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15-105.01 AM Landshaper: Old Mission Trailhead CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND A.M. LANDSHAPER, INC. Contract #15-105.01 For good and valuable consideration,the legal sufficiency of which is hereby acknowledged, City and the Contractor mutually agree as follows: 1. Purpose: This Amendment is for the Contract for the Mission Trailhead Improvements Project by and between the Parties, executed by the Parties on September 24, 2015, and which terminates on November 15,2015. Said contract shall be referred to as the"Original Contract"and its terms are hereby incorporated by reference. Total compensation under the Original Contract is not to exceed $40,465.75. 2. Original Contract Provisions: The Parties agree to continue to abide by those terms and conditions of the Original Contract and any amendments thereto which are not specifically modified by this Amendment. 3. Amendment Provisions: This Amendment is subject to the following amended provisions, which are either as follows. All such amended provisions are hereby incorporated by reference herein and shall control over any conflicting provisions of the Original Contract, including any previous amendments thereto. Extend project completion date until December 31,2015. 4. Compensation Amendment History: This is Amendment #1 of the Original Contract. The history of amendments to the compensation on the Original Contract and all amendments is as follows: Date Compensation Original Contract Amount 09/24/15 $40,465.75 Amendment#1 11/03/15 $0 Total Amended Compensation $40,465.75 The parties have executed this Amendment to the Original Contract this S7Pi day of November, 2015. CIT •F . • • •NE VALLEY: i ike racks°, .A�.�---_- City Marial. r Its: Owner ATTESS APPROVED A. 0 FORM: — . /40 Christine Bainbridge, City Clerk \ 4f the Ci • orney 1 TE 'AR! ° CERTIFICATE OF LIABILITY INSURANCE DAT (MMf 1wvY5YY) 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(les)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 Clinton Morton Spokane Office PHONE 509 838-3501 FAX 509 838-3511 PayneWest Insurance,Inc. E-MAIL 501 ) (ac,No):( ) 501 N.Riverpoint Blvd.,Ste 403 ADDRESS: Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:The Cincinnati Insurance Co. 10677 INSURED INSURER B: A.M.Landshaper,Inc. INSURER C: Mark Albin 8004 North Market INSURER D: Spokane,WA 99217 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. P LTR TYPE OF INSURANCE NSD SWVD POLICY NUMBER (MM/DUBR D/YYYY) (MM DICD/Wilt) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X EPP0128051 02/24/2015 02/24/2016 DAMAGE TO RENTED 500,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) _$ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: WA STOP GAP $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO EPP0128051 02/24/2015 02/24/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accident) $ )( UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS UAB CLAIMS-MADE EPP0128051 02/24/2015 02/24/2016 AGGREGATE $ 1,000,000 DED X RETENTION S 0 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITYSTATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N N/A E.LEACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) EL QISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ A Equipment Floater EPP0128051 02/24/2015 02/24/2016 Leased and Rented 225,000 A EPP0128051 02/24/2015 02/24/2016 Deductible 1,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Project#15-105-Old Mission Trailhead Improvements Project City of Spokane Valley is an additional insured on a primary/non-contributory basis per policy forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Spokane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. Parks and Recreation Department 2426 N Discovery PI Spokane Valley,WA 99216 AUTHORIZED REPRESENTATIVE 5L,*>- ULL° ( 1000 7n1.1 AI'Aflf1/'ACOADATIAW All r...l.tf..r......r..i..i 9/10/2015 • A M LANDSHAPER INC ,z.,r v llome 7nii;iocn rspariol Contact Search L&I ��at�,:. A-Z Index Help My Secwre L&I Safety Claims&Insurance Workplace Rights Trades&Licensing Washington State Department of Labor & Industries A M LANDSHAPER INC Owner or tradesperson 8004 N.MARKET SPOKANE,WA Principals 509-468-4335 ALBIN,MARK C,PRESIDENT SPOKANE County MCGEE,TYE CYRIL,SECRETARY Doing business as A M LANDSHAPER INC WA UBI No. Business type 601 701 273 Corporation Governing persons MARK C ALBIN TYE C MC GEE; License Verify the contractors active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. AM LANI.971 DO Effective—expiration 03/20/2003—02/24/2016 B ond North American Spec Ins Co $12,000.00 Bond account no. 2181927 Received by L&I Effective date 07/16/2014 09/24/2014 Expiration date Until Canceled RLI INS CO $12,000.00 Bond account no. SSB397618 Received by L&I Effective date 10/02/2009 09/24/2009 Expiration date Until Canceled • Bond history Insurance https://secure.lni.wa.gov/verify/Detail.aspx?UBI=601701273&LIC=AM LAN I*971 DO&SAW=False 1/2 9/10/2015 AM LANDSHAPER INC Cincinnati Ins Co $1,000,000.00 Policy no. EPP225013 • Received by L&I Effective date 02/19/2015 02/24/2012 Expiration date 02124/2016 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings ..... ......-u Noolawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is current. 816,368-01 Doing business as A M LANDSHAPER INC Estimated workers reported Quarter 2 of Year 2015"7 to 10 Workers" L&I account representative TO/CAROLYN CRAWFORD(360)902-4715-Email:CRAI235@Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. https://secure.!ni.wa.govNerify/D etai I.aspx?U BI=601701273&LIC=AM LAN I*971 D O&SAW=False 2/2