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16-052.01 AM Landshaper: Valley Mission Dog Park Ph 2 I CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND A.M. LANDSHAPER INC. Spokane.Valley Contract#16-052.01 For good and valuable consideration,the legal sufficiency of which is hereby acknowledged, City and the Contractor mutually agree as follows: 1. Purpose: This Amendment is for the Contract for the construction of the Valley Mission Pocket Dog Park Phase 2 project by and between the Parties, executed by the Parties on April 18, 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 $65,963.51. 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 August 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 4/18/16 $65,963.51 Amendment#1 6/28/16 $ 0 Total Amended Compensation $65,963.51 11/1 The parties have executed this Amendment to the Original Contract this I� day of July,2016 CITY OF SPOKANE VALLEY: CONTRACTOR: ark Calhoun By: Tye C.McGee Acting City Manager Its: Sec/Treasurer ATT S APPROVE AS TO FORM: ristine Bainbridge, City Clerk Office the City Attorney 1 ------"1.1AMLANDS-01 WCHRISTESON I DATE(MM/DD/YYYY) A`�� CERTIFICATE OF LIABILITY INSURANCE IIL 4/18/2016 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). CONTACT PRODUCER NAME: PHONE 509 838-3501 1 FAX No):(509)838-3511 Spokane Office - .—�"� (Arc,No,Ext):( ) 501 N.Rest Insurance,Inc. R t C E I V E D E-MAIL • 501 N.Riverpoint Blvd.,Ste 403 ADDRESS: Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC# APR 18 2U€b INSURERA:The Cincinnati Insurance Co. 10677 INSURED I INSURER B: A.M.Landshaper,Inc. 1PARKS & RECREATIOV ":1EPi INSURERC: Mark Albin --._. .._____._......... INSURER D 8004 North Market INSURERS: Spokane,WA 99217 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. ADDL SU BR POUCY EFF POUCY EXP LTR EACH OCCURRENCE $LIMITS INSR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) 1 QQQ�QQO A X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 500,000 X OCCUR X EPP0128051 02/24/2016 02/24/2017 PREMISES(Ea occurrence) $ CLAIMS MADE MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE OMIT APPLIES PER: 2,000,000 OTHER: X PRO- I I LOC PRODUCTS-COMP/OP AGG $ POLICY JEcr WA STOP GAP $ 1,000,000 OTHER: COMBINED SINGLE LIMIT $ 1,000,000 AUTOMOBILE LIABILITY (Ea accident) A X ANY AUTO EBA0128051 02/24/2016 02/24/2017 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NOVON NED PROPERTY DAMAGE (Per accident) $ X HIRED AUTOS X AU _ EACH OCCURRENCE $ 1,000,000 )( UMBRELLALIAB X OCCUR 1,000,000 A EXCESS UAB CLAIMS-MADE EPP0128051 02/24/2016 02/24/2017 AGGREGATE $ 0 $ DED X RETENTION$ I STATUTE I KH - AND COMPENSATION AND EMPLOYERS'LIABILITY Y/N E.L EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE NIA OFFICER/MEMBER EXCLUDED? E.L DISEASE-EA EMPLOYEE $ (Mandatory in NH) If yes,describe under E.L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below 02/24/2016 02/24/2017 Leased and Rented 225,000 A Equipment Floater EPP0128051 A EPP0128051 02/24/2016 02/24/2017 Deductible 1,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Cincinnati Insurance Company:#10677,A+XV Re: Valley Mission Dog Park Phase 2 City of Spokane Valley is named as Blanket Additional Insured per endorsment#GA233 02/07 including primary and non-contributory and waiver of subrogation,attached. • 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 Attn:Mike Stone ACCORDANCE WITH THE POLICY PROVISIONS. 11707 East Sprague Ave. Suite 106 Spokane Valley,WA 99206 �AU�T�H�ORIfZ/ED REPRESENTATIVE �'"" I n�� I 11/'©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 4/25/2016 A M LAN DSHAPER INC Home Espaiiol Contact Search L&I A-Z Index Help My IRE Safety&Health Claims&Insurance Workplace Rights Trades&Licensing Ciklir 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 Governing 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—04/12/2018 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. SS B397618 Received by L&I Effective date 10/02/2009 09/24/2009 Expiration date Until Canceled Insurance Cincinnati Ins Co $1,000,000.00 ... ,. . . ..._._:z mi_Cnd7MO7OQI Ir'—AAAI AMII*071r1(VLCAlA-Falco 1/2 4/25/2016 A M LANDSHAPER INC Policy no. EPP225013 Received by L&I Effective date 02/19/2016 02/24/2012 Expiration date 02/24/2017 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is current. 816,368-01 Doing business as A M LANDSHAPER INC Estimated workers reported Quarter 4 of Year 2015"7 to 10 Workers" L&I account representative TO/CAROLYN CRAWFORD(360)902-4715-Email:CRAI235@Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. ©Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. httos://secure.lni.wa.aov/verifv/Detai l.asox?U B I=601701273&LIC=AM LAN I*971 D O&SAW=Falsa 2/2