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16-044.01 Michael Terrell Landscape: Browns Park Splash Pad and Sand Volleyball Court CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND MICHAEL TERRELL LANDSCAPE ARCHITECTURE PLLC Spokane Valley Contract#16-044.01 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 plans and specifications for the construction of a championship volleyball court and splash pad at Browns Park by and between the Parties, executed by the Parties on February 20,2016,and which terminates on July 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$15,160.00. 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. The construction contract completion date has been extended with the addition of the splash pad construction as a part of the contract. Originally,the splash pad was not included in the contract due to the cost being over budget. The City Council added funding to complete the splash pad. Therefore,the contract 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 $15,160.00 Amendment#1 6/28/16 $ 0 Total Amended Compensation $15,160.00 The parties have executed this Amendment to the Original Contract this---1 day of July,2016. CI Y OF SPO IV A LLEY: CONS . - 1�J • O// Mark Calhoun /V. � iei e Terrell Acting City Manager Its: Owner ATIAPPRO D AS TO FORM: ,, 4 ,_♦ _ i 4 Christine Bainbridge,City Cle Offic, of the City Attorney 1 • /�R® 'J' DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE R022 3/1/2016 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 PHO(NC,,No,Ext): (888) 242-1430 (NC,No): (888) 443-6112 812846 P: (888) 242-1430 F: (888) 443-6112 ADDRIESS: PO BOX 33015 INSURER(S)AFFORDING COVERAGE NAICR SAN ANTONIO TX 78265 INSURER A:Hartford Casualty Ins Co 29424 INSURED INSURER B MICHAEL TERRELL— LANDSCAPE INSURERC: ARCHITECTURE, PLLC INSURER D: 5312 S CHAPMAN RD INSURERS: GREENACRES WA 99016 INSURERF: 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 INSR MVO (MM/DD/YTYY) I fryray YYYY) COMMERCIAL GENERAL EACH OCCURRENCE $2,000,000 CLAIMS-MADE I I OCCUR DAMAGE TO RENTED (�L LIABILITY $300, 000 PREMISES(Ea occurrence) A X General Liab X 65 SBA PU5843 01/13/2016 01/13/2017 MEDEXP(Anyoneperson) $10,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT AP^PLIES PER: GENERAL AGGREGATE $4,000,000 _ I POLICY PE I I LOC PRODUCTS-COMP/OP AGG $4,000,000 --I( CT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT '$2000000 (Ea accident) / / ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED X 65 SBA PU5843 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 RETENTION$ $ ;YORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YM EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? WA - $ (Mandatoryin NH) E.L DISEASE-EA EMPLOYEE If yes,describe under EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 and the Hired Auto and Non-Owned Auto Endorsement SS0170 attached to this policy. CERTIFICATE HOLDER CANCELLATION City of Spokane Valley SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Browns Park Splash Pad BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE P DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Mike Stone AUTHORIZED REPRESENTATIVE 2426 N DISCOVERY PL SPOKANE VALLEY, WA 99216 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ACc• t.__--- DATE(MM/DD/ YYYY) CERTIFICATE OF LIABILITY INSURANCE 02/29/2016 DD/ 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 NONEACT Karen Bronson CorRisk Solutions PHONE 312-263-4218 FAX 225 W. Washington St. Suite 1560 E.MAS (Ac,No.e.0 Chicago, IL 60606 ADDRESS: kbronson@corrisksolutions.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: New Hampshire Insurance Company 23841 INSURED INSURER B: Michael Terrell — Landscape Architecture, PLLC INSURER C: 5312 South Chapman Road Greenacres, WA 99016 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADM. SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSRD WVD (MM/DD/YYYY) (MMIDD/YYYY) GENERAL LIABILITY EACH OCCURANCE TO COMMERCIAL GENERAL LIABILITY PRS(RENTED PREEMIMI ESES(Ea occurance) CLAIMS MADE OCCUR MED EXP(Any one person) DOES NOT APPLY PERSONAL&AND INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG POLICY nPROJECT r7 LOC AUTOMOBILE LIABILITY accidentl OMOINEU SINGLE Uml I(Ea ANY AUTO BODILY INJURY(Per person) —ALL OWNED ^SCHEDULED DOES NOT APPLY BODILY INJURY(Per accident) AUTOS —AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE(Per Al IMA 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? Y/N N/A DOES NOT APPLY E.L UISESAE-EA (Mandatory in NH) ElEMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT 069991268- Per Occurrence: $1,000,000 A Professional Liability 01/16/16 01/16/17 Annual Aggregate: $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACCORD 101,Additional Remarks Schedule,if more space is required) Browns Park Phase II - Splash Pad CERTIFICATE HOLDER CANCELLATION Cityof Spokane ValleyParks and Recreation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE p THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attention: Mike Stone 2426 N. Discovery Place AUTHORIZED REPRESENTATIVE Spokane Valley, WA 99216 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION.Alirights reserved. The ACORD name and logo are registered marks of ACORD JJW DATE(MM/DD/YYYY) �' R� CERTIFICATE OF LIABILITY INSURANCE R022 3/1/2016 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 WC No,Ext): (888) 242-1430 FAX WC, (888) 443-6112 812846 P: (888) 242-1430 F: (888) 443-6112 ADDRESS: PO BOX 33015 INSURER(S)AFFORDING COVERAGE NAIC# SAN ANTONIO TX 78265 INSURER A:Hartford Casualty Ins Co 29424 INSURED INSURER B: MICHAEL TERRELL— LANDSCAPE INSURERC: ARCHITECTURE, PLLC INSURER D: 5312 S CHAPMAN RD INSURERS: GREENACRES WA 99016 INSURERF: 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. ?NSRADDL SUER POLICY EFF POLICY EXP LIMITS ITR •TYPE OF INSURANCE NSF' WM POLICY DIM/DDATYY) IMM/OD/YYYD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2, 000, 000 CLAIMS-MADE LLOCCUR DAMAGE TO RENTED I I s30-0,000 PREMISES(Ea occurrence) A X General Liab X 65 sBA PU5843 01/13/2016 01/13/2017 MED EXP(Any one person) S10, 000 PERSONAL&ADV INJURY $2,000, 000 GEN'LAGGREGATE LIMIT A�PPPLIESPER GENERAL AGGREGATE $4,-000, 000 POLICY PRO-I X L_LOC PRODUCTS-COMP/OP AGG $4,000, 000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT • s2,000, 000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED X 65 SBA PU5843 01/13/2016 01/13/2017 BODILYINJURY(Peraccident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $ $ DED RETENTION$ WORKERS COMPENSATION PER OTH AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN EL.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A EL DISEASE-EA EMPLOYEE If yes,describe under EL DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 and the Hired Auto and Non-Owned Auto Endorsement SS0170 attached to this policy. CERTIFICATE HOLDER CANCELLATION City of Spokane Valley SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE Browns Park - Championship Volleyball DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. At t n: Mike Stone AUTHORIZED REPRESENTATIVE 2426 N DISCOVERY PL SPOKANE VALLEY, WA 99216 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 1. ACORD YYYY) (MM/DD/DD/ L-- CERTIFICATE OF LIABILITY INSURANCE DATE 02/29/2016 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 OM N.•EAV 312-263-4218 (A/C•Mn EH Chicago, IL 60606 RESS: kbronson@corrisksolutions.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: New Hampshire Insurance Company 23841 INSURED INSURER B: Michael Terrell - Landscape Architecture, PLLC INSURER C: 5312 South Chapman Road . Greenacres, WA 99016 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ' CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SLIER POLICY NUMBER POUCY EFF POLICY EXP LIMITS LTR INSRD WVD (MM/DD/YYYY) (MMIDDIYYYY) GENERAL LIABILITY EACH OCCURANCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurance) CLAIMS MADE 0OCCUR MED EXP(Any one person) DOES NOT APPLY PERSONAL&AND INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 7POLICY [1PROJECT F-7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT(Ea accident) _ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED BODILY INJURY accident) AUTOS —AUTOS DOES NOT APPLY - HIRED AUTOS NON-OWNED PROPERTY DAMAGE(Per ---AI ITrtc accident) - UMBRELLA LIAB _OCCUR EACH OCCURANCE EXCESS LIAB CLAIMS MADE DOES NOT APPLY AGGREGATE DED I RETENTION$ WORKERS COMPENSATION WC STATU- OTHER AND EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT OFFICE/MEMBER EXCLUDED? Y/N N/A DOES NOT APPLY t.LUISESAt-EA (Mandatory In NH) CI If yes,describe under DESCRIPTION OF OPERATIONS below E.LDISEASE-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 1 LOCATIONS/VEHICLES(Attach ACCORD 101,Additional Remarks Schedule,if more space is required) Browns Park Phase II - Championship Volleyball Court 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 WTH THE POLICY PROVISIONS. 2426 N Discovery Place AUTHORIZED REPRESENTATIVE Spokane Valley, WA 99216 6.--- ie - ACORD rACORD 25(2010/05) @ 1988-2010 ACORD CORPORATION.AI frights reserved. The ACORD name and Joao are reaistered marks of ACORD • 2/18/2016 MICHAEL TERRELL LANDSCAPE ARCHITECTURE PLLC If clue E.paul CcattoU Search L&I PIM 3 A-Z Index Hell? h1}Sectue L&1 Safety 8,Health Claims&insurance Workplace Rights Trades&Licensing • y' Washington State Department of is I Labor & Industries MICHAEL TERRELL LANDSCAPE ARCHITECTURE PLLC Owner or tradesperson 5312 S CHAPMAN RD GREENACRES,WA 99016-8832 KARA TERRELL 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.