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16-044.02 Michael Terrell: Browns Park Splash Pad & Champ Sand Volleyball Court CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND MICHAEL TERRELL LANDSCAPE ARCHITECTURE PLLC Spokane Valley Contract#16-044.02 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. -Extend contract completion date to May 1, 2017. This is to allow for project oversight for the closing out of the project and the initial start-up in the spring. 4. Compensation Amendment History: This is Amendment #2 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 Amendment#2 11/7/16 $ 0 Total Amended Compensation $15,160.00 The parties have executed this Amendment to the Original Contract this / day of November, 2016. CITY OF SPOKANE VALLEY: CONSUL OrAt-k-- to3/(67 Mark Calhoun C - j hael errel l City Manager Its: Owner ATTEST: APPROVE. S TO FORM: Christine Bainbridge, City Clerk Offic f the ttorney 1 JJW DATE(MM/DD/YYYY) A CERTIFICATE OF LIABILITY INSURANCE R022 3/1/2016 THIS CERTIFICATE'S 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'S 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 �w"c No,Ext): (888) 242-1430 FAX (A/c, (888) 443-6112 812846 P: (888) 242-1430 F: (888) 443-6112ADDRESS: PO BOX 33015 • INSURER(S)AFFORDING COVERAGE NAILS SAN ANTONIO TX 78265 INSURER A: Hartford Casualty Ins Co 29424 INSURED INSURER B: MICHAEL TERRELL- LANDSCAPE INSURER C: ARCHITECTURE, PLLC INSURER D: 5312 S CHAPMAN RD • INSURER E: GREENACRES WA 99016 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 INSUR/INCE ADDL SUER POLICY NUMBER POLICYEFF POLICY EXP LIMITS 1..77? INV? WO (MM/DD/M7) IMACIDNYT'YYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR DAMAGE TO PREMISES Ea occurrence)RENTED $300,000 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'LAGGREGATE LIMIT APPLIESPER: GENERAL AGGREGATE $4,000,000 1POLICY PRO n LOC PRODUCTS-COMP/OP AGG $4,000,000 JECT 1 I OTHER: $ AUTOMOBILE LIABILITY (Ea accide0;INGLE LIMIT .$2,000,000 ANY AUTO BODILY INJURY(Per person) $ A ALLOWNED SCHEDULED X 65 SBA PU5843 01/13/2016 01/13/2017 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIREDAUTOS X NON-OWNED (PePROPERTY r accfdent)AMAGE $ AUTOS — $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ PER OTH- NDEERSOYM C OMPENSATION STATUTE ER AND EMPLOYERS'L IAB IL lTY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ OFFI(Mandatory NH EXCLUDED? I I N/A = $ (Mandatory in NH) - EL DISEASE-EA EMPLOYEE if yes,describe underE.L 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 — Splash Pad DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Mike Stone AUTHORIZED REPRESENTATIVE 2426N DISCOVERY PL _ ett e- 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 A CERTIFICATE OF LIABILITY INSURANCE DATED(M 9 D016 YYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES BELOW. HIS CERTIFICATE L GE ATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT THE E ISSAFFORDED 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 CONTACT CANE: Karen Bronson CorRisk Solutions PHONE 312-263-4218 FAXExp: WC,Ne.Exp: WNE, .. 225 W. Washington St. Suite 1560 E-MAIL kbronson@corrisksolutions.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIL# Chicago, IL 60606 INSURER A: New Hampshire Insurance Company 23841 INSURED INSURER B: Michael Terrell — Landscape Architecture, PLLC INSURER C: 5312 South Chapman Road INSURER D: Greenacres, WA 99016 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 MAYBE 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. AMYL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS INSR TYPE OFINSURANCE INSRD WVD (MM/DD/YYYY) (MM/DD/YWY) LTR GENERAL LIABILITY EACH OCCURANCE' DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurance) CLAIMS MADE I (OCCUR MED EXP(Any one person) DOES NOT APPLY— PERSONAL&AND INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 7 POLICY pi PROJECT Ii LOC COMBINtU SINGLE UMI I(Ea AUTOMOBILE LIABILITY accident) ANY AUTO BODILY INJURY(Per person) — ALL OWNED —SCHEDULED DOES NOT APPLY BODILY INJURY(Per accident) -AUTOS --AUTOSPROPERTY DAMAGE(Per NON-OWNED accident) -HIRED AUTOS --AI ITC1S UMBRELLALIA6 _OCCUR EACH OCCURANCE — EXCESS LIAB CLAIMS MADE DOES NOT APPLY AGGREGATE DED RETENTION$ WORKERS COMPENSATIONWC STATU- OTHER AND EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT • OFFICE/MEMBER EXCLUDED? YIN N/A DOES NOT APPLY b.LUISLSAE-EA (Mandatory in NH) ❑ EMPLOYEE If yes,describe under DESCRIPTION OF E.L DISEASE-POLICY LIMIT • OPERATIONS below 064991268- 01/16/16 01/16/17 Per Occurrence: $1,000,000 A Professional Liability 00 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE City of Spokane Valley Parks and Recreation THEREOF,NOTICE WLL BE DELIVERED IN ACCORDANCE VeITH THE POLICY PROVISIONS. Attention: Mike Stone 2426 N. Discovery Place AUTHORIZED REPRESENTATIVE Spokane Valley, WA 99216 ' ACORD 25(2010/05) • ©1988-2010 ACORD CORPORATION.Allrights reserved. Theo A!_(1RIl nanla and Irvin arp_ rP.(7LRtP.rad marks of ACORD .---"---< JJW 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 PHONE (A/c,No,Ext): (888) 242-1430 FAX No): (888) 443-6112 812846 P: (888) 242-1430 F: (888) 443-6112 ADDRESS: PO BOX 33015 INSURER(S)AFFORDING COVERAGE NAICS SAN ANTONIO TX 78265 INSURER A:Hartford Casualty Ins Co 29424 INSURED INSURER S: MICHAEL TERRELL- LANDSCAPE INSURER C: ARCHITECTURE, PLLC INSURERD: 5312 S CHAPMAN RD • INSURERS: GREENACRES WA 99016 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 POLICY NUMBER POLICY EFF POLICY EXP LIMITS ITR • IN,SR WO (MM/OD/YURI MM/DD/YYYY! COMMERCIAL GENERAL —LIABILITY EACH OCCURRENCE $2,000,000 CLAIMS-MADE( I OCCUR PGE TO RENTED R A SES(Ea occurrence) $300 r 000 A X General Liab X 65 SBA PU5843 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 $4,000,000 1 POLICY PRO-n LOC PRODUCTS-COMP/OP AGG $4,000, 000 JECT OTHER: $ AUTOMOBILE LIABILITY (Ea aclNED SINGLE LIMIT $2,000, 000 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 (PeOr aEccRTY iden;AMAGE $ AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ S DED RETENTION$ PER OTH- EOYMPENSABILI STATUTE ER ANDNDEMPLOYERS'LIABILITY ANY PROPRIETORJPARTNERJEXECUTNE YIN EL EACH ACCIDENT $ (Mandatory in OFFICER/MEMBER EXCLUDED? L - (Mandatoryin NH) WA EL DISEASE-EA EMPLOYEE $ If yes,describe underEL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERA TIONS/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. Attn:. Mike Stone AUTHORIZED REPRESENTATIVE 2426N DISCOVERY PL �t Gc:t:e 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 ,---, o AWRL ‘.....--- CERTIFICATE ERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 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(). . PRODUCER CONTACT Karen Bronson NAME CorRisk Solutions PHONE X 225 W. Washington St. Suite 1560 (NON,ExT 312-263 4218 FAIA C.N,,E ; 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 5312 South Chapman Road • INSURER C: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 1 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'L SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSRD WVD (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURANCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(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 7POUCY rPROJECT rLOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT(Ea accident) ANY AUTO BODILY INJURY(Per person) — ALL OVVNED --SCHEDULED DOES NOT APPLY BODILY INJURY(Peraccident) —AUTOS —AUTOS _ HIRED AUTOS NON-OWNED acROent)TYDAMAGE(Per — —AI MIR UMBRELLA LIAR _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/MEMBEREXCLUDED? NIA Y/N DOES NOT APPLY t.LUISI_SAb-EA (Mandatory In NH) 0 EMPLOYEE If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT Per A Professional Liability 064991268— 01/16/16 01/16/17 Annual $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) 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 WLL BE DELIVERED IN ACCORDANCE WTH THE POLICY PROVISIONS. 2426 N Discovery Place AUTHORIZED REPRESENTATIVE Spokane Valley, WA 99216 ACORD 25(2010105) ©1988-2010 ACORD CORPORATION.AI frights reserved. Thea ert-to n nmn on,f i,., • ••n rnnfcfn.nel mnrLc of ArrDr' 2/18/2016 MICHAEL TERRELL LANDSCAPE ARCHITECTURE PLLC home l.p,tix31 C'ontatt SearchL&I `Ea4?-rN A-Z Index Help My venue L&1 safety&Health Claims&insurance Workplace Rights Trades&Licensing 111PWashington State Department of 1 Labor & Industries MICHAEL TERRELL LANDSCAPE ARCHITECTURE PLLC 5312 S CHAPMAN RD Owner or tradesperson GREENACRES,WA 99016-8832 KARA TERRELL Doing business as MICHAEL TERRELL LANDSCAPE WA UBI 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.