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19-088.00 Poe Asphalt Paving: Garland Ave Extension {� Contract This agreement is entered into this I4 3ay of 2019, between the City of Spokane Valley ("City")and Poe Asphalt Paving,Inc. ("Contractor') rsuant 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: Garland Avenue Extension Project#0295 Contract 19-088 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 descnbed 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'tenured 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 fulI performance of all covenants required of the Contractor in the contract. IV. 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$1,412,444 00. IN WITNESS WHEREOF,the Contractor has executed this instrument,on the date below, and the City has caused this instrument to be executed on the date stated above City of Spokane Valley 13 Contract Form. Garland Avenue Extension Project Executed by Contractor April 29 ,2019. Date Poe Asphalt Paving, Inc Printed Name Division Manager Title Signature City of Spokane Valley Mark Calhoun Printed Name City Manager Title ' p/°j`in 'yw Signature City of Spokane Valley W Contract Forms Garland Avenue Extension Project Siletl‘\"' lky- BOND NO 107005694 f.0NTRACTOR'SPAYMENT BOND(NON-FEDERALLY FUNDEDPROJECT) to City of Spokane Valley,Washington The City of Spokane Valley, washmgton in Spokane r. ainty, has awarded-to Poe Asphalt Paving Inc (Contractor),asPiineipal,a contractfor*s construction-of the project designatedas GarlandAvenueExtenstoir1 o)ectNo. 2Q�9 in,Spokam Valley, Washington, and said Principal iaxeqiured under the'terms of the Contract to tiumsh a payment bond in accordance with chapter 39.08 Revised Code of Washington(RCW). The Principal, and Travelers Casualty and Surety Company of America (Surety), a corporation otgamzed tinder the laws CT andlicersed to do backless in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in theRederal Register by the Audit-Staff Bureau of Accounts,U.S. Treasury Dept,are Jointly and severally held and fumly boun to the City of Spokane Valley,as Obfigee,in the sum of$ See below total Contract amov t(ineluding Washington State cal-stat subpectto the pmvtuonsherem One million, four hundred twelve thousand, four hundred forty four dollars & 00/100 ($1,412,444.00) This payment b bond shall bcoouenull and void lfand when ate Principal,as lack executors,administrators,successors or assigns shall pay all persons in accordance with chapters39.0S and39.1217.CW,including all workers,laborers,mechames,subcontractors, and materialmen,andatlpersons who shall supply such contractor or snbcontractorwithprovnsnmisard supplies for the canymgon of such wok and shall indemnify and hold harmless the Obligee from all loss,costardamagewhtohObtigee maysid'ferby reason of the failure of Principal to make suchrequired payments;and if such payment obligations have not been fulfilled,this bond shall remain m full force and effect The Surety for value meeived agrees that no change, extension of time, alteration or addition to the tents of the Contact,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 waivesnotice of any change,extorsion of time,alteration or addition to the terns of the Contract or the work performed The Surety ogees that modrfgahens and changes to the term 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 m two original counterparts,and shall be signed by the parties'duly authortzedaTlicers 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 PRINC AL CONTRACTOR Poe-Asphalt Paving Inc Travelers Casualty and Surety ( ) SURETY Company of America fivec 7-)i tolyl � Pnnctpal Signature Date Surety Signature Data d.:&'VaJ C Cella J Allen PrintedName PrimedName �tJttstf"lt r FA Attorney In Fact Title Title Name,address,and telephone of local office/agent of Surety Company is. Stonebraker McQuarv, PQ Box 9 Clarkston WA 99403 509-758-5529 I wsuc l.14 tit City of Spokane Valley 16 Contend Forms Garland Avenue Exlmnw Project Travelers Casualty and Surety Company of America 'Ax 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 Manne 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 Della J.Allen,of Clarkston,Washington,their true and lawful Attorney-in-Fact to sign,execute,seal and acknowledge any and all bonds, recog nizances,conditional undertakings and other wntings 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. A►an'i a'� '"°t 31 44, ° State of Connecticut By City of Hartford ss Robert L Raney,Serum 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 Amenca,Trawlers Casualty and Surety Company, and St Paul Fire and Manne 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 authonzed officer In Witness Whereof.I hereunto set my hand and official seal ,r - .,� My Commission expires the 30th day of June,2021 lThmOJV_L C �/l{pAy � `+ , Mane C Tetreault,Notary Public This Power of Attorney is granted under and by the authonty 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 Manne 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 beharf of the Company and may give such appointee such authonty as his or her certificate of authority may prescube to sign with the Companys name and seal with the Company's seal bonds, recogmzances,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 wnting 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 wnting 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 V[ce 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 prescnbed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authonty,and d 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 cerfficate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretanes or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other wntings 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 Amenca, Travelers Casualty and Surety Company,and St Paul Fire and Manne 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 ` S' day of 11.3Aa.a.y 41:B Is, fir« \ .1 )Ole) t • r Kevin E Hughes,Ass tarn 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 powers attached. S„pokane''` 7 ' ~✓ y BOLVD NO: 107071051 CONTRACTOR'S RETAINAGE BOND to City of Spokane Valley,Washington The City of Spokane Valley,Washington, in Spokane County,has-awarded to Poe Asphalt Paving Inc - ("Contractor"),as Principal,a contract for the constmetion of the project designated as Garland Alrenue Extension Project No. 0245,(the `-'Contract')in Spokane Valley,Washington. The Principal,existing under and byylrtue ofthe laws pf the State of Washington and authorized to dobusiness in the State of Washington,and Tragelere Casualty and Surety Company of America a$anized and existing under the laws'ofthe State of CT 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 Oblige%and are similarly held and bound unto the beneficiaries of the trust find created by chapter 6028 RCW, in the petal slim of 5% of the Contract, 'Which is seventy thousand, six hundred twenty two dollars&00!100 dollars(S 70 622.00 ),plus 5%of any increases in tho Contract amount drat lave occurred or may ocepr, due to change orders, increases,in the quantities,or the addition of any new item of work WHEREAS,on the 1st dgyof May ,201 rho sad Principal and Obligee herein executed and entered into the Contract. WHEREAS,said Contract.and,clia ter 60.28 RCW require the Obligee to withholdfrontthe Principal thesum of 5%from monies earned by the Principal on estimates during the progress of the consttvetton.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 duan. This bond, including eery proceeds therefrom,is subject to all elaima 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 claim under thetmstfundpurposes of chapter 60.28 RCW to the Obligee, and-indemnify and hold the Obligee harmless from any and all loss, cost%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 front 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 thebenefitofthe Principal,the Surety the Obligee, the beneficiaries of the trvst^frmd created by chapter 6Q.28;RCW and their respective heirs,executors, administrators,successor and assigns. 3. Any suit under this bond must be instituted within the time provided by applicable law. City Ofspoksne Valley 17 Contract Forms Garland Avenue Exton ou Project This hood allay be executed in two oti01a1 countetpartd,and shall be Signed,by the parties'duly authorized officers.This bondwill onlybeaccepted if itis accompanied by a fallyaexecuted and original power of attorney for the o$cer executing on behalf of the-surety PRINCIPAL(CasTRACTOR) Poe Asphalt Paving IIRETY Travelers Casualty and Surety n Company of America /,fi " \ tNje_na (\ Q..9-q-rr..� �f4 ~J /1 Principal Signature Date Surety Signature 7l Date &StA.1 4117 _ _ Della J Allen _ Printed Name Printed None ctUte-,\l \ cs, l_ Attorney In Fact Tide `l'it7e Name,address,and telephone of local office/agent of Surety Company is: Stonebraker MCQuary. PO Box 9 Clarkston WA 99403 509-758-5529 itevir:d I Ii Ii City of Spokane Valley IS Centm¢Porms Garland Avenue Warns=Project Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company TRAVELERS 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 Monne 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 Della J.Allen,of Clarkston,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. WWp wvs 40 e State of Connecticut By City of Hartford ss Robert L Raney,Senior Vlce 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 Amenca,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 0- My My Commission expires the 30th day of June,2021 m"JV.L C tCThta uJ. f Mane 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 Marne Insurance Company,which resolutions are now in Mil 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 authonty as his or her certificate of authority may prescnbe 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 certhcate or their certificates of authority or by one or more Company officers pursuant to a wntten delegation of authonty,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 Amenca, Travelers Casualty and Surety Company, and St Paul Fire and Monne 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 1 S4 day of V D...JtrS °ti�mitoscti as i �// f. e Kevin E Hughee Ass cretary To verify the authentldty of this Power of Attorney,please call us at l-800-411-3880. Please refer to the above-named Attorney-in-Fact and the details of the bond to which the power is attached "--....1 POEASPH-01 DALLEN 4�QRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YVY" 5/1/2019 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 HQM�T Stonebraker Mcouary PHONE PAX 616 5th St. INC,No,Exp:(509)758-5529 I INC.No(509)7585311 PO Box 9 ninss.CustomerServicel@stonebrakermcquary.com Clarkston,WA 99403 INSURERS}AFFORDING COVERAGE NAICR INSURER A'Phoenix Insurance Company 25623 INSURED INSURER B Travelers Property Casualty Insurance Company-Main 36161 Poe Asphalt Paving,Inc. INSURER C.Idaho State Insurance Fund 37129 PO Box 449 INSURER D: Lewiston,ID 83501 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 NOWNTHSTANDING 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 MR LTR TYPEOFIHSURANLE ADM SUB POLICY NUMBER POLICY EFF POLICY EXP IWO IMMAOrVYYYI IMMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 1.000,0001 CLAIMS-MADE X OCCUR DT-CO-1537P995-PHX-18 11/1/2018 11/1/2019 DAMAGETO RENTED 300,000 PREMISEES(Fa Ocwnencel $ X Contractual 10,000 MED EXP(Any Otte parson) $ X XCU,Sep of Insured PERSONAL aADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT API LJ S PER GENERAL AGGREGATE $ 2,000,000 —1 POLICY X izef 1 I LOC PRODUCTS- 2,000,000. -COMP/OP AGG $ OTHER WA Stop Gap $ 1,000,000 A AUTOMOBILE LIABILITYCFOMBBIINED SINGLE LIMIT n11 $ 1,000,000 , aIiX ANY AUTO 810-0L841684-18-26-G 11/1/2018 11/1/2019 BODILY INJURY(Per pen) $ SCHEDULED AUTOS ONLY UTBODILY INJURY(Per accident) $ X ATOONLY X 80rB amAMAGE $ $ B UMBRELLA DAS X OCCUR EACH OCCURRENCE $ 4,000,000 X EXCESSLIAB CLAIMS-MADE CUP-7H492823-18-26 11/1/2018 11/1/2019 AGGREGATE $ 4,000,000 DED X RETENTION$ 10,000 $ C WORKERS COMPENSATION X STATUTE FORR AND EMPLOYERS'LIABILITY Y/N 578551 10/1/2018 10/1/2019 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ OFB IC�ERJIR MON EXCLUDED? N N/A �M NH) EL DISEASE-EA EMPLOYEE $ 500,000 If yes desmrbe under DESCRIPTION QF OPERATIONS below E L DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESACORD 101.Addleonel Remarks Schedule,may be attached If more apace Is requIred) The City of Spokane Valley is additional insured(except on work comp)on a primary/noncontributory basis as respects the Garland Avenue Extension Project No.0295 per attached. Cancellation provisions are attached also. 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. City of Spokane Valley AUTHORIZED REPRESENTATIVE 10210 E Sprague Ave Spokane Valley WA 94206 a-AA"�Y" ACORD 25(2018/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - AUTOMATIC STATUS IF REQUIRED BY WRITTEN CONTRACT (CONTRACTORS) This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II -WHO IS (a) The Additional Insured - Owners, AN INSURED: Lessees or Contractors - Scheduled My person or organization that: Person or Organization endorsement CG 20 10 07 04 or CG 20 10 04 13, a. You agree in a 'Written contract requiring in- the Additional Insured - Owners, surance" to include as an additional insured Lessees or Contractors - Completed on this Coverage Part;and Operations endorsement CG 20 37 b. Has not been added as an additional insured 07 04 or OG 20 37 04 13, or both of for the same project by attachment of an en- such endorsements with either of dorsement under this Coverage Part which those edition dates;or includes such person or organization in the (b) Either or both of the following: the endorsements schedule; Additional Insured - Owners, Les- is an insured,but: sees or Contractors - Scheduled a. Only with respect to liability for"body injury", Person Or Organization endorsement "property damage"or"personal injury"; and CG 20 10, or the Additional Insured- 6. Only as described in Paragraph (1), (2) or(3) Owners, Lessees or Contractors - below,whicheverapplies: Completed Operations endorsement CG 20 37, without an edition date of (1) If the "written contract requiring insur- such endorsement specified; ante" specifically requires you to provide the person or organization is an additional additional insured coverage to that per- insured only if the injury or damage is son or organization by the use of: caused, in whole or in part, by acts or (a) The Additional Insured - Owners, omissions of you or your subcontractor in Lessees or Contractors - (Form B) the performance of "your work" to which endorsement CG 2010 11 85;or the "written contract requiring insurance" (b) Either or both of the following, the applies; or Additional Insured - Owners, Les- (3) If neither Paragraph (1) nor(2) above ap- sees or Contractors - Scheduled plies: Person Or Organization endorsement 20 10 10 01, or the Additional In- (a) The person or organization istan ad- CGsured-Owners, Lessees or Contrac- tentditiOthat,al insured only d, and ao the ex- sured tors - Completed Operations en- tent actsce injury or damage is dorsement CO 20 3710 01; causedr subcontractorbor omissions pf you o- yourf"yourwokin theperform- the person Or organization is an additional ance of"your work"to which the'volt- insured only if the injury or damage arises ten contract requiring insurance" sp- out of "your work" to which the "written plies; and contract requiring insurance"applies; (b) The person or organization does not . (2) If the "written contract requiring insur- qualify as an additional insured with ance" specifically requires you to provide respect to the independent acts or additional insured coverage to that per- omissions of such person or organi- son or organization by the use of: zation. CG 06 04 0813 ®2013 The Trawlers Indemnity Company.MI rights reserved. Page 1 of 3 • COMMERCIAL GENERAL LIABILITY 2. The insurance provided to the additional Insured and collectible other insurance, whether primary, by this endorsement is limited as follows excess, contingent or on any other basis, that is a. If the Limits of Insurance of this Coverage available to the additional Insured when that per- Part shown in the Declarations exceed the son or organization Is an additional Insured, or Is minimum limits of liability required by the any other insured that does not qualify as a "written contract requiring insurance", the in- named insured, under such other insurance. surance provided to the additional insured will 4. As a condition of coverage provided to the addi- be limited to such minimum required limits of tional insured by this endorsement: liability. For the purposes of determining a, The additional insured must give us written whether this limitation applies, the minimum notice as soon as practicable of an "occur- Unite of liability required by the "written con- rence" or an offense which may result in a tract requiring insurance will be considered claim. To the extent possible, such notice to Include the minimum limits of liability of any should include: Umbrella or Excess liability coverage required for the additional Insured by that'Written con- (1) How, when and where the "occurrence" tract requiring insurance". This endorsement or offense took place, will not increase the limits of insurance de- (2) The names and addresses of any injured scribed in Section III—Limits Of Insurance. persons and witnesses;and b. The insurance provided to the additional in- (3) The nature and location of any injury or sured does not apply to"bodily injury". "prop- damage arising out of the"occurrence"or erty damage" or "personal injury" arising out offense. of the rendering of, or failure to render, any b. If a claim Is made or"suit" Is brought against professional architectural, engineering or stir- the additional insured, the additional insured veying services, including: must- (1) ust'(1) The preparing, approving, or failing to (1) Immediately record the spedfics of the prepare or approve, maps, shop draw- claim or"suit"and the date received,and ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, (2) Notify us as soon as practicable approving, or failing to prepare or ap- The additional insured must see to It that we prove,drawings and specifications; and receive written notice of the claim or"suit' as (2) Supervisory, inspection, architectural or soon as practicable. engineering activities. c. The additional Insured must Immediately send c. The Insurance provided to the additional in- us copies of all legal papers received in con- sured does not apply to "bodily injury" or nection with the claim or"suit".cooperate with "properly damage"caused by"your work"and us in the investigation or settlement of the included in the "products-completed opera- claim or defense against the "suit", and oth- tions hazard" unless the "written contract re- erwise comply with all policy conditions. quiring insurance" specifically requires you to d. The additional insured must tender the de- provide such coverage for that additional in- Tense and Indemnity of any claim or "suit" to sured during the policy period. any provider of other Insurance which would 3. The insurance provided to the additional insured cover the additional insured for a loss we by this endorsement is excess over any valid and cover under this endorsement. However, this collectible other insurance, whether primary, ex- condition does not affect whether the insur- cess, contingent or on any other basis, that is ante provided to the additional insured by this available to the additional insured, However, if the endorsement is primary to other insurance "written contract requiring insurance" specifically available to the additional Insured which coy- requires that this insurance apply on a primary ers that person or organization as a named basis or a primary and non-contributory basis,this insured as described in Paragraph 3.above. insurance is primary to other insurance available O. The following is added to the DEFINITIONS Se to the additional insured under which that person o- }ion: or organization qualifies as a named insured, and we will not share with that other insurance. But 'Written contract requiring Insurance" means that the insurance provided to the additional insured part of any written contract or agreement under by this endorsement still is excess over any valid which you are required to include a person or or- Page 2 of 3 43 2013 The Travelers indemnity Company.All rights reserved. CG D8 04 08 13 COMMERCIAL GENERAL LIABILITY ganization as an additional insured on this Cover- a. After the signing and execution of the contract age Part, provided that the "bodily injury" and or agreement by you, and "property damage" occurs, and the "personal in- b. While that part of the contract or agreement is jury" is caused by an offense committed, during In effect the policy period and: CG D6 04 0813 m 2013 The Travelers indemnity Company.All rights reserved. Page 3 of 3 NmrKIIN'cLrNVIw In C.rUKIMQ L-11.1"“ • • IL 02 04 09 08 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. IDAHO CHANGES - CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART CRIME AND FIDELITY COVERAGE PART EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART EQUIPMENT BREAKDOWN COVERAGE PART FARM COVERAGE PART LIQUOR LIABILITY COVERAGE PART MEDICAL PROFESSIONAL LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Paragraphs 1. and 2. of the Cancellation Corn- b. More Than 60 Days mon Policy Condition are replaced by the follow- If thisolic has been in effect for more ing: than ea days, or is a renewal of a policy 1. The first Named Insured shown in the Dec- we issued, we may cancel this policy larations may cancel this policy by mailing only for one or more of the following or delivering to us advance written notice of reasons: cancellation. Cancellation will be etiectve on (1) Nonpayment of premium; the later of the date requested by the first Named Insured or the date we receive the (2) Fraud or material misrepresentation request. made by you or with your knowt- 2. Policies In Effect edge in obtaining the policy, contin- uing the policy or in presenting a a. 60 pays Or Less claim under the policy; If this policy has been in effect for 60 (3) Acts or omissions on your part days or less, we may cancel this policy which increase any hazard insured by mailing or delivering to the first against; Named Insured written notice of cancel- (4) Change in the risk which materially lation at least: increases the risk of loss atter the (1) 10 days before the effective date of policy has been issued or renewed cancellation if we cancel for non- including, but not limited to, an in- payment of premium, II delivered via crease in exposure due to regu- United States mail, the 10 day no- lotion, legislation or court decision, tification period begins to run five (5) Loss of or decrease in reinsurance gays following the date of postmark; which provided us with coverage for r all or part of the risk insured; (2) 30 days before the effective date of cancellation if we cancel for any other reason. ISO Properties, Inc., 2907 IL b2 04 OB Oa Page 1 of 2 EP • (6) A determination by the Director of b. You have obtained replacement cover- Insurance that continuation of this age; or policy would jeopardize our sol- c. You have agreed in writing to obtain re- vency or place us in violation of the placement coverage. insurance laws of Idaho or any other state; or 5. If notice is mailed, proof 01 mailing will be (7) Violation or breach by the insured sufficient proof of notice. of any policy terms or conditions C. The following Condition is added: - other than nonpayment of premium. PREMIUM OR COVERAGE CHANGES AT RE- We will mail or deliver written notice of can- NEWAL collation to the first Named Insured at least: 1. If we elect to renew this policy, we will mail (a) 10 clays before the effective or deliver written notice of any total premium date of cancellation if we cancel Increase greater than ten percent (10%) for nonpayment of premium. If which is the result of a comparable increase delivered via United States mail, in premium rates, change in deductible, re- the 10 day notification period duction in limits or reduction in coverage to begins to ruh five days following the first Named Insured, at the last mailing the date of postmark; or address known to us. (b) 30 days before the effective 2. Any such notice will be mailed or delivered date of cancellation if we cancel to the first Named Insured at least 30 days for any other reason stated in before the expiration or anniversary date of 2.b. above. the policy. B. The following Condition is added and supersedes 3. If notice is not mailed or delivered at least 30 any provision to the contrary: days before the expiration or anniversary NONRENEWAL date of the policy, the premium, deductible, limits and coverage in effect prior to the 1. If we elect not to renew this policy, we will changes will remain in effect until the earlier mail or deliver to the first Named Insured a of the following: written notice of intention not to renew at a. 30 days atter notice is given, or least 45 days prior to the expiration or anni- versary date of the policy. b. Tha effective date of replacement cov- 2. We will mail or deliver our notice to the first erage obtained by the first Named !n- Named Insured's last mailing address known sured. to us. 4. If the first Named Insured accepts the re- 3. It notice is not mailed or delivered at least 45 newal, the premium increase, if any, and days before the expiration or anniversary other changes will be effective on and after date of this policy, this policy will remain in the first day of the renewal term. effect until 45 days after notice is mailed or 6. If the first Named Insured elects not to re- delivered. Earned premium for the extended new, any earned premium for the resulting period of coverage will be calculated pro rata extended period of coverage will be calcu- at the rates applicable to the expiring policy. fated pro rata at the lower of the new rates 4. We need not mail or deliver this notice it: or rates applicable to the expiring policy. a. We have offered to renew this policy; 6. If notice is mailed, proof of mailing will be sufficient proof of notice Page 2 of 2 SAM Search Results List of records matching your search for : Search Term : Poe Asphalt Paving, Inc.* Record Status: Active,Inactive ENTITY Poe Asphalt Paving, Inc. Status: Active DUNS: 051168367 +4: CAGE Code: 0H6D9 DoDAAC: Expiration Date: 11/13/2019 Has Active Exclusion?: No Debt Subject to Offset?: No Address: 302 15th st City: Clarkston State/Province: WASHINGTON ZIP Code: 99403-2300 Country: UNITED STATES May 13,201911.27 AM htlpa./Avww Sam gov Page 1 of 1