.Dinneen,H.Keith McNally,Kathy Gurley,Erin L.Repp,and Diana R.Williams Spokane Washington of the City of ,State of ,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 or proceedings allowed by law. ! t '-' • ` 15th IN WITNES S WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this September 14 ; day of rro - Farmington Casualty Company"f .. �� <'ay 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 ASU 1'l Ii,, fIRE 'N �N 1N5(�"'. 1.tY AN Y 02 OV'VOgI.!L ir C aJ M->,VQ <�ORF�R'`! J �.�•92C`: Ug G �� fin '` SATED tti m@ V""" W P!.°.Rnre 7,\ HAR1f, '4 iNq�ypp 1982 0 �.9/! Fn, fi [�: W HARI'FORD� •� a 1896 1951 '' �11 �'•SE Wit. 'O CONN. � n 4y` ctf�aa � 1 �1'4 ��0 ��:, 6 SEAL?D ro AtN W ,•� • °' `nNCE '•!S.AN�a�i d1s.........;3s edi d4b f r�1 49 .• �xmxmn .a� F State of Connecticut By: AO( City of Hartford ss. Robert L.Raney, enior Vice President 15th September 2014 On this the day of , ,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. G,TET A A, t' /1 In Witness Whereof,I hereunto set my hand and official seal. t `TAR Li e U_A `� My Commission expires the 30th day of June,2016. POsmG * 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 and Guaranty Company do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,`'which is in full force and'effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand andaffixed the seals of said Companies this 17th day of Match ,20 15. ( ft Kevin E.Hughes,Assistant Secretary r w,. U ! 1� '` y ky �R r,Ec v�........vgfj o. ;? e yah f *«, MaM ....�. r i a Nt ANt 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 ���.milp POWECIT-03 SSTROH DATE(MM/DD/YYYY) '`� R� CERTIFICATE OF LIABILITY INSURANCE 3/9/2015 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 1 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Spokane Valley Office PHONE 509 FAX PayneWest Insurance,Inc. (A/C,No,Ext):( )455-6767 (A/C,No): 7903 E.Broadway ADDRESS: Spokane,WA 99212 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Phoenix Insurance 25623 INSURED INSURER B:Travelers Indemnity Company of Conn Power City Electric,Inc. INSURER C:Travelers Property Casualty Co of America 25674 P.O.Box 2507 INSURER D:Charter Oak Fire Insurance Co Spokane,WA 99220-2507 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 LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X X DTCO1122P508PHX14 11/01/2014 11/01/2015 DAMAGE TO RENTED 300,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 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 DT8101122P5081ND14 11/01/2014 11/01/2015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ X HIRED AUTOS X NON AUTOS-OWNED (Per accident) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 C EXCESS LIAB CLAIMS-MADE DTSMCUP1122P508TIL14 11/01/2014 11/01/2015 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITYY/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 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 QT660320M9759C0F14 11/01/2014 11/01/2015 Per Location 500,000 D Installation Floater QT660320M9759C0F14 11/01/2014 11/01/2015 Per Disaster 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Re:CenterPlace Lounge Electrical Project City of Spokane Valley is included as additional insured for ongoing and completed operations as per attached forms.Coverage is primary/non-contributory and includes waiver of subrogation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Spokane Valley THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City City o E Soa ne Ave ACCORDANCE WITH THE POLICY PROVISIONS. 117Suite 106 Spokane,WA 99206 AUTHORIZED REPRESENTATIVE ©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- sured does not apply to "bodily injury", "prop- the additional insured by this endorsement still is excess over any valid and collectible "other in- erty damage" or "personal injury" arising out surance", whether primary, excess, contingent or of the rendering of, or failure to render, any 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 receive written notice of the claim or"suit" as person or organization as an additional in- sured on this Coverage Part, provided that soon as practicable. 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 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Aircraft Chartered With Pilot H. Blanket Additional Insured — Lessors Of Leased • B. Damage To Premises Rented To You Equipment C. Increased Supplementary Payments I. Blanket Additional Insured — States Or Political D. Incidental Medical Malpractice Subdivisions--Permits J. Knowledge And Notice Of Occurrence Or Offense E. Who Is An Insured — Newly Acquired Or Formed Organizations K. Unintentional Omission F. Who Is An Insured — Broadened Named Insured L. Blanket Waiver Of Subrogation —Unnamed Subsidiaries M. Amended Bodily Injury Definition G. Blanket Additional Insured — Owners, Managers N. Contractual Liability— Railroads Or Lessors Of Premises • PROVISIONS INJURY AND PROPERTY DAMAGE LI- A. AIRCRAFT CHARTERED WITH PILOT ABILITY: The following added to Exclusion Exclusions c. and g. through n. do not apply isg., Aircraft, Auto Or Watercraft, in Paragraph 1 of SECTION to "premises damage". Exclusion f.(1)(a) I -- COVERAGES — COVERAGE A BODILY IN- does not apply to "premises damage" caused JURY AND PROPERTY DAMAGE LIABILITY: by: This exclusion does not apply to an aircraft that a. Fire; is: b. Explosion; (a) Chartered with a pilot to any insured; c. Lightning; (b) Not owned by any insured;and d. Smoke resulting from such fire, explosion, (c) Not being used to carry any person or prop- or lightning; or erty for a charge. e. Water; B. DAMAGE TO PREMISES RENTED TO YOU unless Exclusion f. of Section I —Coverage A 1. The first paragraph of the exceptions in Ex- -- Bodily Injury And Property Damage Liability elusion j., Damage To Property, in Para- is replaced by another endorsement to this graph 2. of SECTION I -- COVERAGES — Coverage Part that has Exclusion —All Pollu- COVERAGE A BODILY INJURY AND tion Injury Or Damage or Total Pollution Ex- PROPERTY DAMAGE LIABILITY is deleted. clusion in its title. 2. The following replaces the last paragraph of A separate limit of Insurance applies to Paragraph 2., Exclusions, of SECTION 1 — "premises damage" as described in Para- COVERAGES — COVERAGE A. BODILY graph 6. of SECTION III — LIMITS OF IN- SURANCE. CO D3 16 11 11 ©2011 The Travelers Indemnity Company.All rights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph 6. of SEC- C. INCREASED SUPPLEMENTARY PAYMENTS TION III—LIMITS OF INSURANCE; 1. The following replaces Paragraph 1.b. of Subject to 5. above, the Damage To Prem- SUPPLEMENTARY PAYMENTS -- COVER- ises Rented To You Limit is the most we will AGES A AND B of SECTION I — COVER- pay under Coverage A for damages because AGE: of "premises damage" to any one premises. b. Up to $2,500 for the cost of bail bonds The Damage To Premises Rented To You required because of accidents or traffic Limit will apply to all "property damage" law violations arising out of the use of any proximately caused by the same "occur- vehicle to which the Bodily Injury Liability rence",. whether such damage results from: Coverage applies.We do not have to fur- fire;explosion; lightning; smoke resulting from nish these bonds, such fire, explosion, or lightning; or water; or 2. The following replaces Paragraph 1.d. of any combination of any of these causes. SUPPLEMENTARY PAYMENTS — COVER- The Damage To Premises Rented To You AGES A AND B of SECTION I — COVER- Limit will be: AGES: a. The amount shown for the Damage To d. All reasonable expenses incurred by the Premises Rented To You Limit on the insured at our request to assist us in the Declarations of this Coverage Part;or investigation or defense of the claim or b. $300,000 if no amount is shown for the "suit", including actual loss of earnings up Damage To Premises Rented To You to $500 a day because of time off from Limit on the Declarations of this Coverage work. Part. D. INCIDENTAL MEDICAL MALPRACTICE 4. The following replaces Paragraph a. of the 1. The following is added to the definition of"oc- definition of "insured contract" in the DEMI- 'in the DEFINITIONS Section: TIONS Section: "Occurrence" also means an act or omission a. A contract for a lease of premises. How- committed in providing or failing to provide ever, that portion of the contract for a "incidental medical services", first aid or lease of premises that indemnifies any "Good Samaritan services" to a person. person or organization for "premises damage"is not an "insured contract"; 2. The following is added to Paragraph 2.a.(1) of ; SECTION ii--WHO IS AN INSURED: 5. The following is added to the DEFINITIONS Paragraph (1)(d) above does not apply to Section: "bodily injury" arising out of providing or fail- "Premises damage" means "property dam- Ing to provide: age"to: a. Any premises while rented to you or tem- (1) "Incidental medical services" by any of your occupied by you with permission your "employees" who is a nurse practi- ofthe yoor tioner, registered nurse, licensed practical nurse, nurse assistant, emergency medi- b. The contents of any premises while such cal technician or paramedic; or premises is rented to you, if you rent such (ii) First aid or"Good Samaritan services" by premises for a period of seven or fewer any of your "employees" or "volunteer consecutive days. workers", other than an employed or vol- 6. The following replaces Paragraph 4.b.(1)(b) unteer doctor. Any such "employees" or of SECTION IV-- COMMERCIAL GENERAL "volunteer workers" providing or failing to LIABILITY CONDITIONS: provide first aid or "Good Samaritan ser- (b) That is insurance for"premises damage"; vices" during their work hours for you will or be deemed to be acting within the scope 7. Paragraph 4.b.(1)(c) of SECTION IV — of their employment by you or performing COMMERCIAL GENERAL LIABILITY CON. duties related to the conduct of your busi- DITIONS Is deleted. ness. Page 2 of 6 02011 The Travelers Indemnily Company.All rights reserved. CG D3 16 11 11 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 5. of 4. Any organization you newly acquire or form, SECTION III—LIMITS OF INSURANCE: other than a partnership, joint venture or lira- For the purposes of determining the applica- ited liability company, of which you are the ble Each Occurrence Limit, all related acts or sole owner or in which you maintain the ma- omissions committed in providing or failing to jority ownership interest, will qualify as a provide "incidental medical services", first aid Named Insured if there is no other insurance or"Good Samaritan services" to any one per- which provides similar coverage to that or- son will be deemed to be one "occurrence". ganization. However: 4. The following exclusion is added to Para- a. Coverage under this provision is afforded graph 2., Exclusions, of SECTION I —COV- only: ERAGES— COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: (1) Until the 180th day after you acquire or form the organization or the end of the Sale Of Pharmaceuticals policy period, whichever is earlier, if you "Bodily injury" or "property damage" arising do not report such organization in writing out of the willful violation of a penal statute or to us within 180 days after you acquire or ordinance relating to the sale of pharmaceuti- form It; or Gals committed by, or with the knowledge or (2) Until the end of the policy period, when consent of,the Insured. that date is later than 180 days after you 5. The following is'added to the DEFINITIONS acquire or form such organization, If you Section: report such organization in writing to us "incidental medical services"means: within 180 days after you acquire or form e. Medical, surgical, dental, laboratory, x-ray it, and we agree in writing that it will con- or nursing service or treatment, advice or time to be a Named Insured until the end instruction, or the related furnishing of of the policy period; food or beverages;or b. Coverage A does not apply to "bodily injury" b. The furnishing or dispensing of drugs or or "property damage" that occurred before medical, dental, or surgical supplies or you acquired or formed the organization;and appliances. c. Coverage B does not apply to "personal in- "Good Samaritan services" means any emer- jury" or "advertising injury" arising out of an gency medical services for which no compen- offense committed before you acquired or cation is demanded or received. formed the organization. 6. The following is added to Paragraph 4.b., Ex- F. WHO IS AN INSURED -- BROADENED NAMED cess Insurance, of SECTION IV — COM- INSURED — UNNAMED SUBSIDIARIES MERCIAL GENERAL LIABILITY CONDI- TIONS: The following is added to SECTION II — WHO IS AN INSURED: The insurance is excess over any valid and collectible other insurance available to the In- Any of your subsidiaries, other than a partnership, sured,whether primary, excess, contingent or joint venture or limited liability company, that is on any other basis, that is available to any of not shown as a Named Insured in the Declare- your "employees" or "volunteer workers" for tions is a Named Insured if you maintain an own- "bodily injury" that arises out of providing or ership Interest of more than 50% in such subsidi- failing to provide "incidental medical ser- ary on the first day of the policy period. vices", first aid or "Good Samaritan services" No such subsidiary is an insured for"bodily injury" to any person to the extent not subject to or "property damage" that occurred, or "personal Paragraph 2.a.(1) of Section II — Who Is An injury" or "advertising injury" caused by an of- Insured. fense committed after the date, if any, during the E. WHO IS AN INSURED — NEWLY ACQUIRED policy period, that you no longer maintain an OR FORMED ORGANIZATIONS ownership interest of more than 50%in such sub- The following replaces Paragraph 4. of SECTION sidiary. Il—WHO IS AN INSURED: CG D3 1611 11 ©2011 The Travelers Indemnity Company.All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY G. BLANKET ADDITIONAL INSURED —OWNERS, H. BLANKET ADDITIONAL INSURED —LESSORS MANAGERS OR LESSORS OF PREMISES OF LEASED EQUIPMENT The following Is added to SECTION II —WHO IS The following is added to SECTION II—WHO IS AN INSURED: AN INSURED: Any person or organization that is a premises Any person or organization that is an equipment owner, manager or lessor and that you have lessor and that you have agreed in a written con- agreed in a written contract or agreement to In- tract or agreement to include as an insured on elude as an additional insured on this Coverage this Coverage Part is an Insured, but only with re- Part is an insured, but only with respect to liability spect to liability for "bodily Injury", "property dam- for "bodily injury", "property damage", "personal age", "personal injury"or"advertising injury"that: injury"or"advertising injury"that; a. Is "bodily injury" or "property damage" that a. Is "bodily injury" or "property damage" that occurs, or is "personal Injury" or "advertising occurs, or 1s "personal Injury" or "advertising injury" caused by an offense that is commit- injury" caused by an offense that is commit- injury" ted, subsequent to the execution of that can- ted, subsequent to the execution of that con- tracttract or agreement; and or agreement; and b. Arises out of the ownership, maintenance or b. Is caused, In whole or in part, by your acts or omissions in the maintenance, operation or use of that part of any premises leased to you. use of equipment leased to you by such equipment lessor. The Insurance provided to such premises owner, The insurance provided to such equipment lessor manager or lessoris subject to the following pro- is subject to the following provisions: visions: The limits of insurance a. The limits of insurance provided to such a. provided to such equipment lessor will be the minimum limits premises owner, manager or lessor will be which you agreed to provide in the written the minimum limits which you agreed to pro- contract or agreement, or the limits shown on vide in the written contract or agreement, or the.Declarations, whichever are less. the limits shown on the Declarations, which- ever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or b. The insurance provided to such premises "property damage" that occurs, or "personal owner, manager or lessor does not apply to: injury" or"advertising injury"caused by an of- (1) Any "bodily injury" or "properly damage" fense that is committed, after the equipment that occurs, or"personal injury"or"adver- lease expires. Using injury" caused by an offense that is c. The insurance provided to such equipment committed, after you cease to be a tenantI or lessor is excess over any valid and collectible in that premises; other insurance available to such equipment (2) Structural alterations, new construction or lessor, whether primary, excess, contingent demolition operations performed by or on or on any other basis, unless you have behalf of such premises owner, lessor or agreed in the written contract or agreement manager. that this insurance must be primary to, or c. The insurance provided to such premises non-contributory with, such other insurance, owner, manager or lessor is excess over any in which case this insurance will be primary valid and collectible other Insurance available to, and non-contributory with, such other in- to such premises owner, manager or lessor, surance. whether primary, excess, contingent or on I. BLANKET ADDITIONAL INSURED — STATES any other basis, unless you have agreed in OR POLITICAL SUBDIVISIONS—PERMITS the written contract or agreement that this in- The following is added to SECTION iI --WHO IS surance must be primary to, or non- AN INSURED: contributory with, such other insurance, in which case this insurance will be primary to, Any state or political subdivision that has issued a and non-contributory with, such other insur- permit in connection with operations performed by ance. you or on your behalf and that you are required Page 4 of 6 02011 The Travelers Indemnity Company,All rights reserved. CG 03 16 11 11 COMMERCIAL GENERAL LIABILITY by any ordinance, law or building code to include (iI) A manager of any limited liability as an additional insured on this Coverage Part Is company; or an insured, but only with respect to liability for (III)An executive officer or director of "bodily Injury", "property damage", "personal in- any other organization; jury"or "advertising injury" arising out of such op- that is your partner, joint venture orations. member or manager; or The insurance provided to such state or political (b) Any "employee" authorized by such subdivision does not apply to: partnership, Joint venture, limited ii- a. Any "bodily injury," "property damage," "per- ability company or other organization sonal injury" or "advertising injury" arising out to give notice of an "occurrence" or of operations performed for that state or po- offense. litical subdivision; or (3) Notice to us of such "occurrence"or of an b. Any "bodily injury" or "property damage" in- offense will be deemed to be given as eluded in the "products-completed operations soon as practicable if it is given in good hazard". faith as soon as practicable to your work- J, KNOWLEDGE AND NOTICE OF OCCUR- ers' compensation insurer. This applies RENCE OR OFFENSE only if you subsequently give notice to us The following is added to Paragraph 2,, Duties In of the "occurrence"or offense as soon as The Event of Occurrence, Offense, Claim or practicable after any of the persons de Suit, of SECTION IV — COMMERCIAL GEN- scribed in Paragraphs e. (1) or (2) above ERAL LIABILITY CONDITIONS: discovers that the "occurrence"or offense apply to Paragraph may result in sums to which the insurance e. The following provisionspp Y 9 p provided under this Coverage Part may a. above, but only for the purposes of the in- apply. surance provided under this Coverage Part to you or any insured listed in Paragraph 1.or 2. However, if this Coverage Part includes an en- of Section II - Who Is An Insured: dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution (1) Notice to us of such "occurrence" or of- costs arising out of adischarge, release or es fense must be given as soon as practice- cape of "pollutants"which contains a requirement ble only after the "occurrence" or offense that the discharge, release or escape of "pollut- is known by you (if you are an Individual), ants" must be reported to us within a specific — anyofpartners or members who is your number of days after Its abrupt commencement, an individual (If you are a partnership or this Paragraph e. does not affect that require- joint venture), any of your managers who ment. is an individual (if you are a limited liability K. UNINTENTIONAL OMISSION company), any of your "executive offi- cers"or directors (if you are an organize- The following is added to Paragraph 6., Repre- tion other than a partnership,joint venture septations, of SECTION IV — COMMERCIAL or limited liability company) or any "em- GENERAL LIABILITY CONDITIONS: ployee" authorized by you to give notice The unintentional omission of, or unintentional of an"occurrence"or offense. error in, any information provided by you which (2) if you are a partnership, joint venture or we relied upon in issuing this policy will not preju- limited liability company, and none of your dice your rights under this insurance. However, partners, joint venture members or man- this provision does not affect our right to collect agers are individuals, notice to us of such additional premium or to exercise our rights of "occurrence" or offense must be given as cancellation or nonrenewal in accordance with soon as practicable only after the "occur- applicable Insurance laws or regulations. rence"or offense Is known by: L. BLANKET WAIVER OF SUBROGATION (a) Any individual who is: The following is added to Paragraph 8., Transfer (i) A partner or member of any part- Of Rights Of Recovery Against Others To Us, nership or joint venture; of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: CG D3 1611 11 ©2011 The Travelers Indemnity Company.All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- 3. "Bodily injury" means bodily injury, mental meat to waive that insured's right of recovery anguish, mental Injury,shock, fright, disability, against any person or organization, we waive our humiliation, sickness or disease sustained by right of recovery against such person or organiza- a person, including death resulting from any tion, but only for payments we make because of: of these at any time. a. "Bodily injury" or "property damage" that oc- N. CONTRACTUAL LIABILITY—RAILROADS curs;or 1. The following replaces Paragraph o. of the b. "Personal injury" or "advertising injury" definition of "insured contract" in the DEFINI- caused by an offense that is committed; TIONS Section: subsequent to the execution of that contract or c. Any easement or license agreement; agreement. 2. Paragraph f.(1) of the definition of "insured M. AMENDED BODILY INJURY DEFINITION contract" in the DEFINITIONS Section Is de- leted. The following replaces the definition of "bodily Injury" in the DEFINITIONS Section: •• Page 6 of 6 p 2011 The Travelers Indemnity Company.All Tights reserved. CG D3 16 11 11 COMMERCIAL GENERAL LIABILITY 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): EACH "PROJECT" FOR WHICH YOU HAVE AGREED, IN GENERAL AGGREGATE A WRITTEN CONTRACT WHICH IS IN EFFECT DURING LIMIT SHOWN ON THE THIS POLICY PERIOD, TO PROVIDE A SEPARATE DECLARATIONS GENERAL AGGREGATE LIMIT, PROVIDED THAT THE CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS. • 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 Limif 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 a. Damages under Coverage B;and per- forming operations pursuant to a contract or 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 POWER CITY ELECTRIC INC Page 1 of 4 Home Inicio en.Espanol Contact Search L&I A-Z Index Safety Claims & Insurance Workplace Rights Washington State Department of Labor & industries POWER CITY ELECTRIC INC Owner or tradesperson E 3327 OLIVE AVE Aga, Dan SPOKANE, WA 99202 9 509-535-8500 Principals SPOKANE County Aga, Dan, PRESIDENT Thompson, Colin, TREASURER ELEVEN FOURTEEN INC, AGENT MORELAN, BRUCE D JR, CHIEF EXECUTIVE OFFICER (End: 01/10/2013) LONGAN, JIM, CHIEF OPERATING OFFICER (End: 01/10/2013) WOLFF, LES, CHIEF OPERATING OFFICER (End: 01/10/2013) Doing business as POWER CITY ELECTRIC INC WA UBI No. Business type 601 766 181 Corporation Parent company SPOKANE ELECTRICAL SERVICES CO License Verify the contractor's active registration/license/certification (depending on trade)and any past violations. Electrical Contractor Active. Meets current requirements. License specialties GENERAL License no. POWERCE994BA Effective—expiration 01/01/2001—01/01/2017 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601766181&LIC=POWERCE994BA&SAW=False 3/5/2015 POWER CITY ELECTRIC INC Page 2 of 4 Designated administrator Bond Active. AGA, DANIEL K Meets current requirements. License type License no. Master Electrician AGA**DK9630Z TRAVELERS CAS &SURETY CO $4,000.00 Bond account no. 103959087 Received by L&I Effective date 11/22/2002 11/01/2002 Expiration date Until Canceled Savings No savings accounts during the previous 6 year period. License Violations Infraction no. EHUDR00235 Satisfied Issue date RCW/WAC 02/07/2011 19.28.101 RCW Violation city Violation amount Spokane $250.00 Type of violation ELECTRICAL CITATION Description Failing to request an inspection within 3 business days after completion of the installation or 1 business day after energizing, whichever occurs first as referenced in WAC 296-46B-900(10)(a), effective after 12/30/2008 see WAC 296-46B-901(10)(a). Infraction no. E H U DR00234 Satisfied Issue date RCW/WAC 02/07/2011 19.28.101 RCW Violation city Violation amount Spokane $1,000.00 Type of violation ELECTRICAL CITATION Description Failing to obtain or post an electrical/telecommunications work permit prior to beginning the electrical/telecommunication installation or alteration as referenced in WAC 296-46B-900 (3)(6),effective'after 12/30/2008 see WAC 296- 46B-901(3)(6). ........... .. ... Workers' comp https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601766181&LIC=POWERCE994BA&SAW=False 3/5/2015 POWER CITY ELECTRIC INC Page 3 of 4 Do you know if the business has employees? If so, verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is current. 591,819-08 Doing business as POWER CITY ELECTRIC INC Estimated workers reported Quarter 4 of Year 2014"Greater than 100 Workers" L&I account representative T2/SUSAN BETTS (360)902-4828-Email: BETT235@Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Citation issue date 01/30/2015 No violations Inspection no. 317617694 Location 4th and Court Pasco,WA 99301 Citation issue date 06/17/2014 No violations Inspection no. 316973908 Location Wanapum Dam Rd. Royal City,WA 99351 Citation issue date 07/26/2012 Violations Inspection no. 316257914 Location Pole#1206 Kahlotus,WA 99335 Citation issue date 11/24/2010 No violations Inspection no. 314599747 Location Vantage Hwy. and Fox Rd. Vantage,WA 99220 https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601766181&LIC=POWERCE994BA&SAW=False 3/5/2015 POWER CITY ELECTRIC INC Page 4 of 4 Citation issue date 09/29/2010 No violations Inspection no. 314536483 Location Olympia Ave and Forest Way Pullman,WA 99163 Citation issue date 07/13/2010 Violations Inspection no. 314478082 Location 2140 S. Lawson Street Airway Heights,WA 99001 ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601766181&LIC=POWERCE994BA&SAW=False 3/5/2015