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13-074.01 ISS Facility Services: CenterPlace Janitorial Svcs CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND ISS FACILITY SERVICES Spokane Valley Contract#13-074.0f For good and Valuable consideration,the legal sufficiency of Which is hereby Acknowledged,City and the Contractor-mutually agree as follows: the 1.Purpose:This Amendment is othe �' for Janitorial Servicei for nePand between Parties, exeedted by the Parttein May ,2013, and whchtrninates oAl3020161Sad contract shall be referred to as the"Original Contract"and its terms are hereby incorporated by reference. Total compensation under the Original Contract is itot to exceed$85,02.00,. 2. hose terms and itions of the C Contract Provisions:anyThe 'ties thereto which are not specifically to continue to abide by ti Modified by this An endme t. Original Contract and any amendments t 3.Amendment Provisions:This Amendment is subject to the following amended provisions which are as follows. All such amended provisions are hereby incorporated bY refernce amendmin ents mend shall them to.ntrol over any contfiiettng provisions of the Original Contract,includingany previous •e vine 1°' •i e- earArenewal for tl e ,or'•d •i Ma 1 20161• ' ril 30 2117. , ::' s i:T.'1= i 1 • .'•` :. ; :, / tract. 4. Compensation Amendment History: This i„a�Contractand antd all ament#1 of n ettd t�eutse lisas�tfollotvs:The history of amendments to the compensation ong Date Compensation Original Contract Amount 5/2013 $)35,632.001/2017 $ 0.0� Amendment 01 $t35,t 32.1)0 Total Amended Compensation The have executed this Amendment to the Original Contract this I ' partiesday of Janiiany 2017. CIT OF SPO 'NEV ALLEY: CONTRACTOR: ":-1 .t2:),_.., . ,‘frt..ipli--4 .,f,)),/...4.:.(26.3". Mark Calhoun Its: V P 6UeSt City Mafia_ A N APPROVED A TO FORM: e?0::).pristine Bainbridge,City ClerkOffice City orney I AC R® DATE( 01 ) CERTIFICATE OF LIABILITY INSURANCE 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 have ADDITIONAL INSURED provisions or be endorsed. m If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on w this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). c PRODUCER CONTACT 'p NAME: Aon Risk Services Southwest, Inc. PHONE (866) 283-7122 FAX (800) 363-0105 Houston TX office (A/C.No.Ext): (A/C.No.): 5555 San Felipe --- Suite 1500 -p ADDIRESS: I Houston TX 77056 USAC P VINSURER(5)AFFORDING COVERAGE NAIC# INSUREDJ ► i (a t'' INSURER A: AIG Europe Limited AA1120841 ISS Facility Services. Inc INSURER B: American Guarantee & Liability Ins Co 26247 1019 Central Pkwy N INSURER c: Zurich American Ins Co 16535 suite 100 PARKS& RECREATION OPT. • San Antonio TX 78232 USA INSURER D: Greenwich Insurance Company 22322 INSURER E: XL Specialty Insurance Co 37885 INSURER F: COVERAGES CERTIFICATE NUMBER:570064839948 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. Limits shown are as requested INSR ADDL SUER POLICY EFF POLICY EXP LTR, TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD (MM/DDIYYYY) LIMITS C X COMMERCIAL GENERAL LIABILITY GL0983574304 01/01/201 01/01/2018 EACH OCCURRENCE $1,000,000 �—I SIR applies per policy terms & conditions DAMAGE TO RENTED $1,000,000 CLAIMS-MADE I X I OCCUR PREMISES(Ea occurrence) X Per Project Agg$2M MED EXP(Any one person) $10,000 PERSONAL 8 ADV INJURY $1,000,000 X Per Location Agg$2M GENERAL AGGREGATE $5,000,000 m GEN'L AGGREGATE LIMIT APPLIES PER m X POLICY n PRO- 1 1LOC PRODUCTS-COMP/OPAGG _ $2,000,000 I _ JECT 1 1 0 OTHER: o D AUTOMOBILE LIABILITY RAD 943775701 01/01/2017 01/01/2018 COMBINED SINGLE LIMIT $1,000,000 u) (Ea accident) X-ANY AUTO BODILY INJURY(Per person) 0 — OWNED —SCHEDULED BODILY INJURY(Per accident) a _AUTOS ONLY AUTOS PROPERTY DAMAGECZ X HIRED AUTOS x NON-OWNED (Per accident) ONLY —AUTOS ONLY a a B X UMBRELLA LIAB X OCCUR AUC983577404 01/01/2017 01/01/2018 EACH OCCURRENCE $5,000,000 V EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION E WORKERS COMPENSATION AND RWD943533505 01/01/2017 01/01/2018 X PER OTH- EMPLOYERS'LIABILITY Y/N Includes the state of NY STATUTE ER E .ANY PROPRIETOR/PARTNER/EXECUTIVE I N I RWR943533605 01/01/201]01/01/201$ E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? J N/A (Mandatory in NH) WI E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000— A E&O-MPL-Primary FC1640317 11/01/2016 11/01/2017 Crime EE Dishonesty $2,000,000 Crime-Employee Dishonesty ... DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) 1+ RE: Event: City of Spokane Valley-2013. Certificate Holder is included as Additional Insured in accordance with the policy provisions of the General Liability policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Spokane valley AUTHORIZED REPRESENTATIVE Center Place 2426 N. Discovery Place "�x „�vaileD Ye/ � r6; Spokane Valley WA 99216 USA Ell ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1/17/2017 ISS FACILITY SERVICES INCORPORATED ituntz tsg,uivi C'c>n;..:ct Search L&I A 3 A-Z is d \ tielp Ni) l&I Safety&Health Claims&'tn ;trance Workplace Nights 1 racies&L icer sing 0 Washington State Department of Labor & Industries ISS FACILITY SERVICES INCORPORATED Owner or tradesperson 1019 CENTRAL PKWY N STE 100 SAN ANTONIO,TX 78232 CHRISTI ROHMER Doing business as ISS FACILITY SERVICES INC WA UBI No. Governing persons 602 372 770 CHRISTI • ROHMER DARRELL GLOVER; 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. 0721442-00 Doing business as ISS FACILITY SERVICES INC Estimated workers reported Quarter 3 of Year 2016"76 to 100 Workers" L&I account representative T4/JULIE SUR(360)902-4825-Email:SURJ235@Ini.wa.gov Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Inspection results date 05/10/2016 No violations Inspection no. 317940031 Location 1115 SE 164th Ave. Vancouver,WA 98683 Inspection results date 04/27/2015 Violations Inspection no. 317935970 Location 1115 SE 164th Ave Ste 210 Vancouver,WA 98683 0 Washington State Dept,of Labor 3 Industries.Use of this site is subject to the laws of the state of Washington. Help us€'.3 pt?l%e httosJ/secure.Ini.wa.gov/verjfy/DetaiLaspx?UBI=602372770&LIC=&SAW=False 1/2