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18-150.01 David Evans & Associates: Appleway Trail Evergreen to Sullivan 18- 10.01 a Washington State �1 Department of Transportation Supplemental Agreement Organization and Address Number 01 City of Spokane Valley Original Agreement Number 10210 E.Sprague Avenue Spokane Valley,WA 99206 18-150 Phone: 509-720-5000 Project Number Execution Date Completion Date 0268 10/22/18 12/31/19 Project Tine New Maximum Amount Payable Appleway Trail-Crossing Studies $13,000.00 Descdplion of Work The work includes an evaluation of the site characteristics,estimation of pedestrian usage,analysis of treatment warrants,and • recommendation of a crossing treatment at two locations. The Local Agency of City of Spokane Valley desires to supplement the agreement entered in to with David Evans and Associates,Inc. and executed on 10/22/18 and identified as Agreement No. IS-IS0 All provisions in the basic agreement remain in effect except as expressly modified by this supplement. The changes to the agreement are described as follows: I Section 1, SCOPE OF WORK, is hereby changed to read: No change. II Section IV,TIME FOR BEGINNING AND COMPLETION, is amended to change the number of calendar days for completion of the work to read: Contract completion date is revised to 12/31/19 III Section V PAYMENT, shall be amended as follows: No change. as set forth in the attached Exhibit A, and by this reference made a part of this supplement. If you concur with this supplement and agree to the changes as stated above, please sign in the Appropriate spaces below and return to this office for final action. I, n r, By-j4 rfej 011,45 A-- soct.,4, By. ! 'lark l a(b Ilei mat, ca2,6 � Ensu 11 and Signature Approving ii ny 5ignat� uns--- Date DOT Form 140-063 Revised 09/2005 AcoRn. CERTIFICATE OF LIABILITY INSURANCE DATE,MWDDYINY) kr----- 1211/2019 11/13/2018 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies CONTACT 444 W.47th Street,Suite 900 PHONE FAX Kansas City MO 64112-1906 E-MAILo.EEO: WC.No): (816)960-9000 ADDRFSS• INSURERISI AFFORDING COVERAGE NAIC il INSURER A: Zurich American Insurance Company 16535 INSURED DAVID EVANS AND ASSOCIATES,INC. INSURER B: Continental Casualty Company 20443 1332581 2100 8W RIVER PARKWAY PORTLAND OR 97201 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES DEAIN01 CERTIFICATE NUMBER: 11570455 REVISION NUMBER: XXXXXXX 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 MEL SUER 1 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVn POLICY NUMBER IMMIDDIWYYI IMMNDIYVWt LIMITS A x COMMERCIAL GENERAL LIABILITY y N 0L09830389 12)1/2018 12/1/2019 EACH OCCURRENCE $ $1,000,000 CIAIMS-MADEI— OCCUR PREMISES(EaoNuEDre nce) S $300,000 nn MED EXP(Any Oneperson) $ $10,D00 PERSONAL BADV INJURY $ $1,000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ $2,000,000 POLICY[]jEC []LOO PRODUCTS-COMP/OP AGO $ $2,000,000 OTHER: 5 A AUTOMOBILE LIABILITY Y N BAP9830390 12/12018 12/1/2019 jEa acere%USINGLE LIMIT $ $1,000,000 X ANYAUTO _ BODILY INJURY(Per person) $ XXXXXXX AOUTOSDONLY SCHEDULED BODILY INJURY(Per accident S XXXXXXX X ISMS ONLY X Bra° 'Per acoEnIDAMAGE $ XXXXXXX• $ XXXXXXX UMBRELLA UAB _OCCUR EACH OCCURRENCE S XXXXXXX EXCESS UAB CLAIMS-MADEAGGREGATEAPPLICABLE AGGREGATE $ XXXXXXX DED RETENTION$ $ A WORKERS COMPENSATION _ AND EMPLOYERS LIABILITY y/g N WC 9336626 12/1/2018 12/1/2019 PERTUTE ER ANY PNOmeIETOR,zcWOEIE CUTIVE �' NIA EL EACH ACCIDENT $ 1,000,000 (M.�IIdamGn In NM EL DISEASE-EA EMPLOYEE 51.000,000 CPSCRIPTIONIFO [RATIONS below E DISEASE-POLICY LIMY 51,000,000 B PROFESSIONALN N AEH591924704 12/1/2018 1211/2019 PER CLAIM$1,000,000 LIABILITY ANNUAL AGGREGATE$1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space is required) RE:SPKV0000001 I;CITY OF SPOKANE VALLEY IS ADDITIONAL INSURED AS RESPECTS TO GENERAL AND AUTO LIABILITY,THESE COVERAGES ARE PRIMARY AS REQUIRED BY WRITTEN CONTRACT.ADDITIONAL INSURED'S COVERAGE IS EXCESS AND NON-CONTRIBUTORY ON THE GENERAL LIABILITY,AND ON THE AUTO LIABILITY AS RESPECTS USE OF VEHICLES OWNED BY DAVID EVANS AND ASSOCIATES,INC. CERTIFICATE HOLDER CANCELLATION SHOULD Ally OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11570455 AUTHORIZED REPRESENTATWE CITY OF SPOKANE VALLEY ATTN:GLORIA MANTZ 11707 E.SPRAGUE,SUITE 106 SPOKANE VALLEY WA 99206 " .., Ay ACORD 25(2016/03) ©19118-2015 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD ACORn CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYV) L./ 12/1/2019 11/13/2018 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 policylies)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 Lockton Companies NAME:C/ 444 W.47th Street,Suite 900 PHONE FAX Kansas City MO 64112-1906 E M,No,EEA: INC,Not: AIL (816)960-9000 AO ADDRESS: INSURERISI AFFORDING COVERAGE NAICM INSURER A: Zurich American Insurance Company 16535 INSURED DAVID EVANS AND ASSOCIATES,INC. INSURER B: Continental Casualty Company 20443 1332581 2100 SW RIVER PARKWAY PORTLAND OR 97201 INSURER C: INSURER 0: INSURER E: INSURER F: COVERAGES DEAIN01 CERTIFICATE NUMBER: 11570455 REVISION NUMBER: XXXXXXX 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AWL SUBRI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE !NSD IWO POLICY NUMBER IMMNOWYYYI IMMIDD/YYYYl LIMITS A x COMMERCIAL GENERAL LIABILITY Y N GL09830389 12/1/2018 12/1/2019 EA CH OCC{URRENCE $ S1,000,000 ctAIMSMAOE n OCCUR PREa Ee Eo oNe LE, D nee) $ $300,000 MED EXP(Any one person) s $10,000 PERSONALSADV INJURY $ $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 $2,990.000 itucYn jEj LOC PRODUCTS-COMP/OP AGG $ $2,000,000 OTHER: A AUTOMOBILE LIABILITY Y N BAP9830390 12/1/2018 12/1/2019 �olcBcI !MINGLE LIMIT S SI,000,000 X AANN�YAUTO BODILY INJURY(Per person) S XXXXXXX _ AUT0.5ONLY MEWLED BODILY INJURY(Per accent $ XXXXXXX X AUTOS ONLY X AV CS ONLY /PROPERer accident)DAMAGE $ XXXXXXX $ XXXXXXX UMBRELLA LIAB 'OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMSMADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED RETENTIONS $ A WORKERS COMPENSATION WC 9336626 12/12018 12/1/2019 PER OTH. AND EMPLOYERS'LIABILITY YIN NSTATUTE ER ANY PROOPM"TORPMTNPEXWUTIVE N/A EL.EACH ACCIDENT $ 1,000,000 OFFICER/IManatory NH)EXCLUDED? eL OrsEASE.eaEMPLOYEE 5 1,000,000 ors°car.non°aFOPERATIONS below, EL DISEASE-POLICY LIT o 1,000,000 B PROFESSIONAL N N AEH591924704 12/1/2018 12/12019 PER CLAIM$1,000,000 LIABILITY ANNUAL AGGREGATE 81,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached II more space Is required) RE:SPKV00000011;CITY OF SPOKANE VALLEY IS ADDITIONAL INSURED AS RESPECTS TO GENERAL AND AUTO LIABILITY,THESE COVERAGES ARE PRIMARY AS REQUIRED BY WRITTEN CONTRACT.ADDITIONAL INSURED'S COVERAGE IS EXCESS AND NON-CONTRIBUTORY ON THE GENERAL LIABILITY,AND ON THE AUTO LIABILITY AS RESPECTS USE OF VEHICLES OWNED BY DAVID EVANS AND ASSOCIATES,INC. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11570455 AUTHORIZED REPRESENTATIVE CITY OF SPOKANE VALLEY ATTN:GLORIA MANTZ 11707 E.SPRAGUE,SUITE 106 SPOKANE VALLEY WA 99206deal " ACORD 25 42016/03) ©1988-201 ACORD OR COR TION.All rights reserved The ACORD name and logo are registered marks of ACORD