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18-079.00 Acme Concrete: Broadway/Argonne/Mullan PCC Intersection Contract This agreement is entered into this 9 A day of2018, between the City of Spokane Valley ("City") and Acme Concrete Paving, Inc. ("Contr for"), pursuant to Title 35 RCW, as adopted or amended. In consideration of the terms and conditions contained herein and attached and made a part of this agreement,the parties agree as follows: I. The Contractor shall do all work and furnish all tools,materials,and equipment for: Broadway Argonne Mullan Intersection Project#0142 Contract 18-079 in accordance with and as described in the project plans and specification, and the standard specification of the Washington State of Department of Transportation which are by this reference incorporated herein and made part hereof and, shall perform any changes in the work in accord with the Contract Documents. The Contractor shall provide and bear the expense of all equipment, work, and labor, of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in these Contract Documents except those items mentioned therein to be furnished by the City. II. The City hereby promises and agrees with the Contractor to employ,and does employ the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with the project plans and specification and the terms and conditions herein contained and hereby contracts to pay for the same according to the referenced specifications and the schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this contract. III. The Contractor for himself/herself, and for his/hers heirs, executors, administrators, successors, and assigns, does hereby agree to full performance of all covenants required of the Contractor in the contract. W. It is further provided that no liability shall attach to the City by reason of entering onto this contract,except as provided herein. V. The project was awarded for the bid amount of$1,699,437.25,plus applicable sales tax. IN WITNESS WHEREOF, the Contractor has executed this instrument, on the date below,and the City has caused this instrument to be executed on the date stated above. • • City of Spokane Valley 13 Contract Forms Broadway-Argonne-Mullan Intersection Project Executed by Contractor / 13 h ,2018. Date gbh.er4 /14 • Se Printed Name Tre ete n Title Sia City of Spokane Valley Mark Calhoun • • Printed Name City Manager Ti caiefter Signature Revised 1-8-16 • City of Spokane Valley 14 Contract Forms Broadway-Argonne-Mullan Intersection Project • *clime 4,00 vQlley. BOND NO: 106904829 CONTRACTOR'S PAYMENT BOND(NON-FEDERALLY FUNDED PROJECT) to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County,has awarded to Acme Concrete Paving.,Inc. (Contractor), as Principal,a contract for the construction of the project designated as Broadway Argonne Mullan Intersection Project No.0142 in Spokane Valley, Washington, and said Principal is required under the terms of the Contract to furnish a payment bond in accordance with chapter 39.08 Revised Code of Washington(RCW). The Principal, and Travelers Casualty and Surety Company of America (Surety), a corporation organized under the laws Connecticut and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,as Obligee,in the sum of$1,848,987.73 total Contract amount(including Washington State sales tax),subject to the provisions herein. This payment bond shall become null and void, if and when the Principal, its heirs, executors, administrators, successors, or assigns chall pay all persons in accordance with chapters 39.08 and 39.12 RCW, including all workers, laborers, mechanics, subcontractors,and materialmen,and all persons who shall supply such contractor or subcontractor with provisions and supplies for the carrying on of such work;and shall indemnify and hold harmless the Obligee from all loss,cost or dam ge which Obligee may suffer by reason of the failure of Principal to make such required payments;and if such payment obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract,or to the work to be performed under the Contract shall in any way affect its obligation on this bond,except as provided herein,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIP• • ' S '.r ••c . 'oncrete Paving,Inc. Y Travelers Casualty and Surety Company of America • - -_-.......-,..-,.•,, /�� April 27,2018 , A ri1 7 2018 • _{• Date Surety Signature Date �0 -:r ii_S[�f ' . Shawn M.Wilson • . . , 1 '.'rinted`Name U Printed Name ;-.1 _ y' • 4> ,l 1 Attorney-in-Fact - . . • - '„i-- Title Title Name,address,and telephone of local office/agent of Surety Company is: Alliant Insurance Services,Inc. • 818 W Riverside Avenue,Suite 800,Spokane,WA 99201 11509-343-9238 • Revised 1.14.13 City of Spokane Valley 16 Contract Forms Broadway-Argonne-Mullan Intersection Project Travelers Casualty and Surety Company of America AlIl'r Travelers Casualty and Surety Company TRAVELERS J St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That Travelers Casualty and Surety Company of America,Travelers Casualty and Surety Company,and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connqcticut(herein collectively called the "Companies"),and that the Companies do hereby make,constitute and appoint Shawn M.Wilson,of Spokane,Washington,their true and lawful Attorney-in-Fact to sign,execute,seal and acknowledge any and all bonds, recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this Instrument to be signed,and their corporate seals to be hereto affixed,this 3rd day of February, 2017. 411. "AV Aito t. 0 t4 it COLA `qtr • eCCM e et Y Od Ka Yp • State of Connecticut roe By: 'Robert w�-- ..�---' City of Hartford ss. Robert L.Raney,Se or Vice President On this the 3rd day of February,2017,before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Travelers Casualty and Surety Company of America,Travelers Casualty and Surety Company,and St.Paul Fire and Marine Insurance Company,and that he,as such,being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. In Witness Whereof,I hereunto set my hand and official seal. T a My Commission expires the 30th day of June,2021 MOJVZA. C. .� *pa. * Marie C.Tetreault,Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and Surety Company of America,Travelers Casualty and Surety Company, and St.Paul Fire and Marine Insurance Company,which resolutions are now in full force and effect,reading as follows: RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President, any Senior Vice President,any Vice President, any Second Vice President,the Treasurer, any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED,that any bond, recognizance,contract of indemnity,or writing obligatory in the nature of a bond, recognizance,or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President, any Second Vice President,the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;or(b)duly executed(under seal, if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority;and it is FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,any Vice President,any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile se'al shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company,and St. Paul Fire and Marine Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which remains in full force and effect. Dated this 27th day of April , 2018 - ~ - perm a►vTT,µa ... N. _ _ _ e '* �"�` �� _ ' - . . - Kevin E.Hughes,Asst tant Secretary To verify the authenticity of this Power of Attorney,please call us at 1-800-421-3880. Please refer to the above-named Attorney--in-Fact and the details of the bond to which the power is attached. • Sok BOND NO: 106804829 CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Acme Concrete Paying, Inc (Contractor), as Principal,a contract for the construction of the project designated as Broadway Argonne Mullan Intersection Project No.0142 in Spokane Valley,Washington,and said Principal is required under the terms of the Contract to furnish a performance bond in accordance with chapter 39.08 Revised Code of Washington(RCW). The Principal, and Travelers Casualty and Surety Company of America (Surety), a corporation, organized under the laws of Connecticut and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,as Obligee,in the sum of$1,848,987.73 total Contract amount(including Washington State sales tax),subject to the provisions herein. This performance bond shall become null and void,if and when the Principal,its heirs, executors,administrators,successors,or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all the terms and conditions of all duly authorized modifications, additions,and changes to said Contract that may hereafter be made, at the time and in the manner therein specified;shall warranty the work as provided in the Contract and shall indemnify and hold harmless the Obligee from any defects in the workmanship and materials incorporated into the work for the period identified in the Contract;and if such performance obligations have not been fulfilled,this bond shall remain in full force and effect. The Surety for value received agrees that no change, extension of time, alteration or addition to the terms of the Contract, the specifications accompanying the Contract,or to the work to be performed under the Contract shall in any way affect its obligation on this bond,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and notice to Surety is not required for such increased obligation. This bond may be executed in two original counterparts,and shall be signed by the parties' duly authorized officers.This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIP' • 0 C / c •ncrete Paving,Inc. • Ty Travelers Casualty and Surety Company of America r� =" /�! `— ,,r, //L April 27,2018 40' f SrLy‘s_April 27,2018 Date Surey Signature 'Date tt..1.C2111ZAWirn. Shawn M.Wilson :P4inted Name Printed Name Tie j(>Op,✓1�— Attorney-in-Fact •- Title Title Name,address,and telephone of local office/agent of Surety Company is: Alliant Insurance Services,Inc. 818 W Riverside Avenue,Suite 800,Spokane,WA 99201 11509-343-9238 Revised 1.14.13 City of Spokane Valley 15 Contract Forms Broadway-Argonne-Mullan Intersection Project e _ e /1TS' Spokane BOND NO: 10904830 CONTRACTOR'S RETAINAGE BOND to City of Spokane Valley,Washington The City of Spokane Valley,Washington,in Spokane County,has awarded to Acme Concrete Paving,Inc. ("Contractor"),as Principal,a contract for the construction of the project designated as Broadway Argonne Mullan Intersection Project No.0142(the"Contract")in Spokane Valley,Washington. The Principal, existing under and by virtue of the laws of the State of Washington and authorized to do business in the State of Washington, and Travelers Casualty and Surety Company of America organized and existing under the laws of the State of Connecticut and authorized to transact business in the State of Washington as Surety, are jointly and severally held and bound unto the City of Spokane Valley, hereinafter called Obligee, and are similarly held.and bound unto the beneficiaries of the t, Steal'�•�y haU��r0�R RCW, in the penal sum of 5% of the Contract, which is ** mety wo Thousand Fa�ir 1�unCradFor`fy1Q7i e ' Dollars and No Cents***dollars($92,449.00********************),plus 5% of any increases in the Contract amount that have occurred or may occur, due to change orders, increases in the quantities,or the addition of any new item of work. WHEREAS, on the day of , 2018, the said Principal and Obligee herein executed and entered into the Contract WHEREAS, said Contract and chapter 60.28 RCW require the Obligee to withhold from the Principal the sum of 5% from monies earned by the Principal on estimates during the progress of the construction, hereinafter referred to as earned retained funds. WHEREAS, the Principal has requested that the Obligee accept a bond in lieu of earned retained funds as allowed under chapter 60.28 RCW. NOW THEREFORE,the condition of the obligation is such that the Principal and Surety are held and bound unto the beneficiaries of the trust fund created by chapter 60.28 RCW in the aforesaid sum. This bond, including any proceeds therefrom,is subject to all claims and liens and in the same manner and priority as set forth for retained percentages in chapter 60.28 RCW. The condition of this obligation is also such that if the Principal shall satisfy all payment obligations to persons who may lawfully c aim under the trust fund purposes of chapter 60.28 RCW to the Obligee,and indemnify and hold the Obligee harmless from any and all loss, costs, and damages that the Obligee may sustain by release of the earned retained funds to the Principal,then upon notification of such satisfaction and release of the Surety by the Obligee,this obligation shall be null and void. • PROVIDED HOWEVER,that: 1. The Surety shall be liable under this obligation as Principal. The Surety will not be discharged or released from liability for any act, omission or defenses of any kind or nature that would not also discharge Principal. 2. This obligation shall be binding upon and inure to the benefit of the Principal, the Surety, the Obligee,the beneficiaries of the trust fund created by chapter 60.28 RCW and their respective heirs, executors,administrators,successors and assigns. 3. Any suit under this bond must be instituted within the time provided by applicable law. City of Spokane Valley 17 Contract Forms Broadway-Argonne-Mullen Intersection Project J This bond may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers. This bond will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. PRINCIPAL • I Ac Concrete Paving,Inc. SURETY Travelers Casualty and Surety Company of America s ,1"" /..// April 27,2018 ry� LOAApril 27,2018 ,,41101 0,11111119/917410V , 2 t"J'"- Princip�a_l�•_••./',f:► t/S Date Surety Signature Date - r �-D M •- �►pX�► Shawn M.Wilson — - = 4`rinted Name U Printed Name - - J,L ry_ i' � �'� _ Attorney-in-Fact - + %.,, :i'._..Title Title a Name,address,and telephone of local office/agent of Surety Company is: ` Alliant Insurance Services,Inc. 818 W Riverside Avenue,Suite 800,Spokane,WA 99201 1[509-343-9238 Rctiscd 1,14.13 • City of Spokane Valley 18 Contract Farms Broadway-Argonne-Mullan Intersection Project t , • Travelers Casualty and Surety Company of America AiIiik Travelers Casualty and Surety Company TRAVELERS J St. Paul Fire and Marine Insurance Company . POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That Travelers Casualty and Surety Company of America,Travelers Casualty and Surety Company,and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"),and that the Companies do hereby make,constitute and appoint Shawn M.Wilson,of Spokane,Washington,their true and lawful Attorney-in-Fact to sign,execute,seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. • IN WITNESS WHEREOF,the Companies have caused this instrument to be signed,and their corporate seals to be hereto affixed,this 3rd day of February, 2017. „ea 1 4 4AY e 4001NON I. �q�ie At State of Connecticut I . By: City of Hartford ss. �f s Robert L.Raney,Se or Vice President On this the 3rd day of February,2017,before me personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Travelers Casualty and Surety Company of America,Travelers Casualty and Surety Company,and St. Paul Fire and Marine Insurance Company,and that he,as such,being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. In Witness Whereof,I hereunto set my hand and official seal. "T My Commission expires the 30th day of June,2021 , OJk� C :� Marie C.Tetreault,Notary Public i. This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and Surety Company of America,Travelers Casualty and Surety Company, and St.Paul Fire and Marine Insurance Company,which resolutions are now in full force and effect,reading as follows: RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President, any Senior Vice President,any Vice President, any Second Vice President,the Treasurer, any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED, that any bond, recognizance,contract of indemnity,or writing obligatory in the nature of a bond, recognizance,or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority;and it is FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,any Vice President,any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company,and St. Paul Fire and Marine Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which remains in full force and effect. • Dated this 27th day of April , 2018 . IF4 •` f • •�' la-- et- - � - :.. Kevin E.Hughes,Ass, tant Secretary To verify the authenticity of this Power of Attorney,please call us at 1-800-421-3880. Please refer to the above-named Attomey--in-Fact and the details of the bond to which the power is attached. GARCCON-01 SSIMPSON ACOREY DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/27/2018 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 CONTACT Stacia Simpson BK-JET Group,LLC NAME 999 W Riverside Avenue,Suite 510 (A// NEC, o,Ext):(509)319-2912 I(ac,No(509)319-2920 Spokane,WA 99201 n ss:ssimpson@bkjet.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Zurich American Insurance Company 16535 INSURED INSURER B: ACME CONCRETE PAVING,INC. INSURER C: 4124 E BROADWAY AVE. INSURER D: SPOKANE,WA 99202 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. INSR ADDL SUBR POLICY EFF POUCY EXP LTR TYPE OF INSURANCE INSD WVD POUCY NUMBER (MMIDDIYYYY1 (MMIDD/YYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 L/ CLAIMS-MADE X OCCURGLA 0084374 12/31/2017 12/31/2018 DAMAGE TO RENTED 800,000 X x PREMISES fEa co) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 / GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 �/ POLICY X 28T LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: WA STOP GAP $ 1,000,000 A AUTOMOBILE UABIUTY (Ea acccidenSINGLE LIMIT 1,000,000 X ANY AUTO X X GLA 0084374 12/31/2017 12/31/2018 BODILY INJURY(Per person) $ AURTEO�S ONLY SCHEDULED BODILYOINJURY(Per accident) $ X AUTOS ONLY X AUUTOS ONLY (Perr accii mAGE A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 X EXCESS LIAB CLAIMS-MADE X x AUC 0386594 12/31/2017 12/31/2018 AGGREGATE $ 10,000,000 DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS'LIABIUTY Y/N I PER H ER ANY BRN I A PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFIC tory In NH)EXCLUDED? I E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ � 1 DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (ACORD 101 Additional Remarks Schedule may be attached If more space Is required) PROJECT#0142:BROADWAY ARGONNE MULLAN INTERSECTION CONTRACT 18-0179 ALL OPERATIONS OF THE NAMED INSURED IS COVERED BY THE ABOVE POLICIES WHILE PERFORMING WORK FOR THE CERTIFICATE HOLDER. THE CERTIFICATE HOLDER LISTED BELOW IS NAMED ADDITIONAL INSURED WITH RESPECTS TO THE AUTO LIABILITY AND GENERAL LIABILITY PER ATTACHEF FORMS. WAIVER OF SUBROGATION AND PER PROJECT AGGREGATE DO APPLY PER ATTACHED FORMS. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SPOKANE VALLEY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10210 E SPRAGUE AVENUE ACCORDANCE WITH THE POLICY PROVISIONS. SPOKANE VALLEY,WA 99206 AUTHORIZED REPRESENTATIVE 60(19 r_d7Vn44" 1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Waiver Of Subrogation (Blanket) Endorsement Policy No. riff. Date of Pol. Exp. Date of Pol. Bff.Date of Bud. Producer Addl.Prom Return Prem. $ S THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition If you arc required by a written contract or agreement,which is executed before a loss,to waive your rights of recovery from others,we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. • • ti411,-925-E CW(12/01) Page t of • Other Insurance Amendment — Primary And Non- ZURICH Contributory Policy No. Elf. Date of Pol. Exp. Date of Pd. Eff.Date of End. Producer Na Add'I.Prem Return Prem. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: Address(Including ZIP Code): This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part 1. The following paragraph is added to the Other Insurance Condition of Section IV —Commercial General Liability Conditions: This insurance is primary insurance to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: a. The additional insured is a Named Insured under such other insurance;and b. You are required by a written contract or written agreement that this insurance would be primary and would not seek contribution from any any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV--Commercial General Liability Conditions: This insurance is excess over: Any of the other Insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis. All other terms and conditions of this policy remain unchanged. U.a.1327-a CW(04/13) Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV— Commercial General.Liability Conditions: The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim; 2. We receive written notice of a claim or "suit"as soon as practicable;and 3. A request for defense and indemnity of the claim or "suit"will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D. For the purposes of the coverage provided by this endorsement: 1. The'following is added to the Other Insurance Condition of Section IV--Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a The additional insured is a Named Insured under such other insurance;and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b.of the Other Insurance Condition of Section IV—Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary,excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section iii—Limits Of Insurance: The most we wilt pay on behalf of the additional insured is the amount of insurance: 1. Required by the written contract or written agreement referenced in Paragraph A.of this endorsement;or 2. Available under the applicable Limits of Insurance shown in the Declarations, • whichever is less. This endorsement shall not increase the applicable Limits of insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged, U-GL-1175-F CW(04/13) Page 2 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with Its permission. POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -- COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organlzation(s) Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION TO WHOM OR TO WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO THE LOSS EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III--limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage"caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the"products-completed operations hazard". 1. Required by the contract or agreement;or However: 2. Available under the applicable Limits of 1. The insurance afforded to such additional Insurance shown in the Declarations; insured only applies to the extent permitted by whichever is less. law; and This endorsement shall not increase the applicable 2. If coverage provided to the additional insured Limits of Insurance shown in the Declarations. is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 0413 ®Insurance Services Office,Inc., 2012 Page 1 of 1 POLICY NUMBER: - . COMMERCIAL GENERAL LIABILITY CG 25030509 THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ R CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): A GENERAL AGGREGATE LIMIT APPLIES TO EACH CONSTRUCTION PROJECT WHERE THE NAMED INSURED IS PERFORMING OPERATIONS, HOWEVER, A GENERAL AGGREGATE LIMIT DOES NOT APPLY TO ANY CONSTRUCTION PROJECT WHERE THE NAMED INSURED IS PERFORMING OPERATIONS THAT ARE INSURED UNDER A WRAP UP OR ANY OTHER CONSOLIDATED OR SIMILAR INSURANCE PROGRAM. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences"under Section I—Coverage A,and expenses shall reduce the Designated for all medical expenses caused by accidents Construction Project General Aggregate Limit under Section I —Coverage C,which can be for that designated construction project. Such attributed only to ongoing operations at a single payments shall not reduce the General designated construction project shown in the Aggregate Limit shown in the Declarations nor Schedule above: shall they reduce any other Designated 1. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated construction project designated construction project,and that limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A,except General Aggregate Limit shown in the damages because of"bodily injury"or Declarations, such limits will be subject to the "property damage"included in the"products- applicable Designated Construction Project completed operations hazard",and for General Aggregate Limit. medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or"suits"brought;or c. Persons or organizations making claims or bringing''suits". • CG 25 03 05 09 ®Insurance Services Office, Inc.,2008 Page 1 of 2 ❑ B. For all sums which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by "products-completed operations hazard"is "occerrences"under Section I—Coverage A,and provided,any payments for damages because of for all medical expenses caused by accidents 'bodily injury"or"property damage"included in under Section I—Coverage C,which cannot be the"products-completed operations hazard"will attributed only to ongoing operations at a single reduce the Products-completed Operations designated construction project shown in the Aggregate Limit,and not reduce the General Schedule above: Aggregate Limit nor the Designated Construction 1. Any payments made under Coverage A for Project General Aggregate Limit. damages or under Coverage C for medical D. If the applicable designated construction project expenses shall reduce the amount available has been abandoned,delayed, or abandoned under the General Aggregate Limit or the and then restarted, or if the authorized Products-completed Operations Aggregate contracting parties deviate from plans, blueprints, Limit, whichever is applicable;and designs,specifications or timetables, the project 2. Such payments shall not reduce any will still be deemed to be the same construction Designated Construction Project General project. Aggregate Limit. E. The provisions of Section III—Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. • • Page 2 of 2 ®Insurance Services Office, Inc.,2008 CO 25 03 06 09 0 A Additional Insured--Automatic -. Owners,Lessees Or ZURICH° Contractors Po9loy No. EL Date of Poi. 6cp. Date of Poi. Sit Date of 20. Producer No. . Add9.From Return Prem. MIS ENDORSEII IENT CHANGES THE POLICY. PLEASE READ rr CAREFULLY. Named hawed: Address(Including ZIP Code): • • This endorsement modifies Insurance provided under the: Commercial General LIabllityCoovage Part A. Section 41--Who le An Insured is amended to Include as an additional insured any person or organization whom you - I are milked to add as an additional insured on this policy under a written contract or written agreement.Such person or organization is an additional Insured only with respect to liability for"bodily injury",'property damage"or"personal and advertising Injury"caused,In whole or in part,by: 1. Your acts or omissions:or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations or "your work"as included In the 'produt�con�ted operations hazard",which Is the subject of the written conte act or written agreement: However,the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law;and 2. lNlll not be broader than that which you are required by the written contract or written agreement to provide for . such additionai Insured. B. UIRth respect to the Insurance afforded to these additional Insureds,the following additional exclusion applies: - This Insurance does not apply to: "godtiy Injury",'property damage"or'parsbnal and advertising injury"arising out of the rendering of, or failure to render,any professional m'ohifoctural,engineering or surveying services including: a. The preparing,approving or falling to prepare or approve maps,shop drawings, opinions,report, surveys, field orders,change orders or drawings and specifications;or b. Supetvlsory,inspection,architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment:training or monitoring of others by that insured, if the mocourrence° which caused the "boric► injury" or 'properly damage', or the offense which caused the "personal and advertising thine, Involved the rendering of or the failure to render any professional architectural, engineering or surveying services. • Ii41.4175-FCW(04112) Page I of 2 Inoludas copyrighted material of lneurante Services Moe,Irv.,with its perrnieslott. • M ' C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV— Commercial General Liability Conditions The additional insured must see to it that: 1. VMe are notified as soon as practicable of an"occurrence" or offense that may result in a claim; 2. We receive written notice of a claim or"suit"as soon as practicable;and 3. A request for defense and indemnity of the claim or"suit"will promptly be brought against any policy issued by another Insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D. For the purposes of the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section IV--Commercial General Liability Conditions: Primacy and Noncontributory insurance This insurance is primary to and will not seek contribution from any other Insurance available to an additional insured provided that: a The additional insured is a Named Insured under such other insurance;and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph Is added to Paragraph 4.b.of the Other Insurance Condition of Section IV--Commercial General Liability Concfftions: This insurance is excess over: Any of the other insurance, whether primary,excess, contingent or on any other basis, available to an additional Insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence', offense, claim or "suit'. This provision does not apply to any policy in which the additional insured is a Named insured on such other policy and where our policy Is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds,and which endorsement applies specifically to that identified additional insured. P. Nth respect to the Insurance afforded to the additional insureds under this endorsement, the following is added to • i Section ill—Limits Of Insurance: The most we will pay on behalf of the additional insured Is the amount of insurance: 1. Required by the written contract or written agreement referenced in Paragraph A.of this endorsement;or 2. Available under the applicable Limits of insurance shown in the Declarations, • whichever is less. This endorsement shall not increase the applicable Limits of insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. tlGL-1175-FOW(04/73) Page 2 of 2 Includes copyrighted material of insurance Services Office,Inc.,with Its permission, a SEM OF WANISIMPON Department of Labor& Industries Certificate of Workers' Compensation Coverage April 27, 2018 WA UBI No. 602 170 211 — L&I Account ID399,615-01 I Legal Business Name ACME CONCRETE PAVING INC Doing Business As 'ACME CONCRETE PAVING INC Workers' Comp Premium Status: Account is current. Estimated Workers Reported Quarter 4 of Year 2017"51 to 75 (See Description Below) Workers" Account Representative Employer Services Help Line, (360) 902-4817 Licensed Contractor? Yes i License No. ACMECPI986CJ License Expiration 02/11/2020 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).