Loading...
19-201.00 Belsby Engineering: Survey Data Review Contract No. 19-201 AGREEMENT FOR PROFESSIONAL SERVICES Horrocks Engineers,Inc.dba Belsby Engineering THIS AGREEMENT is made by and between the City of Spokane Valley,a code City of the State of Washington, hereinafter "City" and Horrocks Engineers, Inc. dba Belsby Engineering, hereinafter "Consultant,"jointly referred to as"Parties." IN CONSIDERATION of the terms and conditions contained herein,the Parties agree as follows: 1.Work to Be Performed. Consultant shall provide all labor,services,and material to satisfactorily complete the Scope of Services,attached as Exhibit A. A. Administration. The City Manager or designee shall administer and be the primary contact for Consultant. Prior to commencement of work,Consultant shall contact the City Manager or designee to review the Scope of Services, schedule, and date of completion. Upon notice from the City Manager or designee,Consultant shall commence work,perform the requested tasks in the Scope of Services, stop work,and promptly cure any failure in performance under this Agreement. B. Representations. City has relied upon the qualifications of Consultant in entering into this Agreement. By execution of this Agreement,Consultant represents it possesses the ability,skill,and resources necessary to perform the work and is familiar with all current laws,rules, and regulations which reasonably relate to the Scope of Services. No substitutions of agreed-upon personnel shall be made without the prior written consent of City. Consultant represents that the compensation as stated in paragraph 3 is adequate and sufficient for the timely provision of all professional services required to complete the Scope of Services under this Agreement. Consultant shall be responsible for the technical accuracy of its services and documents resulting therefrom, and City shall not be responsible for discovering deficiencies therein. Consultant shall correct such deficiencies without additional compensation except to the extent such action is directly attributable to deficiencies in City-furnished information. C.Standard of Care. Consultant shall exercise the degree of skill and diligence normally employed by professional consultants engaged in the same profession,and performing the same or similar services at the time such services are performed. D. Modifications. City may modify this Agreement and order changes in the work whenever necessary or advisable. Consultant shall accept modifications when ordered in writing by the City Manager or designee, so long as the additional work is within the scope of Consultant's area of practice. Compensation for such modifications or changes shall be as mutually agreed between the Parties. Consultant shall make such revisions in the work as are necessary to correct errors or omissions appearing therein when required to do so by City without additional compensation. 2. Term of Contract. This Agreement shall be in full force and effect upon execution and shall remain in effect until completion of all contractual requirements have been met as determined by City. Consultant shall complete its work by December 31,2020,unless the time for performance is extended in writing by the Parties. Agreement for Professional Services(with professional liability coverage) Page 1 of 9 Contract No. 19-201 Either Party may terminate this Agreement for material breach after providing the other Party with at least 10 days'prior notice and an opportunity to cure the breach. City may,in addition,terminate this Agreement for any reason by 10 days'written notice to Consultant. In the event of termination without breach,City shall pay Consultant for all work previously authorized and satisfactorily performed prior to the termination date. 3. Compensation. City agrees to pay Consultant an agreed upon hourly rate up to a maximum amount of $35,000 as full compensation for everything done under this Agreement,as set forth in Exhibit B. Consultant shall not perform any extra, further, or additional services for which it will request additional compensation from City without a prior written agreement for such services and payment therefore. 4. Payment. Consultant shall be paid monthly upon presentation of an invoice to City. Applications for payment shall be sent to the City Finance Department at the below-stated address. 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 Scope of Services, City standards,City Code,and federal or state standards. 5.Notice. Notices other than applications for payment shall be given in writing as follows: TO THE CITY: TO THE CONSULTANT: Name: Christine Bainbridge, City Clerk Name: Horrocks Engineers,Inc. dba Belsby Engineering do Duane Zimmerman,PLS Phone: (509)720-5000 Phone: (509)747-6790 Address: 10210 East Sprague Avenue Address: 1325 W. 1"Ave, Suite 204 Spokane Valley,WA 99206 Spokane,WA 99201 6.Applicable Laws and Standards. The Parties,in the performance of this Agreement,agree to comply with all applicable federal, state, and local laws and regulations. Consultant states that its designs, construction documents, and services shall conform to all federal,state,and local statutes and regulations. 7. Certification Retarding 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; Agreement for Professional Services(with professional liability coverage) Page 2 of 9 Contract No. 19-201 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.Relationship of the Parties. It is understood and agreed that Consultant shall be an independent contractor and not the agent or employee of City,that City is interested in only 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 Consultant. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Consultant. The Consultant shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 9. Ownership of Documents. All drawings,plans, specifications,and other related documents prepared by Consultant 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. The written, graphic, mapped, photographic, or visual documents prepared by Consultant under this Agreement shall, unless otherwise provided, be deemed the property of City. City shall be permitted to retain these documents, including reproducible camera-ready originals of reports,reproduction quality mylars of maps,and copies in the form of computer files, for the City's use. City shall have unrestricted authority to publish, disclose,distribute, and otherwise use, in whole or in part,any reports,data,drawings,images,or other material prepared under this Agreement,provided that Consultant shall have no liability for the use of Consultant's work product outside of the scope of its intended purpose. 10.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 Consultant'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. 11. Insurance. Consultant 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 Consultant,its agents,representatives,employees,or subcontractors. A.Minimum Scope of Insurance. Consultant shall obtain insurance of the types described below: 1.Automobile liability insurance covering all owned,non-owned,hired,and leased vehicles. Coverage shall be written on Insurance Services Office(ISO)form CA 00 01 or a substitute form providing equivalent liability coverage. 2. Commercial general liability insurance shall be at least as broad as ISO occurrence form CG 00 01 and shall cover liability arising from premises,operations, stop-gap independent contractors and personal injury,and advertising injury. City shall be named as an additional insured under Consultant's commercial general liability insurance policy with respect to the Agreement for Professional Services(with professional liability coverage) Page 3 of 9 Contract No. 19-201 work performed for the City using an additional insured endorsement at least as broad as ISO CG 20 26. 3.Workers'compensation coverage as required by the industrial insurance laws of the State of Washington. 4. Professional liability insurance appropriate to Consultant's profession. B. Minimum Amounts of Insurance. Consultant shall maintain the following insurance limits: 1.Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of no less than$1,000,000 per accident. 2.Commercial general liability insurance shall be written with limits no less than$1,000,000 for each occurrence, and $2,000,000 for general aggregate. 3. Professional liability insurance shall be written with limits no less than $1,000,000 per claim and$1,000,000 policy aggregate limit. C. Other Insurance Provisions. The policies are to contain,or be endorsed to contain,the following provisions for automobile liability and commercial general liability insurance: 1.Consultant's insurance coverage shall be primary insurance with respect to the City. Any insurance,self-insurance,or insurance pool coverage maintained by City shall be in excess of Consultant's insurance and shall not contribute with it. 2. Consultant shall fax or send electronically in .pdf format a copy of insurer's cancellation notice within two business days of receipt by Consultant. 3.If Consultant 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 Consultant,irrespective of whether such limits maintained by Consultant 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 Consultant. 4. Failure on the part of Consultant to maintain the insurance as required shall constitute a material breach of the Agreement,upon which the City may,after giving at least five business days'notice to Consultant 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 Consultant from the City. D.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.Best rating of not less than A:VII. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, Consultant shall furnish acceptable insurance certificates to the City Clerk at the time Consultant returns the signed Agreement,which shall be Exhibit C. The certificate shall specify all of the parties Agreement for Professional Services(with professional liability coverage) Page 4 of 9 Contract No. 19-201 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. Consultant shall be financially responsible for all pertinent deductibles, self-insured retentions,and/or self-insurance. 12.Indemnification and Hold Harmless. Consultant 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,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 Consultant, Consultant's agents, subcontractors, subconsultants, and employees to the fullest extent permitted by law, subject only to the limitations provided below. Consultant'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 pursuant to RCW 4.24.115. Consultant'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)Consultant, Consultant's agents, subcontractors, subconsultants, and employees shall apply only to the extent of the negligence of Consultant,Consultant's agents, subcontractors, subconsultants, and employees. Consultant'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,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. Consultant 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 Consultant's waiver of immunity under this provision extends only to claims against Consultant by City,and does not include,or extend to, any claims by Consultant's employees directly against Consultant. Consultant hereby certifies that this indemnification provision was mutually negotiated. 13.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. A waiver in one instance shall not be held to be a 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. 14. 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 prior written consent of the other Party. 15.Subcontracts. Except as otherwise provided herein,Consultant shall not enter into subcontracts for any of Agreement for Professional Services(with professional liability coverage) Page 5 of 9 Contract No. 19-201 the work contemplated under this Agreement without obtaining prior written approval of City. 16.Confidentiality. Consultant may,from time-to-time,receive information which is deemed by City to be confidential. Consultant shall not disclose such information without the prior express written consent of City or upon order of a court of competent jurisdiction. 17. Jurisdiction and Venue. This Agreement is entered into in Spokane County, Washington. Disputes between City and Consultant shall be resolved in the Superior Court of the State of Washington in Spokane County. Notwithstanding the foregoing,Consultant agrees that it may,at City's request,be joined as a party in any arbitration proceeding between City and any third party that includes a claim or claims that arise out of,or that are related to Consultant's services under this Agreement. Consultant further agrees that the Arbitrator(s)' decision therein shall be final and binding on Consultant and that judgment may be entered upon it in any court having jurisdiction thereof. 18. Cost and Attorney's Fees. The prevailing party in any litigation or arbitration arising out of this Agreement shall be entitled to its attomey's fees and costs of such litigation(including expert witness fees). 19.Entire Agreement. This written Agreement constitutes the entire and complete agreement between the Parties and supersedes any prior oral or written agreements. This Agreement may not be changed,modified,or altered except in writing signed by the Parties hereto. 20. 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. 21. Business Registration. Consultant shall register with the City as a business prior to commencement of work under this Agreement if it has not already done so. 22. Severability. If any section,sentence,clause,or phrase of this Agreement should be held to be invalid for any reason by a court of competent jurisdiction,such invalidity shall not affect the validity of any other section, sentence,clause, or phrase of this Agreement. 23. Exhibits. Exhibits attached and incorporated into this Agreement are: A. Scope of Services B. Fee proposal C. Insurance Certificates D. Assurance of compliance with applicable federal law. The Parties have executed this Agreement this ay of/el:e4,11 2r ,20(9 CITY nOF SPOKANE VALLEY Consultant: Mark Calhoun,City Manager By: Its: Authorized Represent tive Agreement for Professional Services(with professional liability coverage) Page 6 of 9 Contract No. 19-201 ATTES ` pristine Bainbridge, City Clerk: c APPROVED AS TO FORM: Office o e City t hey Agreement for Professional Services(with professional liability coverage) Page 7 of 9 Contract No. 19-201 Exhibit D—Assurance of Compliance with Applicable Federal Law During the performance of this Agreement,the Consultant, for itself, its assignees, and successors in interest(hereinafter referred to as the "Consultant")agrees as follows: 1.Compliance with Regulations:The Consultant 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 a part of this Agreement. 2.Non-discrimination:The Consultant,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 Consultant 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 of 49 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 Consultant 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 Consultant of the Consultant'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 Consultant 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 Consultant is in the exclusive possession of another who fails or refuses to furnish the information, the Consultant 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 Consultant'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 Consultant under the Agreement until the Consultant complies; and/or b. cancelling,terminating,or suspending the Agreement,in whole or in part. 6.Incorporation of Provisions:The Consultant 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 Consultant 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 Consultant becomes involved in,or is threatened with litigation by a subcontractor or supplier because of such direction,the Consultant may request that the City enter into any litigation to protect the interests of the City. In addition,the Consultant 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 Consultant Agreement for Professional Services(with professional liability coverage) Page 8 of 9 Contract No. 19-201 agrees to comply with the following non-discrimination statutes and authorities;including but not limited to: 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 III 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); and 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.). Agreement for Professional Services(with professional liability coverage) Page 9 of 9 Exhibit A Scope of Services 1. As requested by the Community&Public Works Department, the Consultant shall review proposals for short and long subdivisions,binding site plans,boundary line adjustments, street vacations, and right-of-way deeds and easements. When reviewing these documents, the Consultant shall verify the components below for completeness and accuracy, as applicable: • Plat Certificates • Survey data and boundary line closure • Hearing Examiner's conditions of approval • Plat language • Required right-of-way dedications • Required easements • Legal descriptions and exhibits • Parcel ownership and grantor signatures All reviews shall be returned to the Community&Public Works Department within five business days or as otherwise instructed. Reviews shall include redlines and a list of corrections, inconsistencies and omissions. 2. Periodically, the Consultant may be asked to review other documents or perform other tasks. A supplemental scope of services listing the additional requested work may be required and submitted as an addendum to this Scope of Services. Exhibit B Fee Schedule Labor Classification Hourly Rate Surveying Survey Manager/Licensed Surveyor II $135 Project Surveyor/Licensed Surveyor $125 Survey Crew Chief/Surveyor/R/W Tech III $94 Survey R/W Tech II $80 CAD Technician $71 Reimbursable Expenses 1. Transportation by automobile at federal rate, copies, reprographics, and supplies 2. A 15% surcharge for overhead, taxes and administration shall be added to all sub-consultant and sub-contractor contractors invoices. Exhibit A Scope of Services 1. As requested by the Community&Public Works Department, the Consultant shall review proposals for short and long subdivisions,binding site plans,boundary line adjustments, street vacations, and right-of-way deeds and easements. When reviewing these documents, the Consultant shall verify the components below for completeness and accuracy, as applicable: • Plat Certificates • Survey data and boundary line closure • Hearing Examiner's conditions of approval • Plat language • Required right-of-way dedications • Required easements • Legal descriptions and exhibits • Parcel ownership and grantor signatures All reviews shall be returned to the Community&Public Works Department within five business days or as otherwise instructed. Reviews shall include redlines and a list of corrections, inconsistencies and omissions. 2. Periodically, the Consultant may be asked to review other documents or perform other tasks. A supplemental scope of services listing the additional requested work may be required and submitted as an addendum to this Scope of Services. Exhibit B Fee Schedule Labor Classification Hourly Rate Surveying Survey Manager/Licensed Surveyor II $135 Project Surveyor/Licensed Surveyor $125 Survey Crew Chief/Surveyor/R/W Tech III $94 Survey R/W Tech II $80 CAD Technician $71 Reimbursable Expenses 1. Transportation by automobile at federal rate, copies, reprographics, and supplies 2. A 15% surcharge for overhead, taxes and administration shall be added to all sub-consultant and sub-contractor contractors invoices. HORRENG-01 SBARKER ACORC!" DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 12/12/2019 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 co .CT Shauna Barker American Insurance&Investment Corp. /,aHOC No,Ext):(801)364-3434 643 I FAX No):(801)355-5234 448 South 400 East Salt Lake City,UT 84111 Miss:Shauna.Barker@american-ins.com INSURER(S)AFFORDING COVERAGE ?LAIC S INSURER A:Charter Oak Fire Ins Co 25615 INSURED INSURER B:Travelers Prop Cas Co of America 25674 Horrocks Engineers,Inc dba Belsby Engineering INSURER C:Travelers Indemnity Company 25658 2162 West Grove Parkway,Suite 400 INSURER D:XL Specialty Insurance Company 37885 Pleasant Grove,UT 84062 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) UMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X 6802J925302 7/1/2019 7/1/2020 pREMISEs(tea Drrencej $ 1,000,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEM_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X 1 ECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: S B AUTOMOBILE LABILITY (Ea acciden SINGLE LIMIT S 1,000,000 X ANY AUTO X 8104J319844 7/1/2019 7/1/2020 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSRE ONLY _ AUTOS BODILY BODILY INJURY(Per accident) $ X AUTOS ONLY X AUTOS ONLY (Per as a. DAMAGE S C X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 10,000,000 FXrxsS LAB CLAIMS-MADE CUP6667Y094 7/1/2019 7/1/2020 AGGREGATE $ 10,000,000 DED X RETENTION$ 10,000 S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ (FFICE Ein BER EXCLUDED? N/A Ida N E.L DISEASE-EA EMPLOYEE $ If yes,desaibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ D Prof Liab Claim Made DPR9944952 7/1/2019 7/1/2020 Per Claim Limit 10,000,000 D Reto Date 01/01/1965 DPR9944952 7/1/2019 7/1/2020 Aggregate Limit 10,000,000 • DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Project: On-Call Surveying and Consultant Services.The City of Spokane Valley is listed as an additional insured with respects to General and Auto Liability which are Primary and Non-Contributory. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City S Valle THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty of Spokane y ACCORDANCE WITH THE POLICY PROVISIONS. 10210 East Sprague Ave Spokane,WA 99206 AUTHORIZED REPRESENTATIVE A. 6.74-•— ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD -t .i a ...`s;dy ..: .- it - 1,..-` .3 3 _ .47t, =fie 4,,.. &. ..,rc,- , -e- " tiiti p,OM/ I iiiiii il' 7,iiS BUSINESS LICENSE j,. • RP'� T St{{,,qq1 STATE OF t WASHINGTON ti Limited Liability Company Unified Business ID#:602789933 Business ID#: 00111 Location:0001 BELSBY ENGINEERING,LLC Expires:Jan 31, 2020 E a LI 1325 W 1ST AVEtrfi SPOKANE,WA 99201-4135 ,r UNEMPLOYMENT INSURANCE-ACTIVE INDUSTRIAL INSURANCE-ACTIVE j 3 TAX REGISTRATION-ACTIVE l CITY ENDORSEMENTS: SPOKANE VALLEY GENERAL BUSINESS-ACTIVE SPOKANE GENERAL BUSINESS#T12053371BUS-ACTIVE , iii LICENSING RESTRICTIONS: Not licensed to hire minors without a Minot•Work Permit. 4' t I. 1`� REGISTERED TRADE NAMES: 1 BELSBY ENGINEERING It` BELSBY ENGINEERING,LLC e' t t. t. t. ._........z./.......„ , This document lists the registrations,endorsements,and licenses authorized for the business }t' named above.By accepting this document,the licensee certifies the information on the application t± was complete,true,and accurate to the best of his or her knowledge,and that business will be conducted in compliance with all applicable Washington state,county,and city regulations. Director,Department of Revenue STATE OF WASHINGTON UBI:602789933 001 0001 Expires:Jan 31,2020 BELSBY ENGINEERING.LLC UNEMPLOYMENT INSURANCE- 1325 W 1ST AVE ACTIVE SPOKANE.WA 99201-4135 INDUSTRIAL INSURANCE-ACTIVE TAX REGISTRATION-ACTIVE SPOKANE VALLEY GENERAL BUSINESS-ACTIVE SPOKANE GENERAL BUSINESS #T120533718US-ACTIVE 77-.4>iA-.- ,A14:±"(j 941L0002 DETACH THIS SECTION FOR YOUR WALLET Director,Department of Revenue S STATE OF WASHINGTON Department of Labor& Industries Certificate of Workers' Compensation Coverage December 12, 2019 LWAUBINo. - - - -------- -602 884 898 J L&I Account ID 660,248-00 Legal Business Name HORROCKS ENGINEERS INC Doing Business As HORROCKS ENGINEERS INC Workers'Comp Premium Status: Account is current. Estimated Workers Reported Quarter 3 of Year 2019"4 to 6 (See Description Below) I Workers" Account Representative 3 Employer Services Help Line, (360) 902-4817 Licensed Contractor? No What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter.A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See ROW 51.12.050 and 51.16.190). t STATE OF WASHINGTON Department of Labor& Industries Certificate of Workers' Compensation Coverage December 12, 2019 WA UBI No. ;602 789 933 L&I Account ID 7797101 Legal Business Name BELSBY ENGINEERING LLC Doing Business As BELSBY ENGINEERING Workers'Comp Premium Status: Account is current. — ~ Estimated Workers Reported Quarter 3 of Year 2019"7 to 10 (See Description Below) Workers" Account Representative !Employer Services Help Line, (360) 902-4817 Licensed Contractor? No WA UBI No. 602 789 933 L&I Account ID 7797101 ! Legal Business Name BELSBY ENGINEERING LLC I Doing Business As BELSBY ENGINEERING Workers'Comp Premium Status: 4 Account is current. Estimated Workers Reported i Quarter 3 of Year 2019"7 to 10 (See Description Below) !Workers" Account Representative Employer Services Help Line, (360) 902-4817 Licensed Contractor? No -- — WA UBI No. 602 789 933 i L&I Account ID ,7797101 ' Legal Business Name ' BELSBY ENGINEERING LLC Doing Business As BELSBY ENGINEERING Workers'Comp Premium Status: Account is current. Estimated Workers Reported Quarter 3 of Year 2019"7 to 10 (See Description Below) Workers" Account Representative Employer Services Help Line,(360) 902-4817