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17-123.00 Advance Concrete Works: Downhill Driveway Modification y 17-12-3 • CONSTRUCTION AGREEMENT Advance Concrete Works,Inc. THIS CONSTRUCTION AGREEMENT (the "Agreement") is made by and between the City of Spokane Valley, a code City of the State of Washington ("City") and Advance Concrete Works, Inc., ("Contractor")jointly referred to as the"Parties". IN CONSIDERATION of the terms and conditions contained herein the Parties agree as follows: • 1.Work to Be Performed. Contractor shall do all work and furnish all labor,supervision,tools,materials, supplies, and equipment and other items necessary for the construction and completion of the Downhill Driveway Modification Project(the "Work")in accordance with documents described in Exhibit A and in accordance with this Agreement(which are by this reference incorporated herein and made part hereof and referred to as the"Contract Documents"),and shall perform any changes in the work in accordance with the Contract Documents. The terms and provisions in this Agreement shall control over any inconsistent or incompatible terms in any other Contract Document. Contractor shall, for the amount set forth in paragraph 4,below,assume and be responsible for the cost and expense of all work required for constructing and completing the Work and related activities to the City's satisfaction, provided for in the Contract Documents, within the time limits prescribed in the Contract Documents. The City Manager or designee shall administer and be the primary contact for Contractor. Upon notice from City,Contractor shall promptly commence work,complete the same in a timely manner,and cure any failure in performance under this Agreement. Unless otherwise directed by City,all work shall be performed in conformance with the Contract Documents, and all City,state,and federal standards,codes,ordinances,regulations,and laws as now existing or as may be • adopted or amended. 2. Time for Performance. Contractor shall commence the Work within 10 days of receipt of a notice to proceed and shall complete the Work within 30 days,as may be extended in accordance with this Agreement and the Contract Documents. 3. Liquidated Damages.None. 4. Compensation. In consideration of Contractor performing the Work, City agrees to pay Contractor in accordance with the Contract Documents the sum of$16,780, based on the bid submitted by Contractor (Exhibit B), and as may be adjusted in accordance with the Contract Documents. 5.Payment. Contractor may elect to be paid in monthly installments,upon presentation of an application for payment in a form satisfactory to City. Applications for payment shall be sent to the City Finance Department • at the address stated in paragraph 6. Pursuant to chapter 60.28 RCW,five percent of the compensation due Contractor shall be retained by City. City reserves the right to withhold payment under this Agreement for that portion of the work(if any)which is determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Contract Documents,City standards,City Code, state standards,or federal standards. Construction Agreement Page 1 of 7 • 7.; • 6.Notice. Notice other than applications for payment shall be given in writing as follows: TO THE CITY: TO THE CONTRACTOR: Name:Christine Bainbridge,City Clerk Name:, Advance Concrete Works, Inc. Phone:(509)720-5000 Phone: 509-220-5868 Address: 10210 East Sprague Avenue Address: 3026 S.Raymond Circle Spokane Valley,WA 99206 Spokane Valley, 99206 7.Applicable Laws and Standards. The Parties,in the performance of this Agreement,agree to comply with all applicable federal,state,and local laws,codes,and regulations. 8. Certification Regarding Debarment, Suspension, and Other Responsibility Matters — Primary Covered Transactions. A.By executing this Agreement,the Consultant certifies to the best of its knowledge and belief,that it and its principals: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; 2. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction;violation of federal or state antitrust statutes or commission of embezzlement,theft,forgery,bribery,falsification or destruction of records,making false statements,or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph(A)(2)of this certification;and 4. Have not within a three-year period preceding this application/proposal had one or more public transactions(federal,state,or local)terminated for cause or default. B. Where the prospective primary participant is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this Agreement. 9.Prevailing Wages on Public Works. Contractor,any subcontractor,or other person doing work under this Agreement, shall comply with the requirements of chapter 39.12 RCW, and shall pay each employee an amount not less than the Prevailing Rate of Wage,as specified by the Industrial Statistician of the Washington State Department of Labor and Industries("L&I"). If employing labor in a class not shown,Contractor shall request a determination of the correct wage rate for the class and locality from the Industrial Statistician. Contractor shall provide a copy of any such determinations to City. Before commencing,during,and upon completion of the work,Contractor shall file all forms and pay all fees required by L&I and shall indemnify and hold City harmless from any claims related to its failure to comply with chapter 39.12 RCW. The following information is provided pursuant to RCW 39.12.030: Construction Agreement Page 2 of 7 4 . A. State of Washington prevailing wage rates applicable to this public works project,published by L&I,are located at the L&I website address: https://fortress.wa.gov/lni/wagelookup/prvW agelookup.aspx B.This Project is located in Spokane County. C.The effective prevailing wage date is the same date as the bid due date as referenced in the original request for bids and as may be revised by addenda. A copy of the applicable prevailing wage rates is also available for viewing at the City Public Works Department located at 10210 East Sprague Avenue,Spokane Valley,WA 99206. Upon request,City will mail a hard copy of the applicable prevailing wages for this project. 10. Relationship of the Parties. It is understood and agreed that Contractor shall be an independent contractor and not the agent or employee of City,that City is interested only in the results to.be achieved,and that the right to control the particular manner,method,and means in which the services are performed is solely within the discretion of Contractor. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Contractor. Contractor shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 11.Ownership of Documents. All drawings,plans,specifications,and other related documents prepared by Contractor under this Agreement are and shall be the property of City, and may be subject to disclosure pursuant to chapter 42.56 RCW,or other applicable public record laws. 12.Records. The City or State Auditor or any of their representatives shall have full access to and the right to examine during normal business hours all of Contractor's records with respect to all matters covered in this Agreement. Such representatives shall be permitted to audit,examine,make excerpts or transcripts from such records,and to make audits of all contracts,invoices,materials,payrolls,and record of matters covered by this Agreement for a period of three years from the date final payment is made hereunder. 13.Warranty. Unless provided otherwise in the Contract Documents,Contractor warrants that all Work and materials performed or installed under this Agreement are free from defect or failure for a period of one year following final acceptance by City,unless a supplier or manufacturer has a warranty for a greater period,which warranty shall be assigned or transferred to City. In the event a defect or failure occurs in work or materials, Contractor shall, within the warranty period,remedy the same at no cost or expense to City. This warranty provision shall not be construed to establish a period of limitation with respect to Contractor's other obligations under this Agreement. 14.Contractor to Be Licensed and Bonded. Contractor shall be duly licensed,registered,and bonded by the State of Washington at all times this Agreement is in effect. 15.Contractor to Provide Performance and Payment Bonds. Contractor shall provide a payment bond and a performance bond in the full amount of the Agreement on the City's bond forms. Alternatively,Contractor may elect to have the City retain 50%of the Agreement amount in lieu of providing the City with a payment bond and a performance bond, pursuant to RCW 39.08.010(3). 16. Insurance. Contractor shall procure and maintain for the duration of the Agreement insurance against Construction Agreement Page 3 of 7 claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by Contractor, its agents,representatives,or employees. A.Minimum Scope of Insurance. Contractor shall obtain insurance of the types described below: 1.Automobile liability insurance covering all owned,non-owned,hired,and leased vehicles. Coverage shall be written on Insurance Services Office(ISO)form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2.Commercial general liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises,operations,independent contractors,products- completed operations, stop gap liability, personal injury, advertising injury, and liability assumed under an insured contract. The commercial general liability insurance shall be endorsed to provide a per project aggregate limit using ISO form CG 25 03 05 09 or an equivalent endorsement. There shall be no endorsement or modification of the commercial general liability insurance for liability arising from explosion, collapse, or underground property damage. City shall be named as an additional insured under Contractor's commercial general liability insurance policy with respect to the work performed for City using ISO Additional Insured endorsement CG 20 10 10 01 and Additional Insured-Completed Operations endorsement CG 20 37 10 01 or substitute endorsements providing equivalent coverage. 3. Workers'compensation coverage as required by the industrial insurance laws of the State of Washington. B.Minimum Amounts of Insurance. Contractor shall maintain the following insurance limits: 1.Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of no less than$1,000,000 per accident. 2.Commercial general liability insurance shall be written with limits no less than$1,000,000 each occurrence, $2,000,000 general aggregate, and no less than a $2,000,000 products- completed operations aggregate limit. C. Other Insurance Provisions. The insurance policies are to contain,or be endorsed to contain,the following provisions for automobile liability and commercial general liability insurance: 1. Contractor's insurance coverage shall be primary insurance with respect to City. Any insurance,self-insurance, or insurance pool coverage maintained by City shall be excess of Contractor's insurance and shall not contribute with it. 2. Contractor shall fax or send electronically in.pdf format a copy of insurer's cancellation notice within two business days of receipt by Contractor. 3.If Contractor maintains higher insurance limits than the minimums shown above,City shall be insured for the full available limits of commercial general and excess or umbrella liability maintained by Contractor, irrespective of whether such limits maintained by Contractor are greater than those required by this Agreement or whether any certificate of insurance Construction Agreement Page 4 of 7 furnished to the City evidences limits of liability lower than those maintained by Contractor. 4. Failure on the part of Contractor to maintain the insurance as required shall constitute a material breach of this Agreement, upon which the City may, after giving at least five business days' notice to Contractor to correct the breach, immediately terminate the Agreement, or at its sole discretion, procure or renew such insurance and pay any and all premiums in connection therewith, with any sums so expended to be repaid to City on demand, or at the sole discretion of the City, offset against funds due Contractor from the City. D.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.Best rating of not less than A:VII. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, • Contractor shall furnish acceptable insurance certificates to City at the time Contractor returns the signed Agreement,which shall be Exhibit C. The certificate shall specify all of the parties who are additional insureds,and shall include applicable policy endorsements,and the deduction or retention level. Insuring companies or entities are subject to City acceptance. If requested,complete copies of insurance policies shall be provided to City. Contractor shall be financially responsible for all pertinent deductibles,self-insured retentions,and/or self-insurance. F.Subcontractor Insurance. Contractor shall cause each and every subcontractor to provide insurance coverage that complies with all applicable requirements of the Contractor-provided insurance as set forth herein,except Contractor shall have sole responsibility for determining the limits of coverage to be required to be obtained by subcontractors. Contractor shall ensure that the City is an additional insured on each and every subcontractor's commercial'general liability insurance policy using an endorsement at least as broad as ISO additional insured endorsement CG 20 38 04 13. 17.Indemnification and Hold.Harmless. Contractor shall,at its sole expense,defend,indemnify,and hold harmless City and its officers, agents, and employees,from any and all claims, actions, suits, liability, loss, costs,attorney's fees and costs of litigation,expenses,injuries,and damages of any nature whatsoever relating to or arising out of the wrongful or negligent acts,errors,or omissions in the services provided by Contractor, Contractor's agents, subcontractors, subconsultants, and employees to the fullest extent permitted by law, subject only to the limitations provided below. Contractor's duty to defend,indemnify,and hold City harmless shall not apply to liability for damages arising out of such services caused by or resulting from the sole negligence of City or City's agents or employees. Contractor's duty to defend,indemnify,and hold City harmless against liability for damages arising out of such services caused by the concurrent negligence of(a)City or City's agents or employees, and(b)Contractor, Contractor's agents, subcontractors, subconsultants, and employees shall apply only to the extent of the negligence of Contractor,Contractor's agents,subcontractors,subconsultants,and employees. Contractor's duty to defend,indemnify,and hold City harmless shall include,as to all claims,demands,losses, and liability to which it applies,City's personnel-related costs,reasonable attorneys'fees,and the reasonable value of any services rendered by the office of the City Attorney,outside consultant costs,court costs,fees for collection,and all other claim-related expenses. Construction Agreement Page 5 of 7 a • Contractor specifically and expressly waives any immunity that may be granted it under the Washington State Industrial Insurance Act,Title 51 RCW. These indemnification obligations shall not be limited in any way by any limitation on the amount or type of damages,compensation,or benefits payable to or for any third party under workers' compensation acts, disability benefit acts, or other employee benefits acts. Provided, that Contractor's waiver of immunity by the provisions of this paragraph extends only to claims against Contractor by City,and does not include,or extend to,any claims by Contractor's employees directly against Contractor. Contractor hereby certifies that this indemnification provision was mutually negotiated. 18.Waiver. No officer,employee,agent,or other individual acting on behalf of either party has the power, right,or authority to waive any of the conditions or provisions of this Agreement. No waiver in one instance shall be held to be waiver of any other subsequent breach or nonperformance. All remedies afforded in this Agreement or by law shall be taken and construed as cumulative and in addition to every other remedy provided herein or by law. Failure of either party to enforce at any time any of the provisions of this Agreement or to require at any time performance by the other party of any provision hereof shall in no way be construed to be a waiver of such provisions nor shall it affect the validity of this Agreement or any part thereof. 19. Assignment and Delegation. Neither party shall assign, transfer, or delegate any or all of the responsibilities of this Agreement or the benefits received hereunder without first obtaining the written consent of the other party. 20.Confidentiality. Contractor may,from time-to-time,receive information which is deemed by City to be confidential. Contractor shall not disclose such information without the prior express written consent of City or upon order of a Court of competent jurisdiction. 21.Disputes. All disputes arising under or related to this Agreement that cannot be resolved through informal discussion and negotiations shall be resolved by litigation filed in the Superior Court of the State of Washington for Spokane County,unless otherwise required by applicable federal or state law. 22. Subcontractor Responsibility. As required by RCW 39.06.020, Contractor shall verify responsibility criteria for each first tier subcontractor and its subcontractors of any tier that hires other subcontractors shall verify responsibility criteria for each of its subcontractors. Verification shall include that each subcontractor,at the time of subcontract execution,meets the responsibility criteria listed in RCW 39.04.350(1)and possesses an electrical contractor license,if required by chapter 19.28 RCW,or an elevator contractor license if required by chapter 70.87 RCW. This verification requirement shall be included in every subcontract of every tier. 23.Jurisdiction and Venue. This Agreement is entered into.in Spokane County,Washington. Venue shall be in Spokane County,State of Washington. 24. Entire Agreement. This Agreement constitutes the entire and complete agreement between the parties and supercedes any prior oral or written agreements. This Agreement may not be changed,modified,or altered except in writing signed by the Parties. 25. Anti-kickback. No officer or employee of City, having the power or duty to perform an official act or action related to this Agreement, shall have or acquire any interest in this Agreement, or have solicited, accepted, or granted a present or future gift, favor, service, or other thing of value from any person with an interest in this Agreement. 26.Business Registration. Prior to commencement of Work under this Agreement,Contractor shall register • Construction Agreement Page 6 of 7 . V 14 with the City as a business if it has not already done so. 27.Severability. If any section,sentence,clause,or phrase of this Agreement should be held to be invalid for any reason by a court of competent jurisdiction,such invalidity shall not affect the validity of any other section, sentence, clause,or phrase of this Agreement. 28. Exhibits. Exhibits attached and incorporated into this Agreement are: A. Scope of Work B. Cost Statement C. Insurance Endorsements The Parties have executed this Agreement this I g day of 0 kb L r ,20\7. CITY OF SPOKANE VALLEY: Contractor: outti_Cawalt.t,Jov -$' Cg./etiPtA.1"---{ ,YV Ute— GO1(‘> t Mark Calhoun,City Manager By: Its: Authorized Representative ATTEST: ristine Bainbrid:e, City Clerk APPROVED AS TO FORM: Offic:1 he C. gry ey Construction Agreement Page 7 of 7 Exhibit A: Scope of Work Downhill Driveway Modification SVPW Contract#17-123 The following are herein incorporated by reference and are part of this contract to be executed as the scope of work: 1. "The Bid Proposal Detail and Site Plans" 2. Also incorporated into the Contract Documents by reference are: a. City of Spokane Valley Standard Plans General Description of Work: This project includes three driveway sites at 14613 E. 6th Ave, 14515 E. 7th Ave. and 11606 E. 19th Ave. At these sites Cement Concrete Curbing Type R (per COSV standard plan R-102)will be placed at the entrance to the driveway. Respective lengths are 27', 23' ,25'. To tie into Type R existing driveway will be removed with Type 1 Concrete Approach/Driveway (per COSV standard plan R-110). Respective areas are 135, 220, and 340 S.F. Advance dvance / Date: 10/06/17 Phone#: Name: City of Spokane Valley Attn: Chad Phillips Concrete Inc Address: Works (509) 220-5868 Job Site Address: Downhill Driveway Modifications / LEXPIEIT E, We propose to furnish the material and perform the labor necessary for the completion of: 14613 E 6t Ave $4,100.00 11606 E 19`s Ave $7,400.00 14515 E 7th Ave $5,280.00 /(0,766 r, , • • • • • • . • The above work to be performed and completed in a substantial Subtotal • workmanlike manner for the sum of $ dollars Sales Tax down with payment upon completion. Total Due • If payment is not made as above specified Payee agrees to pay all reasonable attorney fees. Reasonable fees being 5500.00. Payee also agrees to pay interest of 18%. Any alteration or deviation from above specifications involving extra cost,will be executed on ly upon written orders,and will become an extra change over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control. • Skip h Owner/Operator ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature Date Signature t KKH1Bi7 C, Saco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/11/2017 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 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). CONT PRODUCER Liberty Mutual Insurance NAMEACT PO Box 188065 PHONE FAX Fairfield, OH 45018 E CAILo.Ext); 800-962-7132 (A/c.No): 800-845-3666 ADDRESS: BusinessServiceALibertyMutual.com INSURER(S)AFFORDING COVERAGE NAIC# ' INSURER A: Ohio Casualty Insurance Company 24074 INSURED INSURER B: Advance Concrete Works Inc 3026 S Raymond Cir INSURER C: Spokane Valley WA 99206 INSURER o: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 38325028 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 EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) A �/ COMMERCIAL GENERAL LIABILITY BK057971310 8/22/2017 8/22/2018 EACH OCCURRENCE $ 1,000,000`/ DAMAGE RENTED CLAIMS-MADE ✓ OCCUR PREM SESO(Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ✓ POLICY JECaT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY BA057971310 8/22/2017 8/22/2018 FEa aBcoideDtSINGLE LIMIT $ 1,000,000" ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) Owned noPPT $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LU1B CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/NSTATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED7 n N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION Cityof Spokane ValleySHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Greg Stauffer ACCORDANCE WITH THE POLICY PROVISIONS. 10210 E.Sprague Ave. Spokane Valley WA 99206 AUTH: EsTAT RIZED I Karp ©1988-2015 ACORD CORPORATION. Allrights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 38325028 157971310 117-18 Master Certificate 1 Chad Karp 110/11/2017 3,08:11 PM (PDT) 1 Page 1 of 1 ADVANCE CONCRETE WORKS INC Page 1 of 1 .liqtr' STATE OF WASHINGTON Department of Labor& Industries Certificate of Workers' Compensation Coverage October 16, 2017 WA UBI No. 602 356 170 L&I Account ID , 897,551-02 Legal Business Name ADVANCE CONCRETE WORKS INC Doing Business As I-ADVANCE CONCRETE WORKS INC Workers'Comp Premium Status: f Account is current. Estimated Workers Reported . Quarter 2 of Year 2017"1 to 3 (See Description Below) 'Workers" Account Representative ' Employer Services Help Line, (360) 902-4817 ` Licensed Contractor? I Yes License No. ADVANCW967BT License Expiration 02/02/2018 What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RCW 51.12.050 and 51.16.190). https://secure.lni.wa.gov/verify/Details/liabilityCertificate.aspx?UBI=6023 5 6170&LIC=... 10/16/2017 ADVANCE CONCRETE WORKS INC. Page 1 of 2 Home Espanol Contact Search L&I SEARCH A-Z Index Help My I.&I Safety&Health Claims&Insurance Workplace Rights Trades&Licensing 0 Washington State Department of Labor & Industries ADVANCE CONCRETE WORKS INC. Owner or tradesperson 3026 S RAYMOND CIRCLE Principals SPOKANE,WA 99206 p 509-892-5871 WHITE,SKIP TERRY,PRESIDENT SPOKANE County WHITE,MICHELE MARIE,VICE PRESIDENT Doing business as ADVANCE CONCRETE WORKS INC. WA UBI No. Business type 602 356 170 Corporation Governing persons MICHELE MARIE WHITE SKIP TERRY WHITE; License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties CONCRETE License no. ADVANCW967BT Effective—expiration 02102/2004—02/02/2018 Bond AMERICAN CONTRACTORS INDEM CO $6,000.00 Bond account no. 100030472 Received by L&I Effective date 08/24/2007 08/29/2007 Expiration date Until Canceled Insurance Ohio Cas Ins Co $1,000,000.00 Policy no. BK057971310 Received by L&I Effective date 07/24/2017 08/22/2017 Expiration date 08/22/2018 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602356170&LIC=ADVANCW967BT&SAW= 10/16/2017 ADVANCE CONCRETE WORKS INC. Page 2 of 2 No lawsuits against the bond or savings accounts during the previous 6 year period. L&l Tax debts No L tax ebts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. 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. 897!551-02 Doing business as ADVANCE CONCRETE WORKS INC Estimated workers reported Quarter 2 of Year 2017"1 to 3 Workers" L&I account contact TO/KARLA BOWMAN(360)902-5535-Email:BOWK235©Ini.wa.gov .r Publicia1NorksiStrikebarmen.ts. Verify the contractor is eligible to perform work on public works projects. Contractor Strikes Nos uke Hie been i.sued against-this-contractor.- Contractors gainst-thiicontractor.Contractors not allowed to bid No debarments.havebeemissued-against this contractor: Workplace safety and health No inspections during the previous 6 year period. 0 Washington State Dept.of Labor&'ndustnes.Use of this site is subject to the laws of the state of Washington Help us improve https://secure.lni.wa.gov/verify/Detail.aspx?UBI=602356170&LIC=ADVANCW967BT&SAW= 10/16/2017 A ® CERTIFICATE OF LIABILITY INSURANCE DATEMM/DD/YY7Y) 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. 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 Liberty Mutual Insurance NAM CONTACT PO Box 188065 WC.No.Ext): 800-962-7132 FAX No): 800-845-3666 Fairfield, OH 45018 EMAIL ADDRESS: BusinessServiceALibertyMutual.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Ohio Casualty Insurance Company 24074 INSURED INSURER B: Advance Concrete Works Inc 3026 S Raymond Cir INSURER C Spokane Valley WA 99206 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 38348287 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 SUBR POLICY EFF POLICY EXP WMM/ LIMITS LTRINSD VD POLICY NUMBER ,( DD/YYYY) (MM/DD/YYYY) A / COMMERCIAL GENERAL UABILITY BKO57971310 8/22/2017 8/22/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE ✓ OCCUR PREMISES Ea occurrence) $ 1,000,000_ MED EXP(Any one person) $ 15,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ✓ POLICY .1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY BA057971310 8/22/2017 8/22/2018 (Ea accldelUINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) _ ,/ Owned noPPT $ UMBRELLA LIAB OCCUR EACH OCCURRENCE _ $ ~— EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y I N STATUTE ERS ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/M EMB ER EXCLUDE D9 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more apace Is required) City of Spokane Valley is Additional Insured if required by written contract or written agreement subject to General Liability Blanket Additional Insured Provision. CERTIFICATE HOLDER CANCELLATION Cityof Spokane ValleySHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Greg Stauffer ACCORDANCE WITH THE POLICY PROVISIONS. 10210 E. Sprague Ave. Spokane Valley WA 99206 AUTHORIZED REPRESENTATIVE ��� G�.�n"'r!����C�C.Y�bupl�tI Kimberleigh Howard —• ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 38348287 157971310 1 17-18 Master Certificate 1 Kimberleigh Howard 1 10/12/2017 2:59:20 PM (CDT) 1 Page 1 of 1 .---'"'N ® ADATE(MM/DD/YYYY) ��Q CERTIFICATE OF LIABILITY INSURANCE 10/12/2017 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(ies)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 Liberty Mutual Insurance NAME: PO Box 188065 E-MAIL No.Ext): 800-962-7132 FAX No): 800-845-3666 Fairfield, OH 45018 IA/C. ADDRESS: BusinessService@LibertyMutual.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Ohio Casualty Insurance Company 24074 INSURED INSURER B: Advance Concrete Works Inc 3026 S Raymond Cir INSURER C: Spokane Valley WA 99206 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 38348287 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 SUBR POLICY EFF POLICY EXP WLIMITS LTR INSD VD POLICY NUMBER (MM/DD/YYYY) (MM YYY /DD/Y ) A / COMMERCIAL GENERALLIABILITY BKO57971310 8/22/2017 8/22/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE „/ OCCUR PREMISES(EaENTED occurrence) $ 1,000,000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ✓ POLICY JEIT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY BA057971310 8/22/2017 8/22/2018 (E BIKED SINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) — ✓ Owned noPPT $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N PER ER - ANYPROPRIETOR/PARTNER/EXECUTIVE nN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more apace is required) City of Spokane Valley is Additional Insured if required by written contract or written agreement subject to General Liability Blanket Additional Insured Provision. CERTIFICATE HOLDER CANCELLATION Cityof Spokane ValleySHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Greg Stauffer ACCORDANCE WITH THE POLICY PROVISIONS. 10210 E. Sprague Ave. Spokane Valley WA 99206 AUTHORIZED REPRESENTATIVE I Kimberleigh Howard —• T I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 38348287 1 57971310 117-18 Master Certificate 1 Kimberleigh Howard 1 10/12/2017 2,59:20 PM (CDT) 1 Page 1 of 1