16-085.04 Clearwater Summit Gp: Browns Park Champ Sand Volleyball Court & Splash Pad . 1
CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF
SPOKANE VALLEY AND CLEARWATER SUMMIT GROUP INC.
Spokane Valley Contract#16-085.04
s
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 Browns Park Championship Sand Volleyball Court
Project by and between the Parties, executed by the Parties on May 4, 2016, and which terminates on
June 10, 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$51,523.80
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 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 the contract time of performance to June 15,2017. This is to allow for the closing out of the
project and the initial start-up in the spring.
4. Compensation Amendment History: This is Amendment #4 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 5/4/16 $ 51,523.80
Amendment#1 6/3/16 $108,359.04
Amendment#2 7/22/16 $ 0.00
Amendment#3 11/7/16 $ 0.00
Amendment#4 4/24/17 $ 0.00
Total Amended Compensation $159,882.84
A414
The parties have executed this Amendment to the Original Contract this /eR day ofd,2017.
Y F SP* ' VALLEY: CONT' = ' OR•
= / i�
Mark Calhoun By: Ty Ilma
City Manager Its: Vice Pres .ent
A S APPROVED AS TO FORM:
i .stme Bainbridge,City Clerk Office • the City Attorney
1
CLEAJUM-02 JSCHILB
i DATE(MMIDD/YYYY)
A` Os/w- CERTIFICATE OF LIABILITY INSURANCE
4/212017
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 enc orse ept(s)„ ¢ }
PRODUCER t E I i/ ED CONTACT Jill Schilb "
NAME:
Alliant Insurance Services Inc. PHONE 509 343-9217 FAX,No):(509)325-1803
MoloneyO'Neill APR t� 7 (ac.No.Esti:1509))
818 W Riverside Ave,Ste 800 0 3 2011 E-MAIL ischilb@mo-ins.com
ADDRESS:!
Spokane,WA 99201 INSURER(S)AFFORDING COVERAGE a NAIC X
PARKS& RECREATION DEPT. INSURER A:Union Insurance Company 25844
INSURED INSURER B:
Clearwater Summit Group,Inc. INSURER C: ,
4228 E Wellesley INSURER D:
Spokane,WA 99217 • 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 POUCY 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 SUER POLICY EFF POLICY EXP
TV TYPE OF INSURANCE ?NSD YYArp POUCY NUMBER (MMIDWYYYY) (MMIDD/YYYY) LIMITS
A X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE, 5 1,000,000
CLAIMS-MADE PREMIS
X OCCUR X X CPA6026627 12/22/2016 12/22/2017 MAGEES(I Ea oeREN'uxrance) $ 300,000
O
MED EXP(Any one person) $ 10,000
— _PERSONAL&ADV INJURY $ 1,000,000
GENt AGGREGATE UMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY X YES- X.LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
A X ANY AUTO CPA6026627 12/22/2016 12/22/2017 BODILY INJURY(Per person) S
—ALL OWED SCHEDULED BODILY INJURY(Per acddent) $
AUTOS AUTOS
ON-OO WNED PROPERTY DAMAGE $
X HIRED AUTOS X AUTOS (Per accident)
$
X UMBRELLA UAB X OCCUR _EACH OCCURRENCE! $ 4,000,000
A - EXCESS LAB CLAIMS-MADE CPA6026627 12/22/2016 12/22/2017 AGGREGATE 1 $ 4,000,000
1
DED RETENTIONS $
WORKERS COMPENSATION PER
STATUTE X 2-12}1.
ANDY PROPRIETOR/LIABILITY Y/N CPA6026627 12/22/2016 12/22/2017 E.LEACH ACCIDENT I $ 1,000,000
A OFF CER/MEM ORIPXCLUDR/DCECl1TIVE I I N/A
(MandaR/MEMNH)EXCLUDED? E.LDISEASE-FAEMPLOYEE`S 1,000,000
(Mandatory In NH)
I(yes,descdbe under EL DISEASE-POLICY UNIT 5 1,000,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
City of Spokane Valley is additional insured pertaining to the General Liability per the policy forms.Coverage is primary and non-contributory and includes
completed operations.Waiver of subrogation applies.
CERTIFICATE HOLDER CANCELLATION
T
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
of Spokane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City p ACCORDANCE WITH THE POLICY PROVISIONS.
2426 N Discovery Place
Spokane Valley,WA 99216 I
AUTHORIZED REPRESENTATIVE
nn I
®1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
•
4 'Search L&l 3
•
414
ti
Washington State Department of
Labor & Industries
CLEARWATER SUMMIT GROUP INC
Owner or tradesperson PO BOX 6470
SPOKANE,WA 99217-0908
Principals 509-482-2722
SWEET,TIM P,PRESIDENT SPOKANE County
ULLMAN,TY ROBERT,VICE PRESIDENT
ULLMAN,LAURA LOUISE,SECRETARY
SWEET,ELAINE,TREASURER
Doing business as
CLEARWATER SUMMIT GROUP INC
WA UBI No. Business type
601 450 995 Corporation
Governing persons
ELAINE
• SWEET
TIMOTHY P SWEET;
LAURA ULLMAN;
TY R ULLMAN;
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.
CLEARSG000KN
Effective—expiration
05/15/2000—07/11/2018
Bond
TRAVELERS CAS&SURETY CO $12,000.00
Bond account no.
055S103627339BCM
Received by L&l Effective date
05/28/2002 07/01/2002
Expiration date
Until Canceled
Insurance
Union Insurance Company $1,000,000.00
Policy no.
CPA6026627
Received by LW Effective date
12/21/2016 12/22/2016
Expiration date
12/22/2017 •
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.
L811 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.
1
License Violations
Infraction no. Satisfied
ESODA00254
Issue date RCW/WAC
06/25/2015 19.28.271 RCW
Violation city Violation amount
SPOKANE $250.00
Type of violation
ELECTRICAL CITATION
Description
Employing an individual for the purposes of
chapter 19.28 RCW who does not possess a
valid certificate of competency or training
certificate to do electrical work.
Ra
Infraction no. Satisfied
ESODA00253
Issue date RCW/WAC
06/25/2015 19.28.101 RCW
Violation city Violation amount
SPOKANE $250.00
Type of violation
ELECTRICAL CITATION
Description
Covering or concealing installations prior to
inspection.
Infraction no.
ESODA00252 Satisfied
Issue date RCW/WAC
06/25/2015 19.28.041 RCW •
Violation city Violation amount
SPOKANE $500.00
Type of violation
ELECTRICAL CITATION
Description
Offering to perform,submitting a bid for, •
advertising,installing or maintaining cables,
conductors or equipment that convey or
utilize electrical current without having a
valid electrical contractor license.
Workers' comp
Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums.
This company has multiple workers'comp accounts.
Active accounts
L&l Account ID Account is current.
472,384-01
Doing business as
CLEARWATER SUMMIT GROUP INC
Estimated workers reported
Quarter 4 of Year 2016"51 to 75 Workers"
L&1 account representative
TO/GARY HONC(360)902-4823-Email:HONC235@Ini.wa.gov
Track this contractor
Workplace safety and health
Check for any past safety and health violations found on jobsites this business was responsible for.
Inspection results date
06/13/2014 Violations
Inspection no.
317319408
Location
4228 E Wellesley
Spokane,WA 99207-6780
>>Washington Slate Dept.of Labor S indus'nc•,.USG or this silo is auks;..d t^.,tiro-lows of t r:,t:ab>of W„J u gtan