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17-072.01 Michael Terrell: CenterPlace West Lawn Master Plan
17-072.0 Parks and Recreation Department • 2426 N.Discovery Place•Spokane Valley,WA 99216 igiooIFValley 509.688.0300♦Fax: 509.688.0188♦parksandrecespokanevaltey.org July 3,2017 Michael Terrell Landscape Architecture,PLLC 1421 N.MeadowWood Lane, Suite 150 Liberty Lake,WA 99019 Re: Extending Time to Complete Work for Agreement for Professional Services, Contract#17-072.00,Executed May 11, 2017 Dear Mr.Terrell: The City executed an Agreement for Professional Services for provision of the CenterPlace West Lawn Master Plan project on May 11, 2017,by and between the City of Spokane Valley, hereinafter"City", and Michael Terrell Landscape Architecture,PLLC, hereinafter"Contractor" and jointly referred to as "Parties." The original Agreement states the work shall be completed by July 7, 2017. The City would like to extend the time to complete the work to October 31,2017. The Compensation as outlined in the-Agreement and Exhibit A includes the labor and material cost negotiated and shall not exceed$4,550.00. All of the other contract provisions contained in the original Agreement shall remain in place and remain unchanged in exercising this option. If you are in agreement with extending the time to complete the work, please sign below to acknowledge the receipt and concurrence to perform the work. Please return two copies to the City for execution, along with current insurance information. A fully executed original copy will be mailed to you for your files. CITY OF SPOKANE VALLEY MICHAEL TERRELL LANDSCAPE ARCHIT'C 141k. vaiihti 74047 *Z"'" 41111141111boe, 41°1 Mark Calhoun,City'Manager a e /0, 7/or Title 1 t A'1'1'hS / , / a.. ...I L1lI hristine Bainbridge,City Clerk r APPROVED AS TO FORM: l ,61 Offi of the Attorney 1 • 'may• tTSR DATE OvAd/DD/YYY]) CERTIFICATE OF LIABILITY INSURANCE • R022 1/16/2017 THIS CHREIS ISSUED ASA MATTER OF THIS CERTIFICATE DOES EROATEDOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY HE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. or be endorsed. IMPORTANT:SUROGATION IS WAIVED,s jectto the Dtermss and conditions ITIONAL INSURED,of the polithe cy,certain policies es)must have DmayO require an endorsement NAL INSURED SA statement on this ' If SUBROGATION certificate does not confer rights to the certificate holder in lieu of such ecndoTsement(s), PRODUCER ' NAME: USAA INSURANCE AGENCY INC/PHS w. WO.W.E4 (888) 242-1430 IA No (888) 443-6112 812846 P: (888) 242-1430 F: (888) 443-6112 :- DRESS: INSURER(S)AFFORDING COVERAGE NAOS PO BOX 33015 SAN ANTONIO TX 78265 - INsupERA:Hartford Casualty Ins Co 29424 7}7y`j ,'�. �y 3::55 rt"" ,5 IrJsURERB: INSURED BFII I,..vg 3 y,.: tF fv LP MICHAEL TERRELL- LANDSCAPE It,JSURERC: ARCHITECTURE, PLLC • 141 j r l.ii dISURERD: 5312 S CHAPMAN RD INSURER E: PARKS& REC1�E �Gi1 G_: .INSURERF: GREENACRES WA 99016 " REVISION NUMBER: COVERAGES CERTIFICATE NO-ITEK:�"""' ITHIS IS TO ERIFY NDICATED.CNOTTWITTSTAND NGT THEPANY IREQUIREME OLICES OF T, TERM SOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH POLICY TH 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 POLICY ESP Y BEEN REDUCED BYPAIDCLAIMS. minis INSR TYPE OF INSURANCE ADDL SUM? POLZCYNUMOER IDDanT Jnwkfm/ I'; rra >Nea mm EACH OCCURRENCE $2,000,000 COMMERCIAL GENERAL��LIABILITY PREMISES(RENTED • $300,000 CLAIMS-MADE I (OCCUR PREMISES(Ea RENTED , A X General Liab X 65 SBA PU5843 01/13/2017 01/13/2018 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY s2,000,000 GENERAL AGGREGATE $4,000,OOO GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS•COMP/0P AGG $4,0 0 0,0 0 0 POLICY I I JE I LOC $ .._d OTHER: CONBINEDSINGLELIMR $2,000,000 _(Ea accident) • pUTANYAILELIABILnY BODILY INJURY(Per person) $ ANY AUTO OWNED ^SCHEDULED X 65 SBA PU5843 01/13/2017 01/13/2018 BODILY INJURY(Per aeddent) $ A (-AUTOSBRED ONLY AUTOS PROPERTY DAMAGE $ X HIRED x NON-OWNED (ROPERdent) AUTOS ONLY_AUTOS ONLY $ EACH OCCURRENCE $ , UMBRELLA UAB OCCUR _ AGGREGATE $ EXCESS LIAB CLAIMS MADE' $ DED( IREfEN11ON$ • (STATUTE PER I IFR IYDDEERSOZE S'amirSCION $ �y�pLDYF,�,,ffgp,,,Y • EL EACH ACCIDENT ANYPROPRIEFORIPARTNERIEXECUTNE YIN EL.EACHAC-IDEA EMPLOYEE $ (Mandatory H EXCLUDED? in WA - (MandatoryM NH) I I $ EL DISEASE-POLICY LIMIT If yes,describe under DESCRIPTION OF OPERATIONS below • • • DESCRIPTION OFOPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe 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. AUTHORIZED REPRESENTATIVE Attn: Mike Stone • 2426 N DISCOVERY PL 7 - -76L1,11,,,,-- , SPOKANE VALLEY, WA 99216 01988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD • Al>C�® INSURANCE DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY05/01/2017 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 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 Num: Tracey Donohue CorRisk Solutions PHONE 631-756-3000 ( roe,¢ 631-756-2500 1 Huntington Quadrangle Suite 4N20 EADORES& traceyd@corrisksolutions.com Melville, NY 11747 INSURER(S)AFFORDING COVERAGE NAIL# INSURER A: New Hampshire Insurance Company 23841 INSURED INSURER B: Michael Terrell - Landscape Architecture, PLLC INSURER C: 5312 South Chapman Road 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 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. IN5RTYPE OF INSURANCE ADD'L SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSRD WVD (MMIDD/YYYY) (MMIDD/YYYY) GENERAL LIABILITY EACH OCCURANCE — DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurance) CLAIMS MADE 17 OCCUR MED EXP(Any one person) DOES NOT APPLY— PERSONAL&AND INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM P/OP AGG 7 POLICY 17 PROJECT pi LOC COMBINED SINGLE LIMIT(Es AUTOMOBILE LIABILITY accident) — ANY AUTO BODILY INJURY(Per person) — AU.OWNED SCHEDULED DOES NOT APPLY BODILY WJURY(Per acddent) _ AUTOS —AUTOS PROPERTY DAMAGE(Per HIRED AUTOS NON-OWNED �cddenn —AIITr14 UMBRELLA IJAB _OCCUR EACH OCCURANCE EXCESS LIAB CLAIMS MADE DOES NOT APPLY AGGREGATE DED I RETENTIONS WORKERS COMPENSATION WC STATU- OTHER AND EMPLOYERS'LIABILITY TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT OFFlCE/MEMBEREXCLUDED? Y/N N/A DOES NOT APPLY t.L.UIStSAt-hi) (Mandatory In NH) ❑ • EMPLOYEE If yes,describe under DESCRIPTION OF E.L DISEASE-POLICYLIMIT below 064991268- Per Occurrence: $1,000,000 A Professional Liability 01 01/16/17 01/16/18 Annual Aggregate: $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACCORD 101,Additional Remarks Schedule,if more space is required) Park Projects CERTIFICATE HOLDER CANCELLATION Cityof Spokane ValleyParks and Recreation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE p THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. DepartmentAttention: Mike Stone 2426 N. Discovery Place AUTHORIZED REPRESENTATIVE Spokane Valley, WA 99216 g..4 ...:- ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION.Alirlghts reserved. The ACORD name and logo are registered marks of ACORD Home Espafiol Contact Search L&1 `A `tt a<, A-Z Index Help My L&I Safety&Health Claims&Insurance Workplace Rights Trades&Licensing 0 Washington State()apartment of Labor & Industries MICHAEL TERRELL LANDSCAPE ARCHITECTURE PLLC Owner or tradesperson 5312 S CHAPMAN RD MICHAEL TERRELL GREENACRES,WA 99016-8832 Doing business as MICHAEL TERRELL LANDSCAPE WA UBI No. Governing persons 603 368 643 MICHAEL D TERRELL KARA L 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 1 of Year 2017"1 to 3 Workers" L&I account representative T3/STEPHANIE HENDERSON(360)902-5598-Email:HSTE235@lni.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. Help us improve