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16-042.01 Bernardo Wills Architects: Valley Mission Dog Park Ph 2 CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND BERNARDO WILLS ARCHITECTURE PC Spokane Valley Contract#16-042.01 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 the Valley Mission Pocket Dog Park Phase 2 project by and between the Parties, executed by the Parties on March 1,2016, 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$7,200.00. 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. Contract completion date is extended until September 15, 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 3/1/16 $7,200.00 Amendment#1 6/28/16 $ 0 Total Amended Compensation $7,200.00 The parties have executed this Amendment to the Original Contract this 12- day of July,2016.4CIT OF SPOKANE VALLEY: CONSULTANT ilk. � (terti„._ ra//i�.i /L- Mar Calhoun By: Del itch Acting City Manager Its: Authorized R-presentative ATTey APPROV AS TO FORM: ,. / c ristine Bainbridge,City Clerk Office f the City Attorney 1 OP ID:JW DATE(MM/DDIYYYY) `� . CERTIFICATE OF LIABILITY INSURANCE ` 02/23/2016 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(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEACT Christy Marzetta Andre-Romberg Ins.Agency,IncPHONE 509-624-3291FAX S.400 Jefferson St.,Ste.333 (A/C.No,Ext): (A1C,No):509-456-0294 S okane,WA 99204 E-MAIL ADDRESS:cmarzetta@andre-romberg.com p Christy Marzetta-Ext.322 PRODUCER BERNA-1 CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED Bernardo-Wills Architects INSURER A:Transportation Insurance Co 35289 Mr.Robert Wills INSURER B:Continental Insurance Co 35289 153 S Jefferson Street Spokane,WA 99204 INSURER C: INSURER D: INSURER E: INSURER F: i 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 SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X 2072475103 11/01/2015 11/01/2016 PREM SES(OEa occu Once) $ 300,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 —1 POLICY n Te- LOC $ COMBINED SINGLE LIMIT $ 1,000,000 AUTOMOBILE LIABILITY (Ea accident) B X ANY AUTO 4024492367 11/01/2015 11/01/2016 BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (PER ACCIDENT) X NON-OWNED AUTOS $ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,000 A 2072475067 11/01/2015 11/01/2016 - DEDUCTIBLE $ X RETENTION $ 10,000 $ WORKERS COMPENSATION WC STATU- x OTH- TORY LIMITS ER ANDY PROPRIETOR' AR ILITYNER/ 2072475103 11/01/2015 11/01/2016 E.L.EACH ACCIDENT $ 1,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N N/A (MandOFFICatory in BERNH)EXCLUDED? STOP GAP ONLY E.L.DISEASE-EA EMPLOYEE $ 1,000,000 (Mandatory in NH) E yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 A PROPERTY 2072475103 11/01/2015 11/01/2016 Bus Prope 506,774 A EMPLOYEE BEN LIAB 2072475103 11/01/2015 11/01/2016 EBL 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) City of Spokane Valley is additional insured and coverage is primarV and non-contributory where required by written contract as per attached SB146968-A. Project:Valley Mission Pocket Dog Park Phase II CERTIFICATE HOLDER CANCELLATION CITYOFS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. c/o Park and Recreation Dept. 2426 N.Discovery Place AUTHORIZED REPRESENTATIVE Spokane Valley,WA 99216 aiii4,7/7,42,0VA—, I ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD CNA SB-146968-A 01/06) IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C., OF THIS ENDORSEMENT FOR THESE DUTIES. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE BLANKET WAIVER OF SUBROGATION Architects, Engineers and Surveyors This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COMMON POLICY CONDITIONS A. WHO IS AN INSURED (Section C.) of the 4. The insurance provided to the additional insured Businessowners Liability Coverage Form is amended does not apply to "bodily injury," "property to include as an insured any person or organization damage," "personal and advertising injury"arising whom you are required to add as an additional insured out of an architect's, engineer's, or surveyor's on this policy under a written contract or written rendering of or failure to render any professional agreement; but the written contract or written services including: agreement must be: a. The preparing,approving, or failing to prepare 1. Currently in effect or becoming effective during the or approve maps, shop drawings, opinions, term of this policy;and reports, surveys, field orders, change orders 2. Executed prior to the "bodily injury," "property or drawings and specifications by any damage,"or"personal and advertising injury." architect, engineer or surveyor performing services on a project of which you serve as B. The insurance provided to the additional insured is construction manager; or limited as follows: b. Inspection, supervision, quality control, 1. That person or organization is an additional engineering or architectural services done by insured solely for liability due to your negligence you on a project of which you serve as specifically resulting from "your work" for the construction manager. additional insured which is the subject of the 5. This insurance does not apply to "bodily injury," written contract or written agreement. No "property damage," or "personal and advertising coverage applies to liability resulting from the sole injury"arising out of: negligence of the additional insured. a. The construction or demolition work while you 2. The Limits of Insurance applicable to the are acting as a construction or demolition additional insured are those specified in the contractor. This exclusion does not apply to written contract or written agreement or in the work done for or by you at your premises. Declarations of this policy, whichever is less. These Limits of Insurance are inclusive of, and not C. BUSINESSOWNERS GENERAL LIABILITY in addition to,the Limits of Insurance shown in the CONDITIONS—Duties In The Event of Occurrence, Declarations. Offense, Claim or Suit (Section E.2.) of the 3. The coverage provided to the additional insured Businessowners Liability Coverage Form is amended within this endorsement and section titled to add the following: LIABILITY AND MEDICAL EXPENSE An additional insured under this endorsement will as DEFINITIONS — "Insured Contract" (Section soon as practicable: F.9.)within the Businessowners Liability Coverage 1. Give written notice of an occurrence or an offense Form, does not apply to"bodily injury"or"property to us which may result in a claim or "suit" under damage" arising out of the "products-completed this insurance; operations hazard" unless required by the written contract or written agreement. SB-146968-A Page 1 of 2 (Ed. 01/06) OP ID:JW A`OR oa CERTIFICATE OF LIABILITY INSURANCE DATE(MM/02/03/22016016 ) 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 Christy Marzetta Andre-Romberg Ins.Agency,Inc f1 E C E V E D PHONE 5093291 FAX -624- S.400 Jefferson St.,Ste.333 (A/C.No,Ext): (A/C,No):509-456-0294 Spokane,WA 99204 E-MAIL Christy Marzetta-Ext.322 FEB 03 2UfU ADDRESS:cmarzetta@andre-romberg.com PRODUCER f CUSTOMER ID#:BRNA-1 FARES lICcr,re-r,( ; ()Ei'T.i INSURER(S)AFFORDINGCOVERAGE NAIC# INSURED Bernardo-Wills Architects INSURERA:Travelers Insurance Co. Mr.Robert Wills INSURER B: 153 S Jefferson Street Spokane,WA 99201 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER PPOLICY NUMBER (MM/DDY/YYYY) (MM/DD/YYYY) LIMITS LTR INSR WVD GENERAL LIABILITY EACH OCCURRENCE $ • DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ —1 POLICY ri PRO- JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (PER ACCIDENT) $ NON-OWNED AUTOS UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ _ DEDUCTIBLE - $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITYY/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVEN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A PROFESSIONAL LIAB 105740569 02/01/2016 02/01/2017 LIABILITY 2,000,000 FULL PRIOR ACTS COVERAGE RETENTION 35,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Proof of coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. 2426 N. Discovery Place Spokane Valley,WA 99216 AUTHORIZED REPRESENTATIVE Christy Marzetta-Ext.322 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD 2/18/2016 BERNARDO WILLS ARCHITECTS PC ihj e a1• ;ivi (.'o;i:,tc'. 1Search L&1_.. Nagai] ._. '] A-7,ittdec MI? My Secure• Safely&Health Claims& Workplace Rights Trades&Lice'oaing. 111PWashington State Department of : Labor & industries BERNARDO WILLS ARCHITECTS PC Owner or tradesperson 153 S JEFFERSON ST GARY BERNARDO SPOKANE,WA 99201-4103 Doing business as BERNARDO WILLS ARCHITECTS PC WA UBI No. Governing persons 601 317 114 GARY M BERNARDO ROBERT M WILLS; 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. 809,775-00 Doing business as BERNARDO WILLS ARCHITECTS PC Estimated workers reported Quarter 4 of Year 2015"21 to 30 Workers" L&I account representative T1/IDA HAYNES(360)902-5635-Email:HAYN235@ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Ci Washington State Dept of Labor&Industries.Use of this site Is subject to the laws of the state of Washington. • httne•//tetra Ini wa nnv/verify/Detail.asox?UBI=601317114&SAW=False 1/1