Loading...
16-043.01 Michael Terrell Landscape: COSV Park Signs Ph 2 CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND MICHAEL TERRELL LANDSCAPE ARCHITECTURE PLLC Spokane Valley Contract#16-043.01 For good and valuable consideration,the legal sufficiency of which is hereby acknowledged, City and the Consultant mutually agree as follows: 1. Purpose: This Amendment is for the Contract for the development of construction documents for three park signs by and between the Parties,executed by the Parties on February 20,2016,and which terminates on June 1, 2016. Said contract shall be referred to as the "Original Contract" and its terms are hereby incorporated by reference. Total compensation under the Original Contract is not to exceed$2,658.00. 2.Original Contract Provisions:The Parties agree to continue to abide by those terms and conditions of the Original Contract and any amendments thereto which are not specifically modified by this Amendment. 3. Amendment Provisions: This Amendment is subject to the following amended provisions, which are either as follows. All such amended provisions are hereby incorporated by reference herein and shall control over any conflicting provisions of the Original Contract, including any previous amendments thereto. Completion date is extended until October 31,2016. 4. Compensation Amendment History: This is Amendment #1 of the Original Contract. The history of amendments to the compensation on the Original Contract and all amendments is as follows: Date Compensation Original Contract Amount 2/20/16 $2,658.00 Amendment#1 6/28/16 $ 0 Total Amended Compensation le $2,658.00 --Yn ___\4-- The parties have executed this Amendment to the Original Con . thisday of July,2016. CI 'OF SPO ••NE VALLEY: CON ali,-I/ _ r Mark Ca- h un :' /ichael Terre//A E Acting City Manager Its: Owner ATT;SS APPROV I AS TO FORM: I-- / • ,ii. Christine Bainbridge, City Cler', Office .f the City Attorney 1 A O r DRB DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE Ro22 2/3/2016 THIS CERTIFICATEIS 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 SUBROGATIONIS 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: USAA INSURANCE AGENCY INC/PHS NC,,Nrm.E,q: (888) 292-1430 (A C.Noy (888) 443-6112 812846 P: (888) 242-1430 F: (888) 443-6112 AODRIESS: PO BOX 33015 INSURER(S)AFFORDING COVERAGE NAIC# SAN ANTONIO TX 78265 I Y�T6i" IAP 'Jn: H rtford Casualty Ins Co 29424 INSURED INSURER B: MICHAEL TERRELL- LANDSCAPE FEB 03 251MERC: ARCHITECTURE, PLLCNSURERD: 5312 S CHAPMAN RD PARKS& RECREAT MA.126,'T. GREENACRES WA 99016 -1NSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR [NCR IYVD (MM/OD/YYYY) IMM/DD/t'YYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2, 000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED $300,000 PREMISES(Ea occurrence) A X General Liab X 65 SBA PU5893 01/13/2016 01/13/2017 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2, 000,000 GEN'L AGGREGATE LIMIT APPLIES� � PER: GENERAL AGGREGATE $Lj 000 POLICY PRO I X I LOC PRODUCTS-COMP/OP AGG S4, 00 0/000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $2000000 (Ea accident) / / ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED 65 SBA PU5893 01/13/2016 01/13/2017 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 1�1 N/A - (Mandatory In NH) I I E.L.DISEASE-EA EMPLOYEE $ If yes,describe under $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION City of Spokane Valley SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Park Signs BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE g DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attention: Mike Stone AUTHORIZED REPRESENTATIVE 2426 N DISCOVERY PL 7a. SPOKANE, WA 99216 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD • AC R YYYY) / (MMDD/DD/ CERTIFICATE OF LIABILITY INSURANCE DATE 0MM/ 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 Karen Bronson CorRisk Solutions PHONE FAX 225 W. Washington St. Suite 1560 N. ° 312-263-4218 (A/C.No.Pte; Chicago, IL 60606 ADDRESS: kbronson@corrisksolutions.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: New�Ham •r9,_fCommany 23841 INSURED —" Michael Terrell - Landscape Architecture, PLLC INSURERS: c 5312 South Chapman Road INSURER C: F 1:13 2n13 Greenacres, WA 99016 INSURER D: INSURER E: D/1(7e 9, RECREATION DEPT. INSURER F: ' . .,.1/ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADD'` SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSRD WVD (MMIDDIYYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURANCE COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurance) (CLAIMS MADE OCCUR MED EXP(Any one person) DOES NOT APPLY PERSONAL&AND INJURY • GENERAL AGGREGATE GEN'`AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 7 POLICY n PROJECT n LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT(Ea accident) _ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED—AUTOS —AUTOS DOES NOT APPLY BODILY INJURY(Per accident) HIRED AUTOS NON-OWNED PROPERTY DAMAGE(Per —AI accident) UMBRELLA LIAB _OCCUR EACH OCCURANCE • EXCESS LIAB CLAIMS MADE DOES NOT APPLY AGGREGATE DED RETENTION$ WORKERS COMPENSATION WC STATU- OTHER AND EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT OFFICE/MEMBER EXCLUDED? YM N/A DOES NOT APPLY EL.DISCSAE-to (Mandatory in NH) El yes,describe under DESCRIPTION OF EMPLOYEE OPERATIONS below E.L.DISEASE-POLICY LIMIT A Professional Liability 064991268— 01/16/16 01/16/17 Per Occurrence: $1,000,000 00 Annual Aggregate: $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACCORD 101,Additional Remarks Schedule,if more space is required) Park Signs • • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE City of Spokane Valley THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2426 N Discovery Place AUTHORIZED REPRESENTATIVE Spokane Valley, WA 99216 , ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION.Allrights reserved. The ACORD.name and logo are registered marks of ACORD 2/18/2016 MICHAEL TERRELL LANDSCAPE ARCH ITECTURE PLLC Howe tsgttiit,l C.>;tiztct arch L&I A-Z Ltde' ieli S1r Secure It'ct Safety&{-:'faith Claims&Insurance Workplaac.Rights hts Trades&Licensing mg Washington State Department of '' . Labor & Industries MICHAEL TERRELL LANDSCAPE ARCHITECTURE PLLC Owner or tradesperson 5312 S CHAPMAN RD KARA TERRELL GREENACRES,WA 99016-8832 Doing business as MICHAEL TERRELL LANDSCAPE • WA U81 No. Governing persons 603 368 643 KARA L TERRELL MICHAEL D TERRELL; Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is current. 072,594-02 Doing business as MICHAEL TERRELL LANDSCAPE Estimated workers reported Quarter 4 of Year 2015"1 to 3 Workers" L&I account representative T3/KENT ANDERSON(360)902-6963-Email:ANDN235@Ini.wa.gov Workplace safety and health • Check for any past safety and health violations found on jobsites this business was responsible for. ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. https://secure.ini.wa.gov/verify/Detail.aspx?UBI=603368643&SAW=False 1/1