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16-095.01 Michael Terrell: Browns Park Water Service CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND MICHAEL TERRELL LANDSCAPE ARCHITECTURE,PLLC Spokane Valley Contract#16-095.01 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 Browns Park Water Service Project by and between the Parties,executed by the Parties on October 19,2016,and which terminates on December 31,2016. 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$6,510.00. 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 July 1,2017 since work by Water District#3 was not completed in 2016. The scope is hereby modified to include design and investigation for future electrical service. Compensation to be increased by$950 to accommodate for additional electrical work as ' requested. 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 10/19/16 $ 6,510.00 Amendment#1 3/16/17 $ 950.00 Total Amended Compensation $7,460.00 The parties have executed this Amendment to the Original Contract this day of March,2017. CITY OF SPOKANE,VALLEY: CON •11 '� It301AAA W2:7117 11111, Calhounrr'ichael err ' City Manager Its: -L7Z�4JC-L � A El APPROVED A TO FORM: Jr 4 -t- 61a')<P. ristine Bainbridge,City Cler i Office kthe City rney 1 k JSR DATE(MM/DD/YYYY) �' CERTIFICATE OF LIABILITY INSURANCE • R022 1/16/2017 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(les)must have ADDITIONAL INSURED provisions or 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: USAA INSURANCE AGENCY INC/PHS PHONE WC NaExtz (888) 242-1430 FAX (NC,NO: (888) 443-6112 812846 P: (888) 242-1430 F: (888) 443-6112 qDD m: PO BOX 33015 INSURER(S)AFFORDING COVERAGE Nava SAN ANTONIO TX 78265 _,•,- INSURERA: Hartford Casualty Ins Co 29424 INSURED1,v., k _..�: `'w 1 INB 1„:„r , MICHAEL TERRELL- LANDSCAPE INSURER C: e'{4\ ? S �f) / INSURER D: • ARCHITECTURE, PLLC JAN , L., , 5312 S CHAPMAN RD INSURER E: GREENACRES WA 99016 PARKS& RECr>:rAPG:! INSURERF: COVERAGES CERTIFICATE NUMBBi2:-''— -' REVISION NUMBER: INDICATED.THIS IS TO ERIFY TT THE IOD CNOTTWITHSTAND NGPANY IREQUIREMENTNTERM ES OF INSURACE SOR CONDITED TION OF ANY CONHAVE BEEN TRACT ED OOR OTHER DOCUMENT WITHE INSURED NAMED DTH RESPECT TO VE FOR THE LW ICH ICY 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS TYPE OFfNSURANCE L7R /MSR WM (7:1M/DD/YYY17 IMMIDD/YYTY) EACH OCCURRENCE $2, 000, 000 COMMERCIAL GENERAL LIABILITY — —DAMAGE TO RENTED $300, 000 CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) A X General Liab X 65.SBA PU5893 01/13/2017 01/13/2018 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2, 000, 000 GENERAL AGGREGATE $4, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- X LOC PRODUCTS-COMP/OP AGG $4, 000, 000 JECT S OTHER COMBINED SINGLE LIMIT $2, 000, 000 AUTOMOBILE LIABILITY (Ea accident) ANY AUTO BODILY INJURY(Per person) $ — — A OWNED SCHEDULED x 65 SBA PU5893 01/13/2017 01/13/2018 BODILY INJURY(Per accident) $ _AUTOS ONLY—AUTOS PROPERTY DAMAGE X HIRED x NON-OWNED (Peraccident) $ AUTOS ONLY AUTOS ONLY S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE• AGGREGATE $ • $ DED RETErmoNs _ PER •OTH- WORXERSCOMPENSATION STATUTE ER AND EMPLOYERS'LIABIL/TY $ ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N • EL.EACH ACCIDENT OFFlCERIMEMBER EXCLUDED? (Mandatory In NH) ^ N/A EL.DISEASE-EA EMPLOYEE If yes,describe underEL.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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE City of Spokane Valley DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn•: Mike Stone AUTHORIZED REPRESENTATIVE • 2426 DISCOVERY PL SPOKANE VALLEY, WA 99216 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD o '�COF LIABILITY INSURANCE DATE(MM/DD/YYYY) CERTIFICATE01/16/2017 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 poilcy(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 IieJ of such endorsement(s). CONTACT Tracey Donohue PRODUCER NAME: CorRisk Solutions "HONE631-756-3000 IFA,`,,,,..* 631-756-2500 war>e.e.o: 1 Huntington Quadrangle Suite 4N20 EMAILtraceyd@corrisksolutions.com Melville, NY 11747 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 • INSURER D: Greenacres, WA 99016 INSURERS: 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 REQUjREMf ENT,TERMOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY ERT J THE INSURANCSA D BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SU H POQI�.S.LIMITS SHOWN MAY VE BEEN REDUCED BY PAID CLAIMS. INSR I ; NS ADD'L SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE (MMIDDIYYYY) (MWDDrYYYY) GENERAL LIABILITY .1tw 1 t - '"/ EACH OCCURANCE DAMAGE TO RENTED • COMMERCIAL GENERAL LIABIPREMISES(Ea occurance) 'CLAIMS MADE FI oc pp UR`US i - •• i :• i. MED EX?(Any one person) _....------_.----- --- DOES NOT APPLY - - PERSONAL&AND INJURY GENERAL AGGREGATE PRODUCTS-COMP/OP AGO GEN'L AGGREGATE LIMIT APPLIES PER: 7 POLICY n PROJECT II LOC UUMBINtU SINGLt L MA I tta AUTOMOBILE LIABILITY accident) BODILY INJURY(Per person) — ANY AUTO ALL OWNED SCHEDULED— DOES NOT APPLY BODILY INJURY per sodded) AUTOS —AUTOS DPERJ Y er(Per NON-OWNED accident) —HIRED AUTOS —AI CM UMBRELLA LIAR _OCCUR EACH OCCURANCE EXCESS UAB CLAIMS MADE DOES NOT APPLY AGGREGATE DED I 'RETENTIONS WORKERS COMPENSATION I WC sTATTORY UMIU- U- I IOTMER AND EMPLOYERS'LIABILITY E.L EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER EXCLUDED? Y/N N/A DOES NOT APPLY L.L.UISESAb-to (Mandatory in NH) EMPLOYEE If yes,describe under DESCRIPTION OF E.L DISEASE-POLICY LIMIT OPERATIONS below 064991268- PerOcrxmen`e' $1,000,000 A Professional Liability • 01 01/16/17 01/16/18 Annual Aggregate: $1, 000,000 DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES(Attach ACCORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD THEREOF, E NY OF THE AVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ER OF,NOTICE BE DELIVERED IN ACCORDANCE Vv1TH THE POLICY PROVISIONS. ATE City of Spokane Valley Parks and Recreation DepartmentAttention: Mike Stone 2426 N. Discovery Place AUTHORIZED REPRESENTATIVE Spokane Valley, WA 99216 ' ©1988-2010 ACORD CORPORATION.Affrights reserved. ACORD 25(2010105) Tha ACORD name and logo are registered marks of ACORD 3/15/2017 MICHAEL TERRELL LANDSCAPE ARCHITECTURE PLLC l.iu4x e, Atilt= Search L&I _ 1 i A.- .� .,t} c, 't?c'tl' .,& > .x r, i.11:i 'e ciet . _i e 51 0,Washington State Department of 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 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 2016"1 to 3 Workers" LAI 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. CO Washington State Dept of Labor&Industries.Use of the sae is subject to the taws of the state of Washingtor.. Hell is Ar >s . https://secure.lni.wa.gov/verify/Detai I.aspx?U Bl=603368643&LIC=&SAW=False 1/1