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18-034.02 Dale & Dale: On-Call Surveying 12-17-19 A03 :48 IN I 40000011Ndley• 10210 E Sprague Avenue♦ Spokane Valley WA 99206 " Phone: (509)720-5000 ♦Fax:(509)720-5075 ♦www.spokanevalley.org Email:cityhall@spokanevalley.org November 18, 2019 Contract No. 18-034.02 Walt Dale Dale&Dale,LLC. 1004 N.Atlantic Street Spokane, WA 99201 Re: Implementation of 2020 option year, Agreement for On-Call Surveying for Capital Improvement Projects18-034, executed March 19, 2018 Dear Mr.Dale: The City executed an Agreement for provision of On-Call Surveying for Capital Improvement Projects on March 19, 2018, by and between the City of Spokane Valley, hereinafter "City", and Dale & Dale, LLC. hereinafter "Contractor" and jointly referred to as"Parties." The original Agreement states that it was for one year, with two optional one-year terms possible if the parties mutually agree to exercise the options each year. This is the second of two possible option years that can be exercised and runs through December 31, 2020. The City would like to exercise the 2020 option year of the Agreement. The Compensation includes the labor and material cost negotiated and shall not exceed $15,040.00. The history of the annual renewals, including dollar amounts, is set forth as follows: Original contract amount $44,851.25 2019 Renewal $31,351.25 (remaining funds) 2020 Renewal ..$15,040.00 (remaining funds) All of the other contract provisions contained in the original Agreement shall remain in place and remain unchanged in exercising this option year. If you are in agreement with exercising the 2020 option year, please sign below to acknowledge the receipt and concurrence to perform the 2020 option year. Please return two copies to the City for execution, along with current insurance information. A fully executed original copy will be mailed to you for your files. CITY O�F"S�POKANE/ VALLEY DAL &DALE,L ra ‘t, _ , ...**--- 'Mark Calhoun, City Manager I/D .;vgDoJ() ame Title ATTEST 'il -c A--66: 4,6 Christine Bainbridge, City Clerk APPROVED AS TO FORM: Office tILI orney DOCUMENTS REQUIRING THIRD-PARTY NOTIFICATION PRIOR TO PUBLIC DISCLOSURE This page has been inserted in place of the page(s) entitled "2020 Hourly Minimum Fee Schedule..." of a contract document which sets forth the rates charged by the contracting entity. Pursuant to the Washington Public Records Act (RCW 42.56), the City has determined that this record may be available for disclosure upon request for review by a third party. However, pursuant to RCW 42.56.520 and RCW 42.56.540, the City has determined it is appropriate to provide the contracting entity notification of any request for this record to allow them time to determine if they wish to seek to obtain a court order requiring the record to be withheld. Please contact the City Public Records Officer at (509) 720-5000 or visit our website at www.spokanevallev.org to complete a Public Record Request to receive a copy of this record. A�� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 12/17/2019 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 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 LeZette Brewton NAME: Assurance Risk Managers, Inc. fare No.Ezt): (303)454-9562 FAX No): (903)454-9564 10651 East Bethany Drive ADDARESS:lezette.brewton@arm-i.cOm Suite 300 INSURER(S)AFFORDING COVERAGE NAIC 0 Aurora CO 80014-2688 INSURERA:RLI Insurance CO 13056 INSURED INSURERB:Hanover Insurance Company 22292 Dale & Dale, LLC, DBA: Benthin & Associates; INSURERC: North 1004 Atlantic LLC INSURERD: 1004 N. Atlantic St INSURERE: Spokane WA 99201 INSURERF: COVERAGES CERTIFICATE NUMBER:19-20 G A EO 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. INS ADDL FF POLICY EXP LTR TYPE OF INSURANCE INso SVD POLICY NUMBER (MDD/YUBR POLICY E W M/ YYY) (MMIDD/YYYYl LIMITS X COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE $ 1,000,000 DAMAGE TO A CLAIMS-MADE n OCCUR PREMISES(EaoTaurrence) $ 1,000,000 X PS130002991 3/1/2019 3/1/2020 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE IJMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY n JECT El LOC PRODUCTS-COMP/OPAGG $ 2,000,000 I OTHER: Stopgap Liablay-WA $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED PSA0001419 3/1/2019 3/1/2020 BODILY INJURY(Per accident) $ NON-OWNED AUTOS N X PROPERTY DAMAGE $ ,HIRED AUTOS AUTOS (Per accident) PIP-Basle $ UMBRELLALJAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CWMS-MADE AGGREGATE S DED I I RETENTION$ $ WORKERS COMPENSATION STATUTE I I ERH AND EMPLOYERS'LIABILITY Y�/N ANY PROPRIETOR/PARTNER/EXECUTIVE 1 1 N!A E.L EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory In NH) EL DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE.POLICY LIMIT $ B PROFESSIONAL LIABILITY LH4 A234519 05 3/1/2018 3/1/2020 EACH CLAIM 2,000,000 CLAIMS-MADE POLICY AGGREGATE 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Project: On Call Land Surveying Professional Services for City of Spokane Valley. The certificate holder is an additional insured as their interest may appear when required by written contract. Coverage is on a primary & non-contibutory basis. CERTIFICATE HOLDER CANCELLATION cphenderson@spokanevalley.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valley THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 11707 E Sprague Ave ACCORDANCE WITH THE POLICY PROVISIONS. Suite 106 Spokane Valley, WA 99206 AUTHORIZED REPRESENTATIVE LeZette Brewton/LAURA At ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS026(201401) Debarred Contractors List Page 1 of 1 Q Some online services are currently unavailable.See a list of service outages.(httns:inni.wa.aov/aoencv/svatem-atatusl J Labor&Industries Debarred Contractors List • A debarred contractor may not bid on,or have a bid considered on,any public works contract.You can search and filter this list using the options presented below. Company Name4Dale&Dale,LLC. WA UBI Number:I License Number Principal:) RCW4 All v From:IMM(DDlYYYY I To:IMM/DD(YYYY Penalty Due: All v Wage Due: All v 44pply Filters'Reset' Download all debarment data® Show®per page Showing 0 records Fi rstPreviousNextLast Company Name UBI License Principals Status RCW Debar Begins Debar Ends Penalty Due Wages Due There are no records that match your search criteria. Show 25 v per page Showing 0 records FirstPreviousNextLast • https://secure.lni.wa.gov/debarandstrike/ContractorDebarList.aspx 1/2/2020 BENTHIN&ASSOCIA1'BS Page 1 of 2 Vrj STATE OF WASHINi TON Department of Labor& Industries Certificate of Workers' Compensation Coverage January 9, 2020 WA UBI No. ,602 177 391 L&I Account ID 6046800 Legal Business Name BENTHIN &ASSOCIATES I Doing Business As DALE&DALE LLC Workers' Comp Premium Status: Account is current. Estimated Workers Reported •Quarter 3 of Year 2019"4 to 6 (See Description Below) Workers" Account Representative..............................................._.......__............_.. .. ......._..,_..............._ Employer Services Help Line, (360) 902-4817 I 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 RCW 51.12.050 and 51.16.190). https://secure.lni.wa.gov/verify/Details/liabilityCertificate.aspx?UBI=602177391&LIC=&V... 1/9/2020