19-127.00 Northwest Playground Equipment: Discovery Playground Surfacing Repair Contract No. 19-127.00
CONSTRUCTION AGREEMENT
Northwest Playground Equipment,Inc.
THIS CONSTRUCTION AGREEMENT(the "Agreement") is made by and between the City of
Spokane Valley,a code City of the State of Washington("City")and Northwest Playground Equipment,Inc,
("Contractor")jointly referred to as the"Parties".
IN CONSIDERATION of the terms and conditions contained herein the Parties agree as follows:
1.Work to Be Performed. Contractor shall do all work and furnish all labor,supervision,tools,materials,
supplies, and equipment and other items necessary for the construction and completion of the Discovery
Playground Poured-in-Place Surfacing Repair 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 atimely 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 November 1,2019.
3. Compensation. In consideration of Contractor performing the Work, City agrees to pay Contractor in
accordance with the Contract Documents the sum of $18,421.14, plus Washington State Sales Tax of
$1,639.48(if applicable),for a total of$20,060.62,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 RC W,five percent of the compensation due Contractor shall be retained by City
City reserves the right to withhold payment under this Agreement for that portion of the work(if any)which is
determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Contract
Documents,City standards,City Code,state standards,or federal standards.
Construction Agreement Page I of 9
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: Northwest Playground Equipment,Inc.
Phone:(509)720-5000 Phone: (509)520-6053
Address: 10210 East Sprague Avenue Address: P.O.Box 2410
Spokane Valley,WA 99206 Issaquah,WA 98027-0109
6.Applicable Laws and Standards. The Part ies,in the performance ofthis 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&P'). 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 infomtation is provided pursuant to RCW 39.12.030:
Construction Agreement Page 2 of 9
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.eov/Ini/waeelookup/pry W aeelookuo.asox
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.
I I.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 final acceptance by City,unless a supplier or manufacturer has a warranty for a greater period,which
warranty shall be assigned or transferred to City. In the event a defect or failure occurs in work or materials,
Contractor shell,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
performance of the work hereunder by Contractor,its agents,representatives,or employees.
Construction Agreement Page 3 of 9
A.Minimum Scope of Insurance. Contractor shall obtain insurance of the types described below:
I.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 Ol 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:
I.Automobile liability insurance with a minimum combined single limit for bodily injuryand
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:
I. 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.
4. Failure on the part of Contractor to maintain the insurance as required shall constitute a
Construction Agreement Page 4 of 9
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 acurrent 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
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
Construction Agreement Page 5 of9
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.
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 othersection,
sentence,clause,or phrase of this Agreement.
Construction Agreement Page 6 of9
27.Exhibits. Exhibits attached and incorporated into this Agreement are:
A. Assurance of Compliance with Applicable Federal Laws
B. Scope of Work/Cost Statement
C. Insurance Endorsements
D.Performance and Payment Bond
The Parties have executed this Agreement this as kin day of August,2019.
CITY OF SPOKANE VALLEY: Contractor: NORTHWEST PLAYGROUND
EQUIPMENT,INC.
Mank CallL CO-�/[qe e `
Mark Calhoun,City Manager By: 50\z> c1ei {ere).&'^sC
Kt/14‘.-4..
h,t � Its: Authorized Representative f
ATT( /' 7
Christine Bainbridge,CirClerk
APPR D O FORM:
Office ore e City Ai
Construction Agreement Page 7 of 9
Exhibit A—Assurance of Compliance with Applicable Federal Law
During the performance of this Agreement,the Contractor,for itself,its assignees,and successors in
interest(hereinafter referred to as the"Contractor")agrees as follows:
I.Compliance with Regulations:The Contractor shall comply with the federal laws set forth in Section 7 of
this Exhibit("Acts and the Regulations")relative to non-discrimination in federally-assisted programs of the
U.S.Department of Transportation,Washington State Department of Transportation(WSDOT),as they may
be amended from time-to-time,which are herein incorporated by reference and made apart of this Agreement.
2.Non-discrimination:The Contractor,with regard to the work performed by it during this Agreement,shall
not discriminate on the grounds of race, color, or national origin in the selection and retention of
subcontractors, including procurements of materials and leases of equipment. The Contractor shall not
participate directly or indirectly in the discrimination prohibited by the Acts and the Regulations,including
employment practices when the contract covers any activity,project,or program set forth in Appendix B of49
CFR Part 21.
3. Solicitations for Subcontracts, Including Procurements of Materials and Equipment: In all
solicitations,either by competitive bidding,or negotiation made by the Contractor for work to be performed
under a subcontract,including procurements of materials,or leases of equipment,each potential subcontractor
or supplier shall be notified by the Contractor of the Contractor's obligations under this Agreement and the
Acts and the Regulations relative to non-discrimination on the grounds of race,color,or national origin.
4.Information and Reports:The Contractor shall provide all information and reports required by the Acts,
the Regulations,and directives issued pursuant thereto,and shall permit access to its books,records,accounts,
other sources of information,and its facilities as may be determined by the City or the WSDOT to be pertinent
to ascertain compliance with such Acts, Regulations,and instructions. Where any information required of
Contractor is in the exclusive possession of another who fails or refuses to furnish the information, the
Contractor shall so certify to the City or the WSDOT,as appropriate,and shall set forth what efforts it has
made to obtain the information.
5.Sanctions for Noncompliance:In the event of a Contractor's noncompliance with the non-discrimination
provisions of this Agreement,the City will impose such contract sanctions as it or the WSDOT may determine
to be appropriate,including,but not limited to:
a.withholding payments to the Contractor under the Agreement until the Contractor complies;and/or
b.cancelling,terminating,or suspending the Agreement,in whole or in part.
6.Incorporation of Provisions:The Contractor shall include the provisions of paragraphs one through six of
this Exhibit in every subcontract,including procurements of materials and leases of equipment,unless exempt
by the Acts,the Regulations and directives issued pursuant thereto. The Contractor shall take action with
respect to any subcontract or procurement as the City or the WSDOT may direct as a means of enforcing such
provisions,including sanctions for noncompliance. Provided,that if the Contractor becomes involved in,or is
threatened with litigation by a subcontractor or supplier because of such direction,the Contractor may request
that the City enter into any litigation to protect the interests of the City. In addition,the Contractor may request
the United States to enter into the litigation to protect the interests of the United States.
7.Pertinent Non-Discrimination Authorities: During the performance of this Agreement,the Contractor
agrees to comply with the following non-discrimination statutes and authorities;including but not limited to:
Construction Agreement Page 8 of9
Title VI of the Civil Rights Act of 1964(42 U.S.C.§2000d et seq.,78 stat 252),(prohibits discrimination
on the basis of race,color,national origin);and 49 CFR Part 21;
The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C.
§4601),(prohibits unfair treatment of persons displaced or whose property has been acquired because of
Federal or Federal-aid programs and projects);
Federal-Aid Highway Act of 1973,(23 U.S.C.§324 et seq.),(prohibits discrimination on the basis of sex);
Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. §794 et seq.), as amended, (prohibits
discrimination on the basis of disability);and 49 CFR Part 27;
The Age Discrimination Act of 1975,as amended,(42 U.S.C.§6101 et seq.),(prohibits discrimination on
the basis of age);
Airport and Airway Improvement Act of 1982,(49 USC§471,Section 47123),as amended,(prohibits
discrimination based on race,creed,color,national origin,or sex);
The Civil Rights Restoration Act of 1987,(PL 100-209),(Broadened the scope,coverage and applicability
of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and Section 504 of the
Rehabilitation Act of 1973,by expanding the definition of the terms"programs or activities"to include all
of the programs or activities of the Federal-aid recipients,sub-recipients and contractors,whether such
programs or activities are Federally funded or not);
Titles II and El of the Americans with Disabilities Act, which prohibit discrimination on the basis of
disability in the operation of public entities,public and private transportation systems,places of public
accommodation,and certain testing entities(42 U.S.C.§§12131-12189)as implemented by Department of
Transportation regulations at 49 C.F.R.parts 37 and 38;
The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. §47123) (prohibits
discrimination on the basis of race,color,national origin,and sex);
Executive Order 12898,Federal Actions to Address Environmental Justice in Minority Populations and
Low-Income Populations,which ensures Non-discrimination against minority populations by discouraging
programs,policies,and activities with disproportionately high and adverse human health or environmental
effects on minority and low-income populations;
Executive Order 13166,Improving Access to Services for Persons with Limited English Proficiency,and
resulting agency guidance, national origin discrimination includes discrimination because of Limited
English proficiency(LEP).To ensure compliance with Title VI,you must take reasonable steps to ensure
that LEP persons have meaningful access to your programs(70 Fed.Reg.at 74087 to 74100);
Title IX of the Education Amendments of 1972,as amended,which prohibits you from discriminating
because of sex in education programs or activities(20 U.S.C. §1681 et seq.).
Construction Agreement Page 9 of 9
Northwest Playground Equipment,Inc.
PO Box 2410,Issaquah,WA 96027-0109
Phone(425)313-9161 PAX(425)313-9194
BmaB:salax®awplayDnantmm
QUOTE
Quote 7282019CB1
To: Spokane Valley parks and Rec Date: 8/162019
Re: Discovery Park Pour in Place
Contact Name:lMce Stone Phone: (509)7206400
Email:m51py®apokanevaley.olg C.NFax
I Rem It Qty Desorption Price Total Rice
EQUIPMENT
Flex Ground Pourin Place Rubber Surfacing
1 Patch repair several areas throughout pad and apply a Flexcoat on entire area $ 18,649.56 $ 18,649.56
to provide IN protection and ammeter stability.Quote is based on prevali g
wages.Not responsible for secerity during acing.
Nobs: Please Note that Me Customer Is Responsible Verifying Qwn68es and
Desaipaons
Equipment Subtotal 6 18,649.56
Mobilization 1 1,100.00
Northwest Playground Equipment Discount NPEI 10.00% 1 (1,884.96)
Equipment Total(tress tax) $ 17,814.60
CERTIFIED INSTALLATION
nob.: Please note that we assume that all work to be done during normal working
tours.
Prevailing Wage Job Installation Total: $ -
Bond or Credit Card Fee: Perfonnance Bond(If Required): 3.0% $ 536.54
Location Code: Resale Certificate Required for Tax Exemption: Tax 8.9% $ 1,639.46
ORDER TOTAL: $ 20,060.62
The items,prices and conditions listed herein are satisfactory and are hereby accepted.
Chris Brummett
Park and Play Consultant Customer Sgnebae Date
Thank you for considering Northwest Playground Equipment,Inc.for your
Park Playground,Shelter and Sports Equipment requirements.
PAGE 1 a 2 Revred 811a011
4 Northwest Playground Equipment,Inc.
PO Box 2410,Issaquah.WA 98027-0109
Phone(925)313-9161 PAX(925)313-9194
Bmmt mka®nwpbypound.amn
Project Name: Discovery Pa Pow in Place Quote 72620I9CB1
TERMS AND CONDITIONS
Al Tanes aid Conditions will be per the City of Spokane Valley Contract
ckdsthnumlett
Pak and Play Contutat Customer Sgndme Dale
Thank you for 0hoosing Northwest Playground Equipment
PAGE 2a 2 Pinked 6/11/2017
A�® CERTIFICATE OF LIABILITY INSURANCE
DATEI6MnW I
00/21/2019
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 pollcy(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 CONTACT
NAME: Nick Ghaffsr!
CHOICE Insurance, LLC B PHONE PAX
1715 Market Street Suite 100 INC No EMI. (425) 739-6565 INC.Not(425) 739-9955
ADDRESS: ServiCeechoiceinsurance.net
Kirkland WA 98033
INSURE/RS/AFFORDING COVERAGE MICR
INSURER A:Western National Assurance 24965
INSURED 14251 313-9161 INSURERS:
Northwest Playground Equipment Inc
Play Safe Construction, Inc. INSURER C:
PO Box 2410 INSURER O:
Issaquah WA 98027 INSURER E•
INSURER F•
COVERAGES CERTIFICATE NUMBER:Cert ID 15135 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES QF 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 WTH 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 TYPEOF INSURANCE ADOLI BR POLICY EFF POLICY EXP UNITSLT0. asp WVO POLICY NUMBER IMM/013/WW1 IMWWM'YYL
A I COMMERCIAL GENERAL UABILRY ETCH OCCURRENCE 1,000,000
LAMAGL WALK/Ell
CLAIMS-MADE 51 OCCUR Y Y CPP1037280 03/01/2019 03/01/1020 PREMISES(EA occurrence) 100,000
MED EXP(MY one Person/ 5,000
PERSONAL BADV INJURY 1,000,000
GEML AGGREGATE LIMIT APPUES PER GENERAL AGGREGATE 2,000,000
POLICY X JFE6 7LOC PRODUCTS-CAMP PAGO 2,000,000
OTHER COMBINED SINGLE OMR
AUTOMOBILE LIABILITY (E9 sodden() 1,000,000
A ANY AUTO CPPl037051 03/01/201903/01/2020 BODILY INJURY(Per pawn)
OWNED -SCHEDULED BODILY INJURY(Pa ddeN)
HAUTOSIRED ONLY %AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
XAUTOS ONLY x
AUTOS ONLY (Pa awde0
A X UMBRELWLIAB X /ICIIUR UMB1006108 03/01/2019 03/01/2020 EACH OCCURRENCE 5,000,000
EXCESS IJAS CLAIMS-MAW AGGREGATE 5,000,000
DED X RETENTIONS 10,000
WOA AND EMPLOYERS'
YERS'LIMINT Y YIN CPP1037280 03/01/2019 03/01/2020 PER X EERH
ANDEMPLOYERSAR114F
OFFICE M MSEREX LUDE07ELUIIVE N/A WA State Stop Gap EL EACH ACCIDENT 1,000,000
(Mandatory InroNHI �UDED7
EL DISEASE-EA EMPLOYEE 1,000,000
Ityes.bamEN
DESCRIPTION
EBCO OPERATIONS OF PENATIONStelcw EL DISEASE-POLICY LIMIT 1,000.000
$
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DESCRIPTOR OF OPERATONS/LOCATIONS/VEHICLES(ACORD 101.AddWonal Romano Schedule.maybe attached lrmore sWa4M require/0
RE: Discovery Playground Poured-in-Place Surfacing Repair Project.
Certificate Holder and Owner of Project are included as additional insured with respect to work
performed on their behalf by the insured per form 10144L49. Coverage is primary and
non-contributory. Waiver of subrogation included per form NNGG39. Additional insured applies per
written contract and/or agreement.
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
Parks E Recreation Department
2426 N. Discovery Piece AUTTHORRIZEE/AI3REPRESENTATNE
Spokane Valley WA 99216 V" '" "
I
®7988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
Page 1 of 1
Policy No.CPP1037280 COMMERCIAL GENERAL LIABILITY
WN GL 49 07 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS WHEN
REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU
PRIMARY AND NONCONTRIBUTORY
This endorsement modifies insurance provided under the following-
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II — Who- Is An Insured is amended to B. With respect to the insurance afforded to these
include as an additional insured any person or or- additional insureds, the following additional exclu-
ganization for whom you are performing opera- sion applies:
tions when you and such person or organization This insurance does not apply to.
have agreed in writing in a contract or agreement 1. "Bodily injury", "property damage"or"personal
that such person or organization be added as an and advertising injury" arising out of the ren-
additional insured on your policy. Such person or dering of, or the failure to render, any proles-
organization is an additional insured only with re- sional architectural, engineering or surveying
spect to liability for "bodily injury", "property dam- services, including:
age" or "personal and advertising injury" caused,
whole or in part, by: a. The preparing, approving, or failing to pre-
inpare or approve, maps, shop drawings,
1. Your acts or omissions, or opinions, reports, surveys, field orders,
2. The acts or omissions of those acting on your change orders or drawings and specifica-
behalf, tions; or
in the performance of your ongoing operations for b. Supervisory, inspection, architectural or
the additional insured engineering activities
A person's or organization's status as an additional This exclusion applies even if the claims
insured under this endorsement ends when your against an additional insured allege negli-
operations for that additional insured are complet- gence or other wrongdoing in the supervision,
ed hiring, employment, training or monitoring of
However others by that insured, if the "occurrence"
1. The insurance afforded to such additional in-
damage,
caused the "bodily injury" or "property
sured only applies to the extent permitted by damage", or the offense which caused the
law; and "personal and advertising injury, involved the
rendering of or failure to render any profes-
2. If coverage provided to the additional insured sional services by you with respect to your
is required by a contract or agreement, the in- providing engineering, architectural or survey-
surance afforded to such additional insured ing services in your capacity as an engineer,
will not be broader than that which you are re- architect or surveyor.
quired by the contract or agreement to provide
for such additional insured
WN GL 49 0715 Page 1 of 2
Includes copyrighted material of Insurance Services Office,inc.with its permission.
2. "Bodily injury' or "property damage" occurring D. The following is added to the Other Insurance
after: Condition and supersedes any provision to the
a. All work, including materials, parts or contrary:
equipment furnished in connection with Primary And Noncontributory Insurance
such work, on the project (other than ser- This insurance is primary to and will not seek
vice, maintenance or repairs) to be per-. any contribution from any other insurance
formed by or on behati of the additional in- available to an additional insured under your
sured(s) at the location of the covered policy provided that:
operations has been completed;or
b. That portion of "your work" out of which (1) The additional insured is a Named Insured
the injury or damage arises has been put under such other insurance; and
to its intended use by any person or or- (2) You have agreed in writing in a contract or
ganization other than another contractor or agreement that this insurance would be
subcontractor engaged in performing op- primary and would not seek contribution
erations for a principal as a part of the from any other insurance available to the
same project. additional insured.
C. With respect to the insurance afforded to these
additional insureds, the following is added to Sec-
tion 01—Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is:
1. The minimum amount required by the contract
or agreement;or
2. The Limits of Insurance shown in the Declara-
tions;
whichever is less.
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
WN GL 400715 Page 2 oft
Includes copyrighted matenal of insurance Services Office,Inc.,with Is permission.
Policy No.CPPI037280 WN GL 39 0715
COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT
The Commercial General Liability Enhancement Endorsement is an optional endorsement that provides coverage en-
hancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is pro-
vided by this summary, refer to following endorsement for changes in your policy.
SUMMARY OF COVERAGES PAGE
Bodily Injury And Property Damage Liability
• Non Owned Watercraft Up To 50 Feet . 2
Property Damage Liability
• Elevators.. . . 3
• Fire, Lightning, Explosion Or Sprinkler Leakage Exception.. . . ... 3
• Borrowed Equipment($25,000 Per Occurrence,$50,000 Aggregate,
$2,500 Deductible Per Occurrence 3
Supplementary Payments—Amended
• Bail Bonds Up To$5,000 4
• Loss of Earnings Up To$500/Day ... .. 4
Who Is An Insured Amendments
• Employee Bodily Injury To A Co-Employee . 4
• Newly Formed Or Acquired Organizations For Up To 180 Days 4
• Blanket Additional Insured—Vendors—As Required By Contract . 4
• Blanket Additional Insured—Lessor Of Leased Equipment 6
• Blanket Additional Insured—Managers Or Lessors Of Premises 6
• Blanket Additional Insured—State Or Governmental Agency Or Subdivision
Or Political Subdivision—Permits Or Authorizations ....7
• Blanket Additional Insured—State Or Governmental Agency Or Subdivision
Or Political Subdivision—Permits Or Authorizations Relating To Premises 8
Damage To Premises Rented To You — 5300,000 9
Medical Payments Increased Limit — $10,000 Or Amount Shown on Declarations.. 9
Conditions
• Knowledge of Occurrence, Offense, Claim Or Suit Amended 9
• Unintentional Failure To Disclose Hazards. . . . . . . . . . . . . . . . . . . . .. 9
• Waiver of Subrogation 10
Insured Contract Amended 10
Personal And Advertising Injury Redefined
• Televised,Videotaped Or Electronic Publication. 10
WN GL 39 07 15 Includes copyrighted material of the Insurance SeMce Office,Inc.with its permission. Page 1 of 10
WN GL 39 07 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT
This endorsement modifies the insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified
by this endorsement. The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement
will be amended as shown below.
SECTION I—COVERAGES AMENDMENTS (4) Liability assumed under any "insured COVERAGE A — BODILY INJURY AND PROPERTY con-
tract"for the ownership, maintenance or use
DAMAGE LIABILITY of aircraft or watercraft;or
(5) "Bodily injury" or "property damage" arising
A. Non Owned Aircraft Or Watercraft out of:
Item 2. Exclusions, Paragraph g. is replaced by the (a) The operation of machinery or equip-
following: ment that is attached to, or part of, a
g. Aircraft,Auto Or Watercraft land vehicle that would qualify under the
"Bodily injury" or "property damage" arising out definition of"mobile equipment"if it were
of the ownership, maintenance, use or entrust- not subject to a compulsory or financial
ment to others of any aircraft, 'auto" or water- responsibility law or other motor vehicle
craft owned or operated by or rented or loaned insurance law where it is licensed or
to any insured Use includes operation and principally garaged;or
"loading or unloading". (b) The operation of any of the machinery
This exclusion applies even if the claims against or equipment listed in Paragraph f. (2)
any insured allege negligence or other wrong- or f. (3) of the definition of mobile
doing in the supervision, hiring, employment, equipment".
training or monitoring of others by that insured, if B. Damage To Property Coverage Extensions
the"occurrence"which caused the"bodily injury" Item 2. Exclusions, Paragraph j. is replaced by the
or"property damage" involved in the ownership, following:
maintenance, use or entrustment to others of
any aircraft, "auto" or watercraft that is owned or j• Damage To Property
operated by or rented or loaned to any insured. "Property damage'to:
This exclusion does not apply to: (1) Property you own, rent, or occupy, including
(1) A watercraft while ashore on premises you any costs or expenses incurred by you, or
own or rent; arty other person, organization or entity, for
(2) A watercraft you do not own that is: repair, replacement, enhancement, restore-
tion or maintenance of such property for any
(a) Less than 50 feet long;and reason, including prevention of injury to a
(b) Not being used to carry persons or prop- person or damage to another's property;
erty for a charge; (2) Premises you sell, give away or abandon, if
This Subparagraph (2) applies to any per- the"property damage" arises out of any part
son, who with your expressed or implied of those premises;
consent, either uses or is responsible for the (3) Property loaned to you;
use of the watercraft; (4) Personal property in the care, custody or
(3) Parking an"auto°on, or on the ways next to, control of the insured;
premises you own or rent, provided the
"auto" is not owned by or rented or loaned to
you or the insured;
WN GL 39 07 15 includes copyrighted matenal of the Insurance Service Office,Inc,with its permission. Page 2 of 10
(5) That particular part of real property on which Paragraph (6) of this exclusion does not apply to
you or any contractors or subcontractors "property damage° included in the "products-corn-
working directly or indirectly on your behalf pleted operations hazard".
are performing operations, if the "property The insurance provided for "property damage° from
damage"arises out of those operations;or the use of elevators and for "property damage" to
(6) That particular part of any property that must borrowed equipment is excess over any other valid
be restored, repaired or replaced because and collectible property insurance (including any de-
"your work"was incorrectly performed on it. ductible portion thereof) available to the insured
Paragraphs (1), (3) and (4) of this exclusion do not whether primary, excess, contingent or on any other
apply to "property damage" (other than damage by basis.
fire, lightning, explosion or sprinkler leakage) to C. Damage To Premises Rented To You
premises, including the contents of such premises, Item 2. Exclusions, the last paragraph is replaced
rented to you for a period of seven or fewer by the following:
consecutive days. A separate limit of insurance
applies to Damage To Premises Rented To You as Exclusions c.through n. do not apply to damage by
described in SECTION III — LIMITS OF fire, lightning, explosion or sprinkler leakage to
INSURANCE. However, the provisions of this premises while rented to you or temporarily occupied
paragraph do not apply if coverage for Damage To by you with permission of the owner A separate
Premises Rented To You is excluded by en- limit of insurance applies to this coverage as de-
dorsement scribed in Paragraph 6.of SECTION III—LIMITS OF
Paragraph (2) of this exclusion does not apply if the INSURANCE.
premises are "your work" and were never occupied, COVERAGE B — PERSONAL AND ADVERTISING
rented or held for rental by you. INJURY LIABILITY
Paragraphs (3)and(4) of this exclusion do not apply D. Personal And Advertising Injury
to the use of elevators.
Item 2. Exclusions is amended by replacing Sub-
Paragraphs (3), (4), (5) and (6) of this exclusion do paragraphs b.and c.with the following:
not apply to liability assumed under a sidetrack
agreement. b. Material Published With Knowledge Of
Falsity
Paragraph (4) of this exclusion does not apply to "Personal and advertising injury' arising out of
"property damage" to borrowed equipment while not oral, written, televised, videotaped or electronic
being used to perform operations at the jobsite. publication, in any manner, of material, if done
Subject to Paragraph 2. of SECTION III — LIMITS by or at the direction of the insured with
OF INSURANCE, the rules below fix the most we knowledge of its falsity.
will pay for"property damage"under this provision:
(1) $25,000 any one"occurrence", regardless of the c. Material Published Prior To Policy Period
number of persons or organizations who sustain °Personal and advertising injury° arising out of
damages because of that"occurrence"; oral, written, televised, videotaped or electronic
publication, in any manner, of material whose
(2) $50,000 annual aggregate; and first publication took place before the beginning
(3) We will pay only for damages in excess of of the policy period.
$2,500 as a result of any one "occurrence", re-
gardless of the number of persons or organiza-
tions who sustain damages because of that "oc-
currence". We may, or if required by law, pay all
or any part of any deductible amount, if applica-
ble, to effect settlement of any claim or "suit".
Upon notice of our payment of a deductible
amount, you shall promptly reimburse us for the
part of the deductible amount we paid
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission Page 3 of 10
SUPPLEMENTARY PAYMENTS—COVERAGES A The following are added:
AND B C. Blanket Additional Insured — Vendors — As Re-
E. Supplementary Payments—Coverages A and B quired By Contract
Item 1. is amended by replacing Subparagraphs b. 1. Section II —Who Is An Insured is amended to
and d.with the following. include as an additional insured any person(s)or
b. Up to $5,000 for cost of bail bonds required be- organization(s) (referred to throughout this
causeaccidents500o traffic law violationsqaris-bendorsement as vendor) with whom you have
ing out ofothuseof ant ay vehicle to which the loagreed in a written contract, executed prior to
Bodily Injury Liability Coverage applies. We do with, torrenaspect
tao an additionalinjury
insured,orbut eronty
not have to furnish these bonds. damage"ge"aris to out"bodilyy r r d is "property
arising of"your products"which are
d. All reasonable expenses incurred by the insured distributed or sold in the regular course of the
at our request to assist us in the investigation or vendor's business
defense of the claim or "suit", including actual However,
loss of earnings up to $500 a day because of a. The insurance afforded to such vendor only
time off from work. applies to the extent permitted by law; and
b. If coverage provided to the vendor is
SECTION II—WHO IS AN INSURED AMENDMENTS required by a contract or agreement, the
insurance afforded to such vendor will not
A. Employee Bodily Injury To A Co-Employee
be broader than that which you are required
Paragraph 2.a.(1)is replaced by the following. by the contract or agreement to provide for
(1) "Bodily injury" or "personal and advertising such vendor.
injury'' 2. With respect to the insurance afforded to these
(a) To you, to your partners or members (if you vendors, the following additional exclusions
are a partnership or joint venture), to your apply
members (if you are a limited liability corn- a. The insurance afforded the vendor does not
pany), or to your other "volunteer workers" apply to:
while performing duties related to the con- (1) "Bodily injury" or "property damage" for
duct of your business; which the vendor is obligated to pay
(b) For which there is any obligation to share damages by reason of the assumption
damages with or repay someone else who of liability in a contract or agreement.
must pay damages because of the injury This exclusion does not apply to liability
described in Paragraph(1)(a)above;or for damages that the vendor would have
(c) Arising out of his or her providing or failing to in the absence of the contract or
provide professional health care services. agreement;
B. Newly Acquired Organizations (2) Any express warranty unauthorized by
Paragraph 3.a. is replaced by the following: you;
a. Coverage under thisprovision is afforded only (3) Any physical or chemical change in the
9 product made intentionally by the
until the 180th day after you acquire or form the vendor,
organization or the end of the policy period,
whichever is earlier, (4) Repackaging, except when unpacked
solely for the purpose of inspection,
demonstration, testing, or the
substitution of parts under instructions
from the manufacturer, and then
repackaged in the original container;
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc,oath its permission. Page 4 of 10
(5) Any failure to make such inspections, 4. With respect to the insurance afforded to these
adjustments, tests or servicing as the vendors, the following is added to Section III —
vendor has agreed to make or normally Limits Of Insurance:
undertakes to make in the usual course
of business, in connection with the If coverage provided to the vendor is required by
distribution or sale of the products; a contract or agreement,the most we will pay on
behalf of the vendor is:
(6) Demonstration, installation, servicing or
repair operations, except such a. The minimum amount required by the
operations performed at the vendor's contract or agreement; or
premises in connection with the sale of b. The Limits of Insurance shown in the
the product; Declarations;
(7) Products which, after distribution or sale whichever is less.
by you, have been labeled or relabeled
or used as a container, part or This endorsement shall not increase the
ingredient of any other thing or applicable Limits of Insurance shown in the
substance by or for the vendor;or Declarations.
(8) "Bodily injury or "property damage" 5. With respect to the insurance afforded to these
arising out of the sole negligence of the additional insureds, the following additional
vendor for its own acts or omissions or exclusion applies:
those of its employees or anyone else This insurance does not apply to:
acting on its behalf However, this
exclusion does not apply to. a. "Bodily injury", "property damage" or
exceptions in "personal and advertising injury" arising out
(i) The exions containedof the rendering of, or the failure to render,
Subparagraphs(4)or(6);
any professional architectural, engineering
(ii) Such inspections, adjustments,tests or surveying services, including:
or servicing as the vendor has (1) The preparing, approving, or failing to
agreed to make or normally prepare or approve, maps, shop
undertakes to make in the usual drawings, opinions, reports, surveys,
course of business, in connection field orders, change orders or drawings
with the distribution or sale of the and specifications; or
products.
3. This Provision C.does nota I (2) Supervisory, inspection, architectural or
apply. engineering activities.
a. To any insured person or organization from This exclusion applies even if the claims
whom you have acquired such products, or against an additional insured allege
any ingredient, part or container, entering negligence or other wrongdoing in the
into, accompanying or containing such supervision, hiring, employment,training
products, or monitoring of others by that insured, if
b. To any vendor for which coverage as an the "occurrence" which caused the
additional insured specifically is scheduled "bodily injury° or "property damage", or
by endorsement; or the offense which caused the "personal
c. When liability included within the "products- and advertising injury", involved the
completed operations hazard" has been ex- rendering of or failure to render any
eluded for such product either by the provi- professional services by you with
sions of the coverage part or by endorse- respect to your providing engineering,
ment. architectural or surveying services in
your capacity as an engineer, architect
or surveyor.
WN GL 39 07 15 Includes copyrighted malenal of the Insurance Service Office,Inc,with Its permission Page 5 of 10
D4. With respect to the insurance afforded to these
D. Blanket Additional Insured — Lessor Of Leased
Equipment additional insureds, the following additional
exclusion applies:
1. Section II —Who Is An Insured is amended to This insurance does not apply to:
include as an additional insured any person(s)or
organization(s) from whom you lease equipment a. "Bodily injury", "property damage" or
when you and such person(s) or organization(s) "personal and advertising injury' arising out
have agreed in writing in a contract or of the rendering of, or the failure to render,
agreement, executed prior to loss, that such any professional architectural, engineering
person(s) or organization(s) be added as an or surveying services, including
additional insured on your policy. Such (1) The preparing, approving, or failing to
person(s) or organization(s) is an insured only prepare or approve, maps, shop
with respect to liability for "bodily injury", drawings, opinions, reports, surveys,
"property damage" or "personal and advertising field orders, change orders or drawings
injury" caused, in whole or in part, by your and specifications: or
maintenance, operation or use of equipment
leased to you by such person(s) or (2) Supervisory, inspection, architectural or
organization(s). engineering activities.
However, the insurance afforded to such This exclusion applies even if the claims
additional insured: against an additional insured allege
negligence or other wrongdoing in the
a. Only applies to the extent permitted by law,
and supervision, hiring, employment, training or
monitoring of others by that insured, if the
b. Will not be broader than that which you are "occurrence° which caused the "bodily
required by the contract or agreement to injury or"property damage", or the offense
provide for such additional insured. which caused the "personal and advertising
A person's or organization's status as an addi- injury", involved the rendering of or failure to
tional insured under this endorsement ends render any professional services by you with
when their contract or agreement with you for respect to your providing engineering,
such leased equipment ends. architectural or surveying services in your
2. With respect to the insurance afforded to these capacity as an engineer, architect or
additional insureds, this insurance does not ap- surveyor.
ply to any "occurrence" which takes place after E. Blanket Additional Insured — Managers Or Les-
the equipment lease expires. sors Of Premises
3. With respect to the insurance afforded to these 1. Section II —Who Is An Insured is amended to
additional insureds, the following is added to include as an additional insured any person(s)or
Section III—Limits Of Insurance: organization(s)with whom you have agreed in a
If coverage provided to the additional insured is written contract, executed prior to loss, to name
required by a contract or agreement, the most as an additional insured, but only with respect to
we will pay on behalf of the additional insured is: liability arising out of the ownership,
a. The minimum amount required by the maintenance or use of that part of the premises
contract or agreement; or leased to you, subject to the following additional
b. The Limits of Insurance shown in the exclusions:
Declarations: This insurance does not apply to:
whichever is less. a. Any "occurrence" which takes place after
This endorsement shall not increase the you cease to be a tenant in that premises.
applicable Limits of Insurance shown in the b. Structural alterations, new construction or
Declarations. demolition operations performed by or on
behalf of such additional insured.
WN GL 39 07 15 Includes copyrighted malenal of the Insurance Service Office, Inc,with its permission. Page 6 of 10
However: F. Blanket Additional Insured — State Or
a. The insurance afforded to such additional Governmental Agency Or Subdivision Or Politi-
insured only applies to the extent permitted cal Subdivision—Permits Or Authorizations
by law; and Section II — Who Is An Insured is amended to in-
b. If coverage provided to the additional crude as an additional insured any state or
insured is required by a contract or governmental agency or subdivision or political
agreement, the insurance afforded to such subdivision with whom you have agreed in a written
additional insured will not be broader than contract, executed prior to loss, to name as an
that which you are required by the contract additional insured, subject to the following
or agreement to provide for such additional provisions:
insured 1. This insurance applies only with respect to op-
2. With respect to the insurance afforded to these erations performed by you or on your behalf for
additional insureds, the following is added to which the state or governmental agency or sub-
Section III—Limits Of Insurance: division or political subdivision has issued a
If coverage provided to the additional insured is permit or authorization.
required by a contract or agreement, the most However:
we will pay on behalf of the additional insured is: a. The insurance afforded to such additional
a. The minimum amount required by the insured only applies to the extent permitted
contract or agreement; or by law; and
b. The Limits of Insurance shown in the b. If coverage provided to the additional
Declarations, insured is required by a contract or
whichever is less agreement, the insurance afforded to such
additional insured will not be broader than
This endorsement shall not increase the that which you are required by the contract
applicable Limits of Insurance shown in the or agreement to provide for such additional
Declarations. insured.
3. With respect to the insurance afforded to these 2. This insurance does not apply to:
additional insureds, the following additional a. "Bodily injury", "property damage" or "per-
exclusion applies sonal and advertising injury" arising out of
This insurance does not apply to: operations performed for the federal govern-
a. "Bodily injury", "property damage" or ment,state or municipality, or
"personal and advertising injury" arising out b. "Bodily injury' or "property damage" in-
of the rendering of, or the failure to render, eluded within the "products-completed op-
any professional architectural, engineering erations hazard".
or surveying services, including: 3. With respect to the insurance afforded to these
(1) The preparing, approving, or failing to additional insureds, the following is added to
prepare or approve, maps, shop Section III—Limits Of Insurance:
drawings, opinions, reports, surveys, If coverage provided to the additional insured is
field orders, change orders or drawings required by a contract or agreement, the most
and specifications;or we will pay on behalf of the additional insured is:
(2) Supervisory, inspection, architectural or a. The minimum amount required by the
engineering activities. contract or agreement; or
This exclusion applies even if the claims b. The Limits of Insurance shown in the
against an additional insured allege Declarations;
negligence or other wrongdoing in the
supervision, hiring, employment, training or whichever is less.
monitoring of others by that insured, if the This endorsement shall not increase the
"occurrence" which caused the "bodily applicable Limits of Insurance shown in the
injury or "property damage", or the offense Declarations.
which caused the "personal and advertising
injury", involved the rendering of or failure to
render any professional services by you with
respect to your providing engineering,
architectural or surveying services in your
capacity as an engineer, architect or
surveyor.
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc,with Its permission Page 7 of 10
4. With respect to the insurance afforded to these b. The construction, erection or removal of
additional insureds, the following additional elevators; or
exclusion applies: c. The ownership, maintenance or use of any
This insurance does not apply to elevators covered by this insurance
a. "Bodily injury", "property damage" or However,
"personal and advertising injury' arising out a. The insurance afforded to such additional
of the rendering of, or the failure to render, insured only applies to the extent permitted
any professional architectural, engineering by law;and
or surveying services, including: b. If coverage provided to the additional
(1) The preparing, approving, or failing to insured is required by a contract or
prepare or approve, maps, shop agreement, the insurance afforded to such
drawings, opinions, reports, surveys, additional insured will not be broader than
field orders, change orders or drawings that which you are required by the contract
and specifications; or or agreement to provide for such additional
(2) Supervisory, inspection, architectural or insured
engineering activities. 2. With respect to the insurance afforded to these
This exclusion applies even if the claims additional insureds, the following is added to
against an additional insured allege Section III—Limits Of Insurance:
negligence or other wrongdoing in the If coverage provided to the additional insured is
supervision, hiring, employment, training or required by a contract or agreement, the most
monitoring of others by that insured, if the we will pay on behalf of the additional insured is:
"occurrence" which caused the °bodily
injury or "property damage", or the offense a. The minimum amount required by the
which caused the "personal and advertising contract or agreement; or
injury", involved the rendering of or failure to b. The Limits of Insurance shown in the
render any professional services by you with Declarations;
respect to your providing engineering,
architectural or surveying services in your whichever is less.
capacity as an engineer, architect or This endorsement shall not increase the
surveyor applicable Limits of Insurance shown in the
Declarations.
G. Blanket Additional Insured — State Or 3. With respect to the insurance afforded to these
Governmental Agency Or Subdivision Or Politi- additional insureds, the following additional
cal Subdivision — Permits Or Authorizations Re- exclusion applies.
lating To Premises This insurance does not apply to:
Section II —Who Is An Insured is amended to in- a. "Bodily injury", "property damage" or
dude as an additional insured any state or "personal and advertising injury arising out
governmental agency or subdivision or political of the rendering of, or the failure to render,
subdivision with whom you have agreed in a written any professional architectural, engineering
contract, executed prior to loss, to name as an or surveying services, including:
additional insured, subject to the following provision: (1) The preparing, approving, or failing to
1. This insurance applies only with respect to the prepare or approve, maps, shop
following hazards for which the state or drawings, opinions, reports, surveys,
governmental agency or subdivision or political field orders, change orders or drawings
subdivision has issued a permit or authorization and specifications; or
in connection with premises you own, rent or (2) Supervisory, inspection, architectural or
control and to which this insurance applies: engineering activities.
a. The existence, maintenance, repair,
construction, erection or removal of
advertising signs, awnings, canopies, cellar
entrances, coal holes, driveways, manholes,
marquees, hoist away openings, sidewalk
vaults, street banners or decorations and
similar exposures; or
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 8 of 10
This exclusion applies even if the claims
against an additional insured allege SECTION IV — COMMERCIAL GENERAL LIABILITY
negligence or other wrongdoing in the CONDITIONS AMENDMENTS
supervision, hiring, employment, training or A. Knowledge Of Occurrence
monitoring of others by that insured, if the
"occurrence" which caused the "bodily Item 2. Duties In The Event Of Occurrence, Of-
injury" or "property damage", or the offense fense, Claim or Suit is amended by adding the fol-
which caused the "personal and advertising lowing.
injury", involved the rendering of or failure to e. You must give us or our authorized representa-
render any professional services by you with tive prompt notice of an "occurrence", claim or
respect to your providing engineering, loss only when the"occurrence", claim or loss is
architectural or surveying services in your known to:
capacity as an engineer, architect or (1) You, if you are an individual;
surveyor.
(2) A partner, if you are a partnership;
SECTION III — LIMITS OF INSURANCE AMEND- (3) An executive officer or insurance manager, if
MENTS you are a corporation;or
A. Damage To Premises Rented To You (4) A member or manager, if you are a limited
Paragraph 6. is replaced by the following: liability company.
6. Subject to Paragraph 5. above, the most we will B. Other Insurance
pay under Coverage A for damages because of Item 4. Other Insurance, b. Excess Insurance (1)
"property damage" to any one premises, while (a)(ii)is replaced by the following:
rented to you, or in the case of damage by fire, (ii) That is fire, lightning, explosion or sprinkler leak-
lightning, explosion or sprinkler leakage, while age insurance for premises rented to you or
rented to you or temporarily occupied by you temporarily occupied by you with permission of
with permission of the owner is the greater of: the owner;
a. $300,000;or C. Unintentional Failure To Disclose Hazards
b. The amount shown next to the Damage To Item 6. Representations is replaced by the
Premises Rented To You Limit in the Decla- following
rations. 6. Representations And Unintentional Failure
However,the provisions of this paragraph do not To Disclose Hazards
apply if Damage To Premises Rented To You a. By accepting this policy, you agree:
Coverage is excluded by endorsement. (1) The statements in the Declarations are
B. Medical Expense Limit accurate and complete;
Paragraph 7. is replaced with the following. (2) Those statements are based upon
7. Subject to Paragraph 5. above, the most we will representations you made to us;and
pay under Coverage C for all medical expenses (3) We have issued this policy in reliance
because of"bodily injury" sustained by any one upon your representations
person is the greater of: b. If you unintentionally fail to disclose any haz-
a. $10,000; or ards existing at the inception date of your
b. The amount shown next to the Medical Ex- policy, we will not deny coverage under this
pence Limit in the Declarations. Coverage Part because of such failure.
However, this provision does not affect our
This insurance does not apply if coverage for right to collect additional premium or exer-
Medical Expenses is excluded either by the pro- cise our right of cancellation or non-renewal.
visions of the coverage part or by endorsement.
WN GL 39 07 15 Includes copyrighted maledal of the Insurance Service Office,Inc,with its permission. Page 9 of 10
D. Waiver of Subrogation SECTION V—DEFINITIONS AMENDMENTS
Item 8. Transfer of Rights of Recovery Against A. Insured Contract Amended
Others to Us is hereby amended by the addition of
Paragraph 9.a.is replaced by the following:
the following.
We waive any right of recovery we may have be- a. A contract for a lease of premises However,
cause of payments we make for injury or damage that portion of the contract for a lease of prem-
arising out of your ongoing operations or"your work" ises that indemnifies any person or organization
done under a written contract, executed prior to loss, for damage by fire, lightning, explosion or sprin-
requiring such waiver with that person or organiza- kler leakage to premises while rented to you or
tion and included in the "products-completed opera- temporarily occupied by you with permission of
tions hazard" However, our rights may only be the owner is not an "insured contract",
waived prior to the "occurrence" giving rise to the B. Personal And Advertising Injury Redefined
injury or damage for which we make payment under Paragraph 14. d. and e are replaced by the follow-
this Coverage Part. The insured must do nothing ing:
after a loss to impair our rights. At our request, the
insured will bring "suit" or transfer those rights to us d. Oral, written, televised, videotaped or electronic
and help us enforce those rights. publication of material that slanders or libels a
person or organization or disparages a person's
or organization's goods, products or service;
e. Oral, written, televised, videotaped or electronic
publication of material that violates a person's
right of privacy;
WN GL 39 07 15 Includes copyrighted material of the insurance Service Office,Inc.,with Its permission. Page 10 of 10
la.n Luau„I r 011 L. :Search L61 ] SEARCH
IL I.
Sorely d Health claims er b anraoae Warred).e Rights Trades a Licensing
Washington State Department of
JLabor & Industries
NORTHWEST PLAYGROUND EQUIP INC
Owner or lrade_genan PO BOX 2410
Principals ISSAQUAH,WA 911021
MCGARVEY,ROBERTS 425-313-9161
KING County
MCGARVEY,CAROLYN C
Doig business as
NORTHWEST PLAYGROUND EQUIP INC
WA IAN No. Business type
501091557 Corporation
Governing persons
CAROLYN
C
MC GARVEY
ROBERTS MC GARVEY,
Certifications 8 Endorsements
OMWOE Certifications
Noecl re urflkaUo setlN roc Wsbusiness
Appron ed tto o have
Aeent
to
Not allowed have apprentices.
License
WM&the con*acb s active reglskation I Tions/cerNkation(depemmn°on trade/and any post violations-
Construction Contractor ACdve.
Meets current requirements.
License specialties
GENERAL
License no.
NORTHPE044DJ
EfeeNe—espiNbn .
03/11/1990-03/1W2020
Bond
CHIC $12,000.00
Bond access no.
SA1740
Received by ISl Effective dale
02/21/2002 0.3/01/2002
EsybeUon date
Until Canceled
neuronal
Western National Assur Co $1,000,000.00
Poky no.
CPP103I2100S Help LIS improve
Received by LSI Effective dab
02125/2019 03/0112016
Expiation date
03101/2020
Insurance history
Facings
No savings accounts during the prevlofm 6 year Period.
LawsWts Nernst the bond or savings
No lawsu0s against the bond or aavbp accounts during the previous 6 year period.
LEI Tax debts
No LSI tax debts are recorded for this contractor license during the previous 6 year period,but seine debts
may be recorded by other agencies.
Lions.Viatstions
!drachm no. Satlsiied
NCZIK01020
Issue date RCWM'AC
02/14/2014 1621200(1)(e)RCW
Violation city Vtlalion amount
ISSAQUAH $1,000A0
Type of violation
CONSTRUCTION INFRACTION
Descrgibn
Subcontracting to or using an ureeglstered
contractor.Northwest Playground Equip Inc
contracted alt Aquaseal Resurfacing LLC on
orabout 1/3/2013 who was an unregistered
sub contractor.
Workers' comp
Do you know Rte business has employees?If so.verify the busli ss Is up-to-date on workers'comp premiums.
Ill Account ID Account Is current.
cosawo
Doing business as
NORTHWEST PLAYGROUND EaUWMENT
Estimated workers reported
Quarter 2 of Year 2019'11 to 20 W orbs•
LSI account contact
T3/KENT ANDERSON(360)002-6963- W:ANON235@bi.wa.gov
Public Works Requirements J
Ve&y the contractor Is eligible to perform work on public works pro(ects.
Regtired Training—Effective July 1,2019
Exempt from gds nook/rrenl
Contractor Strikes
No strikes have bean issued against this contractor.
Contractors not allowed to Md
No debarments have been Issued against this contractor.
Workplace safety and health
No inspections during the previous 0 year period.
a W ahegwn Slate cep.of Lshun lridwebs Use of IS uu is=bled to Ore tons cd the able of WbelrnalOn.
Help us improve
Spokaneller
BOND NO: BD762977
CONTRACTOR'S PERFORMANCE BOND
to City of Spokane Valley,Washington
The City of Spokane Valley, Washington, in Spokane County, has awarded to Northwest Playground Equipment, Inc.
(Contractor),as Principal,a contract for the construction of the project designated as Discovery Playground Poured-In-Place
Surfacing Repair Protect,Project No.19-127 in Spokane Valley,Washington,and said Principal is required under the terms
of the Contract to furnish a performance bond in accordance with chapter 39.08 Revised Code of Washington(RCW).
The Principal, and Nationwide Mutual Insurance Company (surety), a corporation,
organized under the laws of Ohio and licensed to do business in the State of Washington as surety and named
in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff
Bureau of Accounts,U.S.Treasury Dept,are jointly and severally held and firmly bound to the City of Spokane Valley,as
Obligee,in the sum of$20,060.62 total Contract amount (including Washington State sales tax), subject to the
provisions herein.
This performance bond shall become null and void,if and when the Principal,its heirs,executors,administrators,successors,
or assigns shall well and faithfully perform all of the Principal's obligations under the Contract and fulfill all the terms and
conditions of all duly authorized modifications,additions,and changes to said Contract that may hereafter be made,at the time
and in the manner therein specified;shall warranty the work as provided in the Contract and shall indemnify and hold harmless
the Obligee from any defects in the workmanship and materials incorporated into the work for the period identified in the
Contract;and if such performance obligations have not been fulfilled,this bond shall remain in full force and effect.
The Surety for value received agrees that no change,extension of time,alteration or addition to the terms of the Contract,the
specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its
obligation on this bond,and waives notice of any change,extension of time,alteration or addition to the terms of the Contract
or the work performed. The Surety agrees that modifications and changes to the terms and conditions of the Contract that
increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety on this bond and
notice to Surety is not required for such increased obligation.
This bond may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers.This bond
will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf
of the surety. Northwest Playground Nationwide Mutual
PRLNCIPAL(CONTRACTOR)Equipment, Inc. Suppqy InsuranceICompany
ief/4 9/S� f� �/I dbt IW 9/4/2019
Principal Signature Date Surety Signature / Date
6a 6 M eLori McKimmy
Printed Name Printed Name
P< tea,* Attorney-in-Fact
Title Title
Name,address,and telephone of local office/agent of Surety Company is:
Kennth J. Frick
112 South Fourth Street,Yakima, WA 98901 509-245-3515
Updated 1.14.2013
spam/�
BOND NO: BD762977
CONTRACTOR'S PAYMENT BOND(NON-FEDERALLY FUNDED PROJECT)
to City of Spokane Valley,Washington
The City of Spokane Valley, Washington, in Spokane County, has awarded to Northwest Playground Equipment. Inc.
(Contractor),as Principal,a contract for the construction of the project designated as Discovery Playground Poured-In-Place
Surfacing Repair Project,Project No. 19-127.00 in Spokane Valley,Washington,and said Principal is required under the
terms of the Contract to furnish a payment bond in accordance with chapter 39.08 Revised Code of Washington(RCW).
The Principal, and Nationwide Mutual Insurance Company (Surety), a corporation
organized under the laws Ohio and licensed to do business in the State of Washington as surety and named in
the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff
Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,as
Obligee,in the sum of$20,060.62 total Contract amount (including Washington State sales tax), subject to the
provisions herein.
This payment bond shall become null and void,if and when the Principal, its heirs,executors,administrators,successors,or
assigns shall pay all persons in accordance with chapters 39.08 and 39.12 RCW, including all workers, laborers,mechanics,
subcontractors,and materialmen,and all persons who shall supply such contractor or subcontractor with provisions and supplies
for the carrying on of such work;and shall indemnify and hold harmless the Obligee from all loss,cost or damage which
Obligee may suffer by reason of the failure of Principal to make such required payments;and if such payment obligations have
not been fulfilled,this bond shall remain in full force and effect.
The Surety for value received agrees that no change,extension of time,alteration or addition to the terms of the Contract,the
specifications accompanying the Contract, or to the work to be performed under the Contract shall in any way affect its
obligation on this bond,except as provided herein,and waives notice of any change,extension of time,alteration or addition
to the terms of the Contract or the work performed.The Surety agrees that modifications and changes to the terms and conditions
of the Contract that increase the total amount to be paid the Principal shall automatically increase the obligation of the Surety
on this bond and notice to Surety is not required for such increased obligation.
This bond may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers.This bond
will only be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf
of the surety.
Northwest Playground Nationwide Mutual
PRINCIPAL(CONTRACTOR)Equipment, Inc. SURETY Insurance Company
ifA .i( `_. 4 f lr F UMU, i lYtk 9/4/2019
Principal Signature Date Surety Signature Date
Gob (ane LC."w01r Lori McKimmy
Printed Name Printed Name
Pre y Lula., Attorney-in-Fact
Title Title
Name,address,and telephone of local office/agent of Surety Company is:
Kenneth J. Frick
112 South Fourth Street,Yakima, WA 98901 509-248-3515
Updated 1.14.2013
Power of Attorney
KNOW ALL MEN BY THESE PRESENTS THAT:
Nationwide Mutual Insurance Company,an Ohio corporation AMCO Insurance Company,an Iowa corporation
Allied Property and Casualty Insurance Company,an Iowa corporation
hereinafter referred to severally as the"Company"and collectively as"the Companies"does hereby make,constitute and appoint:
RODNEY C LEWIS DONNA S.MARTINEZ LORI MCKIMMY KENNETH I.FRICK AARON M.MCCOY
each In their individual capacity,its true and lawful attorney-in-fact,with full power and authority to sign,seal.and execute an Its behalf any and all bonds and
undertakings,and other obligatory instruments of similar nature,In penalties not exceeding the sum of
TEN MILLION AND NO/100 DOLLARS $10,000,000.00
and to bind the Company thereby.as fully and to the same extent as If such instruments were signed by the duly authonzed officers of the Company;and all acts
of said Attorney pursuant to the authority given are hereby ratified and confirmed.
This power of attorney is made and executed pursuant to and by authority of the following resolution duly adopted by the board of directors of the Company
'RESOLVED,that the president,or any vice president be,and each hereby Is,authorized and empowered to appoint attorneys-in-fact of the Company.
and lo authorize them to execute and deliver on behalf of the Company any and all bonds,forms,applications,memorandums,undertakings,
recognlzances,transfers,contracts of indemnity,policies,contracts guaranteeing the fidelity of persons holding positions of public or private bust,and other
wrtbngs obligatory in nature that the business of the Company may require;and to modify or revoke,with or without cause,any such appointment or
authority:provided,however,that the authority granted hereby shall in no way limit the authority of other duly authorized agents to sign and countersign any
of said documents on behalf of the Company'
"RESOLVED FURTHER,that such attorneys-in-fact shall have full power and authority to execute and deliver any and all such documents and to bind the
Company subject to the terms and limitations of the power of attorney Issued to them,and to affix the seal of the Company thereto:provded,however,that
said seal shall not be necessary far the validity of any such documents.'
This power of attorney Is signed and sealed under and by the following bylaws duly adopted by the board of directors of the Company.
Execution of Instruments.Any vice president,any assistant secretary or any assistant treasurer shall have the power and authonty to signor attest all
approved documents,Instruments,contracts,or other papers in connection with the operation of the business of the company in addition to the chairman of
the board,the chief executive officer,president,treasurer or secretary;provided.however,the signature of any of them may be panted,engraved.or
stamped on any approved document,contract,instrument,or other papers of the Company.
IN WITNESS WHEREOF,the Company has caused this instrument opesealedanand du
y attested by the signature of Its officer the 27" day of February,2019
� w.��, I1 �` Antonio C.Albanese,Vice President of Nationwide Mutual Insurance Company.AMCO Insurance
/$yrs'.. li s$ k Company,Allied Property and Casualty Insurance Company
•.(SEAL 40 i jSF.Ai. / ACKNOWLEDGMENT
, wxnm.S `"•., :� STATE OF NEW YORK,COUNTY OFNEW YORK:ss
,�=�e /,,=v/ On this 2T`clay of February 2019 before me came the above-named officer for the Company
aforesaid,to me personally known to be the officer described in and who executed the preceding
instrument,and he acknowledged the execution of the same,and being by me duly sworn,deposes
� and says,that he is the officer of Me Company aforesaid,that the seal affixed hereto Is the
eww , corporate seal of said Company,and the said corporate seal and his signature were duly affixed
O `
/SSEALsand subscribed to said instrument by the authority and direction of said Company
� •
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CERTIFICATE m.mIawn
I,Laura B.Guy.Assistant Secretary of the Company,do hereby certify that the foregoing is a full.true end correct copy of the original power of attorney Issued
by the Company,that the resolution included therein is a true and correct transcript from the minutes of the meetings of the boards of directors and the same has
not been revoked or amended in any manner;that said Antonio C.Albanese was on the date of the execution of the foregoing power of attorney the duly elected
officer of the Company,and the corporate seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority of said board
of directors;and the foregoing power of attorney is still in full force and effect
IN WITNESS WHEREOF.I have hereunto subscnbed my name as Assistant Secretary,and affixed the corporate seal of said Company this 4th day of
September 2019 6v"..„
Assistant Secretary
SOJ 1(02-19)00
46-06533