15-083.00 Inland Aspalt Company: Mullan Preservation Sprague to Broadway Contract
THIS AGREEMENT, made and entered into this day o , 2015,
((IL
between the City of Spokane Valley under and by virtue of Title 35 RC , as a ended and
pCompany
Inland As halt /
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:
Mullan Road Street Preservation Project
Sprague Ave to Broadway Ave
SVPW Contract#15-083
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.
CITY OF SPOKANE VALLEY WSDOT STANDARD SPECIFICATIONS REV 4/6/15
MULLAN ROAD STREET PRESERVATION PROJECT 18 BID NO: 15-083
V. The project was awarded for the bid amount of$470,985
IN WITNESS WHEREOF, the Contractor has executed this instrument, on the day and
year first below written and the City of Spokane Valley has caused this instrument to be
executed by and in the name of the said City of Spokane Valley the day and year first
above written.
Executed by Contractor July 16 , 2015.
Date
Al Hughbanks
Printed Name
Chief timator
Title //
ir ,
Signaturei . 11
City of Spokane� Valley
w/, 4€ llacicom
Printed Name
Ctiria4MQVA
Titl
//4%,----------
Sn Revised 6.19.13
1
CITY OF SPOKANE VALLEY WSDOT STANDARD SPECIFICATIONS REV 4/6/15
MULLAN ROAD STREET PRESERVATION PROJECT 19 BID NO: 15-083
S1ÔIn
a.
.0 `MLlley
BOND NO: 9195120
CONTRACTOR'S PERFORMANCE BOND
to City of Spokane Valley,Washington
The City of Spokane Valley, Washington, in Spokane County, has awarded to
INLAND ASPHALT COMPANY (Contractor), as Principal, a contract for the construction of the project
designated as Mullan Street Preservation Project,Sprague Ave to Broadway Ave Project No. 15-083 in Spokane
Valley, Washington, and said Principal is required under the terms of the Contract to furnish a performance bond in
accordance with chapter 39.08 Revised Code of Washington(RCW).
The Principal, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND (Surety), a
corporation, organized under the laws of MARYLAND and licensed to do business in the State of
Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published
in the Federal Register by the Audit Staff Bureau of Accounts, U.S.Treasury Dept., are jointly and severally held and
firmly bound to the City of Spokane Valley, as Obligee, in the sum of$ 470,985.00 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 'ehalf of the surety.
PRINCIit Tryio SURETY
INLAND • / • FIDELITY AN; DEPOSIT COMPANY OF MARYLAND
Ar 7/16/15 7/16/2015
I.
Principal Signatu 1 Date Surety Signatu,- , • -
Al Hughbanks TINA DAVIS
Printed Name Printed Name
5111 E.BROADWAY AVE.
SPOKANE,WA 99212 Chief Estimator ATTORNEY-IN-FACT
Title Title
Name, address, and telephone of local office/agent of Surety Company is:
MARSH USA,INC.
TINA DAVIS
15 W.SOUTH TEMPLE,STE.700,SALT LAKE CITY,UT 84101 801-533-3624
Rtt.tsh'i 1 I4 *3
CITY OF SPOKANE VALLEY WSDOT STANDARD SPECIFICATIONS REV 4/6/15
MULLAN ROAD STREET PRESERVATION PROJECT 20 BID NO: 15-083
(It1'tR' iIr � �"wi
Spokane
4.0,•*Valley
BOND NO: 9195120
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 Mullan Street Preservation Project,Sprague Ave to Broadway Ave Project No. 15-083 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$470,985.00 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 be If of the surety.
PRINCIPAL('O ,T��C)i' SURETY
INLAND ASPH LT P FIDELITY D.eEPOSIT COMPANY OF MARYLAND
4 A ",� /�I' 16 15 7/16/2015
Principal Signature i� Date Sure Si
Al Hughbanks TINA DAVIS
Printed Name Printed Name
chef Estimator ATTORNEY-IN-FACT
Title Title
Name, address,and telephone of local office/agent of Surety Company is:
MARSH USA,INC.
TINA DAVIS
15 W.SOUTH TEMPLE,STE.700,SALT LAKE CITY,UT 84101 801-533-3624
R‘ntsej . '4 '3
CITY OF SPOKANE VALLEY WSDOT STANDARD SPECIFICATIONS REV 4/6/15
MULLAN ROAD STREET PRESERVATION PROJECT 21 BID NO: 15-083
SURETY ACKNOWLEDGMENT
STATE OF UTAH
COUNTY OF SALT LAKE } SS
On this 16TH day of JULY, 2015, before me personally came TINA DAVIS 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 Resolutions thereof.
Notary Public
iH.
LISA HALL
Notary Public
4 hO State of Utah
"�� Comm. No. 681511
My Comm.Expires Mar 13,2019
11004w -111/ �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, Lindsey PLATTNER and Linda NIPPER, 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 27th day of April,A.D.2015.
ATTEST:
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
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BY: , 01
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Secretary Vice President
Michael McKibben Thomas O.McClellan
State of Maryland
County of Baltimore
On this 27th day of April,A.D.2015,before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,THOMAS O.
MCCLELLAN,Vice President,and MICHAEL MCKIBBEN,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.
97/AA
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-,,,,:i ...,,! ' '
Maria D.Adamski,Notary Public
My Commission Expires:July 8,2019
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 Attorney...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,
thisl6THday of JULY ,2015 .
":91i, 0.4.4
los SEAL
to. ji
Gerald F.Haley,Vice President
Sp7o"lane
..,Walley.
BOND NO: 9195121
CONTRACTOR'S RETAINAGE 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 Mullan Street Preservation
Project, Sprague Ave to Broadway Ave Project No. 15-083 (the "Contract") in Spokane Valley,
Washington.
The Principal, existing under and by virtue of the laws of the State of Washington and authorized to
do business in the State of Washington, and
FIDELITY AND DEPOSIT COMPANY OF MARYLAND organized and existing under the
laws of the State of MARYLAND and authorized to transact business in the State
of Washington as Surety, are jointly and severally held and bound unto the City of Spokane Valley,
hereinafter called Obligee, and are similarly held and bound unto the beneficiaries of the trust fund
created by chapter 60.28 RCW, in the penal sum of 5% of the Contract, which is
TWENTY THREE THOUSAND FIVE HUNDRED FORTY NINE AND 25/100 dollars. ($ 23,549.25 ), plus
5% of any increases in the Contract amount that have occurred or may occur, due to change
orders, increases in the quantities, or the addition of any new item of work.
WHEREAS, on the day of , 20_, the said Principal
and Obligee herein executed and entered into the Contract.
WHEREAS, said Contract and chapter 60.28 RCW require the Obligee to withhold from the
Principal the sum of 5% from monies earned by the Principal on estimates during the progress of
the construction, hereinafter referred to as earned retained funds.
WHEREAS, the Principal has requested that the Obligee accept a bond in lieu of earned retained
funds as allowed under chapter 60.28 RCW
NOW THEREFORE, the condition of the obligation is such that the Principal and Surety are held
and bound unto the beneficiaries of the trust fund created by chapter 60.28 RCW in the aforesaid
sum. This bond, including any proceeds therefrom, is subject to all claims and liens and in the
same manner and priority as set forth for retained percentages in chapter 60.28 RCW. The
condition of this obligation is also such that if the Principal shall satisfy all payment obligations to
persons who may lawfully claim under the trust fund purposes of chapter 60.28 RCW to the
Obligee, and indemnify and hold the Obligee harmless from any and all loss, costs, and damages
that the Obligee may sustain by release of the earned retained funds to the Principal, then upon
notification of such satisfaction and release of the Surety by the Obligee, this obligation shall be null
and void.
PROVIDED HOWEVER, that:
1. The Surety shall be liable under this obligation as Principal. The Surety will not be
discharged or released from liability for any act, omission or defenses of any kind or nature
that would not also discharge Principal.
2. This obligation shall be binding upon and inure to the benefit of the Principal, the Surety, the
Obligee, the beneficiaries of the trust fund created by chapter 60.28 RCW and their
CITY OF SPOKANE VALLEY WSDOT STANDARD SPECIFICATIONS REV 416115
MULLAN ROAD STREET PRESERVATION PROJECT 22 BID NO: 15-083
respective heirs, executors, administrators, successors and assigns.
3. Any suit under this bond must be instituted within the time provided by applicable law.
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.
PRlNCl• , 0 yillf 10 SURETY
INLAN• -/ 7/16/15 L AO .; / /
A . 41110 (
FIDELITY .ND DEPOSIT COMPANY OF MARYLAND
N,_
.111•111........ 6/2015
Princirl wignirlp Date Surety Signa ...__ " — late
Al Hughbanks T
40.1160.1111!....
• r '
Printed Name Printed Name ,
Chief Estimator ATTORNEY-IN-FACT
Title Title
Name, address, and telephone of local office/agent of Surety Company is:
MARSH USA,INC.
TINA DAVIS
15 W.SOUTH TEMPLE,STE.700,SALT LAKE CITY,UT 84101 801-533-3624
14
CITY OF SPOKANE VALLEY WSDOT STANDARD SPECIFICATIONS REV 4/6/15
MULLAN ROAD STREET PRESERVATION PROJECT 23 BID NO: 15-083
SURETY ACKNOWLEDGMENT
STATE OF UTAH }
COUNTY OF SALT LAKE } SS
On this 16TH day of JULY, 2015, before me personally came TINA DAVIS 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 Resolutions thereof.
Ai
Notary Pu. ,'c
LISA HA
tip
State of Utah
Comm. No.681511
My Comm.Expires Mar 13,2019
•
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, Lindsey PLATTNER and Linda NIPPER, 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 27th day of April,A.D.2015.
ATTEST:
ZURICH AMERICAN INSURANCE COMPANY
COLONIAL AMERICAN CASUALTY AND SURETY COMPANY
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
µp....�NyA
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BY: *CfS12""*..... 16"
Secretary Vice President
Michael McKibben Thomas O.McClellan
State of Maryland
County of Baltimore
On this 27th day of April,A.D.2015,before the subscriber,a Notary Public of the State of Maryland,duly commissioned and qualified,THOMAS O.
MCCLELLAN,Vice President,and MICHAEL MCKIBBEN,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.
°'‘1;"1!"11,1
,1<;.,..,4f..pie
9„„_
( ��. T..:.,;'.:t:
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,iii.I no,:s
Maria D.Adamski,Notary Public
My Commission Expires:July 8,2019
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 Attorney...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].6TH day of JULY ,20 15.
'1 DEP 0,r4. a''�►� gTf _— -�!/
•
MOM Atb.
L �
Gerald F.Haley,Vice President
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 ~'
Inland Asphalt CompanyNAME AND e
CPM Development Corporation dba ADDRESS �� Liberty
PO Box 3366
—J OF INSURED
Spokane, WA 99220-3366 I
rll*k
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 not altered by any recuirement,term or condition of any contract or other document with respect to which this certificate may be issued.
EXP DATE
0 CONTINUOUS
TYPE OF POLICY 0 EXTENDED POLICY NUMBER LIMIT OF LIABILITY
®POLICY TERM
WORKERS 9/1/2015 WA7-C8D-004095-024 COVERAGEC ATHAFFE FOLLOWINGEMPLOYERSEMPLOYERS 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
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 9/1/2015 TB2-C81-004095-114 $2,000,000
0 OCCURRENCE -Per project aggregate included Products/Completed Operations Aggregate
$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
AUTOMOBILE 9/1/2015 AS2-C81-004095-124 $2,000,000 Each mit
B.I.And P.D.Combined
LIABILITY
Comp Ded$10,000 Each Person
OWNED
IBJ NON-OWNED Coll Dees$10,000 Each Accident or Occurrence
li HIRED Each Accident or Occurrence
OTHER
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: Mullan Street Preservation Project,Contract No. 15-083
City of Spokane Valley,its officers,employees and elected officials are named as additional insured with respect to the above referenced project.
Coverage is primary and non-contributory. Waiver of subrogation applies.
•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 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
11707 E. Sprague Ave., Suite 106 Stanley S.Esposito Jr.
W 7, Spokane Valley,WA 99206 Pittsburgh/0387 AUTHORIZED REPRESENTATIVE
I12 Federal Street,Ste.310
Pittsburgh PA 15212-5706 412-231-1331 7/20/15
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