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15-136.00 AM Landshaper: Discovery Playground Shade Structure CONSTRUCTION AGREEMENT AM Landshaper,Inc. THIS CONSTRUCTIONAGREEMENT (the "Agreement") is made by and between the City of Spokane Valley, a code City of the State of Washington("City")and AM Landshaper, Inc., ("Contractor") jointly referred to as the"Parties". IN CONSIDERATION of the terms and conditions contained herein the Parties agree as follows: 1. Work to Be Performed. Contractor shall do all work and furnish all labor, supervision,tools,materials, supplies and equipment and other items necessary for the construction and completion of the Discovery Playground—Shade Structure Project(the"Work")in accordance with documents described in Exhibit A and in accordance with this Agreement(which are by this reference incorporated herein and made part hereof(the "Contract Documents")), and shall perform any changes in the work in accordance with the Contract Documents. The terms and provisions in this Agreement shall control over any inconsistent or incompatible terms in any other Contract Document. Contractor shall, for the amount set forth in paragraph 4,below, assume and be responsible for the cost and expense of all work required for constructing and completing the Work and related activities provided for in the Contract Documents to City's satisfaction,within the time limits prescribed in the Contract Documents. The City Manager,or designee,shall administer and be the primary contact for Contractor. Upon notice from City,Contractor shall promptly commence work,complete the same in a timely manner,and cure any failure in performance under this Agreement. Unless otherwise directed by City,all work shall be performed in conformance with the Contract Documents, and all City,State and federal standards,codes,ordinances,regulations and laws as now existing or as may be adopted or amended. 2. Time for Performance. Contractor shall commence the Work within 10 days of receipt of a notice to proceed and shall complete the Work by December 31,2015. 3. Liquidated Damages. TIME IS OF THE ESSENCE FOR THIS CONTRACT. Delays cause inconvenience to the residents of City and cost taxpayers undue sums of money, adding time needed for administration,engineering,inspection and supervision. It is impractical for City to calculate the actual cost of delays. Accordingly, Contractor agrees to pay liquidated damages for failure to achieve Substantial Completion(as defined in the Contract Documents)which shall be in the amount of$100.00 per day.These liquidated damages are not a penalty, but are fixed and agreed upon by and between Contractor and City because of the impracticability and difficulty of fixing and ascertaining the actual damages that City would sustain in the event that the Work is not completed in accordance with the Contract Documents. Liquidated damages may be retained by City and deducted from payments otherwise due to the Contractor. 4. Compensation. In consideration of Contractor performing the Work, City agrees to pay Contractor in accordance with the Contract Documents the sum of $12,500.00, plus Washington State Sales Tax of $1,087.50,for a total of$13,587.50,based on the Base Bid submitted by Contractor(Exhibit B),and as may be adjusted in accordance with the Contract Documents. Construction Agreement Page 1 of 7 5.Payment. Contractor may elect to be paid in monthly installments,upon presentation of an application for payment in a form satisfactory to City. Applications for payment shall be sent to the City Finance Department at the below stated address. Pursuant to chapter 60.28 RCW, five percent of the compensation due Contractor shall be retained by City. City reserves the right to withhold payment under this Agreement 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 Contract Documents,City standards, City Code, and federal or state standards. 6. Notice. Notice other than applications for payment shall be given in writing as follows: TO THE CITY: TO THE CONTRACTOR: Name: Christine Bainbridge, City Clerk Name: A.M. Landshaper,Inc. Phone: (509)921-1000 Phone: (509)468-4335 Address: 11707 East Sprague Ave, Suite 106 Address: 8004 N. Market Spokane Valley, WA 99206 Spokane,WA 99217 7.Applicable Laws and Standards. The Parties,in the performance of this Agreement,agree to comply with all applicable federal, state, and local laws, codes and regulations. 8. Certification Regarding Debarment, Suspension, and Other Responsibility Matters — Primary Covered Transactions. A.By executing this Agreement,the Consultant certifies to the best of its knowledge and belief,that it and its principals: 1. Are not presently debarred, suspended, proosed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; 2. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission or fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction;violation of federal or state antitrust statues or commission of embezzlement,theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph(A)(2)of this certification; and 4. Have not within a three-year period preceding this application/proposal had one or more public transactions(federal, state,or local)terminated for cause or default. B. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this Agreement. 9.Prevailing Wages on Public Works. Contractor,any subcontractor,or other person doing work under this Agreement, shall comply with the requirements of chapter 39.12 RCW, and shall pay each employee an amount not less than the Prevailing Rate of Wage,as specified by the Industrial Statistician of the Washington State Department of Labor and Industries("L&P'). If employing labor in a class not shown,Contractor shall request a determination of the correct wage rate for the class and locality from the Industrial Statistician. Construction Agreement Page 2 of 7 Contractor shall provide a copy of any such determinations to City. Before commencing,during,and upon completion of the work,Contractor shall file all forms and pay all fees required by L&I and shall indemnify and hold City harmless from any claims related to its failure to comply with chapter 39.12 RCW. The following information is provided pursuant to RCW 39.12.030: A. State of Washington prevailing wage rates applicable to this public works project, published by L&I are located at the L&I website address: https://fortress.wa.gov/ln i/wagelookup/prvWagelookup.aspx B. This Project is located in Spokane County. C. The effective prevailing wage date is the same date as the bid due date as referenced in the original request for bids and as may be revised by addenda. A copy of the applicable prevailing wage rates is also available for viewing at the offices of City located at 11707 East Sprague,Suite 106,Spokane Valley,WA 99206. Upon request,City will mail a hard copy of the applicable prevailing wages for this project. 10.Relationship of the Parties. It is understood,agreed and declared that Contractor shall be an independent contractor,and not the agent or employee of City,that City is interested in only the results to be achieved,and that the right to control the particular manner,method and means in which the services are performed is solely within the discretion of Contractor. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Contractor. Contractor shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 11.Ownership of Documents. All drawings,plans,specifications,and other related documents prepared by Contractor under this Agreement are and shall be the property of City, and may be subject to disclosure pursuant to chapter 42.56 RCW, or other applicable P PP public record laws. 12.Records. The City or State Auditor or any of their representatives shall have full access to and the right to examine during normal business hours all of Contractor's records with respect to all matters covered in this Agreement. Such representatives shall be permitted to audit,examine and make excerpts or transcripts from such records and to make audits of all contracts,invoices,materials,payrolls and record of matters covered by this contract for a period of three years from the date final payment is made hereunder. 13.Warranty. Unless provided otherwise in the Contract Documents,Contractor warrants that all Work and materials performed or installed under this Agreement are free from defect or failure for a period of one year following final acceptance by City,unless a supplier or manufacturer has a warranty for a greater period,which warranty shall be assigned or transferred to City. In the event a defect or failure occurs in work or materials, Contractor shall, within the warranty period, remedy the same at no cost or expense to City. This warranty provision shall not be construed to establish a period of limitation with respect to Contractor's other obligations under this Agreement. Construction Agreement Page 3 of 7 14.Contractor to Be Licensed And Bonded. Contractor shall be duly licensed,registered and bonded by the State of Washington at all times this Agreement is in effect. 15.Contractor to provide performance and payment bonds. Contractor shall provide a payment bond and a performance bond in the full amount of the contract on the City's bond forms. Alternatively,Contractor may elect to have the City retain 50%of the contract amount lieu of providing the City with a payment bond and a performance bond, pursuant to RCW 39.08.010(3). 16. Insurance. Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by Contractor, its agents,representatives,or employees. A. Minimum Scope of Insurance. Contractor shall obtain insurance of the types described below: 1.Automobile liability insurance covering all owned,non-owned,hired,and leased vehicles. Coverage shall be written on Insurance Services Office(ISO)form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2.Commercial general liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises,operations,independent contractors,products- completed operations,stop gap liability,personal injury and advertising injury,and liability assumed under an insured contract. The commercial general liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. There shall be no endorsement or modification of the commercial general liability insurance for liability arising from explosion,collapse or underground property damage. City shall be named as an insured under Contractor's commercial general liability insurance policy with respect to the work performed for City using ISO Additional Insured endorsement CG 20 10 10 01 and Additional Insured-Completed Operations endorsement CG 20 37 10 01 or substitute endorsements providing equivalent coverage. 3.Workers' compensation coverage as required by the industrial insurance laws of the State of Washington. B. Minimum Amounts of Insurance. Contractor shall maintain the following insurance limits: 1.Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of 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, and no less than a $2,000,000 products- completed operations aggregate limit. C. Other Insurance Provisions. The insurance policies are to contain,or be endorsed to contain,the following provisions for automobile liability,professional liability and commercial general liability insurance: 1. Contractor's insurance coverage shall be primary insurance with respect to City. Any insurance, self-insurance, or insurance pool coverage maintained by City shall be excess of Contractor's insurance and shall not contribute with it. Construction Agreement Page 4 of 7 2. Contractor shall fax or send electronically in .pdf format a copy of insurer's cancellation notice within two business days of receipt by Contractor. D.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.Best rating of not less than A:VII. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, Contractor shall furnish acceptable insurance certificates to City at the time Contractor returns the signed Agreement,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. Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions, and/or self-insurance. 17.Indemnification and Hold Harmless. Contractor shall,at its sole expense,defend,indemnify and hold harmless City and its officers, agents, and employees, from any and all claims, actions, suits, liability, loss, costs,attorney's fees and costs of litigation,expenses,injuries,and damages of any nature whatsoever relating to or arising out of the wrongful or negligent acts,errors or omissions in the services provided by Contractor, Contractor's agents, subcontractors, subconsultants and employees to the fullest extent permitted by law, subject only to the limitations provided below. Contractor's duty to defend,indemnify and hold harmless City shall not apply to liability for damages arising out of such services caused by or resulting from the sole negligence of City or City's agents or employees. Contractor's duty to defend,indemnify and hold harmless City against liability for damages arising out of such services caused by the concurrent negligence of(a) City or City's agents or employees, and(b)Contractor, Contractor's agents, subcontractors, subconsultants and employees, shall apply only to the extent of the negligence of Contractor, Contractor's agents, subcontractors, subconsultants and employees. Contractor's duty to defend,indemnify and hold City harmless shall include,as to all claims,demands,losses and liability to which it applies, City's personnel-related costs,reasonable attorneys'fees,and the reasonable value of any services rendered by the office of the City Attorney,outside consultant costs,court costs,fees for collection, and all other claim-related expenses. Contractor specifically and expressly waives any immunity that may be granted it under the Washington State Industrial Insurance Act,Title 51 RCW. These indemnification obligations shall not be limited in any way by any limitation on the amount or type of damages, compensation or benefits payable to or for any third party under workers' compensation acts, disability benefit acts, or other employee benefits acts. Provided, that Contractor's waiver of immunity by the provisions of this paragraph extends only to claims against Contractor by City,and does not include,or extend to,any claims by Contractor's employees directly against Contractor. Contractor hereby certifies that this indemnification provision was mutually negotiated. 18. Waiver. No officer, employee,agent or other individual acting on behalf of either party has the power, right or authority to waive any of the conditions or provisions of this Agreement. No waiver in one instance shall be held to be waiver of any other subsequent breach or nonperformance. All remedies afforded in this Agreement or by law, shall be taken and construed as cumulative, and in addition to every other remedy provided herein or by law. Failure of either party to enforce at any time any of the provisions of this Agreement or to require at any time performance by the other party of any provision hereof shall in no way be construed to be a waiver of such provisions nor shall it affect the validity of this Agreement or any part thereof. Construction Agreement Page 5 of 7 19. 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. 20. Confidentiality. Contractor may,from time to time,receive information which is deemed by City to be confidential. Contractor shall not disclose such information without the prior express written consent of City or upon order of a Court of competent jurisdiction. 21.Disputes. All disputes arising under or related to this Agreement that cannot be resolved through informal discussion and negotiations shall be resolved by litigation filed in the Superior Court for Spokane County, unless otherwise required by applicable federal or state law. 22. Subcontractor Responsibility. As required by RCW 39.06.020, Contractor shall verify responsibility criteria for each first tier subcontractor and its subcontractors of any tier that hires other subcontractors shall verify responsibility criteria for each of its subcontractors. Verification shall include that each subcontractor,at the time of subcontract execution,meets the responsibility criteria listed in RCW 39.04.350(1)and possesses an electrical contractor license,if required by chapter 19.28 RCW,or an elevator contractor license if required by chapter 70.87 RCW. This verification requirement must be included in every subcontract of every tier. 23.Jurisdiction and Venue. This Agreement is entered into in Spokane County,Washington. Venue shall be in Spokane County, State of Washington. 24. Entire Agreement. This Agreement constitutes the entire and complete agreement between the parties and supercedes any prior oral or written agreements. This Agreement may not be changed,modified or altered except in writing signed by the Parties. 25. Anti-kickback. No officer or employee of City,having the power or duty to perform an official act or action related to this Agreement shall have or acquire any interest in this Agreement, or have solicited, accepted or granted a present or future gift, favor, service or other thing of value from any person with an interest in this Agreement. 26.Business Registration. Prior to commencement of Work under this Agreement,Contractor shall register with the City as a business. 27. 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. 28. Exhibits. Exhibits attached and incorporated into this Agreement are: A. Scope of Work B. Cost Statement C. Insurance Endorsements The Parties have executed this Agreement this 3rd day of December,2015. Construction Agreement Page 6 of 7 CITY OF SPOKANE VALLEY: Contractor: , , / / . - 1L 1. / !'l,jr Mike Jackso/City Manager Owner Tye C. McGee Sec/Treasurer ATTES ,d APPROVED AS TO FORM: .---- ( () 1.. . (614....vezji Christine Bainbridge, City Clerk ' Office o t e City Att ey Construction Agreement Page 7 of 7 Spot ane .•••••0Valley PART 3 BID RESPONSE DOCUMENTS ADDENDUM #1 DISCOVERY PLAYGROUND - SHADE STRUCTURE November 17, 2015 City of Spokane Valley, Washington Parks and Recreation Department 2426 N. Discovery Place Spokane Valley, WA 99216 Prepared By: IJ M T ■ L A Michael Terrell ■ Landscape Architecture, PLLC 1421 North Meadowwood Lane, Suite 150 Liberty Lake, WA 99019 (509) 922-7449 v DISCOVERY PLAYGROUND #1N November SHADE STRUCTURE ADDENDUM o e e 17,2015 CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT Person/Entity Name: AM Landshaper Inc Signature Of Bidder: C ' A G Part 3 - Bid Response Documents Page II 1 DISCOVERY PLAYGROUND-SHADE STRUCTURE ADDENDUM #1 November 17,2015 CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT PART 3 - BID RESPONSE DOCUMENTS BID PROPOSAL PROJECT TITLE: DISCOVERY PLAYGROUND - SHADE STRUCTURE • NAME OF FIRM SUBMITTING BID: AM Landshaper, Inc. Each bid shall constitute an offer to the City of Spokane Valley as outlined herein and no bidder may withdraw his bid after the hour set for the bid closing except under the conditions explained in the Information to Bidders Section. RECEIPT OF ADDENDA: Bidder acknowledges receipt of the following addenda: Addendum No. Date Addendum No. Date 1 11/17/15 REJECTION: The City reserves the right to reject any or all proposals, portions or parts thereof and to waive all minor irregularities in bidding. Special attention will be directed to the qualifications of the bidders when considering awarding a contract. TIME TO COMPLETE: The work related to the DISCOVERY PLAYGROUND - SHADE STRUCTURE will be Substantially Completed by December 31, 2015. BID IS NOT ELIGIBLE FOR CONTRACTOR'S BOND ELECTION to withhold 50% retainage in lieu of furnishing a Contractor's Bond (Performance and Payment Bond). SUBCONTRACTORS LIST: See Special Conditions SUBMITTAL: The "Bid Response Documents" Section constitutes the Bid Proposal when completed and submitted. Please do not submit the entire Invitation to Bid manual. FREIGHT: Bid price(s) to include all freight costs to the job site. Shade Structure will be available for pick up in Spokane Valley. • Person/Entity Name:AM Landshaper Inc.Signature Of Bidder: Part 3 - Bid Response Documents Page III DISCOVERY PLAYGROUND-SHADE STRUCTURE ADDENDUM #1 November 17,2015 CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT BASE BID — DISCOVERY PLAYGROUND - SHADE STRUCTURE As identified in the Construction Documents plans and details with the exception of Alternate #1 work detailed below. BASE BID = $ (Z, .oc 8.7% SALES TAX = $ TOTAL BASE BID= $ 1.3 . 'O ALTERNATE #1 — DISCOVERY PLAYGROUND - SHADE STRUCTURE Cast-in-Place Concrete: Pour, finish, provide saw cut and contraction joints to replace concrete removed for installation of shade structure poles. Includes: compaction and rough grade, 4" compacted (95%) crushed surfacing base course, 4" of poured in place concrete with: Synthetic Micro-Fiber: Monofilament polypropylene micro-fibers engineered and designed for use in concrete, complying with ASTM C 1116/C 1116M, Type III, 1/2 to 1-1/2 inches. Finish to match existing adjacent concrete flat work. ALTERNATE #1 BID = I 1-1 �O 8.7% SALES TAX = $ l TOTAL ALTERNATE #1= $ l[7L4 BID SUMMARY i Si .5Y-7-6O TOTAL BASE BID = $ f TOTAL ALTERNATE #1= $ bgtfg GRAND TOTAL = $ [ 6 43 - AM Landsha er In Person/Entity Name: A signature Of Bidder: Part 3 - Bid Response Documents Page IV DISCOVERY PLAYGROUND-SHADE STRUCTURE ADDENDUM #1 November 17,2015 CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT REPRESENTATIONS AND CERTIFICATIONS ANTI-KICKBACK No officer or employee of the City of Spokane Valley, having the power or duty to perform an official act or action related to this submittal, shall have or acquire any interest in this submittal, or have solicited, accepted or granted a present or future gift, favor, service, or other thing of value from or to any person involved in this submittal. REPRESENTATION: In submitting this bid we represent that the bid documents have been read and understood, that the site has been visited and or that we have familiarized ourselves with the local conditions under which the work is to be performed, that by signature of this proposal we acknowledge all requirements and that we have signed all certificates contained herein. REPRESENTATION: In submitting this bid we acknowledge the requirements and conditions applicable to bid deposits in the form of a cash bid deposit or surety bond bid deposit. I CERTIFY that no final determination of violation of RCW 50.12.070(1)(b), 50.16.070(1)(b), or 82.32.070(1)(b) has been made by the Washington State Departments of Employment Security, Labor And Industries or Revenue respectively dated within two years of the date of the opening of this bid. I understand further that no bid may be submitted, considered or contract awarded for a public work to any person or entity that has a determination of violation of the above referenced statutes within two years from the date that a violation is finally determined and the date of this bid opening. I CERTIFY that to the best of my knowledge the information contained in this proposal is accurate and complete and that I have the legal authority to commit this Firm to a contractual agreement. I realize the final funding for any service is based upon budget levels and the approval of the City of Spokane Valley. Name: AM Landshaper, Inc. Person/Entity submitting bid (print) Signature: - Title: President Date: 11/23/15 Part 3 - Bid Response Documents Page V DISCOVERY PLAYGROUND-SHADE STRUCTURE ADDENDUM #1 November 17,2015 CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT c cu BIDDER'S ADMINISTRATIVE INFORMATIONco 5 co O C OA N _ O c c to To' c • Y o •U f0 1. PERSON/ENTITY o d N • m Q O •c a. Name as registered with the State Of Washington: AM Landshaper, Inc. 03 M c c b. Physical Address: 8004 N. Market Spokane, WA 99217e4 N ° c. Mailing Address including zip code: same a▪ u 0 Q- d. Remit To Address includingzipcode: same ° E' o v e. Telephone number including area code: (509)468-4335 V 0 > • N cVl v O f. Fax number including area code: (509)468-4225 • L L -0up `� L N • Gl C7 g. E-mail address for business correspondence: amlandshaper@msn.com V - c co o h. Washington State Contractors License Number: AMLANI*971D0 E :42 3 i. Federal Tax Identification Number: REDACTED Q j. Washington State UBI Number: 601 701 273s ° E .0 } 2 2 n k. State Industrial Account Identification Number: 816,368 01 2. INSURANCE COMPANY: a. Name of company: Cincinnati Insurance Company b. Mailing Address including zip code: PO Box 145620 Cincinnatti, OH 45250-5620 c. Insurance Agent Name: Clint Morton d. Insurance Agent Telephone number including area code: (509)838-3502 e. Insurance Agent Fax number including area code: (509)8383511 3. BONDING COMPANY: a. Surety Name: North AMerican Speciality Insurance Co. b. Surety Mailing Address including zip code: 1429 5th AVE Ste 2200 Seattle, WA 98101 c. Bonding Agent Name: George Schroeder, Wells Fargo Insurance d. Bonding Agent Mailing Address including zip code: 601 W. 1st Ste 800 Spokane, WA e. Bonding Agent Telephone number including area code:( 509)358-3800 99201 f. Bonding Agent Fax number including area code: (509) 358-3805 Part 3 - Bid Response Documents Page VI DISCOVERY PLAYGROUND-SHADE STRUCTURE ADDENDUM#1 November 17,2015 CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT Bidder to provide Bidder Qualification information for General Contractor: BIDDER QUALIFICATION STATEMENT The following statements of experience, personnel, equipment, and general qualifications of the Bidder are submitted with the assurance that the owner can rely on its accuracy and truthfulness. If more space is required for your answers please attach a continuation sheet(s) to the corresponding bid response page referencing the item number. 1. The company has been in business continuously from (month and year) 2/1992 2. Provide the following information on three similar projects the company has completed that was on an order of magnitude equal to or greater in scope and complexity to that required under the proposed contract. Project Name Owner Phone No. Location #1 Terrace View Park City of Spokane Valley 927-1000 Spokane Valley #2: Sullivan Park City of Valley/DOT 927-1000 Spokane Valley Moore Turner #3: Heritage Garden City of Spokane 625-6680 Spokane Provide responses to the following items regarding each project listed above: A. Short description of project, for example, shade structure, park shelter or concrete sidewalk/pad or park irrigation systems. 1 . Picnic shelter construction/ landscape restoration/ arbor, walls 2. picnic shelter/drinking fountain/landscape, irrigation 3. Historic preservation of garden including walls, shelter, plants and irrigation B. Identify elements of project focused particularly on excavation, setting critical grades and layout. Each of these 3 projects required the creation of grades using heavy equipment in preparation for newly constructed picnic shelters, and/or arbors, concrete slabs, and accessible walkways in public places. C. Name of Designer. 1 . Michael Terrell Landscape Architecture 2. Linda M. Cyra-Korsggard L.A, Mark A Brower Engineer, Craig Aldworth, P.M. 3 . AHBL Richard Hartlage. Part 3 - Bid Response Documents Page VII DISCOVERY PLAYGROUND-SHADE STRUCTURE ADDENDUM #1 November 17,2015 CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT D. Construction contract value, both at the time of award and upon completion. 1 . $76. 000 - $78,619. 25 2. $151 , 842 - $149,561 3. $499,645 - 525,527 E. Identify if you were the general contractor or a subcontractor on the project. 1 . General 2 . General 3. General F. The date each project was started and completed. 1 . 7/2011 - 11/2011 2 . 10/2013 - 4/2014 3 . 10/2007 - 11/2008 4. List supervisory personnel currently employed by the Bidder and available for work on the project (Construction Manager, principal foreman, superintendents and engineers) is as follows: Years of Name Title Experience Mark Albin President 31 Tye McGee Sec/Treasurer . 35 Ryan Wicke Foreman 19 Jon Wagner Project Manager 33 Eric Von Trapp Foreman 7 5. Attach a resume with the qualifications, previous employers, and experience of the project manager who is proposed to be assigned to this project. If a resume is not included in the bid documents the bidder agrees to furnish a resume within 24 hours of notice by the City. Part 3 - Bid Response Documents Page VIII 1\ ' A.111. LANDS V. • Contractors AMLAND 971 DO 8004 N. Market Spokane, WA 99217 PHONE(509)468-4335 FAX (509)468-4225 • Project Managers: Tve McGee Tye has worked in the commercial landscape industry since 1979. He origihally worked for Nelson Landscape Service from Fall 1979 until winter of 1992 and since that time has been self employed at AM Landshaper Inc. He involved in all aspects of the business. Project experience includes but is not limited to- -Phi Kappa Theta 6,500 sf keystone retaining wall @ WSU _ 1996 -Home Depot, Richland 255,000 sf keystone retaining wall 1998-1999 -EWU, Woodward Stadium north concourse improvements 2004 -Spokane Convention Center new construction 2006 -GU West Boone Pedestrian Mall 2007 -GU Johnston Mall 2007 -Moses Lake; WA Lions Field reconstruction 2008 • -City of Spokane Parks and Rec Comstock Park new irrigation system 2009 -C/DA Casino Renovation, additions 2009-2013 Mar kAlbin Mark has worked in the commercial landscape industry, singe 1984 and is co- founder of AM Landshaper Inc. in 1992. He is involved in all aspects of the business and some of his project experience includes but is not limited to: -Whitworth University Athletic Field, landscape and irrigation 2002 -Sky Prairie Park, building of park from excavation to finish 2001-2002 -GU Base field, installation of field from excavation to finish 2006 -GU Mulligan Field underground drainage 2006 -VVhitworth University Intramural sports field, earthwork/landscape/irrigation 2007 -GU Soccer Field, excavation to completion of field 2008 -CDA Site Revisions, 5.4 Million landscape/irrigation 2009-2012 -SFCC Athletic Field improvements excavation and site prep for synthetic turf field 2012 -WU Merkel Field, excavation and site prep for synthetic turf field, construct dugouts, and bleachers. Jon Wagner Jon came to us from Wesslen Construction employed there from 2001-2011 . where he worked as a project manager, project supervisor and heavy equipment operator. He has been employed with AM Landshaper from 2011 and works as an estimator and project manager. His project experience includes but is not limited to- -Sandy River Bridge removal and relocation 2011 -SFCC Athletic Field Improvements syntheic turf field, track resurfacing and improvements 2012 -WU Merkel Field excavation for synthetic turf field, construction of dugouts and bleachers. 2012 -Sullivan Park improvements remodel of an existing park to allow new bridge construction including excavation, landscape, irrigation and construction of a new picnic shelter. DISCOVERY PLAYGROUND-SHADE STRUCTURE ADDENDUM #1 November 17, 2015 CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT Part 3 - Bid Response Documents Page IX DISCOVERY PLAYGROUND-SHADE STRUCTURE ADDENDUM #1 November 17,2015 CITY OF SPQKANE VALLEY PARKS AND RECREATION DEPARTMENT BIDDER COMPLIANCE CERTIFICATION PROJECT COMPLIANCE In compliance with the request for quotation, bidder hereby proposes to perform all work for this project in strict accordance with the contract documents, within the time set forth therein, and at the prices bid. SPECIFICATION COMPLIANCE The bidder certifies below that his/her bid complies in all respects with the attached specification documents, including the minimum specifications. YES X NO Part 3 - Bid Response Documents Page X DISCOVERY PLAYGROUND-SHADE STRUCTURE ADDENDUM #1 November 17,2015 CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT SUBCONTRACTOR LIST Project: DISCOVERY PLAYGROUND - SHADE STRUCTURE Subcontract List. It is strongly recommended that the subcontractor list be enclosed with the bid documents. Please refer to "SUBCONTRACTORS" in the Information For Bidders Section for specific information regarding the listing requirements. Attach additional sheets if required. Use copies of these pages as masters for attachment. If a subcontractor list is not submitted with the bid, it must be delivered to the City of Spokane Valley Parks and Recreation Department, 2426 N. Discovery Place Spokane Valley, WA 99216 no later than 1:00 P.M. the same day of the published bid submittal date and time (one hour after the closing time of 12:00 P.M.). Type of work -CONCRETE CONTRACTOR. If this work is required and the bidder will be doing the work the bidder must list its name as the contractor below. Jim Johnson CONCRETE CONTRACTOR NAME (please print) Type of work / Material - SHADE STRUCTURE CONTRACTOR. If this work is required and the bidder will be doing the work the bidder must list its name as the contractor below. SHADE STRUCTURE CONTRACTOR NAME (please print) Part 3 - Bid Response Documents Page XI DISCOVERY PLAYGROUND-SHADE STRUCTURE ADDENDUM #1 November 17, 2015 CITY OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT BID DEPOSIT FORM OF BID DEPOSIT - CHECK ONE: Please submit this sheet with the bid deposit. CASH. Attach the deposit behind this sheet. X SURETY BOND - Attach bid bond behind this sheet. IT IS STRONGLY RECOMMENDED THAT YOU USE THE ATTACHED FORM. Part 3 - Bid Response Documents Page XII DISCOVERY PLAYGROUND-SHADE STRUCTURE ADDENDUM #1 November 17, 2015 Crit OF SPOKANE VALLEY PARKS AND RECREATION DEPARTMENT BOND NO: N/A Valle V' CONTRACTOR'S BID DEPOSIT SURETY BOND S to City of Spokane Valley,Washington We A.M.Landshaper,Inc. , as Principal, existing under and by virtue of the laws of the State of Washington and authorized to do business in the State of Washington, aniforth American Specialty Insurance Company Surety,organized and existing under the laws of the State of NH , are held and firmly bound. unto the City of Spokane Valley,a Washington municipality,as Obligee,in the penal sum of 5%of the total amount bid,not to exceed Five Percent of Amount Bid(5%) ,for the payment of which we jointly and severally bind ourselves, and our legal representatives and successors. WHEREAS,the Principal has submitted a bid.for DISCOVERY PLAYGROUND-SHADE STRUCTURE. NOW THEREFORE,the condition of the obligation is such that if the Obligee shall accept the bid of Principal and make timely award to the Principal according to the terms of the bid documents;and the Principal shall,within ten days after notice of the award,exclusive of the day of notice,enter into the contract with the Obligee and furnish the contractor's bonds(performance and payment bonds)with Surety satisfactory to the Obligee in an amount equal to 100%of the amount of the bid proposed including additives,alternatives and Washington State sales tax,then this obligation shall be null and void;otherwise if the Principal fails to enter into the contract and fails to furnish the contractor's bonds within ten days of notice of award,exclusive of the day of notice,the amount of the bid deposit shall be forfeited to the Obligee,payable by the Surety;but in no event will the Surety's liability exceed the face amount of this bid bond. This bond may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. North American Specialty PRINCIPAL(CONTRACTOR) SURE Insurance Company A.M. Landu(iaper,'In '\,,, �-- rL---I1/23/2015 �.� et1/23/2015 Principal Signature Date u -ty Signature Date .•tea r k C. Albin Kathy Gurley Printed Name Printed Name President Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: Wells Fargo Insurance Services USA,Inc. 601 W.First Ave.,Suite 800,Spokane,WA 99201 Part 3 - Bid Response Documents Page XV NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Manchester,New Hampshire,and Washington International Insurance Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg,Illinois,each does hereby make,constitute and appoint: GEORGE C.SCHROEDER,KATHY GURLEY,CHRIS LARSON,ERIN L.REPP,H.KEITH McNALLY, DIANA R.WILLIAMS and ALISON FREISZ-STEWARD JOINTLY OR SEVERALLY Its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION($50,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9th of May,2012: "RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached." "NG jNg~�OptSnomPNoumtu ", cr.6064.0.i. 064. G.e sG By gai SEAL ':A Steven P.Anderson,Senior Vice President of Washington International Insurance Companytti SEAL n 1973 o1.n &Senior Vice President of North American Specialty insurance Company em M PS dad`; r� omniini Michael A.Ito Senior Vice President of ashmgton International Insurance Company wOItamonneW &Senior Vice President of North American Specialty Insurance Company IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 1st day of June ,2015 . North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook ss: On this 1st day of June ,2015 before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A.Ito, Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. OFFICIAL SEAL M KENNY NOTARY PUBLIC,STATE OF ILLINOIS M.Kenny,Notary Publicr ' MY COMMISSION EXPIRES 12104/2017 I, Jeffrey Goldberg , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect. IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 23rd day of November ,20 15 AZ/ - Jeffrey Goldberg,Vice President&Assistant Secretary of Washington International Instsance Company&North American Specialty Insurance Company Spo° �ane 2200091 BOND NO: CONTRACTOR'S PAYMENT BOND(NON-FEDERALLY FUNDED PROJECT) to City of Spokane Valley,Washington The City of Spokane Valley,Washington,in Spokane County,has awarded to A.M.Landshaper,Inc.,as Principal,a contract for the construction of the project designated as Discovery Playground Shade Structure,Project No. 15-136 in Spokane Valley,Washington,and said Principal is required under the terms of the Contract to furnish a payment bond in accordance with chapter 39.08 Revised Code of Washington(RCW). The Principal, and North American Specialty Insurance Company (Surety), a corporation organized under the laws New Hampshire and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,as Obligee,in the sum of$ 13,587.50 total Contract amount (including Washington State sales tax), subject to the provisions herein. This payment bond shall become null and void,if and when the Principal,its heirs,executors,administrators,successors,or assigns shall pay all persons in accordance with chapters 39.08 and 39.12 RCW,including all workers,laborers,mechanics, subcontractors,and materialmen,and all persons who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work; and shall indemnify and hold harmless the Obligee from all loss, cost or damage which Obligee may suffer by reason of the failure of Principal to make such required payments;and if such payment obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change,extension of time,alteration or addition to the terms of the Contract,the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond,except as provided herein,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. North American Specialty PRINCI AL(COONt TRACTO A.M.Landshaper,Inc. Ft Ty Insura►ce Co ,any ( - � 12/3/2015 - , l 1 /2015 Princip Signature Date Surety Signature Date Tye C. McGee Diana R.Williams Printed Name Printed Name Attorney-in-Fact Sec/Treasurer Title Title Wells Fargo Insura ie nSery ces USA,In ent of Surety Company is: 601 W.First Avenue,Suite 800,Spokane,WA 99201 (509)358-3800 Updated 1.14.2013 Spokane 'alley 2200091 BOND NO: CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley,Washington,in Spokane County,has awarded to A.M.Landshaper,Inc.,as Principal,a contract for the construction of the project designated as Discovery Playground Shade Structure,Project No. 15-136 in Spokane Valley,Washington,and said Principal is required under the terms of the Contract to furnish a performance bond in accordance with chapter 39.08 Revised Code of Washington(RCW). • The Principal, and North American Specialty Insurance Company (Surety), a corporation, organized under the laws of New Hampshire and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,as Obligee,in the sum of$ 13,587.50 total Contract amount (including Washington State sales tax), subject to the provisions herein. This performance bond shall become null and void,if and when the Principal,its heirs,executors,administrators,successors, or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all the terms and conditions of all duly authorized modifications,additions,and changes to said Contract that may hereafter be made,at the time and in the manner therein specified;shall warranty the work as provided in the Contract and shall indemnify and hold harmless the Obligee from any defects in the workmanship and materials incorporated into the work for the period identified in the Contract;and if such performance obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change,extension of time,alteration or addition to the terms of the Contract,the specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its obligation on this bond,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. North Am• ican Specialty PRINCIPAL(CONTRACTOR)A.M.Landshaper,Inc. S;&,'Ty Insuranc/ pa• 12/3/2015 / - l� 2015 Principal Signature Date Surety Signature Date Diana R.Williams Tye C. McGee Printed Name Printed Name Sec/Treasurer Attorney-in-Fact Title Title Dries address,land teleenhone of local cel/agent of Surety Company is: e s argoinsurance ervices , n . 601 W.First Avenue,Suite 800,Spokane WA 99201 (509) 358-3800 Updated 1.14.2013 NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Manchester,New Hampshire,and Washington International Insurance Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg,Illinois,each does hereby make,constitute and appoint: GEORGE C.SCHROEDER,KATHY GURLEY,CHRIS LARSON,ERIN L.REPP,H.KEITH McNALLY, DIANA R.WILLIAMS and ALISON FREISZ-STEWARD JOINTLY OR SEVERALLY Its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of FIFTY MILLION($50,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 9th of May,2012: "RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached." tGIAUTYjNSO�iG 5 01^C2-- e��Ggq�gSPPR�i SEAL : Styo B2' SEAL oZIONA Steven P.Anderson,Senior Vice President of Washington International Insurance Company :y ss to W iZ�J�, 1973 4.0 n Zr. &Senior Vice President of North American Specialty Insurance Company m h i O` 1j. 'dNuni1��\ By j7/ "'1f•..,7,...) Michael A.Ito,Senior Vice President of ashmgton International Insurance Company &Senior Vice President of North American Specialty Insurance Company IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 1st day of June ,2015 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook ss: On this 1st day of June ,2015 before me,a Notary Public personally appeared Steven P.Anderson ,Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A.Ito, Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company,personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. OFFICIAL SEAL M KENNY \--_. � �/ S NOTARY PUBLIC,STATE OF ILLINOIS M.Kenny,Notary Public MY COMMISSION EXPIRES 12104/2017 I, Jeffrey Goldberg , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect. IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this 3rd day of December ,20 15 . Jeffrey Goldberg,Vice President&Assistant Secretary of Washington International Insurance Company&North American Specialty Insurance Company ,,.�...., AMLANDS-01 WCHRISTESON ARL " DATE(MM/DD/YYYY) `,,,�, CERTIFICATE OF LIABILITY INSURANCE 12/3/2015 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 NAME: Spokane Office PHONE 509 838-3501 FAX 509 838-3511 PayneWest Insurance,Inc. (A/C.No.Est): ) (A/C,No): ) AIL 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) 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 REN I ED 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 'CT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: WA STOP GAP $ 1,000,000 AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT $ 1,000,000 f 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 X HIRED AUTOS X PROPERTY DAMAGE $ NON-OWNED (Per accident) AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE EPP0128051 02/24/2015 02/24/2016 AGGREGATE $ 1,000,000 DED X RETENTION$ 0 $ WORKERS COMPENSATION PER H AND EMPLOYERS'LIABILITY Y/N STATUTE ER , ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ '.. OFFICER/MEMBER EXCLUDED? N/A '... (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 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:Discovery Playground Shade Structure 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 0*kattn\., I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) 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 UABIUTY COVERAGE PART A. Endorsement-Table of Contents: Coverage; j3eains on Paae: 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:l iablity-Work Within 50'of Railroad Property 14 11. Property Damage to Borrowed Equiment 14 12. Employees as insureds Specified Health Cam Services: 14 • Nurses; • Emergency Medical Technicians;and • Paramedics 13. Broadened Notice of Occurrence 14 B. Omits 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 {{ Units () Other b. Care, Custody $ or Control TOTAL ANNUAL PREMIUA) ±$ , 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: have used up the ap- plicable limit of insur- 1. Employee Benefit Liability Coverage ance in the payment of a. The following is added to SECTION I judgments or settle- -COVERAGES: Employee Benefit ments. Liability Coverage. No other obligation or liabil- (1) insuring Agreement ity to pay sums or perform acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay- obligated ayobligated to pay as dam ments. ages caused by any act,er- ror (b) This insurance applies to or omission of the in- damages only if the act,er- sured, or of any other per- ror or is rregG- son for whose acts the in- eptly committed omission, in the eared is tens liable, to administration" of your which this insurance "employee benefit pro- gram";We w have the right gram";and and duty to defend the in- sured against any "suit" 1) Occurs during the poi- 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- sutt But: fectivve date of this endorsement. 1) The amount we will pay for damages is United You will be as described in SEC- deemed to have TION III - UMITS OF knowledge of a INSURANCE;and claim or "suit" when any 2) Our right and duty to "authorized repro- defend ends when we sentative"; Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 2 of 16 i) Reports all, or formance of investment any part,of the vehicles;or act, error or given to any to us 3) Advice 9 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- included in the em- bal demand or pioyee benefit pro- claim for dam- gram" e of the act,e- (f) Workers' Compensation ror or omis- and Similar Laws sion;and Any claimm arising out of b) There is no other your failure to comply with applicable instil.- the mandatory provisions of ance. any workers'compensation. unemployment compensa- (2) Exclusions tion insurance, social secu- rityThis Insurance does not or disability benefits law apply or any similar bw. to: (a) Bodily Injury, Property (g) ERISA Damage or Personal and Damages for which any in- Advertising Injury sured is table because of liability imposed on a fiduci- "Bodily injurer", "property 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 an (h) Available Benefits intentional, dishonest, fraudulent, criminal or mall- Any claim for benefits to the clous act,error or omission, extent that such benefits committed by any insured, are available, with reason- including the willful or rack able effort and cooperation less violation of any statute. of the insured, from the ap- (c) Failure to Perform a Con- plicable funds accrued or tract other collectible 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 underpractices 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 I Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion., 1 Failure of anyinvest- evaluation, reassign- ) merit, 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 16 ment-related practices, (e) A trust, you are an insured. acts or omissions;or Your trustees are also in- (4) Consequential liabilitysureds, but only with re- spect to their duties as as a result of(1),(2) or trustees. (3)above. (2) Each of the following is also an This exclusion applies 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 the ty y damages because of (b)• Any parsons, oorganizaattiions ns mi proper temporary authon- (3) Supplementary Payments zation to administer your "employee benefit program" SECTION I - COVERAGES, if you die.but only until 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 Uabil- spect to duties as such. ity Coverage, SECTION 11 -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 urWer this Coverage Part. (1) If you are designated In the organization Declarations as: (3) Any 9 you newly 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 which you maintain ownership conduct of a business of or majority interest, will qualify which you are the sole as a Named Insured if no other owner. similar insurance applies to that organization. However, cover- (b) A partnership or joint von- age under this provision: lure, you are an insured. Your members, your part- (a) is afforded only until the ners,and their spouses are 180th day after you acquire also insureds but only with or form the organization or respect to the conduct of the end of the policy period, your business. whichever is earlier;and (c) A limited liability company, (b) Does not apply to any act, you are an insured. Your error or omission that was members are also insureds, committed before you ac- but only with respect to the wired or formed the or- conduct of your business. ganization. Your managers are in- sureds, but only with re- spect to their duties as your As respects Employee Benefit t_iabil- managers. ity Coverage, SECTION HI - LIMITS (d) An organization other than OF INSURANCE is deleted in its en- a partnership, point venture tirety and replaced by the following: or limited liability company, (1) The units of Insurance shown you are an insured. Your in Section B. Limina of tnsur- executive officers" and di- ance, 1. Employee Benefit ti- rectors are insureds, but ability Coverage and the rules only with respect to their below fix the most we will pay duties as your officers or di- regardless of the number of: rectors. Your stockholders are also insureds, but only (a) Insureds; with respect to their liability as 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 c Persons or organizations applies to all damages { } sustained by any one "em- making claims or bringing ployee", including such "suits"; employee's" dependents (d) Acts,errors or omissions;or and beneficiaries, because of all acts, errors or omis- (e) Benefits included in your sions to which this insur- "employee benefit pro- arca applies. gram". (c) The terms of this insurance, (2) The Agg,regate 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 endorsementdefend the insured is the most we will pay for all against any "sults` damages because of acts, er- seeking those dam- rots or omissions negligently committed in the `administra- ages;and tion" of your "employee benefit 2) Your duties, and the program . 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 Limit shown in Section B.Limits omission,or claim, of insurance, 1. Employee apply irrespective of the Benefit Liability Coverage of application 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 (a) An act,error or omission;or notification of the action taken, you shall promptly (b) A series of related acts, or- reimburse us for such part tors or omissions, regard- of the deductible amount as less of the amount of time we have paid. that lapses between such d. Additional Conditions acts,errors or omissions, As respects Employee Benefit U- neggl'igently committed inthe ability Coverage, SECTION IV - "admmistration "of your em COMMERCIAL GENERAL LIABIL- ployee benefit program`. iTY CONDITIONS Is amended as However, the amount paid un- follows: der this endorsement shall not (1) Item 2. Duties in the Event of exceed, and will be subject to Occurrence,Offense,Claim or the limits and restrictions that Suit is deleted in Its entirety and apply to the payment of benefits replaced by the following: in any plan included in the "em- ployee benefit program". 2. Duties In the Event of an Act, Error or (4) Deductible Amount Omission,or Claim or Suit a Our obligation to dam- a. You must see to it that we are noti- (a) ig payfied 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- lice should Include: cess of the deductible amount stated In the Nide- (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 (2) The names and addresses of reduced by the amount of anyone who may suffer dam- this deductible. ages as a result of the act,error or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Offioe,Inc.,with its permission. Page 5 of 15 b. if a claim 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 lion by equal shares, date received;and we will follow this (2) Notify us as soon as practicable. method also. n in- this approach each 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- rnonses or tegal papers re- mit contribution by calved in connection with the equal shares, we will claim or"suit"; contribute by Emits. (2) Authorize us to obtain records Under this method, each insurers share is and other information; based on the ratio of its (3) Cooperate with us in the investi- applicable limit of in- (3) or settlement of the claim surance to the total insur- or defense against the 'suit"; pficable all insits re tinsur- and ante of atl tinsurers. (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 lion which may be liable to the which the insured is insured because of an act,error entitled to recovery un- or omission to which this insur- der any other insur- ance may also apply. Inca in force previous d. No insured will, except at that in- to the effective date of this sured's own cost,voluntarily make a Part' 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 foi- 1 feted in its entirety and replaced lows: by the following: S. Other Insurance (1) gadded°dowingfmit�ns are 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 theirdependents and as follows: beneficiaries, with re- a. Primary Insurance sccooppet toof "em foror This insurance is pri- mary except when c. b. Interpreting the "em- below applies. If this pioyee 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- will share with all that grams";or other insurance by the d. Etfecti , continuing or method described in b. n$ below. tervnatng any em- 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'corn- in the "employee bene- pensation and disability fit program". benefits;and However, "administration" d. Vacation plans. inctud- does not include: ing buy and sell pro- ' a. Handlingpayroll ds- grams; leave of ab- sence programs, in- ductions;or in- cluding military, mater- nity, Tamil , and civil i b. The failure to effect or leave; tuition assis- maintain any insurance tante plans; transpor- tation and health club coverage of Insurance, subsklies. including but not limited to unemployment in- (2) The foNowing definitions are surance,social security deleted In their entirety and re- benefits,workers'corn- placed by the following: pensation and disability benefits. 21. "Suit" means a civil pro- 2. "Cafeteria t " ceeding in which money p damages because of an plan authoriansmeans zed by appfica- act, error or omission to bie law to allow "employ- which this insurance applies ees" to elect to pay for cer- are alleged. "Suit"includes: tain benefits with pre-tax dollars. a. An arbitration pro- cch 3. "Employee benefit pro- damaiges are claiimmed grams" means a program and to which the in- providing some or all of the cured must submit or following benefits to "em- does submit with our pbyees , whether provided consent through a"cafeteria plan"or otherwise: b. Any other alternative dispute resolution pro- a. Group Me insurance; oseding in which such group accident or damages are claimed health insurance; den- and to which the in- tel, vision and hearing sured submits with our plans; and flexible consent;or spending accounts; provided that no one c. An appeal of a civil other than an "em- proceeding. ployee" may subscribe to such benefits and 8. "Employee" means a per- such benefits arreemade son actively employed, for- generally available to molly employed, on leave those"employees"who of absence or disabled, or satisfy the plan's eligi- retired. "Employee" in- bilty requirements; chides aleased worker. "Employee" does not in- b. Profit sharing plans, dude a"temporary worker". employee savings plans, employee stock2. Unintentional Failure to Disclose Haz- ownership plans, pen- ards sign plans and stock SECTION IV-COMMERCIAL GENERAL subscription plans, LIABILtt1Y CONDITIONS, 7. Represen- provided that no one tations is hereby amended by the addi- other than an "em- tion of the following: ployee" may subscribe to such benefits and Based on our dependence upon your such benefits are made representations as to exist hazards, if generally available to unintentionally you should fail to disclose all "employees" who all such hazards at the inception date of are eNgibie under the your policy, we will not reject coverage plan for such benefits; under this Coverage Part based solely on c. Unemployment incur- such failure.ante, 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 e) Settling, cracking, a. 'The last Subparagraph of Paragraph senor ex- 2. SECTION I - COVERAGES, pennsisi on;;or COVERAGE A. - BODILY INJURY f) Nesting or infesta- AND PROPERTY DAMAGE, 2. U- lion, or discharge ABiUTY Exclusions is hereby de- or release of leted and replaced by the following: waste products or 1 secretions, by in- Exclusions c.through q.do not apply sects, birds, ro- to damage by fire, explosion, fight dents or other ning, smoke or soot to premises animals. while rented to you or temporarily occupied by you with permission of (b) Loss caused directly or indi- the owner. redly by any of the follow- b. The insurance provided under SEC- ' TION 1- COVERAGES,COVERAGE 1) Earthquake, volcanic A. BODILY INJURY AND PROP- eruption, landslide or ERTY DAMAGE UABIUTY applies any other earth move- to "property damage" arising out of menta water damage to premises that are both rented to and occupied by you. 2) Water that backs up or overflows from a (1) As respects Water Damage Le- sewer,drain or sump; gal Liability, as provided in Paragraph 3.b. above: 3) Water under the ground surface press- The exclusions under SECTION ing on, or flowing or I - COVERAGES, COVERAGE seeping through: A. BODILY INJURY AND Foundations, PROPERTY DAMAGE LIABIL- ITY,2.Exclusions,other than I. walls, floors or War and the Nuclear Energy paved surfaces; Liability Exclusion,are deleted b) Basements, and the following are added: whether paved or This insurance does not apply not;or to: c) Doors,windows or (a) "Property damage`: other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract;or from water that leaks or flows from plumbing, heat- 2) Loss caused by or re- ing, air conditioning, or fire sultinq from any of the protection systems caused following: by or resulting from freez- a) Wear and tear; ing,unless: b) Rust, corrosion. 1) You did your best to maintain heat in the fungus, decay, building or structure;or deterioration, hid- den or latent de- 2) You drained the fact or any quality equipment and shut off in property that the water supply if the causes it to darn- heat was not main- age or destroy it- tamed. self; (d) Loss to or damage to: c) Smog; 1) Piumbing, heating, air d) Mechanical conditioning, fire pro- breakdown in- tection systems, or chiding rupture or other equipment or ap- bursting caused pliances;or by centrifugal force; 2) The interior of an building or structure, or to personal property In the building or structure Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 8 of 15 I caused by or resulting 5. Medical Payments from i rain, snow,hrsleet The Medical Expense limit of AnyOne or wind whether driven Person as stated In the Declaratns is by wind or not. amended to the trait shown in Section B. c. Limit of Insurance limits of Insurance, 5. Medical Pay- The Damage to Premises Rented to manta of this endorsement You Limit as shown in the Declare- 6. Voluntary Property Damage and Care, lions is amended as follows: Custody or Control liability Coverage (2) Paragraph 6. of SECTION III - a. Voluntary Property Damage Cov- UMITS OF INSURANCE is erage hereby deleted and replaced by We will y for" ro damage" to the following: property of others arising out of op- 6. Subject to 5. above, the orations incidental to the insured's Damage to Premises business when: Rented to You Unit is the (1) Damage is caused bythe In- COVERAGE most we will pay under COVERAGE A. BODILY sured;or INJURY AND PROPERTY (2) Damage occurs while in the in- DAMAGE UABIUTY, for sured's possession. damages because of "property damage" to With your consent, we will make premises while rented to these payments regardless of fault. you or temporarily occupied by you with permission of b. Car., Custody or Control liability One owner, arising out of Coverage any one "occurrence" to SECTION I - COVERAGES, COV- which this insurance ap- ERAGE A. BODILY INJURY AND pis PROPERTY DAMAGE UABIUTY,2. (3) The amount we will pay Is urn. Exclusions, Damage to Property, dad as described In Section B. Subparagraphs (3), (4) and do limits of Insurance, 3. Dam- not apply to "property damage" to age to Premises Rented to the property of others described You of this endorsement therein. 4. Supplementary Payments With respect to the insurance provided by this section of the endorsement, the fel- Under SECTION I - COVERAGE, SUP- lowing additional provisions apply: PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. The Limits of insurance shown in the Declarations are replaced by the Lim- a. Paragraph 2. is replaced by the tot- its designated in.Section B.limits of lowing: Insurance, 6. Voluntary Property Up to the limit shown in Section B. Damage and Care, Custody or Limits of Insurance,4.a.Bal Bonds endendorse Liability Coverage of this cover- of this endorsement for cost of ball age provided with respect to . bonds required because of accidents 1?ne provided by this endorsement. or traffic law violations ails out of se lmits are inclusive of and not in addition to the limits being re- the use of any vehicle to which the placed. The Limits of Insurance Bodily Injury Liability Coverage ap- shown in Section B. Limits ot Insur- plies. We do not have to furnish encs, 6. Voluntary Property Dam- these bonds. age and Care, Custody or Control b. Paragraph 4. is replaced by the tot- Liability Coverage of this endorse- lowing: ment fix the most we will pay in any one "occurrence" regardless of the Al reasonable expenses incurred by number of: the Insured at our request to assist us in the investigation or defense of (1) Insureds; the claim or 'suit", includingactual (2) Claims made or"suits' brought; boss of earnings up to the limshown or in Section B. Limits of Insurance, 4.b. Loss of Earnings of this en- (3) Persons or organizations mak- dorsement per day because of time Ing claims or bnnging"suits'. off from work. Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 9 of 15 b. Deductible Clause 9. Automatic Additional Insured - Speci- (1) Our obligation to pay damages fled Relationships on your behalf applies only to a. The following is hereby added to the amount of damages for each SECTION II-WHO IS AN INSURED: "occurrence" which are in ex- person or cess of the deductible amount (1) Anyorganization de- stated stated In Section B. Umits of scribed in Paragraph 9.a.(2) Insurance, 6. Voluntary Prop- below(hereinafter referred to as trty Damage and Care, Cus- additional insured) whom you ody or Control Liability Coy- are required to add as an addi- erage of this endorsement. The tonal insured under this Cover- limits of insurance will not be re- age Part by reason of: duced by the application of such (a) A written contract or deductible amount agreement;or (2) Condition 2.Duties in the Event b of Occurrence,Offense,Claim ( ) An oral agreement or Con- or Suit,applies to each claim or tract where a certificate of "suit'irrespective of the amount. insurance showing that per- son or organization as an (3) We may pay any part or all of additional insured has been the deductible amount to effect issued, settlement of any claim or "suit" is an insured,provided: and, upon notification of the ac- tion taken, you shall promptly (a) The written or oral contract reimburse us for such part of the or agreement is: deductible amount as has been paid by us. 1) Currently in effect or 7. 180 DayCoverage for Newlybecomesueffective Formed or during the policy pa- Acquired Organizations riod;and SECTION II - WHO IS AN INSURED is 2) Executed prior to an amended as follows: "occurrence"or offense Subparagraph a. of Paragraph 4. is to which this insurance would apply;and hereby deleted and replaced by the fol- lowing: (b) They are not specifically a. Insurance under this provision is af- named as an additional in- forded only until the 180th day after sured under any other pro- you acquire or form the organization vision of, or endorsement or the end of the policy period, added Paari. to, this Coverage whichever is earlier; 8. Waiver of Subrogation (2) Only the following persons or organizations are additional in- SECTION IV-COMMERCIAL GENERAL sureds under this endorsement, LIABILITY GOND mONS,9. Transfer of and insurance coverage pro- Rights of Recovery Against Others to vided to such additional in - Us is hereby amended by the addition of sureds is limited as provided the following: herein: We waive any right of recovery we may (a) The manager or lessor of a have because of payments we make for premises leased to you with injury or damage arising out of your on- whom you have agreed per going operations or"your work"done un- Paragraph 9.a.(1) above to der a written contract requiring such provide insurance, but only waiver with that person or organization with respect to liability aris- and included In the `products-completed Ing out of the ownership. operations hazard". However, our rights maintenance or use of that may only be waived prior to the 'occur- part of aemises leased to ranee"giving rise to the injury or damage you,subject to the following for which we make payment under this additional exclusions: Coverage Part. The insured must do This insurance does not nothing after a loss to impair our rights. aPPIY to: At our request,the insured will bring suit" or transfer those rights to us and help us 1) Any "occurrence" enforce those rights. which takes place after Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 10 of 15 you cease to be a ten- c) Any physical or ant in that premises. chemical change in 2) Structural alterations, the product new construction or made Intentionallyvendor; by the demolition operations performed by or on be- d) Repackaging, un- half of such additional less unpacked Insured. solely for the pur- pose of inspection,(b) Any person or organization demonstration, from which you lease testing, or the equipment with whom you substitution of have agreed per Paragraph parts under in- t 9.a.(1) above to prov an- structions from the surance. Such person(s)or manufacturer, and organization(s)are insureds then repackaged solely with respect to their in the original liability arising out of the container; maintenance, operation or use by you of equipment e) Any failure to leased to you by such per- make such in- son(s) or organizations(s). spections, adjust- However, this insurance ments, tests or does not apply to any "oc- servicing as the currence"which takes place vendor has after the equipment lease agreed to make or expires. normally under- (c) Any person or organization the s ua ccoourse (referred to below as von- of business, in dor) with whom you have connection with agreed per Paragraph the distribution or 9.a.(1) above to provide in- sale of the :prod- surance, but only with re- ucts; spect to "bodily injury" or "property damage' arising t) Demonstration, in- out of"your products"which stailation, servic- ing distributed or sold the ing or repair op- regular course of the von- orations, except dors business, subject to such operations the following additional ex- performed at the elusions: vendor's premises 1) The insurance afforded thn connectionathe the vendor does not product; apply to: g) Products which a) "Bodily injury" or after distribution or "property damage" sale by you, have for which the Yen- been labeled or dor is obligated to relabeled or used pay damages by as a container, reason of the as- part or ingredient sumption of habil- of any other thing ity in a contract or or substance by or agreement. This for the vendor. exclusion does not apply to liability for 2) This insurance does damages that the not apply to any in- vendor would cured person or or- have in the ab- ganization: sense of the con- tract or agree- a) From whom you menta have acquired such products, or b) Any express war- any ingredient, ranty unauthorized part or container, by you; entering into, ac- Includes sIncludes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 11 of 15 companying or 2) This insurance does containing such not apply to "roily in- products; -products;or jury", "property thm- b) When liability in- age" or "personal and ctuded within the advertising injury" aris- ing out of operations "products- feted o ra- performed for the state completed hazard"peha or political subdivision. been excluded (f) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9.a.(1) spect to such above to provide insurance, products. but only with respect to An state or political subdi- li- ability arising out of "your (d) y po work performed for that vision with which you have additional insured by you or agreed per Paragraph on your behalf. A person or 9.a.(1) above to provide in organization's status as an surance, subject to the fol- insured under this provision lowing additional provision: of this endorsement contin- This Insurance applies only ues for only the period of with respect to the following time required by the written hazards for which the state contract or agreement, but or political subdivision has in no event beyond the ex- issued a permit in connec- plration date of this Cover- tion with premises you own, age Part. if there is no rent or control and to which written contract or agree- this insurance applies: merit,or if no period of time is required by the written 1) The existence, mainte- contract or agreement, a Hance, repair, con- person or organization's struction, erection, or status as an insured under removal of advertising this endorsement ends signs, awnings, cano- when your operations for pies, cellar entrances, that insured are 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 decora- (a) Subparagraphs (e) and (I) tions and similar expo- does not apply to "bodily sures;Of injury"or"property damage 2) The construction, erec- included within the "prod- tion, or removai of ale- ucts-completed operations vators;or hazard"; 3) The ownership, main- (b) Subparagraphs (a), (b), (d), (e)and( does not apply to tenance, or use of any « elevators covered by daily e" orpersopropnal er y this insurance. advertisingvinjury" arising (e) Any state or political subdi- out of the sole negligence vision with which you have or willful misconduct of the agreed per Paragraph additional insured or their 9.a.(1) above to provide in- agents,"employees" or any surance, subject to the lot- other representative of the towing provisions: additional insured;or 1) This insurance applies (c) Subparagraph (f9 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" or which the state or arising out of: palm?subdivision has 1) Defects in design issued a permit. fur- nished by or on behalf • Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 12 of 15 of the additional in- spects any other insurance sured;or policy issued to the addi- tional insured, and such 2) The rendering of, or other insurance poky shall falure to render, any be excess and/or noncon- professional architec- tributing,whichever applies, tural, engineering or with this insurance. surveying services, in- ducing: (b) Any insurance provided by this endorsement shall be a) The preparing, primary to other insurance approving or fail- available to the additional ing to prepare or insured except: I approve maps,shop drawings, 1) As otherwise provided rovided opinions, reports, In SECTION IV - • surveys, field or- COMMERCIAL GEN- ders, change or- ERAL UABIUTY dors or drawings CONDITIONS,5.Other and specifications; Insurance, b. Excess and Insurance;or b) Supervisory, in- 2) For any other valid and spection, archi- coliectnbie insurance lecturai or engi- avatiable to the addi- neering 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 programhas insurance policy that is been provided bY written on an excess primecontractor-project basis. In such case manager or owner of the coverage idea the construction project under this endorse- in which you are in- merit shall also be ex- volved. cess. b. Only with regard to insurance pro- (2) Condition 11. Conformance to vided to an additional insured deslg- Specific Written Contract or nated under Paragraph 9.a.(2) Sub- Agreement is hereby added: paragraph (f) above, SECTION III - LiMITS OF INSURANCE is amended 11. Conformance to Specific to include: Written Contract or The limits applicable to the additional Agreement insured are those specified in the With respect to additional written contract or agreement or in insureds described in Para- the Declarations of this Coverage graph 9.a.(2)(1)above only: Part,whichever are less. if no limits I are specified In the written contract If a written contract or or agreement,or if there is no written agreement between you contract or agreement, the limits ap- and the additional insured plicabte to the additional insured are specifies that coverage for those specified in the Declarations of the additional insured: this Coverage Part. The limits of in- a, Be provided b the In- surance are inclusive of and not in surance Services Of- addition to the limits of insurance fico additional insured shown in the Declarations. form number CG 20 10 c. SECTION IV-COMMERCIAL GEN- or CG 20 37 (where ERAL UABIUTY CONDITIONS is edition specified);or hereby amended as follows: b. Include coveragefor (1) Condition 5.Other Insurance is completed operations; amended to include: or (a) Where required by a written c. include coverage for contract or agreement, this "your work"; insurance is primary and 1 and where the limits or cov- or noncontributory as re- erage provided to the addi- Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 13 of 15 tional insured is more re- 11. of this endorsement fix the strictive than was specifi- most we will pay in any one"oc- cally required in that written currence regardless of the contract or agreement, the number of: terms of Paragraphs Insureds; 9.a.(3)(a), 9.a.(3)(b) or 9.b. (a) above, or any combination (b) Claims made or "suits' thereof, shall be Interpreted brought;or as providing the limits or coverage required by the (o) Persons or organizations terms of the written contract making claims or bring or agreement, but only to "suits". the extent that such Emits or coverage is included within (2) Deductible Clause the terms of the Coverage (a) Our obligation to pay dam- Part to which this endorse- ages onyour behalf ies ment is attached. If. how- apps ever,the written contract or only to the amount of dam- agreement specifies the in- which are in excess of the surance Services Office Deductible amount stated in additional Insured form Section 8. Limits of 'nem- number CG 2010 but does enc., 11. of this endorse- not specify which redden,,or meat. The limits of insur- specifies an edition that ante will not be reduced by does not exist, Paragraphs the application of such De- ductible and 9.a.(3Xb) of amount this endorsement shag not apply and Paragraph 9.b.of (b) Condition 2. Duties in the this endorsement shall ap- Event of Occurrence, Of- ply. tense, Claim or Suit, ap- 10. Broadened Contractual Liability-Work plies to each claim or'sub' Within 50'of Railroad Property irrespective of the amount it is hereby agreed that Paragraph f.(1)of (c) We may pay any part or al Definition 12. Insured contract* (SEC- of the deductible amount to TION V-DEFINITIONS)is deleted. effect settlement of any claim or 'suit" and, upon 11. Property Damage to Borrowed Equip- notification of the action ment taken, you shall promptly reimburse us for such part a. The following is hereby added to Ex- of the deductible amount as elusion j. Damage to Property of has been paid by us. Paragraph 2., Exclusions of SEC- TION I-COVERAGE, COVERAGE 12. Employees as insureds - Specified A. BODILY INJURY AND PROP- Health Care Services ERTY DAMAGE LIABILITY: It is hereby agreed that Paragraph Paragraphs(3)and(4)of this emits- 2.a.(1 (d) of SECTION Ii - WHO IS AN sion do not apply to tools or equip- INSUUHRED, does not apply to your -em- inent loaned to you, provided they ptoyees-who provide professional health are not being used to perform opera- care services on your behalf as duly a- tions at the time of loss. censed: b. With respect to the insurance pro- a. Nurses; vided by this section of the en- b. Emergency Medical Technicians;or dorsement, the following additional provisions apply: c. Paramedics, (1) The Limits of insurance shown in the jurisdiction where an "occurrence" in the Declarations are replaced or offense to which this insurance applies by the Emits designated in Sec- takes place. don B.Limits of Insurance, 11. of this endorsement with respect 13. Broadened Notice of Occurrence to coverage provided by this Paragraph a. of Condition 2. Duties in endorsement. These tato the Event of Occurrence, Offense, inclusive of and not addition to Claim or Suit(SECTION IV-COMMER- Limits of Insurance shown in the limits being replaced. n CIAL GENERAL LIABILITY CONDI- Section 8. Limits of Insurance, includes copyrighted material of insurance GA 233 02 07 Services Office,inc.,with its permission. Page 14 of 15 TIONS) is hereby deleted and replaced (2) The names and addresses of by the following: any injured persons and wit- a. You must see to it that we are noti• nesses;and fied as soon as practicable of an (3) The nature and location of any "occurrence" or an offense which injury or damage arising out of may result in a claim, To the extent the"occurrence"or offense. possible,notice should include: This requirement applies only when (1) How, when and where the "oc- the"occurrence"or offense is known currences or offense took place; to an"authorized representative". • Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 15 of 15 12/1/2015 AM LANDSHAPER INC Home Inicio en Espaflol Contact Search L&I SEARCH • A-Z Index Help My Secure 1&1 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 99217 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 Goveming persons MARK C ALBIN TYE C MC GEE; License Verify the contractor's 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 Bond ................. 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 Insurance ............................... Cincinnati Ins Co $1,000,000.00 https://secure.lni.wa.gov/verify/Detai I.aspx?U BI=601701273&LIC=AM LAN I*971 DO&SAW=False 1/2 Z2 esled=MVS'80aLL6.IWPM=0Il'8£LZLOLL09=18mxdse•Ilelea/A uan/noftem•lul•aanoas//:sduy •uol6uigse%rl Jo aims aql Jo sMeI Sill of pafgns si alls siy1 Jo asn•saulsnpul g Jogai JO Idaa ems uol6uiyseM O 'Jo;alglsuodsaJ sem ssaulsnq sly;sallsgol uo puno;suolleloln ylleaq pue Rla;es;sed cue Jo;>pa4O ymeaq pue/Claps eoeId)JoM no6•emluIN7S£ZIVJO:IleW3-SLL4-Z06(09£)OdOdMV2IO NA1O21V3/01 angeluesaidaj lunoo a I'gl „saavoM OZ o; LL..SLOZ JeaA;o£Ja1enO pe2JodeJ sie)pom pelewlls3 ONI 213dVHSONVI IN V se ssaulsnq 6uloa 10-89£`91 luauna sl4unoo3V al lun000V I'81 •swnlwaJd dwoo sJe>pom uo elep-o;-dn sl ssaulsnq eill L;uen'os;l ,seaRoldwe seq ssaulsnq aq;;l mow!noA oa dump ,sia)1aoM •pouad aeeA 9 snolnaad ay;6uunp suoleloln asuaall ON suol;eloln asueoll •salaue6e Jaw papaooe aq Aew swap mos;nq`pouad Jean 9 snolnaad ay;6uunp asuaall Jo;oeJ;uoo sly;Jo;papaooal Sae swap xe;pgl oN swap xel pgl •pouad Jeal(9 snolnaad ay;6uunp s;un000e s6ulnes Jo puoq eq;;sule6e s;lnsmel oN s6u les Jo puoq ay;;sule6e s;lnsmel •pouad Jean 9 snolnaJd ay;6uunp s;unoaae s6ulnes ON s6ulnes FJo;sly aoueansul 9 LOZ/4Z/Z0 alep uolleJldx3 Z LOZ/4Z/Z0 91.0Z/6 L/Z0 amp anlloa;;3 Aq panlaoeJ £1OSZZdd3 •ou AoIlod ONI 213dVHSONVI W V 91.OZ/1.21.