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18-165.00 Steves Install: Park Amenities Installation Ig-i(5 CONSTRUCTION AGREEMENT Steves Install LLC 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 Steves Install LLC,("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 Park Amenities Installation 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 by December 1,2018. 3. Compensation. In consideration of Contractor performing the Work, City agrees to pay Contractor in accordance with the Contract Documents the sum of$9,710.00,plus Washington State Sales Tax of$854.48 (if applicable),for a total of$10,564.48,based on the bid submitted by Contractor(Exhibit B),and as may be adjusted in accordance with the Contract Documents. 4.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—Revised 9-20-18 Page 1 of 7 5. 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: Steve Install LLC Phone: (509) 720-5000 Phone: (509)714-9165 Address: 10210 East Sprague Avenue Address: P.O.Box 263 Spokane Valley, WA 99206 Nine Mile Falls, WA 99026 6.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. 7. 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. 8.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—Revised 9-20-18 Page 2 of 7 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/prvWagelookup.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 Community&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. 9.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. 10.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. 11.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. 12.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 fmal 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. 13.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. 14.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 10%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). 15. Insurance. Contractor shall procure and maintain for the duration of the Agreement insurance against claims for injuries to persons or damage to property which may arise from or in connection with the Construction Agreement—Revised 9-20-18 Page 3 of 7 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 furnished to the City evidences limits of liability lower than those maintained by Contractor. Construction Agreement—Revised 9-20-18 Page 4 of 7 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. 16.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. 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 Construction Agreement—Revised 9-20-18 Page 5 of 7 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. 17.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. 18. 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. 19. 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. 20.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. 21. 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. 22.Jurisdiction and Venue. This Agreement is entered into in Spokane County,Washington. Venue shall be in Spokane County, State of Washington. 23. 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. 24. 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. 25.Business Registration. Prior to commencement of Work under this Agreement,Contractor shall register with the City as a business if it has not already done so. Construction Agreement—Revised 9-20-18 Page 6 of 7 26.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. 27. Exhibits. Exhibits attached and incorporated into this Agreement are: A. Scope of Work B. Cost Statement C. Insurance Endorsements City will retain 10% in lieu of Bonds / ( Ho✓A41 The Parties have executed this Agreement this �. day of.Oetabec,-2018. CITY OF SPOKANE VALLEY: Contractor: J\v1& CL ar Calhoun,City Manager By: _ Its: Authorized Representative ATTES ILLA A. , ^' 'tine Bainbridge, City Clerk APPROVED AS TO FORM: ps ' , „clijii 6lif Officthe City A orney Construction Agreement—Revised 9-20-18 Page 7 of 7 StrY1 llft �e Parks and Recreation Department ® 2426 N. Discovery Place •Spokane Valley, WA 99216 41ValleY 509.688.0300 • Fax: 509.688.0188 • parksandrec@spokanevalley.org September 20, 2018 Scope of Services For Installation of Park Amenities for Valley Mission and Greenacres Park • Project Location: Valley Mission Dog Park- 11123 E Mission Avenue and Greenacres Park- 1311 N Long Avenue. • Bidder Requirements: 1. This is a prevailing wage public works project. 2. Successful contractor will need to have a current City of Spokane Valley business license as well as being licensed and bonded. 3. 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 10%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). 4. The insurance requirements will include naming the City of Spokane Valley as additionally insured and having the following minimum amounts of insurance: a. Automobile Liability- $ 1,000,000 per accident. b. Commercial General Liability-$ 1,000,000 per occurrence and $2,000,000 general aggregate and $2,000,000 products- completed operation aggregate limit. • Valley Mission Dog Park 1. City will provide the following pieces of equipment from Dog On It Parks: • Four 6' Dog Paw Benches- in ground mount. Two per each side. 1 • Two 20'x 30'Rectangle Peak Shade Structures,8' Eave - In ground mount. One on each side. • Contractor to install as per manufacturer's recommendations and provided specifications. • Greenacres Park 1. City will provide the following pieces of equipment: • One 15'x 15'offset single post pyramid Shade Systems shelter 10'height. • Contractor to install as per manufacturer's recommendations and provided specifications. • Project Guidelines: 1. Contractor will notify the Director of Parks and Recreation Department of their planned work schedule in writing prior to beginning the project. 2. Contractor will keep the jobsite clean and free of safety hazards during the entire project. 3. City of Spokane Valley reserves the right to stop work by contractors for any reason deemed to be necessary. 4. If for any reason work must be stopped by contractor,the Director of Parks and Recreation must be notified. 5. All work must be approved by the City of Spokane Valley Parks and Recreation Department prior to completion of project. 6. Contractor will be responsible for any damage done to the facility or its contents. 7. Contractor is responsible for any permits that are required for this project. All applicable permits will be posted on jobsite. 8. All work will adhere to manufacturer's specifications and acceptable installation practices. • Project Contact: Mike Stone, Director of Parks and Recreation, (509) 720-5400 • Additional Information For additional information, please contact Mike Stone, Director of Parks and Recreation at(509) 720-5400 or mstonena spokanevalley.org. 2 Steves Install LLC Estimate p.o.box 263 Nine Mile Falls WA 99026 Date Estimate# 9/21/2018 12 Name/Address center place 2426 N discovery place spokane valley,wa 99216 Project Description Qty Rate Total move decomposed granite from area to stockpile,dig 8 3ft x 3ft x 6,200.00 6,200.00 4ft footers,dig 8 lft x 2ft footers with excavator,haul off dirt with skid steer,build 16 rebar cages,pour 12 yards of concrete,let set for 48 hours,return and install 2 shade structures and 4 benches, spread decomposed granite.valley mission dog park.Call for locates prior to location determination. .46 160 eens,niewn,.. Fee, _ Ana x-53-9749 sr39 4th 8.8% sales tax 545.60 545.60 valley mission park $6,745.60 Total wiNx442 Steves Install LLC Estimate p.o. box 263 Nine Mile Falls WA 99026 Date Estimate# 9/21/2018 11 Name/Address center place 2426 N discovery place spokane valley,wa 99216 Project Description Qty Rate Total dig 3ft x 3ft x 6.5ft footer with excavator,laydown plywood to 3,510.00 3,510.00 protect grass,haul off dirt,build rebar cage for footer,wheel barrow 2.2 yards concrete for footer,let set for 48 hours,return and install shade structure,cleanup.at green acres park. 8.8% sales tax $308.88 $308.8E Green acres park $3,818.88 Total $ . ,- f lornt, f,pflfh), Cu,:2r ,Search L&I r:" A-1 ndex Ilel.p }i,:'til. Salety&Health G:a€rets&Insurance Workplace R€ghts Trades&Licerisu g IC)Washington State Department of Labor & Industries STEVES INSTALL LLC Owner or tradesperson NE 263 NINE MMI LE FALLS,WA 99026 Burgener,Steven Paul 509-714-9165 Principals SPOKANE County Burgener,Steven Paul,PARTNER/MEMBER WA UBI No. Business type 604 114 890 Limited Liability Company License Verify the contractor's active registration/license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. STEVEIL826NG Effective—expiration 08/07/2018—08/07/2020 Bond American Contractors Indem CO $12,000.00 Bond account no. 100403403 Received by L&I Effective date 08/07/2018 08/07/2018 Expiration date Until Canceled Insurance Western World Ins Co $1,000,000.00 Policy no. NPP8427723 Received by L&I Effective date 08/08/2018 08/07/2018 Expiration date 08/07/2019 Western World Ins Co $1,000,000.00 Policy no. NA3928765 Received by L&I Effective date 08/07/2018 08/07/2018 Expiration date 08/07/2019 Savings Help us improve No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L SI Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp No active workers'comp accounts during the previous 6 year period. Public Works Strikes and Debarments Verify the contractor is eligible to perform work on public works projects. Contractor Strikes No strikes have been issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace safety and health No inspections during the previous 6 year period. .0 Washington State Dept.of Labor&Industries.Use of this site is subject to the laws of the state of Washington. Neap us improve A�a CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 10/01/2018 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 NAME: Pam Whaley All Lines Insurance Inc uuHI�°Ne.Ed): (509)624-5110 ( ,No):FAX (509)6243972 616 E 3rd Ave =Dm= pam@alllinesinc.com Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC S INSURERA: Western World Insurance Company INSURED INSURER B: Steves Install L.L.C. INSURER C: Steve Burgener INSURER D: PO Box 263 Nine Mile Falls,WA 99026 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00000000-0 REVISION NUMBER: 2 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. IEXP LTRR TYPE OF INSURANCE ADDLSR WVD POLICY NUMBER (MMIDDDYf EYYYY) (MMIUDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y NPP8427723 08/07/2018 08/07/2019 EACH OCCURRENCE S 1,000,000 AGE TO RTED CLAIMS-MADE X OCCUR PREM SES(Ea occurrence) S 100,000 MED EXP(Any one person) S 10,000 PERSONAL&ADV INJURY S 1,000,000 GEM.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY 1./7C LOC PRODUCTS-COMP/OP AGG 5 2,000,000 OTHER: S AUTOMOBILE U ABIUTY i COMBINED SINGLE UMIT $ (Ea accident) _ ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY i (Per accident) S UMBRELLA UAB _ OCCUR EACH OCCURRENCE _ 8 EXCESS UAB CLAIMS-MADE AGGREGATE S DED I RETENTION 5 5 WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE —i N/A E.L EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? ' (Mandatory in NH) E.L DISEASE-EA EMPLOYEE S Um,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) Certificate Holder is named as Additional Insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. 10210 E Sprague Ave Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE I a.41110 c, •..t# (NW)* ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Printed by PJW on October 01,2018 at 11:24AM Amo CERTIFICATE OF LIABILITY INSURANCE DATE(MSUDDIYYYY) 10/10/2018 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 NAME: Pam Whaley All Lines Insurance Inc (ac No.Ext): (509)624-5110 FAX No):(509)6243972 616 E 3rd Ave ADDRESS: pam@alllinesinc.com Spokane,WA 99202 INSURERS)AFFORDING COVERAGE NAIC s INSURERA: Western World Insurance Company INSURED INSURER B: The Ohio Casualty Insurance Co Steves Install L.L.C. INSURER C: PO Box 263 INSURER D: Nine Mile Falls,WA 99026 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 00000000-0 REVISION NUMBER: 1 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 SUER POUCY EFF POLICY EXP TYPE OF INSURANCE LTR INSD VWD POUCY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL.UABIUTY Y NPP8427723 08/07/2018 08/07/2019 EACH OCCURRENCE S 1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(EaENTED occurrence) $ 100,000 MED EXP(Any one person) S 10,000 PERSONAL&ADV INJURY S 1,000,000 GEN'LAGGREGATE UMTrAPPUESPER: GENERAL AGGREGATE S 2,000,000 X POUCY TiTer LOC PRODUCTS-COMP/OP AGG s 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S (Ea accident) ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Peracdden,) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) S UMBRELLA UAB _ OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTIONS S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE nN/A E.L EACH ACCIDENT s OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L DISEASE-EA EMPLOYEE S If yes,desaiba under DESCRIPTION OF OPERATIONS below E.L DISEASE-POUCY LIMIT S B Inland Marine BM059181394 10/02/2018 10/02/2019 Rented Equipment 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space is required) Certificate Holder is named as Additional Insured on equipment rental. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Star Rentals ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 2611 Pasco,WA 99302 AUTHORIZED�_REPRESENTATIVE ( {� 6 P.I..40l 1} ff (PJylt) . ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Printed by PJW on October 10,2018 at 12:00PM StafeFarm State Farm Mutual Automobile Insurance Company 17642-2-P MUTL VOL • PO Boz 5000 DuPont, WA 98327-5000 DECLARATIONS PAGE NAMED INSURED ATi 47-92E3-2 P A POLICY NUMBER 186 4250-D11-47C 002297 0058 POLICY PERIOD AUG 07 2018 to OCT 11 2018 — BURGENER, STEVE 12:01 A.M.Standard Time PO BOX 263 NINE MILE FLS WA 99026-0263 STATE FARM PAYMENT PLAN NUMBER 1065106115 AGENT — MARK HEIDINGER INS AGENCY INC 9221 N DIVISION ST STE A SPOKANE,WA 99218-1239 — PHONE:(509)467-6659 DO NOT PAY PREMIUMS SHOWN ON THIS PAGE. IF AN AMOUNT IS DUE,THEN A SEPARATE STATEMENT IS ENCLOSED. YOUR CAR -x '�ilts r-,.,- -t xi.,._ •=.—»•---,=-�.%.Bid ....,;-.:N,.-a +'R-f7-'>:,<-_--* .,ti AS.�1....3-•;��f>l�.�x 1'.j r7 .-r,...-?.'+�.-S,�+..4 '•;•=,ti?' 2004 DODGE RAM 2500 PICKUP 3D7KU28C94G193618 6001-140H000 v>r _ f�:o- •.�,.o: xen i �-t��{�e �;, � t+ci,,"�.��-'ie�'• t�-�,.Y7 c-: t ^" � rs �,���dyr`jr��-� }�. .U.,a��z;�•s rA `S�i-&_`1 .a...-A'"'-r -:.:». r z. ba t - ;>;:e:.>::�-..:.b r �" `M. Bodil In'u Limits �._. -.t&. - ' •._..�; r- iB'...."1}i{.1,�Mz.^-Tli;.l•'rl'�'-1•!F M.:....x........ .a i ..,.,.S"�.'�., `x-...I-`.' a. _y....,. �'.xr,.aa l'4-` r:.,.>�`.a :`?�.,.,.„}<.n F.. $1 000 000 $1 000 000 Yh-`..k.wW'i`w9"�' .�3 °kw i :r"'_ -�v' t- .;�" .. c. -s #"k_`> Y k w .�.. ..•',c„ > S: E w .,. Each Accident "Ns, em"°`°,a-k=`. t t. , ...,.Frs.[ >.,<`-w- wc,e' se, +�- u�1i}hi }, ,,. .c 5. ” " ra'+v r. .c. "'S.,o-'`"' x`....c_. _,.r.,r}:;-•..: t P2 Personal In'u Protection Covera.e $11.91 :�-..,..:�;€:. i`.4..v.i..r.-.i:=r=-�..__ '•�:'.i:. .-e�r1r:•�iTf�.�l ti- f,f.�::-:,.,.-, .- .,,.,r:,S..:.. :s:...,:. .-...:-.... -...�'r..F--.:`.."'.._:,.�,:h. . Sr � �::?f.`�a.'3-. U Underinsured Motor Vehicle Covera•e $13.88 ;.' a's: ;{�.�:'.Yt° d .''-1 •' 1 ��...,yr4-i 1 _ ..a '_..y^3'r., ...:......''�u....... .`•C...-.-.''..` .,..``.'- ,.. .a t, 5" ,.' F ,.:...? "- _ ff; Each Person Each Accident sfbtsz:zi: 240t s, ...A:, xa!Y`'. , _.. U1 Underinsured Motor Vehicle Pro•- Dama•eCovera•e $3.85 ';G--t .,.o:.�.a..�.:,r°'.,4..-'4�'�.a:,=:tttl�i�T?t2,`�•. •C-a`etl-....r..�,4'`. �..,...:... .�.- .a.-,.';?.'3,-...,�.-:`.-�'�'-...-....tet';;..:+-x.a..a.. :.�,.�. ,r:-.�-,-v.�.,.-..�_ .. ..x.';-::•:.``.�.: $100.000 • "" w ,. 6f. iV2.4o r1:};;•:7. ,r' BT.1 i - r .. F.. •....c,-a..'.y+"oi.fax+tea.-..,:;;�ilY-n t„`C't_ lrs •fii `. z_ rz<ew ix+xr ... s ,C z� y �,v ti.. > ..r1._-F Ir.ct! Replaced policy number 1864250-47B. Your total renewal premium for APR 11 2018 to OCT 11 2018 Is$289.72. State Farm works hard to offer you the best combination of price,service,and protection. The amount you pay for automobile insurance is determined by many factors such as the coverages you have,where you live,the kind of car you drive,how your car is used,who drives the car,and information from consumer reports. You have the right to request,no more than once during a 12-month period,that your policy be re-rated using a current credit-based insurance score.Re-rating could result in a lower rate,no change in rate,or a higher rate. Location used to determine rate charged-6422 TIMBER DR,NINE MILE FLS WA 99026. g ``^`€t r_° . s .:-i��r1<* , f� r t5 +�iy} � P FR8YNDSNYSNRSNSLTHATIPP ,cILDGLHOEDDSSEOM 947AADAEDOEMETHAALYFICUINTSIUD TO YOU WITH ANY SOEpOEENOREME18BAMNDATRYDSNT. 6947A.2 AMENDATORY ENDORSEMENT. Agent: MARK HEIDINGER INS AGENCY INC Telephone:(509)467-6659 03264/05524 See Reverse Side Prepared AUG 10 2018 92E3-AB4 DocuSign Envelope ID:77F6D0A1-5278-49E6-9ADD-EDAA54000ADB Prepared for STEVES INSTALL L.L.C. I Quote: 59181394BM01Q1 3 Commercial Inland Marine Proposal Commercial Lines Contractors Equipment Insurance Limit of Insurance Coverage: Broad Form IM 7000 Equipment Classification (Tools-Owners) $10,000 Description: Tools-Owners with $2,500 per Item Max(See IM 7034) Valuation"Actual Cash Value" Tools-Owners Deductible $500 Split Deductible • Peril: $1,000 •All Other Peril Deductible $500 Coinsurance (Applies to all items) 100% Increased Rental Reimbursement"No" Debris Removal Increased Limit"No" Equipment Leased/Rented from Others"Yes"Auditable Equipment Leased/Rented from Others -Limit $100,000 Equipment Annual Rental Expenditures $10,000 Contractors Equipment Income Coverage"No" Property Loaned To Others-Scheduled Coverage"No" Property Loaned To Others-Jobsite Coverage"No" Trailers And Spare Parts Endorsement"No" Commercial Lines Installation Floater Coverage Limit of Insurance ., At Location: 6244 Timber Dr, Nine Mile Falls,WA 99026 Average Job Length 5 Average Dollar Value of Jobs $3,000 Maximum Value-Any Single Job $5,000 Annual Number of Jobs 20 Average Number of Jobs(at any time) 1 Installation Gross Receipts Amount $90,000 Jobsite Limit $10,000 Catastrophe Limit $10,000 Transit Limit See Endorsement Form Coinsurance 100% Contractor Class:All Other Classes Deductible $500 Increased Debris Removal Coverage"No" Testing and Commissioning Coverage"No" ALL LINES INSURANCE INC Liberty Mutual insurance StateFarm• SURCHARGES AND DISCOUNTS AUTOMOBILE RATING PLAN -Applies to private property damage liability and collision coverages for an passenger cars only. at-fault accident. Accident-Free Discount -Once your policy has been in Surcharges -If there are chargeable accidents,you may force for at least three years with no chargeable accidents, lose your Good Driving Discount or Accident-Free Discount you may qualify for our Accident-Free Discount.Once you and receive accident surcharges.But if the accident is the qualify,this discount applies as long as there are no first to become chargeable in nine years and this policy has chargeable accidents,and may even increase over time. been in force for at least that long,the Accident-Free Good Driving Discount -Newer policyholders who do not Discount will continue and no surcharge will apply.The yet qualify for our Accident-Free Discount (available after surcharge for each accident depends upon the number and three years with no chargeable accidents)may already be timing of the accidents,and each accident surcharge will receiving a Good Driving Discount.This discount continues remain in effect up to three years. to apply until your policy qualifies for the Accident-Free Surcharges will be removed if the company is given Discount as long as there are no chargeable accidents and satisfactory evidence that the driver involved is no longer a no new drivers. If you add new drivers,they must also member of the household or will not be driving the car in the qualify in order for your Good Driving Discount to continue. future. If that driver is insured on another State Farm policy, Chargeable Accidents -For new business rating,an his or her driving record will be considered in the rating of accident is chargeable if it results in$750 or more of the other policy. damage to any property. For renewal business,an accident These discounts and surcharges do not apply to all is chargeable as of the date State Farm pays at least$750 coverages. For complete details,see your State Farm agent. (for accidents occurring on or after April 1, 1999)under ADDITIONAL INFORMATION If any information on this renewal notice is incomplete or information regarding discounts or coverages,see your inaccurate,or if you want to confirm the information we have State Farm agent or visit statefarm.com®. in our records, please contact your agent. For additional Paying this bill just got easier with automatic payments Never worry about misplacing a bill or missing a payment when you set up automatic payments.Choose what works best for you and set up your automatic payments with either a bank account,debit card,or credit card. Pay monthly or every six months,and we'll keep you in the loop by sending you a reminder in advance of your automatic draft that confirms both your amount due and payment amount. Call your agent today to get started. Buying a new car? Remember to contact your agent! When you buy an additional car or one that replaces a car already on your policy,you need to report the change to your agent promptly. Even though the dealership you purchased the car from may offer to notify your agent or insurance company,you,as the named insured,are responsible for reporting all changes to your auto policy. By contacting your agent,you can help: • avoid any complications or lack of coverage in the event of an accident or loss, • avoid insurance verification problems with a lienholder,the police,or the department of motor vehicles,and • ensure that you receive any new discounts you may be entitled to. Your current State Farm policy automatically provides certain coverages for a new or replacement car for up to a specified,limited number of days after you take possession of the car. Please refer to your policy for the number of days that applies in your state. If you have any questions about coverage for a newly acquired car,please contact your State Farm agent. Disclaimer:This message is provided for informational purposes only and does not grant any insurance coverage. The terms and conditions of coverage are set forth in your State Farm Car Policy booklet, the most recently issued Declarations Page, and any applicable endorsements. Policy Number:186 4250-D11-47C Page number 4 of 4 Prepared September 5,2018 4 Statefarm• IMPORTANT NOTICE REGARDING YOUR PREMIUM continued that you will use and pay on time,can often help improve to the loan amount or the credit limit. The accounts this aspect of your score. Delinquencies on your accounts considered include credit cards as well as installment loans; stay on your credit report for seven years.. but mortgage accounts,installment accounts with a credit The length of time since the most recent account limit of$50,000 or greater,and auto loans are not delinquency is one of many pieces of information that was considered. All other things being equal, balances which used to help determine your premium.All other things being are low to medium when compared to the credit limit results equal, no delinquencies or a longer time since the most are more favorable than balances which are high when recent delinquency can have a favorable effect on insurance compared to the credit limit. Consequently,only utilizing premiums.Consequently, keeping your accounts paid as what credit is necessary and paying more than the minimum agreed may help improve this aspect of your score.. amount owed in a particular month generally helps to The length of time since the most recent public record is one decrease the balance owed,minimizes finance charges, of many pieces of information that was used to help and may result in a more favorable insurance premium.. determine your premium. Public record information is Consumer report reference number: 18240091103168 obtained from local and federal courts. Examples include Credit information was obtained on: STEVE BURGENER civil judgments,tax liens and bankruptcies.All other things You have the right to request, no more than once during a being equal, no recent public records can have a favorable 12-month period,that your policy be re-rated using a current effect on insurance premiums.. credit-based insurance score. Re-rating could result in a The number of open accounts where the balance is a high lower rate, no change in rate,or a higher rate. percentage of the credit limit is one of many pieces of information that was used to help determine your premium. Please refer to the enclosed insert for additional information. This means that we've considered the number of accounts where the amount owed is high (75%or greater)compared COVERAGE AND LIMITS See your policy for an explanation of these coverages. A Liability Bodily Injury 1,000,000/1,000,000 Property Damage 1,000,000 $188.32 P2 Personal Injury Protection Includes Medical 25,000 Income Loss 200/wk/1yr $32.45 U Underinsured Motor Vehicle Bodily Injury 100,000/300,000 $41.33 U1 Underinsured Motor Vehicle Property Damage 100,000 $11.54 If any coverage you carry is changed to give broader you the broader protection without issuing a new policy, protection with no additional premium charge,we will give starting on the date we adopt the broader protection. DISCOUNTS These adjustments have already been applied to your premium. Multiple Line Vehicle Safety ✓ Accident-Free Policy Number:186 4250-D11-47C Page number 3 of 4 Prepared September 5,2018 � 1 Statefarm• VEHICLE INFORMATION Review your policy information carefully.If anything is incorrect,or if there are any changes to your vehicle information,please let us know right away. Vehicle Identification Vehicle Description Number(VIN) Who principally drives this vehicle? How is this vehicle normally used? 2004 DODGE RAM 2500 3D7KU28C94G193618 STEVE BURGENER,a single male,who To Work,School or Pleasure. will be age 59 as of October 11,2018. Other Household Vehicle(s) Your premium may be influenced by other State Farm policies that currently insure the following vehicle(s) in your household: 2013 SKIDOO 800CC Premium Adjustment annually to determine which makes and models have Each year,we review our medical payments and personal earned decreases or increases from State Farm's standard injury protection coverages claim experience to determine rates. If any changes result from our reviews,adjustments the vehicle safety discount that is applied to each make and are reflected in the rates shown on this renewal notice. model. In addition,we review the comprehensive,collision, bodily injury and property damage claim experience DRIVER INFORMATION Assigned Driver(s) The following driver(s)are assigned to the vehicle(s)on this policy. Age as of Marital Name October 11,2018 Gender Status STEVE BURGENER 59 Male Single Principal Driver&Assigned Drivers Your premium may be influenced by the information shown For each automobile,the Principal Driver is the individual for these drivers. who most frequently drives it. Each driver is designated as an Assigned Driver on the household automobile that he or she most frequently drives. IMPORTANT NOTICE REGARDING YOUR PREMIUM State Farm works hard to offer you the best combination of The ratio of accounts active and satisfactory in the last 24 price,service, and protection. The amount you pay for months to the total number of accounts is one of many automobile insurance is determined by many factors such pieces of information that was used to help determine your as the coverages you have,where you live,the kind of car premium. This means we looked at all accounts on file,and you drive, how your car is used,who drives the car,and then considered the percent of those accounts active and information from consumer reports. satisfactory in the last 24 months. All other things being Your premium was determined by information from equal,consumers with recent experience in paying their consumer reports: accounts on time have fewer insurance losses. Keeping your accounts paid up to date,and only opening accounts (continued on next page) Policy Number.186 4250-D11-47C Page number 2 of 4 Prepared September 5,2018 State Farm Mutual Automobile Insurance Company DuPont,PO Box 5000 WA 98327-5000 StateFariii • AT1 A-92E3 A BURGENER, STEVE PO BOX 263 AUTO RENEWAL NINE MILE FLS WA 99026-0263 PREMIUM PAID: $273.64 DO NOT PAY. Your premium is billed through the State Farm Payment Plan State Farm Payment Plan Number: 1065106115 Your State Farm Agent MARK HEIDINGER INS AGENCY INC Policy Number: 186 4250-D11-47C Office:509-467-6659 Policy Period: October 11,2018 to April 11,2019 Address:9221 N DIVISION ST STE A Vehicle: SPOKANE,WA 99218-1239 2004 DODGE RAM 2500 If you have a new or different car,have added any drivers,or have moved, Principal Driver: please contact your agent. STEVE BURGENER Thank you for choosing State Farm. Location used to determine rate charged-6422 TIMBER process the payment as a check transaction.When we use DR,NINE MILE FLS WA 99026. information from your check to make an electronic fund Based on your driving record,you have our Accident-Free transfer,funds may be withdrawn from your account as soon Discount for preferred customers. as the same day we receive your payment,and you will not When you provide a check as payment,you authorize us receive your check back from your financial institution. either to use information from your check to make a one-time electronic fund transfer from your account or to Policy Number:186 4250-D11-47C Page number 1 of 4 Prepared September 5,2018 1004583 143562 202 01-15-2018 Life's ab out more a than insurance. Y So are we.We'll always be there with ..0., w / k , protection if something goes wrong, but we're also here to help life go right i F ' '' r 'Talk to your State Farm®agent. TP27 z. ,.<_ .