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15-024.03 Senske Lawn & Tree Care: Roadway Landscaping Svcs i f [�-029.o Spokane .000Valley. CHANGE ORDER NO: 3 DEPARTMENT OF PUBLIC WORKS CONSTRUCTION CONTRACT NO: 15-024 PROJECT: Roadway Landscaping Services CONTRACT DATE: 3/16/2015 PRIME CONTRACTOR: Senske Lawn and Tree Care,Inc. DESCRIPTION OF CHANGES Replacing 2 street trees severely damaged in a vehicle accidents earlier this year. Section 3.3.3 of the contract specifications state,,"The City will keep track of vehicular accidents that occur and damage City-owned landscaping; The Contractor will be asked to supply the City a cost estimate to cleanup and repair the landscaping at these locations from time to time. The City will execute any cleanup and repair work separately or in addition to this Contract." Description Total Dead tree removal and stump grind $ 400.00 Irrigation repair to damaged main line $ 350.00 Replace topsoil and sod $ 325.00 Replace tree with Bradford Pear, 2.5 caliper $ 900.00 Total Amount of this Change Order: $ 0,975.00 SUBSTANITIAL COMPLETION Original Contract Working Days: n/a Revision By This Change Order: n/a Revisions by Prior Change Orders: n/a Total Revised Contract Working Days: n/a • CONTRACT AMOUNT THESE CHANGES RESULT IN THE FOLLOWING ADJUSTMENTS OF CONTRACT PRICE: ORIGINAL TOTAL CONTRACT AMOUNT $ 53,250.00 TOTAL PRIOR CONTRACT CHANGE ORDER AMOUNT(through COt 2) $ 7,586.00 TOTAL CONTRACT AMOUNT PRIOR TO THIS CHANGE ORDER $ 60,836.00 NET THIS CHANGE ORDER $ 1,975.00 TOTAL CONTRACT AMOUNT INCLUDING THIS CHANGE ORDER $ 6;,811.00 • // f CONTRACTOR ACCEPTANCE: i _ ��,i7►J DATE: /s— • The contractor hereby accepts this a•, tment and-r the" s of the origins con ract for all work performed. RECOMMENDED BY: rA.AwtDATE: iD//a/ASeranager APPROVED BY: re DATE: /D /3 �� Public Works Director ✓ APPROVED BY: 4.41101P/ DATE: (0‘)//)---- / City Manager ATTACHMENTS: 1 Distribution: ORIGINAL TO: City of Spokane Valley Clerk's Office COPIES TO: Contractor,PW Project File,Finance Department,City Manager COSI Form:...i20, _ nsise . A, we , , , ,. , , - , services , I 9ii .i S . 1 .t :.two 11 t 1.. 4 is . S A. 1 41 f. ( S o I - --.�.Iw ek'•AFNM....+Oa.x.,.fT.s.t `S.A-<. 6.; f - ,,......,x .... taltiVtigtfaq Pelt('&MFo1 Cif6Hti&- K6War Md,iteNdtieet LtyHUti¢ lawn; Tree and Petst Control Experts City of the Spokane Valley Aaron Clary 11707 East Sprague,Spokane RE:tree replacement/Sprague Ave1 e /1040 (rwd(((Jo (S("`Jen) ) Service To Be Performed Cost Per Visit Quantity Total Cost Tree removal and stump grind $ 200.00 1 $ 20000 Remove and replace 96 sq ft oo sod and top soil $ 325.00 1 $ 325,00 Irrigation repair/replace valve and damaged main line $ 350.00 1 $ 350.00 replace tree with Bradford pear 2.5 caliper $ 450.00 1 $ 450100 I I $ i $ 1 i Sub Total $ 1,325100 miliiiiiiimS $ dalliOr iiclie0 - 7.V, Z.--- Date: ( /e//,,c Kevin Bordelon Maintenance Manager X Date: Client Representative 1 1 Asensne, services I - 1 171 _ ! •'!1, tll ly, l!l1Y l.tl.i'_:l i! ill i Ii!Iill ' Liwn&flee Post(Pinto! Aioundf Hondey Mointerionce Lighting Lawn, Tree and Pest Control Experts City of the Spokane Valley Aaron Clary 11707 East Sprague, Spokane RE:tree replacement/Sprague Ave .l 5 6 g I g- �6d.1c- Service To Be Performed Cost Per Visit Quantity Total Cost Tree removal and stump grind $ 200.00 1 $ 200.00 replace tree with Bradford pear 2.5 caliper $ 450.00 1 $ 450.00 $ $ Sub Total $ 650.00 Zama. - U'u $ i5 Tstr l $ tail* A' Date: /0/57/1" Kevin Bordelon Maintenance Manager Date: Client Representative. SENSLAW-01 PURLACHER ACOREYDATE(MM/DD/YYYY) k.....---- CERTIFICATE OF LIABILITY INSURANCE 3/5/2015 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 POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Richland Office PHONE 509 946.6161 FAX No):(509)946-0715 Paynewest Insurance,Inc. (NC.No.Ext): 390 Bradley Blvd. E-MAILADDRESS: Richland,WA 99352 INSURER(S)AFFORDING COVERAGE NAM# INSURERA:The Cincinnati Insurance Co. 10677 INSURED INSURER B:Homeland Ins Co of New York Senske Lawn&Tree Care,Inc INSURER C: 400 North Quay Street INSURER O: Kennewick,WA 99336 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 INSD L sWVD POLICY NUMBER (UBR MM/DDY/YYYY) (EFF MM/DD/YYYY) UMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE X OCCUR X X ENP0177069 01/28/2016 01/28/2016 $00,000MMGOENTEDe $ X WA Stop Gap MED EXP(Any one person) $ 10,000 X BIIkt Addl Insured PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER. GENERAL AGGREGATE $ 2,000,000 POLICY I X I jECT LOC PRODUCTS-COMP/OP AGG s 2,000,000 OTHER: $ AUTOMOBILE LIABIUTY CO WNE SINGLE LIMIT $ 1,000,000 (Eaccide A X ANY AUTO ENP0177069 01/28/2015 01/28/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS — NTri WNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accident) S X UMBRELLA UAB X OCCUR EACH OCCURRENCE S 4,000,000 A EXCESS UAB CLAIMS-MADE ENP0177069 01/28/2015 01/28/2016 AGGREGATE s 4,000,000 DED RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y0 N IA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? . (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Rent/Leased Equip ENP0177069 01/28/2015 01/28/2016 Policy Limit 110,000 B Pollution Liability 7930017960000 01/28/2014 01/28/2016 Per Occurrence 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more apace Is required) re:Project 16-024,Roadway Landscape Services. City of Spokane Valley is added as additional insured per attached GA233 which includes completed operations,primary and non-contributory wording and waiver of subrogation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. 11707 E Sprague Ave,Ste 106 Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE glv 4 1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD •• -SENSKE LAWN AND TREE CARE INC Page 1 of 1 ti,/d1 RATE OFIAMINGTON Department of Labor& Industries Certificate of Workers' Compensation Coverage March 10, 201 5 I WA UBI No. :600 124 706 L&I Account ID 1156,937-00 i [Legal Business Name :SENSKE LAWN AND TREE CARE • INC Doing Business As I SENSKE LAWN&TREE CARE INC -- Workers'Comp Premium Status: :Account is current. .._+.. . Estimated Workers Reported I Quarter 4 of Year 2014"Greater than : (See Description Below) ; 100 Workers" rccount Representative . _._, ;TO/GARY HONC(360)902-4823- Email: HONC235@Ini.wa.gov .___. .._ . .---• —__. . . . • ------. • I Licensed Contractor? Yes _ f License No. - !SENSKLT117PT 1 License Expiration 01/30/2017 -_ __- 1 What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person,or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See ROW 51.12.050 and 51.16.190). httns l/secureini-wa_gov/verify/Details/liabilitvCertificate.aspx?UBI=6001247068LLIC=S... 3/10/2015