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15-123.00 NW Plant Health Care AGREEMENT FOR PROFESSIONAL SERVICES Contract 15-123 With NW Plant Health Care THIS AGREEMENT is made by and between the City of Spokane Valley,a code City of the State of Washington,hereinafter"City"and NW Plant Health Care,hereinafter"Consultant,"jointly referred to as "Parties." IN CONSIDERATION of the terms and conditions contained herein,the Parties agree as follows: 1.Work to Be.Performed. Consultant shall provide all labor,services and material to satisfactorily complete the attached Proposal,dated 10/12/15. A.Administration. The City Manager or designee shall administer and be the primary contact for Consultant. Prior to commencement of work,Consultant shall contact the City Manager or designee to review the Scope of Services,schedule and date of completion. The Scope of Services is attached hereto as Exhibit A. Upon notice from the City Manager or designee,Consultant shall commence work,perform the requested tasks in the Scope of Services,stop work and promptly cure any failure in performance under this Agreement. B. Representations. City has relied upon the qualifications of Consultant in entering into this Agreement. By execution of this Agreement,Consultant represents it possesses the ability,skill and resources necessary to perform the work and is familiar with all current laws,rules and regulations which reasonably relate to the Scope of Services. No substitutions of agreed-upon personnel shall be made without the prior written consent of City. Consultant represents that the compensation as stated in paragraph 3 is adequate and sufficient compensation for its timely provision of all professional services required to complete the Scope of Services under this Agreement. Consultant shall be responsible for the technical accuracy of its services and documents resulting therefrom,and City shall not be responsible for discovering deficiencies therein. Consultant shall correct such deficiencies without additional compensation except to the extent such action is directly attributable to deficiencies in City furnished information. C.Standard of Care. Consultant shall exercise the degree of skill and diligence normally employed by professional consultants engaged in the same profession,and performing the same or similar services at the time such services are performed. D. Modifications. City may modify this Agreement and order changes in the work whenever necessary or advisable. Consultant will accept modifications when ordered in writing by the City Manager or designee. Compensation for such modifications or changes shall be as mutually agreed between the Parties. Consultant shall make such revisions in the work as are necessary to correct errors or omissions appearing therein when required to do so by City without additional compensation. 2.Term of Contract. This Agreement shall be in full force and effect upon execution and shall remain in effect until completion of all contractual requirements have been met as determined by City. Consultant shall complete its work by December 31,2018,unless the time for performance is extended in writing by the Parties. Agreement for Professional Services Page 1 of 6 Either Party may terminate this Agreement for material breach after providing the other Party with at least ten days'prior notice and an opportunity to cure the breach. City may,in addition,terminate this Agreement for any reason by ten days'written notice to Consultant. In the event oftermination without breach,City shall pay Consultant for all work previously authorized and satisfactorily performed prior to the termination date. 3.Compensation. (Option A)City agrees to pay Consultant$675.00,(which includes Washington State Sales Tax if any is applicable)as full compensation for everything done under this Agreement,as set forth in the 10/12/15 Proposal. Consultant shall not perform any extra,further or additional services for which it will request additional compensation from City without a prior written agreement for such services and payment therefore. 4.Payment. Consultant shall be paid once upon presentation of an invoice to City. Applications for payment shall be sent to the City Finance Department at the below stated address. City reserves the right to withhold payment under this Agreement for that portion of the work(if any)which is determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Scope of Services,City standards,City Code,and federal or state standards. 5.Notice. Notices other than applications for payment shall be given in writing as follows: TO THE CITY: TO THE CONSULTANT: Name:Christine Bainbridge,City Clerk Name:Joseph Zubaly,President Phone:(509)921-1000 Phone:509-892-0110 Address: 11707 East Sprague Ave,Suite 106 Address:PO Box 1978,Post Falls,ID 83877 Spokane Valley,WA 99206 6.Applicable Laws and Standards. The Parties,in the performance of this Agreement,agree to comply with all applicable federal,state,and local laws and regulations. Consultant warrants that its designs,construction documents,and services shall conform to all federal,state and local statutes and regulations. 7. 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 Agreement for Professional Services Page 2 of 6 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. 8.Relationship of the Parties. It is understood,agreed and declared that Consultant 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 Consultant. Any and all employees who provide services to City under this Agreement shall be deemed employees solely ofConsultant.The Consultant shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 9.Ownership of Documents. All drawings,plans,specifications,and other related documents prepared by Consultant under this Agreement are and shall be the property of City, and may be subject to disclosure pursuant to chapter 42.56 RCW or other applicable public record laws. The written, graphic, mapped, photographic, or visual documents prepared by Consultant under this Agreement shall, unless otherwise provided, be deemed the property of City. City shall be permitted to retain these documents, including reproducible camera-ready originals of reports,reproduction quality mylars of maps,and copies in the form of computer files,for the City's use. City shall have unrestricted authority to publish,disclose,distribute and otherwise use,in whole or in part,any reports,data,drawings,images or other material prepared under this Agreement,provided that Consultant shall have no liability for the use of Consultant's work product outside of the scope of its intended purpose. 10.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 Consultant'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 Agreement for a period of three years from the date final payment is made hereunder. 11.Insurance. Consultant 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 performance of the work hereunder by Consultant,its agents,representatives,employees or subcontractors. A.Minimum Scope of Insurance. Consultant 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 and personal injury and advertising injury. City shall be named as an insured under Consultant's commercial general liability insurance policy with respect to the work performed for the City. 3.Workers'compensation coverage as required by the industrial insurance laws of the State of Washington. 4.Professional liability insurance appropriate to Consultant's profession. Agreement for Professional Services Page 3 of 6 B.Minimum Amounts of Insurance. Consultant shall maintain the following insurance limits: 1.Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of no less than$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. 3. Professional Iiability insurance, if applicable, shall be written with Iimits no less than $1,000,000 per claim and$1,000,000 policy 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.Consultant's insurance coverage shall be primary insurance with respect to the City. Any insurance,self-insurance,or insurance pool coverage maintained by City shall be in excess of Consultant's insurance and shall not contribute with it. 2.Consultant shall fax or send electronically in.pdf format a copy of insurer's cancellation notice within two business days of receipt by Consultant. 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, Consultant shall furnish acceptable insurance certificates to the City Clerk at the time Consultant returns the signed Agreement,which shall be Exhibit C. The certificate shall specify all of the parties who are additional insureds,and shall 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. Consultant shall be financially responsible for all pertinent deductibles,self-insured retentions,and/or self-insurance. 12.Indemnefcation and Hold Harmless. Consultant shall,at its sole expense,se 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 Consultant, Consultant's agents, subcontractors, subconsultants and employees to the fullest extent permitted by law, subject only to the limitations provided below. Consultant'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. Consultant'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)Consultant, Consultant's agents, subcontractors, subconsultants and employees, shall apply only to the extent of the negligence of Consultant,Consultant's agents,subcontractors,subconsultants and employees. Agreement for Professional Services Page 4 of 6 Consultant'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 ofthe City Attorney,outside consultant costs,court costs,fees for collection,and all other claim-related expenses. Consultant 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 Consultant's waiver of immunity under this provision extends only to claims against Consultant by City,and does not include,or extend to,any claims by Consultant's employees directly against Consultant. Consultant hereby certifies that this indemnification provision was mutually negotiated. 13.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 a 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. 14. 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. 15.Subcontracts. Except as otherwise provided herein,Consultant shall not enter into subcontracts for any of the work contemplated under this Agreement without obtaining prior written approval of City. 16.Confidentiality. Consultant may,from time to time,receive information which is deemed by City to be confidential. Consultant shall not disclose such information without the prior express written consent of City or upon order of a court of competent jurisdiction. 17.Jurisdiction and Venue. This Agreement is entered into in Spokane County, Washington. Disputes between City and Consultant shall be resolved in the Superior Court of the State of Washington in Spokane County. Notwithstanding the foregoing,Consultant agrees that it may,at City's request,be joined as a party in any arbitration proceeding between City and any third party that includes a claim or claims that arise out of,or that are related to Consultant's services under this Agreement. Consultant further agrees that the Arbitrator(s) decision therein shall be final and binding on Consultant and that judgment may be entered upon it in any court having jurisdiction thereof. 18. Cost and Attorney's Fees. The prevailing party in any litigation or arbitration arising out of this Agreement shall be entitled to its attorney's fees and costs of such litigation(including expert witness fees). 19.Entire Agreement. This written Agreement constitutes the entire and complete agreement between the Parties and supersedes any prior oral or written agreements. This Agreement may not be changed,modified or altered except in writing signed by the Parties hereto. 20.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, Agreement for Professional Services Page 5 of 6 accepted or granted a present or future gift,favor,service or other thing of value from any person with an interest in this Agreement. 21.Business Registration. Prior to commencement of work under this Agreement,Consultant shall register with the City as a business. 22.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. 23.Exhibits. Exhibits attached and incorporated into this Agreement are: A. Proposal B. Insurance Certificates th The Parties have executed this Agreement this day of 0 t✓ er ,20 • CITY OF SPOKANE VALLEY Consultant: CAALA Mikeiaekson7eitrivranager By: Mt rK e (14.4u l Cj��l j(,�/_(ye� r Its: thorized Representative Q ATTEST: APPROVED AS ORM: Christine Bainbridge,City CIerk Office o © City Attorney Agreement for Professional Services Page 6 of 6 kg Proposal 11 h c City of Spokane Valley Work Address: 12515 E Mansfield Ave,Spokane Valley,WA 99216 ____. nw plant health care Billing Address: (509)892-0110 (208)687-2884 11707 E Sprague Ave,STE 106,Spokane Valley,WA 99206 Joseph R.Zubaly,President Home:(509)720-5044 Work/Cell: P.O.Box 1978,Post Falls,ID 83877 Email:accountspayable@spokanevalley.org nphc((northwestpIantheaithcare.com Proposal Date:10/12/2015 www.NorthwestPlantHealthCare.com Rep:Benjamin Kappen Rep Cell:(208)640-6343 x"'�:c�� "h' .4.4-.42 -'�<r�,;v"..d�.,��.�-. 9Rs,.3-- s''' '.i'a.,'�-.�5.-� . �''�,�^'_ Consulting Consulting services to provide annual inspection of the health of 1 existing $675.00 Flowering Cherry in front yard(basic visual evaluation only).Report as to findings.October 2016,October 2017,October 2018(total price of evaluations and report reflects$225.00 per.aiste.annually) V`tsrr Sales Tax Pricing is valid for 90 days from proposal date Total $675.00 "Ask the Tree Care Experts" 0MrrIUR Pruning,Removals,Stump Grinding, _ r - Fertilizing,Plant Health Care,Consulting, -�r Insect,Disease,&Weed Management BBB Landscape Design&Construction ('MEP ISA. ::cac,: r-r.;:F" ;M1.o'.-.:... mtti?.v >r-a- _. <--;5' —AL,_ ,zzi'1'`iEc,wv,:iL4-+,a--c'=m�am," ,�` -^�y''cic.'Tv �.,As;•3::r -w' . x �a'ct'�^���,re'�>�,� � 'k``3"'-� '=�3y,�r.ra�c-�='�'� ��`,c ��?. v'" a.��.� - '�� < ,,. �T ;rte1 93Viv7edgeabi e;Xper#s±:kir_ a sion`7 e1 'cS :0Misk trWal uct� '� '10: L+.?;�y'�a�+..^.'-�'- ac' vk°`wc�'�.r�v4 '39+C.L' :+: . .G ..i�'ja.!!,b_.?"� n�ey':.,.�-`aeus /- .. 0156-Mansfield Ave Connection All Activity as of Oct 12 2015 '... ___..ate..-..�. --*-`-.-.-`rY Prion„ ...- -tar-- - ` C �:Oii incl) i ;Adjusted) yYe.ars;' 201}) 2015 o Dates Allalile� i _ A..,� { Actual. fl_anddll - Actuaij :imam edj .Fuad; REVENUE53 � Bpdget?�,�`Ana) Actualj:.,-,, ,. � CMAQ 0.00 887,500.00 125,464.21 577,179.86 35,612.05 738,256.12 0.00 149,243.88 TIB 792,700.00 0.00 0.00 659.94 659.94 0.00 792,040.06 Project Bid Documents 0.00 0.00 50.00 0.00 50.00 0.00 -50.00 Developer Contribution 0.00 197,700.00 0.00 0.00 197,700.00 197,700.00 0.00 0.00 302 0.00 124,450.00 31,555.39 92,353.15 20,910.40 144,818.94 0.00 -20,368.94 302 0.00 0.00 3,031.27 0.00 0.00 3,031.27 0.00 -3,031.27 Total Revenue .. 0.00 2,002,350.00 160,050.87 669,583.01 254,882.39 1,084,516.27 0.00 917,833.73 r _ -_-,"Ts. f'P riljusted -`y:. P -r r _11b14), ), 'u � �' _ 4%41 :,p . EXPENDITURES -? eirclig ,Budd get Yearst_ Acta1 . `Actual fo Dates €Encumbered Funds: Preliminary Engineering Salaries&Wages 45,000.00 63,600.00 48,154.48 27,792.22 11,384.96 87,331.66 0.00 -23,731.66 Overtime 300.00 286.91 145.26 0.00 432.17 0.00 -132.17 Employee Benefits 15,750.00 25,000.00 20,111.29 11,680.26 3,975.15 35,766.70 0.00 -10,766.70 FICA/401A OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Medicare OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 L&I OT 0.00 7.47 3.36 0.00 10.83 0.00 -10.83 PERS OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Office&Operating Supplies 0.00 26.87 0.00 0.00 26.87 0.00 -26.87 Engineering&Architectural 0.00 0.00 0.00 246.30 0.00 246.30 0.00 -246.30 Prof.Svcs-Survey 20,000.00 22,500.00 22,323.64 0.00 0.00 22,323.64 0.00 176.36 Prof.Svcs.-Geotech 20,000.00 16,000.00 10,500.00 0.00 0.00 10,500.00 0.00 5,500.00 Advertising 3,000.00 3,000.00 0.00 1,203.82 0.00 1,203.82 0.00 1,796.18 Printing&Binding 2,000.00 2,000.00 0.00 0.00 0.00 0.00 0.00 2,000.00 Miscellaneous Services 8,800.00 18,800.00 16,287.88 1,325.39 614.99 18,228.26 722.04 -150.30 COSV Permits 350.00 350.00 0.00 0.00 350.00 0.00 0.00 PE Contingency 11,450.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Prelim.Engineering 126,000.00 151,550.00 118,048.54 42,396.61 15,975.10 176,420.25 722.04 -25,592.29 Right of Way Salaries&Wages 10,000.00 12,250.00 4,195.65 16,496.60 8,718.24 29,410.49 0.00 -17,160.49 Employee Benefits 3,500.00 4,350.00 1,943.85 6,062.29 4,054.51 12,060.65 0.00 -7,710.65 FICA/401A OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Medicare OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 L&I OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PERS OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Professional Services 35,000.00 72,000.00 29,200.63 45,202.00 3,456.68 77,859.31 5,088.84 -10,948.15 Prof.Svcs.Mat.Testing 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Miscellaneous Services 0.00 0.00 651.58 0.00 651.58 0.00 -651.58 ROW Acquisition 500,000.00 515,000.00 0.00 426,095.17 22,819.00 448,914.17 0.00 66,085.83 RW-Land Improvements 20,000.00 152,000.00 0.00 46,408.76 0.00 46,408.76 0.00 105,591.24 RW:Tennant Relocation 250,000.00 125,000.00 5,400.00 86,220.00 0.00 91,620.00 0.00 33,380.00 RW Contingency 81,500.00 19,400.00 0.00 0.00 0.00 0.00 0.00 19,400.00 Total Right of Way 900,000.00 900,000.00 40,740.13 627,136.40 39,048.43 706,924.96 5,088.84 187,986.20 Construction Salaries&Wages 0.00 35,000.00 817.72 0.00 16,057.74 16,875.46 0.00 18,124.54 Employee Benefits 0.00 12,250.00 444.48 0.00 6,339.60 6,784.08 0.00 5,465.92 FICA/401A OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Medicare OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 L&I OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 PERS OT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Professional Services 0.00 0.00 0.00 8,891.72 8,891.72 25,809.28 -34,701.00 Prof.Svcs.Mat.Testing 0.00 23,550.00 0.00 0.00 0.00 0.00 0.00 23,550.00 Prof.Svcs.-Consulting 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Advertising 0.00 0.00 0.00 0.00 807.82 807.82 0.00 -807.82 Printing&Binding 0.00 0.00 0.00 0.00 558.85 558.85 0.00 -558.85 Construction 0.00 800,000.00 0.00 0.00 132,599.53 132,599.53 322,316.47 345,084.00 CN Contingency 0.00 80,000.00 0.00 0.00 0.00 0.00 0.00 80,000.00 Total Construction 0.00 950,800.00 1,262.20 0.00 165,255.26 166,517.46 348,125.75 436,156.79 Other Construction Construction 0.00 0.00 0.00 58,499.82 58,499.82 19,851.28 -78,351.10 Total Other Construction 0.00 0.00 0.00 0.00 58,499.82 58,499.82 19,851.28 -78,351.10 Total Expenditures . -1,026,506.6 2,004350.00 160,050.87 669,533.01' 278,778.61 1,108,362.49 373,787.91 520,199.60 �..,,, OP ID:SB ACORO° DATE(MM/DD/YYYY) 4,...---- CERTIFICATE OF LIABILITY INSURANCE 10/20/2015 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 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Wheat&Associates Insurance PHON:E P.O.Box 3548 (A/C.No.Ext): (NC,No): Spokane,WA 99220-3548 E-MAIL Tena M Wheat ADDRESS: PRODUCER NWPLA-2 CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED Northwest Plant Health Care INSURER A:Cincinnati Insurance Co 10677 Inc INSURER B:Ohio Casualty Ins Co 10937 PO Box 1978 Post Falls,ID 83877 INSURER C: INSURER D: 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 ADDL SUBR POLICY EFF POUCY EXP LIMITS LTR TYPE OF INSURANCE 0/SR WVD POLICY NUMBER (MM/DDIYYYY) IMMIDD/YYYYI GENERAL UABIUTY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X ENP0129989 03/17/2015 03/17/2016 DAMAGEES((OEa RENT EDoccunence) $ 500,000 PREMIS CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES� PER: PRODUCTS-COMP/OP AGG $ 2,000,000 7 POLICY n ofI 7I LOC S AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT $ 1,000,000 — BAW55482690 03/17/2015 03/17/2016 (Ea accident)A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOSBODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (PER ACCIDENT) $ NON-OWNED AUTOS Hired Auto Comp 5 100 Hired Auto Coll $ 500 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS UAB CLAIMS-MADE ENP0129989 10/15/2015 03/17/2016 AGGREGATE $ 1,000,000 A G DEDUCTIBLE /L Only s X RETENTION $ 0 S WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER A ANY PROPRIETOR/PARTNER/EXECUTIVE IT YNIA NH) E. (Mandatory in NH) ENP0129989 03/17/2015 03/17/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? STOP GAP L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes.describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY OMIT 5 1,000,000 A Inland Marine ENP0129989 03/17/2015 03/17/2016 Rented Eq 140,000 Deduct 500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLESAttach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate holder is included as an additional insured as required by written contract or agreement as per GA233 as respects the operations of the named insured performed on their behalf. CERTIFICATE HOLDER CANCELLATION CITSP-3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof$ okane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. 11707 E Sprague Ave Ste 106 Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE I , L ,,,..,:,„_ , ©1988-2009 ACORD CORPORATION. All rights reserved. 1 ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement-Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage 2 2. Unintentional Failure to Disclose Hazards 7 3. Damage to Premises Rented to You 8 • 4. Supplementary Payments 9 5. Medical Payments 9 6. Voluntary Property Damage(Coverage a.)and Care,Custody or Control Liability Coverage(Coverage b.) 9 7. 180 Day Coverage for Newly Formed or Acquired Organizations 10 8. Waiver of Subrogation 10 9. Automatic Additional Insured-Specified Relationships: 10 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Political Subdivisions-Permits Relating to Premises; • State or Political Subdivisions-Permits;and • Contractors'Operations 10. Broadened Contractual Liability-Work Within 50'of Railroad Property 14 11. Property Damage to Borrowed Equipment 14 12. Employees as Insureds-Specified Health Care Services: 14 • Nurses; • Emergency Medical Technicians;and • Paramedics 13. Broadened Notice of Occurrence 14 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment,except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations;or b. $500,000 unless otherwise stated$ 4. Supplementary Payments a. Bail bonds: $ 1,000 b: Loss of earnings: $ 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 • Services Office,Inc.,with its permission. Page 1 of 15 6. Voluntary Property Damage(Coverage a.)and Care,Custody or Control Liability Coverage (Coverage b.) Limits of Insurance(Each Occurrence) Coverage a.$1,000 Coverage b.$5,000 unless otherwise stated $ Deductibles(Each Occurrence) Coverage a.$250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM a Area (For Limits in Excess of (For Limits in Excess of b Payroll $5,000) $5,000) c Gross Sales d Units e Other b. Care, Custody $ or Control TOTAL ANNUAL PREMIUM $ 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: have used up the appli- cable limit of insurance 1. Employee Benefit Liability Coverage in the payment of a. The following Is added to SECTION I Judgments or settle -COVERAGES: Employee Benefit ments. LiabilityCoverage. No other obligation or liabil- ity g 9 it topaysums or perform 1 InsuringAgreement Y ( ) g acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay- obligated to pay as dam- ments. ages caused by any act,er- (b) This insurance applies to ror or omission of the in- damages only if the act, er- sured, or of any other per- ror or omission, is negli- son for whose acts the in- gently committed in the sured is legally liable, to "administration" of your which this insurance ap- "employee benefit pro- plies. We will have the right gram";and and duty to defend the in- gram";and sured against any "suit' 1) Occurs during the pal- seeking those damages. icy period;or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeking damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our discretion, investigate any a) You did not have report of an act, error or knowledge of a omission and settle any claim or "suit" on claim or"suit" that may re- or before the ef- suit. But: fective date of this endorsement. 1) The amount we will pay be will for damages is limited You Youmed to have as described in SEC- TION III - LIMITS OF knowledge of a INSURANCE;and claim or "suit' when any"author- 2) Our right and duty to ized representa- defend ends when we tive"; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 2 of 15 I) Reports all, or formance of investment any part,of the vehicles;or act, error or omission to us 3) Advice given to any or any other person with respect to insurer; that person's decision to participate or not to ii) Receives a participate in any plan written or ver- includedin the "em- bal demand or ployee benefit pro- claim for dam- gram". ages because of the act, er- (f) Workers' Compensation ror or omis- and Similar Laws sion;and Any daim arising out of your b) There is no other failure to comply with the applicable insur- mandatory provisions of any • ance. workers' compensation, un- employment compensation (2) Exclusions insurance,social security or This insurance does nota I disability benefits law or any apply similar law. to: (g) ERISA (a) Bodily Injury, Property Damage or Personal and Damages for which any in- Advertising Injury sured is liable because of injury", "property li- ability imposed on a fiduci- "Bodily 1 ry ary by the Employee Re- damage" or "personal and tirement Income Security advertising injury". Act of 1974, as now or (b) Dishonest, Fraudulent, hereafter amended, or by Criminal or Malicious Act any similar federal, state or local laws. Damages arising out of any (h) Available Benefits intentional, dishonest, fraudulent, criminal or mali- Any claim for benefits to the cious act, error or omission, extent that such benefits are committed by any insured, available, with reasonable including the willful or reck- effort and cooperation of the less violation of any statute. insured,from the applicable (c) Failure to Perform a Con- funds accrued or other col- tract lectible insurance. Damages arising out of fail- (i) Taxes,Fines or Penalties ure of performance of con- Taxes, fines or penalties, tract by any insurer. including those Imposed (d) Insufficiency of Funds under the Internal Revenue Code or any similar state or • Damages arising out of an local law. insufficiency of funds to (j) Employment-Related meet any obligations under Practices any plan included in the "employee benefit pro- Any liability arising out of gram". any: (e) Inadequacy of Perform- (1) Refusal to employ; ance of Investment / Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any daim based upon: (3) Coercion, demotion, reassign- 1) Failure of anyinvest- evaluation,ment, discipline, defa- ment to perform; mation, harassment, 2) Errors in providing in- humiliation, discrimina- formation on past per- tion or other employ- Includes copyrighted material of Insurance GA 233 02.07 Services Office, Inc.,with its permission. Page 3 of 15 ment related practices, (e) A trust, you are an insured. acts or omissions;or Your trustees are also in- sureds, re- (4) Consequential liability but only with eq spect to their duties as trus- as a result of(1), (2)or tees. (3)above. This exdusion applies (2) Each of the following is also an Pp insured: whether the insured may be held liable as an employer (a) Each of your "employees" or in any other capacity and who is or was authorized to to any obligation to share administer your "employee damages with or repay benefit program". someone else who must pay damages because of (b) Any persons, organizations the injury. or "employees" having proper temporary authorize- (3) Supplementary Payments tion to administer your"em- ram" if SECTION I - COVERAGES, you die, but leefonlyrunt l your SUPPLEMENTARY PAY- legal representative is ap- MENTS -COVERAGES A AND pointed. B also apply to this Coverage. b. Who is an Insured (c) Your legal representative if you die, but only with re- As respects Employee Benefit Liabil- spect to duties as such. ity Coverage, SECTION II-WHO IS That representative will AN INSURED is deleted in its en- have all your rights and du- tirety and replaced by the following: ties under this Coverage Part. (1) If you are designated in the Dec- (3) Any organization you newly larations as: ac- quire or form, other than a part- (a) An individual, you and your nership, joint venture or limited spouse are insureds, but liability company, and over only with respect to the con- which you maintain ownership or duct of a business of which majority interest,will qualify as a you are the sole owner. Named Insured if no other simi- lar insurance applies to that or- (b) A partnership or joint yen- ganization. However, coverage ture, you are an insured. under this provision: Your members, your part- ners, and their spouses are (a) Is afforded only until the also insureds but only with 180th day after you acquire respect to the conduct of or form the organization or your business. the end of the policy period, whichever is earlier;and (c) A limited liability company, you are an insured. Your (b) Does not apply to any act, members are also insureds, error or omission that was but only with respect to the committed before you ac- conduct of your business. quired or formed the organi- Your managers are insur- zation. eds,but only with respect to c. Limits of insurance their duties as your manag- ers. As respects Employee Benefit Liabil- ity Coverage, SECTION III - LIMITS (d) An organization other than a partnership,joint venture or OF INSURANCE is deleted in its en- limited liability company, tirety and replaced by the following: you are an insured. Your (1) The Limits of Insurance shown "executive officers" and di- In Section B. Limits of Insur- rectors are insureds, but ance, 1. Employee Benefit Li- only with respect to their du- ability Coverage and the rules ties as your officers or direc- below fix the most we will pay tors. Your stockholders are regardless of the number of: also insureds, but only with respect to their liability as (a) Insureds; stockholders. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with Its permission. Page 4 of 15 • (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations Persons or organizations applies to all damages sus- (c) 9 tained by any one "em- making claims or bringing ployee",including such"em- "suits"; ployee's" dependents and (d) Acts,errors or omissions;or beneficiaries, because of all acts, errors or omissions to (e) Benefits induded in your which this insurance ap- "employee benefit pro- plies. gram". (c) The terms of this insurance, (2) The Aggregate Limit shown in including those with respect Section B. Limits of Insurance, to: 1. Employee Benefit Liability 1) Our right and duty to Coverage of this endorsement defend the insured Is the most we will pay for all damages because of acts,errors against any "suits" or omissions negligently commit- seeking those dam- ted in the "administration" of ages;and your "employee benefit pro- 2) Your duties, and the gram". duties of any other in- (3) Subject to the limit described in volved insured, in the (2) above, the Each Employee event of an act,error or omission,or claim, Limit shown in Section B.Limits of Insurance, 1. Employee apply irrespective of the ap- Benefit Liability Coverage of plication of the deductible this endorsement is the most we amount. will pay for all damages sus- tained by any one "employee", (d) We may pay any part or all including damages sustained by of the deductible amount to such "employee's" dependents effect settlement of any and beneficiaries,as a result of: claim or"suit"and,upon An act, error or omission;or no- tification of the action taken, • (a) you shall promptly reim- (b) A series of related acts, er- burse us for such part of the rors or' omissions, regard- deductible amount as we less of the amount of time have paid. that lapses between such d. Additional Conditions ads,errors or omissions, Li- negligently committed in the As respects Employee Benefit ability Coverage, SECTION IV - "administration" of your "em- COMMERCIAL GENERAL LIABIL- ployee benefit program". ITY CONDITIONS is amended as fol- However,the amount paid under lows: this endorsement shall not ex- (1) Item 2. Duties in the Event of ceed, and will be subject to the Occurrence, Offense, Claim or limits and restrictions that apply Suit is deleted in its entirety and to the payment of benefits in any replaced by the following: plan included in the "employee benefit program". 2. Duties in the Event of an Act,Error or (4) Deductible Amount Omission,or Claim or Suit Our obligation to paydam- a. You must see to it that we are noti- (a) g fled as soon as practicable of an act, ages on behalf of the in- error or omission which may result in sured applies only to the a claim. To the extent possible, no- amount of damages in ex- tice should include: cess of the deductible amount stated in the Decla- (1) What the act, error or omission rations as applicable to was and when it occurred;and Each Employee. The limits of insurance shall not be re- (2) The names and addresses of duced by the amount of this anyone who may suffer dam- deductible. ages as a result of the act,error or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 5 of 15 b. If a daim is made or"suit"is brought b. Method of Sharing against any insured,you must: If all of the other insur- (1) Immediately record the specifics ance permits contribu- of the claim or "suit" and the tion by equal shares, date received;and we will follow this (2) Notifyus as soon aspracticable. method also. eachUnin- this approach in- You must see to it that we receive surer contributes equal written notice of the claim or"suit'as amounts until it has soon as practicable. paid its applicable limit of insurance or none of c. You and any other involved insured the loss remains, must: whichever comes first. (1) Immediately send us copies of If any of the other in- any demands, notices, sum- surance does not per- monses or legal papers received mit contribution by in connection with the claim or equal shares, we will "suit"; contribute by limits. Under this method, (2) Authorize us to obtain records each insurer's share is and other information; based on the ratio of its aof in- (3) Cooperate with us in the invests- surance to theicable �t total ap- gation or settlement of the claim plicable limits of insur- or defense against the "suit"; ance of all insurers. and (4) Assist us, upon our request, in c. No Coverage the enforcement of any right This insurance shall not against any person or organiza- cover any loss for tion which may be liable to the which the insured is en- insured because of an act,error titled to recovery under or omission to which this insur- any other insurance in ance may also apply. force previous to the ef- d. No insured will, except at that in- fecdatePof this Coverage sured's own cost,voluntarily make a Cerr age Paart. payment, assume any obligation, or • e. Additional Definitions incur any expense without our con- sent. As respects Employee Benefit Li- ability Coverage, SECTION V - (2) Item 5. Other Insurance is de- DEFINITIONS is amended as fol- 1 feted in its entirety and replaced lows: by the following: 5. Other Insurance (1) The following definitions are added: If other valid and collectible 1. "Administration"means: insurance is available to the insured for a loss we cover a. Providing information to under this Coverage Part, "employees", including our obligations are limited their dependents and as follows: beneficiaries, with re- spect to eligibility for or a. Primary Insurance scope of "employee This insurance is pri- benefit programs"; mary except when c. b. Interpreting the "em- below applies. If this ployee benefit pro- insurance is primary, grams"; our obligations are not affected unless any of c. Handling records in the other insurance is connection with the also primary. Then,we "employee benefit pro- wl!! share with all that grams";or other insurance by the d. Effecting, continuing or method described in b. terminating any "em- below. ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 6 of 15 in any benefit included benefits, workers' corr- in the"employee bene- pensation and disability fit program". benefits;and However, "administration" d. Vacation plans, includ- does not include: ing buy and sell pro- grams; leave of ab- a. Handling payroll sence programs, in- tions;or cluding military, mater- b. The failure to effect or nity, family, and civil assis- maintain any insurance_ leave; tuition or adequate limits of tante plans;transporta- coverage of insurance, tion and health club including but not limited subsidies. to unemployment in- (2) The following definitions are de- surance,social security feted in their entirety and re- benefits, workers' corn- placed by the following: pensation and disability benefits. 21. "Suit' means a civil means pro- ceeding in which money 2. "Cafeteria plans" damages because of an act, plan authorized by applica- error or omission to which ble law to allow "employ- this insurance applies are ees"to elect to pay for cer- alleged. "Suit"includes: tain benefits with pre-tax dollars. a. An arbitration proceed- ing in which such dam- 3. "Employee benefit pro- ages are claimed and grams" means a program to which the insured providing some or all of the must submit or does following benefits to "em- submit with our con- ployees", whether provided sent; through a"cafeteria plan"or otherwise: b. Any other alternative dispute resolution pro- a. Group life insurance; ceeding in which such group accident or damages are claimed health insurance; den- and to which the In- tal, vision and hearing sured submits with our plans; and flexible consent;or spending accounts; provided that no one c. An appeal of a civil pro- other than an "em- ceeding. ployee" may subscribe to such benefits and 8. "Employee" means a per- such benefits are made son actively employed, for- generally available to merly employed,on leave of those "employees"who absence or disabled, or re- satisfy the plan's eligi- tired. "Employee" includes bility requirements; a "leased worker". "Em- ployee does not indude a b. Profit sharing plans, 'temporary worker". employee savings plans, employee stock 2. Unintentional Failure to Disclose Haz- ownership plans, pen- ards sion plans and stock SECTION IV-COMMERCIAL GENERAL subscription plans, pro- LIABILITY CONDITIONS, 7. Represen- vided that no one other tations is hereby amended by the addi- than an "employee" tion of the following: may subscribe to such benefits and such Based on our dependence upon your rep- benefits are made gen- resentalions as to existing hazards, if un- erally available to all intentionally you should fail to disclose all "employees" who are such hazards at the inception date of your eligible under the plan policy, we will not reject coverage under for such benefits; this Coverage Part based solely on such c. Unemployment insur- failure. ance, social security Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 7 of 15 3. Damage to Premises Rented to You f) Nesting or infesta- tion, e a. The last Subparagraph of Paragraph rrelease rar of 2. SECTION I - COVERAGES, waste products or COVERAGE A. - BODILY INJURY secretions, by in- AND PROPERTY DAMAGE, 2. LI- sects, birds, ro- ABILITY Exclusions is hereby de- dents or other leted and replaced by the following: animals. Exclusions c.through q.do not apply (b) Loss caused directly or indi- to damage by fire, explosion, light- rectly by any of the follow- ning, smoke or soot to premises ing: while rented to you or temporarily oc- cupied by you with permission of the 1) Earthquake, volcanic owner. eruption, landslide or b. The insurance provided under SEC- any other earth move- TION I-COVEAGES,COVERAGE menta A. BODILY INJURY AND PROP- 2) Water that backs up or ERTY DAMAGE LIABILITY applies overflows from a sewer, to "property damage" arising out of drain or sump; water damage to premises that are both rented to and occupied by you. 3) Water under the ground surface pressing on, or (1) As respects Water Damage Le- flowing or seeping gal Liability, as provided in through: Paragraph 3.b.above: a) Foundations, The exdusions under SECTION walls, floors or I - COVERAGES, COVERAGE paved surfaces; A. BODILY INJURY AND PROPERTY DAMAGE LIABIL- ' b) Basements, ITY,2.Exclusions,other than I. whether paved or War and the Nuclear Energy not;or Liability Exclusion, are deleted c) Doors,windows or and the following are added: other openings. This insurance does not apply (c) Loss caused by or resulting to: from water that leaks or (a) "Property damage": flows from plumbing, heat- ing, air conditioning, or fire 1) Assumed in any con- protection systems caused tract;or by or resulting from freez- 2) Loss caused by or re- ing,unless: sulting from any of the 1) You did your best to following: maintain heat in the a) Wear and tear; building or structure;or b) Rust, corrosion, 2) You drained the equipment and shut off fungus, decay,de- the water supply if the terioration, hidden heat was not main- or latent defect or tained. any quality in property that (d) Loss to or damage to: causes it to dam- age or destroy it- 1) Plumbing, heating, air self; conditioning, fire pro- tection systems, or c) Smog; other equipment or ap- d) Mechanical break pliances;or down including 2) The interior of any rupture or bursting building or structure, or caused by cen- to personal property in trifugal force; the building or structure Settling, cracking, caused by or resulting e) 9 9 from rain, snow, sleet shrinking or ex- or ice, whether driven pansion;or by wind or not. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 8 of 15 c. Limit of Insurance Limits of Insurance, 5. Medical Pay- The Damage to Premises Rented to ments of this endorsement. You Limit as shown in the Declara- 6. Voluntary Property Damage and Care, tions is amended as follows: Custody or Control Liability Coverage (2) Paragraph 6. of SECTION III - a. Voluntary Property Damage Cov- LIMITS OF INSURANCE is erage hereby deleted and replaced by the following: We will pay for"property damage"to property of others arising out of op- . 6. Subject to 5. above, the erations incidental to the insured's Damage to Premises business when: Rented to You Limit is the most we will pay under (1) Damage is caused by the in- COVERAGE A. BODILY sured;or INJURY AND PROPERTY (2) Damage occurs while in the in- DAMAGE LIABILITY, for sured's possession. damages because of"prop- erty damage" to premises With your consent, we will make while rented to you or tem- these payments regardless of fault. porarily occupied by you with permission of the b. Care, Custody or Control Liability owner, arising out of any Coverage one "occurrence" to which SECTION I - COVERAGES, COV- this insurance applies. ERAGE A. BODILY INJURY AND (3) The amount we will pay is lim- PROPERTY DAMAGE LIABILITY, ited as described in Section B. 2. Exclusions, I. Damage to Prop- Limits ro - Limits of Insurance, 3. Dam- erty, Subparagraphs (3), (4) and (5) age to Premises Rented to do not apply to"property damage"to You of this endorsement. the property of others described therein. 4. Supplementary Payments With respect to the insurance provided by Under SECTION I - COVERAGE, SUP- this section of the endorsement, the fol- PLEMENTARY PAYMENTS - COVER- lowing additional provisions apply: AGES A AND B: a. The Limits of Insurance shown in the a. Paragraph 2. Is replaced by the fol- Declarations are replaced by the lira- lowing: its designated in Section B.Limits of Up to the limit shown in Section B. Insurance, 6. Voluntary Property Limits of Insurance,4.a.Bail Bonds Comaoe and Care,Coverage Custodyf or of this endorsement for cost of bail Control entLiawithility of thisr- bonds required because of accidents endorsement this respect ro went. q age provided by this endorsement. or traffic law violations arising out of These limits are inclusive of and not the use of any vehicle to which the in addition to the limits being re- Bodily Injury Liability Coverage ap- placed. The Limits of Insurance plies. We do not have to furnish shown in Section B.Limits of Insur- these bonds. ance, 6. Voluntary Property Dam- b. Paragraph 4. is replaced by the fol- age and Care, Custody or Control lowing: Liability Coverage of this endorse- ment fix the most we will pay in any All reasonable expenses incurred by one "occurrence" regardless of the the insured at our request to assist number of: us in the investigation or defense of the daim or "suit", including actual (1) Insureds; loss of earnings up to the limit shown (2) Claims made or "suits" brought; in Section B. Limits of Insurance, or 4.b. Loss of Earnings of this en- dorsement per day because of time (3) Persons or organizations making off from work. claims or bringing"suits". 5. Medical Payments b. Deductible Clause The Medical Expense Limit of Any One (1) Our obligation to pay damages Person as stated in the Declarations is on your behalf applies only to amended to the limit shown in Section B. the amount of damages for each "occurrence" which are in ex Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 9 of 15 cess of the deductible amount (1) Any person or organization de- stated in Section B. Limits of scribed in Paragraph 9.a.(2)be- Insurance, 6. Voluntary Prop- low (hereinafter referred to as erty Damage andCare, Cus- additional insured) whom you tody or Control Liability Cov- are required to add as an addi- erage of this endorsement. The tional insured under this Cover- limits of insurance will not be re- age Part by reason of: duced by the application of such deductible amount. (a) A written contract or agree- ment;or (2) Condition 2. Duties in the Event of Occurrence, Offense, (b) An oral agreement or con- Claim or Suit, applies to each tract where a certificate of claim or"suit"irrespective of the insurance showing that per- amount. son or organization as an additional insured has been (3) We may pay any part or all of issued, the deductible amount to effect settlement of any claim or"suit" is an insured,provided: and, upon notification of the ac- (a) The written or oral contract tion taken,you shall promptly re- or agreement is: imburse us for such part of the deductible amount as has been 1) Currently in effect or paid by us. becomes effective dur- ing7. 180 Day Coverage for Newly Formed or the policy period; Acquired Organizations 2) Executed prior to an SECTION 11 - WHO IS AN INSURED is "occurrence"or offense amended as follows: to which this insurance Subparagraph a. of Paragraph 4. is would apply;and hereby deleted and replaced by the fol- (b) They are not specifically lowing: named as an additional in- a. Insurance under this provision is af- sured under any other pro- forded only until the 180th day after vision of, or endorsement you acquire or form the organization added to, this Coverage or the end of the policy period, Part. whichever is earlier; (2) Only the following persons or • 8. Waiver of Subrogation organizations are additional in- sureds under this endorsement, SECTION IV-COMMERCIAL GENERAL and insurance coverage pro- LIABILITY CONDITIONS,9.Transfer of vided to such additional insureds Rights of Recovery Against Others to is limited as provided herein: Us is hereby amended by the addition of (a) The manager or lessor of a the following: premises leased to you with We waive any right of recovery we may whom you have agreed per have because of payments we make for Paragraph 9.a.(1) above to injury or damage arising out of your ongo- provide insurance, but only ing operations or"your work"done under with respect to liability aris- a written contract requiring such waiver ing out of the ownership, with that person or organization and in- maintenance or use of that cluded in the 'products-completed opera- part of a premises leased to tions hazard". However, our rights may you,subject to the following only be waived prior to the "occurrence" additional exclusions: giving rise to the injury or damage for This insurance does not ap which we make payment under this Cov- erage Part. The insured must do nothing ply to: after a loss to impair our rights. At our 1) Any"occurrence"which request, the insured will bring "suit" or takes place after you transfer those rights to us and help us en- cease to be a tenant in force those rights. that premises. 9. Automatic Additional Insured - Sped- 2) Structural alterations, fled Relationships new construction or a. The following is hereby added to demolition operations SECTION it-WHO IS AN INSURED: performed by or on be- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 10 of 15 half of such additional solely for the pur- insured. pose of inspection, demonstration, (b) Any person or organization testing, or the from which you lease substitution of equipment with whom you parts under in- have agreed per Paragraph structions from the • 9.a.(1) above to provide in- manufacturer, and surance. Such person(s)or then repackaged organization(s) are insureds in the original con- solely with respect to their tainer; liability arising out of the maintenance, operation or e) Any failure to use by you of equipment make such inspec- leased to you by such per- tions, adjustments, son(s) or organizations(s). tests or servicing However, this insurance as the vendor has does not apply to any "oc- agreed to make or currence"which takes place normally under- after the equipment lease takes to make in expires. the usual course or organization of business, in (c) Any persong connection with (referred to below as ven- the distribution or dor) with whom you have sale of the prod- agreed per Paragraph ucts; 9.a.(1) above to provide in- surance, but only with re- f) Demonstration, in- spect to "bodily injury" or stallation, servic- "property damage" arising ing or repair op- out of"your products"which erations, except are distributed or sold in the such operations regular course of the ven- performed at the dors business, subject to vendor's premises the following additional ex- in connection with clusions: the sale of the product; 1) The insurance afforded the vendor does not g) Products which, apply to: after distribution or 'Bodily in'u or sale by you, have a) 1 rY been labeled or re- "property damage" labeled or used as for which the ven- a container,part or dor is obligated to ingredient of any pay damages by other thing or sub- reason of the as- stance by or for sumption of liabil- the vendor. ity in a contract or agreement. This 2) This insurance does exclusion does not not apply to any in- apply to liability for sured person or organi- damages that the zation: vendor would have in the absence of a) From whom you . the contract or have acquired agreement; such products, or • any ingredient, b) Any express war- part or container, ranty unauthorized entering into, ac- by you; companying or c) Any physical or containing such products;or chemical change in the product b) When liability in- made intentionally cluded within the by the vendor; "products- completedRepackaging, opera- d) tions hazard" has unless unpacked Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 11 of 15 been excluded (1) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9.a.(1)above spect to such to provide insurance, but products. only with respect to liability (d) Anystate orpolitical subdi- arising out of "your work" performed for that additional vision with which you have insured by you or on your agreed per Paragraph behalf. A person or organi- 9.a.(1) above to provide in- zation's status as an Insured surance, subject to the fol- under this provision of this lowing additional provision: endorsement continues for • This insurance applies only only the period of time re- with respect to the following quired by the written con- hazards for which the state tract or agreement,but in no or political subdivision has event beyond the expiration idate of this Coverage Part. issued a permit in connec- tion with premises you own, If there is no written contract rent or control and to which or agreement, or if no pe- riod of time is required by the written contract or 1) The existence, mainte- agreement, a person or or- nance, repair,construc- ganization's status as an in- tion, erection, or re- sured under this endorse- moval of advertising ment ends when your op- signs, awnings, cano- erations for that insured are pies, cellar entrances, completed. coal holes, driveways, (3) Any insurance provided to an manholes, marquees, additional insured designated hoist away openings, sidewalk vaults, street under Paragraph 9.a.(2): banners,or decorations (a) Subparagraphs (e) and (f) and similar exposures; does not apply to 'bodily in- or jury" or "property damage" 2) The construction, erec- included within the "prod- tion, or removal of ele- ucts-completed operations vators;or hazard"; 3) The ownership, main- (b) Subparagraphs(a), (b), (d), (e)and(f)does not apply to to or use of any 'bodily injury", "property elevators covered by damage" or "personal and this insurance. advertising injury" arising (e) Any state or political subdi- out of the sole negligence or vision with which you have willful misconduct of the ad- agreed per Paragraph ditional insured or their 9.a.(1) above to provide in- agents, "employees" or any surance, subject to the fol- other representative of the lowing provisions: - additional insured;or 1) This insurance applies (c) Subparagraph (f) does not only with respect to op- apply to "bodily injury", erations performed by 'property damage" or "per- you or on your behalf sonal and advertising injury" for which the state or arising out of: political subdivision has 1) Defects in design fur- Issued a permit nished by or on behalf 2) This insurance does of the additional in- not apply to "bodily in- sured;or jury", "property dam- 2) The rendering of, or age" or 'personal and advertising injury" aris- failure to render, any ing out of operations professional architec- performed for the state tural, engineering or or political subdivision. surveying services, in- cluding: Includes copyrighted material of Insurance GA 233 02 07 Services Office, inc.,with its permission. Page 12 of 15 a) The preparing, primary to other insurance approving or fail- available to the additional ing to prepare or Insured except: approve maps, 1) As otherwise provided shop drawings,surveys, in SECTION IV - opinions, field or- reports, COMMERCIAL GEN- , change or- dersERAL LIABILITY ders or drawings CONDITIONS, 5. and specifications; Other Insurance, b. and Excess Insurance;or b) Supervisory, in- 2) For any other valid and spection, architec- collectible insurance tural or engineer- available to the addi- ing activities. tional insured as an additional insured by 3) "Your work"for which a attachment of an en- consolidated (wrap-up) dorsement to another insurance program has insurance policy that is been provided by the written on an excess primecontractor-project basis. In such case, manager or owner of the coverage provided the construction project under this endorsement in which you are in- shall also be excess. volved. (2) Condition 11. Conformance to b. Only with regard to insurance pro- Specific Written Contract or vided to an additional insured desig- Agreement is hereby added: nated under Paragraph 9.a.(2) Sub- paragraph (f) above, SECTION III - 11. Conformance to Specific LIMITS OF INSURANCE is amended Written Contract or to include: Agreement The limits applicable to the additional With respect to additional insured are those specified in the insureds described in Para- written contract or agreement or In graph 9.a.(2)(f)above only: the Declarations of this Coverage If a written contract or Part,whichever are less. If no limitsj specified in the written contractor agreement between you are and the additional insured agreement, or if there is no written specifies that coverage for contract or agreement, the limits ap- the additional insured: plicable to the additional Insured are those specified in the Declarations of a. Be provided by the In- this Coverage Part. The limits of in- surance Services Office surance are indusive of and not in additional insured form addition to the limits of insurance number CG 20 10 or shown in the Declarations. CG 20 37 (where edi- c. SECTION IV-COMMERCIAL GEN- tion specified);or ERAL LIABILITY CONDITIONS is b. Include coverage for hereby amended as follows: completed operations; (1) Condition 5.Other Insurance is or amended to include: c. Include coverage for (a) Where required by a written "your work"; contract or agreement, this and where the limits or cov- insurance is primary and / erage provided to the addi- or noncontributory as re- tional insured is more re- spects any other insurance strictive than was specifi- policy issued to the addi- caliy required in that written tional insured, and such contract or agreement, the other insurance policy shall terms of Paragraphs be excess and/or noncon- 9.a.(3)(a), 9.a.(3)(b) or 9.b. tributing, whichever applies, above, or any combination with this insurance. thereof, shall be interpreted (b) Anyinsuranceprovided byas providing the limits or coverage required by the this endorsement shall be terms of the written contract Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 13 of 15 or agreement, but only to (c) Persons or organizations the extent that such limits or making claims or bring coverage is included within "suits". the terms of the Coverage Part to which this endorse- (2) Deductible Clause ment is attached. If, how- (a) Our obligation to pay dam- ever,the written contract or ages on your behalf applies agreement specifies the In- only to the amount of dam- surance Services Office ad- ages for each "occurrence" ditional Insured form num- which are in excess of the ber CG 20 10 but does not Deductible amount stated in specify which edition, or Section B. Limits of Insur- specifies an edition that ance, 11. of this endorse- does not exist, Paragraphs ment. The limits of insur- 9.a.(3)(a) and 9.a.(3)(b) of ance will not be reduced by this endorsement shall not the application of such De- apply and Paragraph 9.b.of ductible amount. this endorsement shall ap- ply. (b) Condition 2. Duties In the Of- 10. Broadened Contractual Liability Work Event Claimof Ocorre Suit,, apWithin 50'of Railroad Property fense, or ap- plies to each claim or"suit' It is hereby agreed that Paragraph f.(1)of irrespective of the amount. Definition 12. "Insured contract" (SEC- (c) We may pay any part or all TION V-DEFINITIONS)is deleted. of the deductible amount to 11. Property Damage to Borrowed Equip- effect settlement of any ment claim or"suit"and,upon no- tification of the action taken, a. The following is hereby added to Ex- you shall promptly reim- clusion J. Damage to Property of burse us for such part of the Paragraph 2., Exclusions of SEC- deductible amount as has TION I-COVERAGES,COVERAGE been paid by us. A. BODILY INJURY AND PROP- 12. Employees as Insureds - Specified PROP- ERTY DAMAGE LIABILITY: HelthCare Services p Paragraphs (3) and(4)of this exclu- sion do not apply to tools or equip- Itis hereby agreed that Paragraph ment loaned to you, provided they 2.a.(1)(d) of SECTION II - WHO IS AN are not being used to perform opera- INSURED, does not apply to your "em- tions at the time of loss. ployees"who provide professional health • care services on your behalf as duly li- b. With respect to the insurance pro- censed: vided by this section of the endorse- ment, the following additional provi- a. Nurses; sions apply: b. Emergency Medical Technicians;or (1) The Limits of insurance shown in c. Paramedics, the Declarations are replaced by the limits designated in Section in the jurisdiction where an "occurrence" B. Limits of Insurance, 11. of or offense to which this insurance applies this endorsement with respect to takes place. coverage provided by this en- dorsement. These limits are in- 13. Broadened Notice of Occurrence elusive of and not in addition to Paragraph a. of Condition 2. Duties in • the limits being replaced. The the Event of Occurrence, Offense, Limits of Insurance shown in Claim or Suit(SECTION IV-COMMER- Section B.Limits of Insurance, CIAL GENERAL LIABILITY CONDI- 11. of this endorsement fixthe TIONS) is hereby deleted and replaced most we will pay in any one"oc- by the following: currence" regardless of the number of: a. You must see to it that we are noti- fied as soon as practicable of an"oc- (a) Insureds; currence or an offense which may (b) Claims made or "suits" result in a claim. To the extent pos- brought;or sible,notice should include: (1) How, when and where the "oc- currence"or offense took place; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 14 of 15 (2) The names and addresses of This requirement applies only when any injured persons and wit- the"occurrence" or offense is known nesses;and to an"authorized representative". (3) The nature and location of any injury or damage arising out of the"occurrence"or offense. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 15 of 15 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 4/4/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: York International Agency, LLC FAX PHONE 914-376-2200914-376-2891 (A/C, No): (A/C, No, Ext): Attn: bartlettcert@yorkintl.com E-MAIL 500 Mamaroneck Avenue ADDRESS: Harrison NY 10528 INSURER(S) AFFORDING COVERAGENAIC # Travelers Property & Casualty Co of25674 INSURER A : Travelers Indemnity Company25658 INSURED INSURER B : The F.A. Bartlett Tree Expert Company INSURER C : 1290 East Main Street INSURER D : Stamford CT 06902 INSURER E : INSURER F : 589347712 COVERAGESCERTIFICATE 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. ADDLSUBR POLICY EFFPOLICY EXP INSR TYPE OF INSURANCELIMITS POLICY NUMBER (MM/DD/YYYY)(MM/DD/YYYY) LTRINSDWVD BTC2J-GLSA-1005A129-TIL-1612/1/201612/1/2017 COMMERCIAL GENERAL LIABILITY X 1,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED X 1,000,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 10,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- X 2,000,000 POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT A 12/1/201612/1/2017 $ AUTOMOBILE LIABILITY TC2J-CAP-1005A130-TIL-16 2,000,000 (Ea accident) X BODILY INJURY (Per person)$ ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOSAUTOS NON-OWNED PROPERTY DAMAGE XX $ HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB EACH OCCURRENCE$ OCCUR EXCESS LIAB CLAIMS-MADEAGGREGATE$ $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION ATC2K-UB-1005A105-1612/1/201612/1/2017 X STATUTEER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valley THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 11707 E. Sprague Ave., Suite 106 ACCORDANCE WITH THE POLICY PROVISIONS. Spokane Valley 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 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/15/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: York International Agency, LLC FAX PHONE 914-376-2200914-376-2891 (A/C, No): (A/C, No, Ext): Attn: bartlettcert@yorkintl.com E-MAIL 500 Mamaroneck Avenue ADDRESS: Harrison NY 10528 INSURER(S) AFFORDING COVERAGENAIC # Travelers Property & Casualty Co of25674 INSURER A : Travelers Indemnity Company25658 INSURED INSURER B : The F.A. Bartlett Tree Expert Company INSURER C : 1290 East Main Street INSURER D : Stamford CT 06902 INSURER E : INSURER F : 1846717695 COVERAGESCERTIFICATE 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. ADDLSUBR POLICY EFFPOLICY EXP INSR TYPE OF INSURANCELIMITS POLICY NUMBER (MM/DD/YYYY)(MM/DD/YYYY) LTRINSDWVD BTC2J-GLSA-1005A129-TIL-1712/1/201712/1/2018 COMMERCIAL GENERAL LIABILITY X 1,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED X 1,000,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 10,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- X 2,000,000 POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT A 12/1/201712/1/2018 $ AUTOMOBILE LIABILITY TC2J-CAP-1005A130-TIL-17 2,000,000 (Ea accident) X BODILY INJURY (Per person)$ ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOSAUTOS NON-OWNED PROPERTY DAMAGE XX $ HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB EACH OCCURRENCE$ OCCUR EXCESS LIAB CLAIMS-MADEAGGREGATE$ $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION ATC2K-UB-1005A105-1712/1/201712/1/2018 X STATUTEER AND EMPLOYERS' LIABILITY BTRK-UB-1005A117-1712/1/201712/1/2018 Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valley THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 11707 E. Sprague Ave., Suite 106 ACCORDANCE WITH THE POLICY PROVISIONS. Spokane Valley 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