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20-158.00 LaRiviere Inc: Browns Park Playground & Shelter
Contract No. 20-158 CONSTRUCTION AGREEMENT LaRiviere,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 LaRiviere, 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 Browns Park Playground and Shelter Project(the "Work") in accordance with documents described in Exhibit B 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 a timely 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 within the times specified in the Contract Documents, as may be extended in accordance with this Agreement and the Contract Documents. 3. Liquidated Damages. Time is of the essence for this Agreement. Delays cause inconvenience to the residents of City and cost taxpayers undue sums of money, adding time needed for administration, engineering, inspection, and supervision. It is impractical for City to calculate the actual cost of delays. Accordingly, Contractor agrees to pay liquidated damages for failure to achieve Substantial Completion(as defined in the Contract Documents) which shall be in the amount consistent with Section 1-08.9 of the Standard Specifications within the Contract Documents. These liquidated damages are not a penalty,but are fixed and agreed upon by and between Contractor and City because of the impracticability and difficulty of fixing and ascertaining the actual damages that City would sustain in the event that the Work is not completed in accordance with the Contract Documents. Liquidated damages may be retained by City and deducted from payments otherwise due to the Contractor. 4. Compensation. In consideration of Contractor performing the Work, City agrees to pay Contractor in accordance with the Contract Documents the sum of$344,883.00, plus applicable Washington State Sales Tax of$30,694.59 for a total of$375,577.59 based on the bid submitted by Contractor(Exhibit C), and as may be adjusted in accordance with the Contract Documents. City of Spokane Valley I Contract No.20-158 Browns Park Playground and Shelter 5. 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 RCW,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. 6.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: Matthew James, General Manager Phone: (509)720-5000 Phone:(208)683-2646 Address: 10210 East Sprague Avenue Address: 17564 N. Dylan Court Spokane Valley,WA 99206 Rathdrum, ID 83858 7. Applicable Laws and Standards. The Parties, in the performance of this Agreement, agree to comply with all applicable federal,state, and local laws,codes,and regulations. 8. 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. 9. 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&I"). 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. City of Spokane Valley 2 Contract No.20-158 Browns Park Playground and Shelter 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 information is provided pursuant to RCW 39.12.030: 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.gov/lni/wagelookup/prvWagelookup.aspx 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. 10. 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. 11. 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. 12.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. 13. 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 shall, 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. 14. 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. 15. 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). City of Spokane Valley 3 Contract No.20-158 Browns Park Playground and Shelter 16. 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. A.Minimum Scope of Insurance. Contractor 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. 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 01 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: 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 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: 1. 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 material breach of this Agreement, upon which the City may, after giving at least five City of Spokane Valley 4 Contract No.20-158 Browns Park Playground and Shelter 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 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, Contractor shall furnish acceptable insurance certificates to City at the time Contractor returns the signed Agreement,which shall be Exhibit D. 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. 17. 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 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. City of Spokane Valley 5 Contract No.20-158 Browns Park Playground and Shelter 18.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. 19. 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. 20. 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. 21. 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. 22. 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. 23.Jurisdiction and Venue. This Agreement is entered into in Spokane County,Washington. Venue shall be in Spokane County, State of Washington. 24. 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. 25.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. 26. 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. 27. 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. 28. Exhibits. Exhibits attached and incorporated into this Agreement are: A. Assurance of compliance with applicable federal laws B. Scope of Work C. Bid Proposal D. Insurance Endorsements City of Spokane Valley 6 Contract No.20-158 Browns Park Playground and Shelter E. Performance and Payment Bond The Parties have executed this Agreement this ay of bece IAA 4 e , 20?w CITY OF SPOKANE VALLEY: ontrac or: Fos M rk Calhoun, City Manager ' By: atthew James,General Manager Its: uthorized Representative ATTEST: / C 41Akeig,0-- ciyyv Christine Bainbridge,City Clerk APPROVED AS TO FORM: Office the ity omey City of Spokane Valley 7 Contract No.20-158 Browns Park Playground and Shelter 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: 1. 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 a part 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 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 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: City of Spokane Valley 8 Contract No.20-158 Browns Park Playground and Shelter 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); 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.). City of Spokane Valley 9 Contract No.20-158 Browns Park Playground and Shelter Exhibit B—Scope of Work Browns Park Playground and Shelter Project #0315 consists of: Demolition of existing site improvements including playground equipment, sidewalk and other improvements. Construction includes grading, underground utilities, concrete curb, concrete flatwork, electrical installation (new restroom/shelter lighting and site lighting), site preparation and installation of new Owner provided pre- manufactured restroom, new Owner provided pre-manufactured shelter, and new Owner provided playground equipment with poured-in-place resilient surfacing and engineered wood fiber surfacing, irrigation and landscaping,and other related work,all in accordance with the Contract Provisions and Plans. The bid schedules included for this contract consist of the following: 1. Schedule A—Base Bid: site work, install City provided restroom and shelter,permit fees,etc. 2. Schedule B—Alternate#1: install City provided Toddler Swings 3. Schedule C—Alternate#2: install City provided We-Go-Round 4. Schedule D—Alternate#3: install City provided 5-12 Arch Swings 5. Schedule F—Alternate#5: procure and install park trees 6. Schedule G—Alternate#6; install concrete base and City provided dedication plaque Contract Documents consist of: • Bid Proposal • Contract Provisions and Plans • Standard Specifications • Standard Plans • Addenda • Certifications and Affidavits • Supplemental Agreements • Change Orders City of Spokane Valley 10 Contract No.20-158 Browns Park Playground and Shelter City of Spokane Valley I 1 Contract No.20-158 Browns Park Playground and Shelter Exhibit C PROPOSAL FORM PROJECT NUMBER: 0315 PROJECT TITLE: Browns Park Playground and Shelter NAME OF FIRM SUBMITTING BID: LaRiviere, Inc Each bid shall constitute an offer to the City of Spokane Valley as outlined herein and no bidder may withdraw his bid after the hour set for the bid closing except under the conditions explained in the Information to Bidders Section. RECEIPT OF ADDENDA: Bidder acknowledges receipt of the following addenda by checking the box(es): [v'1 C72 ❑3 ❑4 ❑ 5 REJECTION: The City reserves the right to reject any or all proposals, portions or parts thereof and to waive all minor irregularities in bidding. Special attention will be directed to the qualifications of the bidders when considering awarding a contract. TIME TO COMPLETE: The contract shall be substantially completed in fifty (50) working days from the date of commencement. BID IS NOT ELIGIBLE FOR CONTRACTOR'S BOND ELECTION to withhold 50%retainage in lieu of furnishing a Contractor's Bond(Payment and Performance Bonds). FREIGHT:Bid price(s)to include all freight costs to the job site. SCHEDULES: A Bidder must complete all the schedules or his bid will be rejected as non-responsive. The undersigned hereby certifies that (he/they) (has/have) personally examined the location and construction details of work as outlined on the plans and specifications for the above project and (has/have) read thoroughly and understands the plans, specifications, and contract governing the work embraced in this improvement and the method by which payment will be made for said work and hereby proposes to undertake and complete the work embraced in this improvement in accordance with said plans,specifications, and contract in accordance with the unit prices provided below. The Bidder, to be considered responsible, shall provide in legible figures (not words) hand written in ink or typed, a unit price (except Lump Sum items) and total for each of the items shown on the following schedules: City of Spokane Valley 2 Bid Proposal Documents Browns Park Playground and Shelter Bid Schedule A —Base Bid: Site Work ITEM# ITEM DESCRIPTION UNITS QUANTITY PRICE/UNIT TOTAL 101 Site Work LUMP SUM 1 L.S. 263,609.00 102 Minor Change CALC 1 CALC $25,000.00 103 Allowance for Permit Fees CALC 1 CALC $5,000.00 BID SCHEDULE A SUB-TOTAL 293,609.00 8.9%Tax 26,131.20 BID SCHEDULE A TOTAL 319,740.20 Bid Schedule B — Alternate#1 ITEM# ITEM DESCRIPTION UNITS QUANTITY PRICE/UNIT TOTAL Alternate#1—Install Owner provided 201 Toddler Swings with poured-in-place LUMP SUM 1 L.S. 9,353.00 surfacing BID SCHEDULE B SUB-TOTAL 9,353.00 8.9%Tax 832.42 BID SCHEDULE B TOTAL 10,185.42 Bid Schedule C — Alternate #2 ITEM# ITEM DESCRIPTION UNITS QUANTITY PRICE/UNIT TOTAL Alternate#2—Install Owner provided 301 We-Go-Round with poured-in-place LUMP SUM I L.S. 22,806.00 surfacing and concrete containment curb BID SCHEDULE C SUB-TOTAL 22,806.00 8.9%Tax 2,029.73 BID SCHEDULE C TOTAL 24,835.73 Bid Schedule D —Alternate #3 ITEM# ITEM DESCRIPTION UNITS QUANTITY PRICE/UNIT TOTAL Alternate 43—Install Owner provided 5-12 401 Arch Swings with engineered wood fiber LUMP SUM 1 L.S. 9,916.00 surfacing and concrete containment curb BID SCHEDULE D SUB-TOTAL 9,916.00 8.9%Tax 882.52 BID SCHEDULE D TOTAL 10,798.52 City of Spokane Valley 3 Bid Proposal Documents Browns Park Playground and Shelter Bid Schedule E — Alternate #4 ITEM# ITEM DESCRIPTION UNITS QUANTITY PRICE/UNIT TOTAL Alternate#4—Install Owner provided 501 Omni-Spin Spinner with poured-in-place LUMP SUM 1 L.S. surfacing and concrete containment curb Sin place of We-Go-Round) 22,674.00 BID SCHEDULE E SUB-TOTAL 22,674.00 8.9%Tax 2,017.99 BID SCHEDULE E TOTAL 24,691.99 Bid Schedule F—Alternate #5 ITEM# ITEM DESCRIPTION UNITS QUANTITY PRICE/UNIT TOTAL 601 Alternate#5—Procure and Install fifteen LUMP SUM 1 L.S. 7,681.00 (15)trees with bark mulch tree rings BID SCHEDULE F SUB-TOTAL 7,681.00 8.9%Tax 683.61 BID SCHEDULE F TOTAL 8,364.61 Bid Schedule G— Alternate #6 ITEM# ITEM DESCRIPTION UNITS QUANTITY PRICE/UNIT TOTAL 701 Alternate#6—Install Owner Provided LUMP SUM 1 L.S. 1,518.00 Dedication Plaque on new concrete base* BID SCHEDULE G SUB-TOTAL 1,518.00 8.9%Tax 135.10 BID SCHEDULE G TOTAL 1,653.10 *Addendum#1 City of Spokane Valley 4 Bid Proposal Documents Browns Park Playground and Shelter Bid Schedule Summary BID SCHEDULE TOTAL BID SCHEDULE A-INCLUDING TAX 319,740.20 BID SCHEDULE B—INCLUDING TAX 10,185.42 BID SCHEDULE C-INCLUDING TAX 24,835.73 BID SCHEDULE D-INCLUDING TAX 10,798.52 BID SCHEDULE E-INCLUDING TAX 24,691.99 BID SCHEDULE F-INCLUDING TAX 8,364.61 BID SCHEDULE G-INCLUDING TAX 1653.10 TOTAL BID 400,269.57 Person/Entity Name: Thomas LaRiviere Signature of Bidder- Company: LaRiviere, Inc Date: 11/13/20 Note:To be considered responsive,the Bidder shall submit a price on each and every Bid item included in the Base Bid and all Alternates. Bids will be evaluated by the City to determine which Bid is apparent lowest and responsive Bid based on the total of the base Bid and all Alternates. The City is not required to accept an Alternate or Alternates and shall exercise its sole discretion to do so in any order or combination. 'll City of Spokane Valley 5 Bid Proposal Documents Browns Park Playground and Shelter S""Pokane� Valley Contractor Certification Wage Law Compliance - Responsibility Criteria Washington State Public Works Contracts FAILURE TO RETURN THIS CERTIFICATION AS PART OF THE BID PROPOSAL PACKAGE WILL MAKE THIS BID NONRESPONSIVE AND INELIGIBLE FOR AWARD I hereby certify,under penalty of perjury under the laws of the State of Washington,on behalf of the firm identified below that,to the best of my knowledge and belief,this firm has NOT been determined by a final and binding citation and notice of assessment issued by the Washington State Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated,as defined in RCW 49.48.082,any provision of RCW chapters 49.46,49.48,or 49.52 within three(3)years prior to the date of the Call for Bids. Bidder Name: LaRiviere, Inc Name or Contractor/Bidder—Print full legal entity name of firm By: Thomas LaRiviere Signature of authorized Print Name of person making certifications for firm Title: President Place: Rathdrum, Idaho Title of person signing certificate Print city and state where signed Date: 11/13/20 City of Spokane Valley 6 Bid Proposal Documents Browns Park Playground and Shelter CONTRACTOR'S ADMINISTRATIVE INFORMATION 1.PERSON/ENTITY a. Name as registered with the State of Washington: LaRiviere,Inc b. Physical Address:17564 N Dylan Ct,Rathdrum ID 83858 C. Mailing Address including zip code: 17564 N Dylan Ct,Rathdrum ID 83858 d. Remit To Address including zip code: 17564 N Dylan Ct,Rathdrum ID 83858 e. Telephone number including area code: 208.683.2646 f. Fax number including area code: 208.518.2003 g. E-mail address for business correspondence: Matthew James,GM mattj@lariviere.co h. Washington State Contractors License Number: LARIVI'817J3 i. Federal Tax Identification Number: 20-8914273 j. Washington State UBI Number: 602 764 461 k. State Industrial Account Identification Number: 190265WA 1. City of Spokane Valley Business License Number: 602764461-001-0001 (Business License not required for Bid,but will be required prior to Contract execution.) 2.INSURANCE COMPANY: a. Name of company: Payne West b. Mailing Address including zip code: 501 N.Riyerpointe Blvd Ste 403 Spokane WA 99202 c. Insurance Agent Name: Jim Majesky d. Insurance Agent Telephone number including area code: 509.455.6767 e. Insurance Agent Fax number including area code:509.838.3511 3.BONDING COMPANY: a. Surety Name:Great American Insurance b. Surety Mailing Address including zip code: 301 East Fourth Street,Cincinnati OH 45202 c. Bonding Agent Name: Jim Majesky d. Bonding Agent Mailing Address including zip code: 501 N.Riverpolnte Blvd Ste 403 Spokane WA 99202 e. Bonding Agent Telephone number including area code:509.455.6767 f. Bonding Agent Fax number including area code: 509.838.3511 Person/Entity Name: Thomas LaRiviere Signature Of Bidde Company: LaRiviere, Inc Date: 11/13/20 City of Spokane Valley 7 Bid Proposal Documents Browns Park Playground and Shelter BIDDER QUALIFICATION STATEMENT The following statements of experience, personnel, equipment, and general qualifications of the Bidder are submitted with the assurance that the owner can rely on its accuracy and truthfulness. If more space is required for your answers please attach a continuation sheet(s) to the corresponding bid response page referencing the item number. 1.The company has been in business continuously from(month and year) June 1976 2.The company has had experience comparable to that required under the proposed contract: a.As a prime contractor for 44 years. b.As a subcontractor for 44 years. 3.The following is a partial list of work completed that was on an order of magnitude equal to or greater in scope and complexity to that required under the proposed contract. Year Owner&Person to contact Phone No. Location Contract Value 2020 Spokane Co Parks&Rec Kris Krohn 509-477-4730 $6.457,312.62 Bidwell Park,Colbert WA 2020 City of Spokane Parks&Rec,Berry Ellison 509-625-6276 Northbank Playground $8.454,218.46 4. A list of supervisory personnel currently employed by the Bidder and available for work on the project (Construction Manager,principal foreman,superintendents and engineers)is as follows: Years of Name Title Experience Scott Foster Construction/Project Manager 20+years Eugene Chavez Superintendent 20 years 5. Please attach a resume of the qualifications, previous employers, and experience of the project manager who is proposed to be assigned to the project. If a resume is not included in the bid documents the bidder agrees to furnish a resume within 24 hours of notice by the City. Sep a-1ac,neCt 6. Following is a listing of all projects the company has undertaken in the last five years, which have resulted in: a.Arbitration or litigation. None b. Claims or violations being filed by the Federal Government or the Washington State Departments of L& I,Employment Security or Revenue. c. Liens being filed by suppliers or subcontractors. None Person/Entity Name: Thomas LaRiviere Signature Of Bidder. Company: LaRiviere, Inc Date: 11/13/20 City of Spokane Valley 8 Bid Proposal Documents Browns Park Playground and Shelter Local Agency Name Local Agency Subcontractor List Local Agency Address Prepared in compliance with RCW 39.30.060 as amended To Be Submitted with the Bid Proposal Project Name Browns Playground and Shelter RE BID Failure to list subcontractors with whom the bidder, if awarded the contract,will directly subcontract for performance of the work of heating,ventilation and air conditioning,plumbing,as described in Chapter 18.106 RCW,and electrical,as described in Chapter 19.28 RCW or naming more than one subcontractor to perform the same work will result in your bid being non-responsive and therefore void. Subcontractor(s)with whom the bidder will directly subcontract that are proposed to perform the work of heating, ventilation and air conditioning,plumbing,as described in Chapter 18.106 RCW, and electrical as described in Chapter 19.28 RCW must be listed below. The work to be performed is to be listed below the subcontractor(s)name. To the extent the Project includes one or more categories of work referenced in RCW 39.30.060,and no subcontractor is listed below to perform such work,the bidder certifies that the work will either(i)be performed by the bidder itself.or(ii)beperformed by a lower tier subcontractor who will not contract directly with the bidder. Subcontractor Name no plumbing required Work to be Performed Subcontractor Name no hvac required Work to be Performed Subcontractor Name COIviCo, Inc Work to be Performed Electrical work Subcontractor Name Work to be Perfor,med Subcontractor Name Work to be Performed Bidder's are notified that is the opinion of the enforcement agency that PVC or metal conduit,junction boxes,etc, are considered electrical equipment and therefore considered part of electrical work,even if the installation is for future use and no wiring or electrical current is connected during the project. SR DOT Form 271-01SA EF Rovised 08/2012 City of Spokane Valley 9 Bid Proposal Documents Browns Park Playground and Shelter REPRESENTATIONS AND CERTIFICATIONS Pursuant to RCW 9A.72.085, I Thomas LaRiviere , declare under penalty of perjury under the laws of the State of Washington that the following Representations and Certifications are true and correct: REPRESENTATION: I am the President (position)for LaRiviere, Inc (company name), (hereinafter "Firm"), and have been duly authorized to make all such representations and certifications herein on behalf of the Firm. Any reference herein to"I,""me,"or"we"means the Firm. ANTI-KICKBACK REPRESENTATION:No officer or employee of the City of Spokane Valley, having the power or duty to perform an official act or action related to this submittal, has, nor will they acquire any interest in this submittal,or have solicited, accepted or granted a present or future gift, favor,service, or other thing of value from or to any person involved in this submittal. REPRESENTATION: In submitting this bid I represent that the bid documents have been read and understood, that the site has been visited and or that I have become familiarized with the local conditions under which the work is to be performed, that by signature of this proposal I acknowledge all requirements and that I or authorized representatives of the Firm have signed all certificates contained herein. REPRESENTATION: In submitting this bid I acknowledge and agree to the requirements and conditions applicable to bid deposits in the form of a cash bid deposit or surety bond bid deposit. NON-COLLUSION: That the Firm and all associated members, officers, and employees of such Firm have not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the project for which this bid is submitted. I CERTIFY that pursuant to RCW 39.04.350(1)(d) and RCW 39.06.010, no final determination of violation of RCW 50.12.070(1)(b),50.16.070(1)(b),or 82.32.070(1)(b)has been made by the Washington State Departments of Employment Security, Labor And Industries or Revenue respectively dated within two years of the date of the closing of this bid. I understand further that no bid may be submitted, considered or contract awarded for a public work to any person or entity that has a determination of violation of the above referenced statutes within two years from the date that a violation is finally determined and the date of this bid closing. I CERTIFY that the Firm is not in violation of RCW 39.04.350(1)(d) and RCW 39.12.065(3)with regard to payment of prevailing wages. I CERTIFY that pursuant to RCW 39.04.350(1)(g), in the three-year period immediately preceding the date of the bid solicitation, no final and binding citation and assessment has been issued by the Department of Labor and Industries and no civil judgment has been entered by a court of limited or general jurisdiction for any willful violation of chapters 49.46,49.48,or 49.52 RCW. I CERTIFY that pursuant to RCW 39.04.350(1)(f),all necessary members, officers, and employees of the Firm have: CHECK ONE: Completed the appropriate training on prevailing wage and public works requirements prior to contract award; or X Completed three or more public works projects and has held a valid Washington business for three or more years. City of Spokane Valley 12 Bid Proposal Documents Browns Park Playground and Shelter A copy of evidence of such training or exemption from the Department of Labor and Industries has been attached to this Representation and Certification Form. I CERTIFY that pursuant to RCW 39.06.020, if selected, I will verify the responsibility criteria for all subcontractors as set forth in RCW 39.04.350(1). I CERTIFY that to the best of my knowledge the information contained in this proposal is accurate and complete and that I have the legal authority to commit this Firm to a contractual agreement. I realize the final funding for any service is based upon budget levels and the approval of the City of Spokane Valley. I CERTIFY that by signing the signature page of this bid, I am deemed to have signed and have agreed to the provisions of this declaration. Name: Thomas LaRiviere Pers entity submitting bid(print) Signature: ' Title: President Date: 11/13/20 Place Signed: Rathdrum, Idaho City of Spokane Valley 13 Bid Proposal Documents Browns Park Playground and Shelter 12/28/2020 LARIVIERE INC STATE OF WASHINGION Department of Labor& Industries Certificate of Workers' Compensation Coverage December 28, 2020 WA UBI No. 602 764 461 L&I Account ID 262,678-00 Legal Business Name LARIVIERE INC Doing Business As T LARIVIERE EQUIPMENT& EXCAV Workers'Comp Premium Status: Account is current. Estimated Workers Reported Quarter 3 of Year 2020"1 to 3 Workers" (See Description Below) Account Representative Employer Services Help Line, (360)902-4817 Licensed Contractor? Yes License No. LARIVI`817J3 License Expiration 04/23/2021 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 .1 2.050 and 51.16.190). https://secure.lni.wa.gov/verify/Details/IiabilityCertificate.aspx?UBI=602764461&SAW=&ACCT=26267800&LIC=LARIVI*817J3 1/1 Exhibit D LARIINC-01 MNEIGHBORS ACCUZGO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) • 12/28/2020 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 NAMEACT Spokane Office HM Paynewest Insurance,Inc. (A/CC,NN ,Ext):(509)838-3501 I FAX No):(509)838-3511 501 N.Riverpoint Blvd.,Ste 403 Runiass: Spokane,WA 99202 INSURER(S)AFFORDING COVERAGE NAIC(I INSURER A:Alaska National Insurance Company 38733 INSURED INSURER B: LaRiviere,Inc. INSURER C 17564 North Dylan Court INSURER D: Rathdrum,ID 83858 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR ,INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 20D PS 08913 4/10/2020 4/1/2021 PAMAGES(RENTED 100,000 X X PREMISES(Ea occurrencel $ MED EXP(My one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JERCT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: WA STOP GAP $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO _ X X 20D AS 08913 4/10/2020 4/1/2021 BODILY INJURY(Per person) $ — OWNED SCHEDULED _ AUTOSRE ONLY AUTOS WNE pBODILY INJURY(Per accident) $ _ AUTOS ONLY _ AUTOi ONLY (Peer accident)AMAGE A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6,000,000 EXCESS LIAB CLAIMS-MADE 20D LU 08913 4/10/2020 4/1/2021 AGGREGATE $ 6,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY Y/N STATUTE ERH ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Contract No.20-158,Browns Park Playground and Shelter,Spokane Valley Capital Improvement Project No.0315 City of Spokane Valley Is additional insured,on a primary/non-contributory basis,Including waiver of subrogation,as per attached forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Spokane ValleyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P ACCORDANCE WITH THE POLICY PROVISIONS. 10210 E Sprague Avenue Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE 1 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AirAlaska National INSURANCE COMPANY CONTRACTORS' GENERAL LIABILITY ENHANCEMENT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Coverage afforded under this extension of coverage endorsement does not apply to any person or organization covered as an additional insured on any other endorsement now or hereafter attached to this Coverage Part. SCHEDULE OF COVERAGES ARE SUMMARIZED BELOW 1. Miscellaneous Additional Insureds 14. In Rem Actions 8 additional insured extensions. 1. MISCELLANEOUS ADDITIONAL INSUREDS Primary and Noncontributory Insurance Section II Who Is An Insured is amended to 2. Damage To Premises Rented to You include as an additional Insured any person or Limit increased to$500,000. organization described in Paragraphs 2.a.through 2.h. below whom you are required to add as an 3. Medical Payments additional insured on this policy under a written Limits increased to$15,000. contract or written agreement. However, the Reporting period increased to three years from the written contract or written agreement must be: date of accident. 1. Currently in effect or becoming effective 4. Non-owned Watercraft during the term of this policy; and Increased to 50 feet. 2. Executed prior to the "bodily injury", 5. Supplementary Payments "property damage"or"personal injury and Cost of bail bonds increased to$10,000. advertising injury", but Daily loss of earnings increased to$500. Only the following persons or organizations 6. Newly Formed Or Acquired Organizations are additional insureds under this Coverage extended to the end of the policy period endorsement and coverage provided to such or the next anniversary of this policy's effective additional insureds is limited as provided date. herein: 7. Liberalization Clause a. State or Governmental Agency or Subdivision or Political Subdivi- 8. Unintentional Failure To Disclose Hazards lions 9. Notice of Occurrence Any state or governmental agency or subdivision or political subdivision that 10. Broad Knowledge of Occurrence has issued a permit in connection with operations performed by you or on 11. Bodily Injury-Extension of Coverage your behalf and that you are required by any ordinance, law or building code 12. Expected Or Intended Injury to include as an additional insured on Reasonable force - bodily injury or property this coverage part is an additional damage. insured, but only with respect to liability for "bodily injury", "property 13. Blanket Waiver of Subrogation damage", "personal and advertising Waiver of subrogation where required by written injury"arising out of such operations. contract or written agreement. ANIC GL 1187 07 16 Page 1 of 6 Air Alaska National INSURANCE COMPANY The insurance provided to such state e. Owners or Other Interests From or political subdivision does not apply Whom Land Has Been Leased to any "bodily injury", "property damage" or"personal and advertising An owner or other interest from whom injury" arising out of operations land has been leased by you but only performed for that state or political with respect to liability arising out of subdivision. the ownership, maintenance or use of that specific part of the land leased to b. Controlling Interest you and subject to the following additional exclusions: Any persons or organizations with a controlling interest in you but only with This insurance does not apply to: respect to their liability arising out of: (1) Any "occurrence" which takes (1) Their financial control of you, or place after you cease to lease that land;or (2) Premises they own, maintain or control while you lease or occupy (2) Structural alterations, new con- these premises. struction or demolition operations performed by or on behalf of such This insurance does not apply to additional insured. structural alterations, new construc- tion and demolition operations f. Co-owner of Insured Premises performed by or for such additional insured. A co-owner of a premises co-owned by you and covered under this c. Managers or Lessors of Premises insurance but only with respect to the co-owners liability as co-owner of A manager or lessor of premises but such premises. only with respect to liability arising out of the ownership, maintenance or use g. Lessor of Equipment of that specific part of the premises leased to you and subject to the Any person or organization from following additional exclusions: whom you lease equipment. Such person or organization is an additional This insurance does not apply to: insured only with respect to their liability for "bodily injury", "property (1) Any "occurrence" which takes damage"or"personal and Advertising place after you cease to be a injury" caused, in whole or in part, by tenant in that premises; or your maintenance, operation or use of equipment leased to you by such (2) Structural alterations, new con- person or organization. A person's or struction or demolition operations organization's status as an additional performed by or on behalf of such insured under this endorsement ends additional insured. when their written contract or written agreement with you for such leased d. Mortgagee,Assignee or Receiver equipment ends. A mortgagee,assignee or receiver but With respect to the insurance afforded only with respect to their liability as these additional insureds, the mortgagee, assignee, or receiver and following additional exclusions apply: arising out of the ownership, maintenance, or use of a premises by This insurance does not apply: you. (1) To any "occurrence" which takes This insurance does not apply to place after the equipment lease structural alterations, new construc- expires; or tion or demolition operations performed by or for such additional insured. ANIC GL 1187 07 16 Page 2 of 6 617) Alaska National INSURANCE COMPANY (2) To "bodily injury", "property additional insured. However, damage", or "personal and even if coverage within the advertising injury" arising out of "products-completed operations the sole negligence of such hazard" is required by the written additional insured. contract, such coverage is available to the additional insured h. Owners, Lessees or Contractors only if the "bodily injury" or "property damage"occurs prior to (1) Such person or organization is an the end of the time period during additional insured for "bodily which you are required by the injury", "property damage" and written contract to provide such "personal and advertising injury" coverage or the expiration date of if, and only to the extent that, the the policy,whichever comes first. injury or damage is caused by negligent acts or omissions of you Any insurance provided to an additional or your subcontractor in the insured designated under Paragraphs 2.a. performance of "your work" to through 2.g. above does not apply to "bodily which the written contract applies. injury" or "property damage" included within This person or organization does the products-completed operations hazard." not qualify as an additional insured with respect to injury or Primary And Noncontributory Insurance damage caused in whole or in part by independent negligent acts or The following is added to the Other Insurance omissions of such person or Condition and supersedes any provision to the organization. contrary: (2) However, this insurance does not This insurance is primary to and will not seek apply to "bodily injury", "property contribution from any other insurance available to damage" or "personal and advertising injury"arising out of an an additional insured under your policy provided architect's, engineer's, or that: surveyor's rendering of or failure to render any professional (1) The additional insured is a Named services including: Insured under such other insurance;and i. the preparing, approving, or failing to prepare or approve (2) You have agreed in writing in a maps, drawings, opinions, contract or agreement that this reports, surveys, change insurance would be primary and design or would not seek contribution from orders, ocations; and any other insurance available to the additional insured. ii. supervisory, inspection, or Section III - Limits of Insurance, the following is engineering services. added: (3) The insurance provided to this With respect to the insurance afforded to the additional insured,does not cover additional insureds described in Paragraphs a. "bodily injury" or "property through h.above,the most we will pay on behalf of damage" caused by your such additional insured is the amount of insurance: negligent acts and omissions in the performance of "your work" (1) Required by the contract or that occurs within the "products agreement;or completed operations hazard", unless the written contract (2) Available under the applicable contains a specific requirement that you procure completed Limits of Insurance shown in the Declarations; operations coverage or coverage within the "products-completed whichever is less. operations hazard"for the ANIC GL 1187 07 16 Page 3 of 6 lir Alaska National INSURANCE COMPANY This provision shall not increase the applicable 4. NON-OWNED WATERCRAFT Limits of Insurance shown in the Declaration. A. If endorsement CG 21 09, CG 21 10, CG 24 2. Damage To Premises Rented to You 50, or CG 24 51 is attached to the policy, Paragraph A. 2. g. (2) (b) is replaced by the SECTION III — LIMITS OF INSURANCE, following: Paragraph 6. is replaced by the following: (b) A watercraft that you do not 6. Subject to Paragraph 5. above, the own that is: Damage to Premises Rented to You Limit is the most we will pay under Coverage A (i) Less than 50 feet long: for damages because of "property and damage" to any one premises, while rented to you, or in the case of damage by (ii) Not being used to carry fire, while rented to you or temporarily persons or property for a occupied by you with permission of the charge. owner. B. If Paragraph A. does not apply, Paragraph g. If a limit is shown for Damage to Premises Rented (2) of 2. EXCLUSION under SECTION I — to You the most we will pay under Coverage A for COVERAGES, COVERAGE A — BODILY damages because or "property damage" to any INJURY AND PROPERTY DAMAGE one premises is the Limit shown in the LIABILITY is replaced by the following: Declarations or$500,000, whichever is greater. (2) A watercraft that you do not own 3. MEDICAL PAYMENTS that is: A. Section III—Limits of Insurance, Paragraph (a) Less than 50 feet long; and 7. is replaced by the following: (b) Not being used to carry 7. Subject to Paragraph 5.above the Medical persons or property for a Expense Limit is the most we will pay charge. under Coverage C for all medical expenses because of "bodily injury" 5. SUPPLEMENTARY PAYMENTS sustained by any one person. A. Under Section I -Supplementary Payments If a limit is shown for Medical Expense in -Coverage A and B, Paragraph 1.b., the limit the Declarations the most we will pay of $250 shown for the cost of bail bonds is under Coverage C for all medical replaced by$10,000; expenses because of "bodily injury" sustained by any one person is the Limit B. In Paragraph 1.d., the limit of$250 shown for shown in the Declarations or $15,000, daily loss of earnings is replaced by$500. whichever is greater. 6. NEWLY FORMED OR ACQUIRED B. This provision 5. (Medical Payments)does not ORGANIZATIONS apply if Section I - Coverage C Medical Payments is excluded either by the provisions Paragraph 3.a.of Section II -Who Is An Insured of the Coverage Part or by endorsement. is deleted and replaced by the following: C. Paragraph 1.a.(3)(b) of Section I -Coverage Coverage under this provision is afforded only until C - Medical Payments, is replaced by the the end of the policy period or the next anniversary following: of this policy's effective date after you acquire or form the organization,whichever is earlier. (b) The expenses are incurred and reported to us within three years of the date of the accident;and ANIC GL 1187 07 16 Page 4 of 6 Alaska National INSURANCE COMPANY 7. LIBERALIZATION CLAUSE 10. BROAD KNOWLEDGE OF OCCURRENCE If we adopt a change in our forms or rules which The following is added to Paragraph 2. of Section would broaden coverage for contractors under this IV - Commercial General Liability Conditions - endorsement without an additional premium Duties in The Event of Occurrence, Offense, charge, your policy will automatically provide the Claim or Suit: additional coverages as of the date the revision is effective in your state. You must give us or our authorized representative notice of an "occurrence", offense, claim, or"suit" 8. UNINTENTIONAL FAILURE TO DISCLOSE only when the"occurrence",offense,claim or"suit' HAZARDS is known to: SECTION IV — COMMERCIAL GENERAL (1) You, if you are an individual; LIABILITY CONDITIONS — Paragraph 6. — Representations is replaced by the following: (2) A partner,if you are a partnership; 6. Representations (3) An executive officer or the employee designated by you to By accepting this policy,you agree: give such notice, if you are a corporation; or a. The statements in the Declarations are accurate and complete; (4) A manager, if you are a limited liability company. b. Those statements are based upon 11. EXPANDED BODILY INJURY representations you made to us; and Section V - Definitions, the definition of "bodily c. We have issued this policy in reliance injury"is changed to read: upon your representations. "Bodily injury" means bodily injury, sickness or The unintentional omission of,or unintentional disease sustained by a person, including death, error in, any information you provided to us humiliation,shock,mental anguish or mental injury which we relied upon in issuing this policy will by that person at any time which results as a not prejudice your rights under this insurance. consequence of the bodily injury, sickness or However, this provision does not affect our disease. right to collect additional premium or to exercise our rights of cancellation or 12. EXPECTED OR INTENDED INJURY nonrenewal in accordance with applicable laws and regulations. Exclusion a. of Section I - Coverage A - Bodily Injury and Property Damage Liability is replaced 9. NOTICE OF OCCURRENCE by the following: The following is added to Paragraph 2. of Section a. "Bodily injury" or "property damage" IV - Commercial General Liability Conditions - expected or intended from the Duties In The Event of Occurrence, Offense, standpoint of the insured. This Claim or Suit: exclusion does not apply to "bodily injury" or"property damage" resulting Your rights under this Coverage Part will not be from the use of reasonable force to prejudiced if you fail to give us notice of an protect persons or property. "occurrence", offense, claim or "suit" and that failure is solely due to your reasonable belief that the "bodily injury" or "property damage" is not covered under this Coverage Part. However, you shall give written notice of this "occurrence", offense, claim or"suit" to us as soon as you are aware that this insurance may apply to such "occurrence", offense, claim or"suit." ANIC GL 1187 07 16 Page 5 of 6 AV Alaska National INSURANCE COMPANY 13. BLANKET WAIVER OF SUBROGATION However, this waiver applies only when you have agreed in writing to waive such rights of recovery The Transfer Of Rights Of Recovery Against in a contract or agreement,and only if the contract Others To Us Condition (Section IV - or agreement: Commercial General Liability Conditions) is amended by the addition of the following: 1. Is in effect or becomes effective during the term of this policy;and We waive any right of recovery we may have against any person or organization because of 2. Was executed prior to loss. payments we make for injury or damage arising out of: 14. IN REM ACTIONS 1. Your ongoing operations; or Any action in rem against any vessel owned, operated by or for, or chartered by or for you will 2. "Your work" included in the "products- be treated in the same manner as though the completed operations hazard." action were in personam against you. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective April 10,2020 Policy No.20D PS 08913 Insured LaRiviere Incorporated Endorsement No. Countersigned By Includes copyrighted material of Insurance Services Office, Inc.,with its permission ANIC GL 1187 07 16 Page 6 of 6 Alaska National INSURANCE COMPANY DESIGNATED CONSTRUCTION PROJECT(S)GENERAL AGGREGATE LIMIT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): All Projects Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences" under Section I —Coverage A, and expenses shall reduce the Designated for all medical expenses caused by accidents Construction Project General Aggregate Limit under Section I — Coverage C, which can be for that designated construction project. Such attributed only to ongoing operations at a single payments shall not reduce the General designated construction project shown in the Aggregate Limit shown in the Declarations nor Schedule above: shall they reduce any other Designated 1. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated construction project designated construction project, and that limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, except General Aggregate Limit shown in the damages because of "bodily injury" or Declarations, such limits will be subject to the "property damage" included in the "products- applicable Designated Construction Project completed operations hazard", and for medical General Aggregate Limit. expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or"suits" brought; or c. Persons or organizations making claims or bringing"suits". CG 25 03 05 09 Page 1 of 2 lir Alaska National INSURANCE COMPANY B. For all sums which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by "products-completed operations hazard" is "occurrences" under Section I — Coverage A, and provided, any payments for damages because of for all medical expenses caused by accidents "bodily injury"or"property damage"included in the under Section I — Coverage C, which cannot be "products-completed operations hazard" will attributed only to ongoing operations at a single reduce the Products-completed Operations designated construction project shown in the Aggregate Limit, and not reduce the General Schedule above: Aggregate Limit nor the Designated Construction 1. Any payments made under Coverage A for Project General Aggregate Limit. damages or under Coverage C for medical D. If the applicable designated construction project expenses shall reduce the amount available has been abandoned, delayed, or abandoned and under the General Aggregate Limit or the then restarted, or if the authorized contracting Products-completed Operations Aggregate parties deviate from plans, blueprints, designs, Limit,whichever is applicable; and specifications or timetables, the project will still be 2. Such payments shall not reduce any deemed to be the same construction project. Designated Construction Project General E. The provisions of Section III — Limits Of Insurance Aggregate Limit. not otherwise modified by this endorsement shall continue to apply as stipulated. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective April 10,2020 Policy No 20D PS 08913 Insured LaRiviere Incorporated Endorsement No. 18 Countersigned By Scott Zino& ©Insurance Services Office, Inc., 2008 CG 25 03 05 09 Page 2 of 2 Alaska National INSURANCE COMPANY BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM Various provisions in this endorsement restrict SECTION IV — Business Auto Conditions, coverage. Read the entire policy carefully to Paragraph A. 5. — Transfer of Rights of Recovery determine rights, duties, and what is and is not Against Others To Us is amended to include: covered. 5. Transfer of Rights of Recovery Against Throughout this policy, the words "you" and "your" Others to Us refer to the Named Insured shown in the Declarations. The words "we", "us", and "our" refer to This condition does not apply to any the company providing this insurance. person(s) or organization(s) to the extent that subrogation against that person or Other words and phrases that appear in quotation organization is waived prior to the "accident" marks have special meaning. Refer to SECTION V— or the"loss" under a contract with that person DEFINITIONS in the Business Auto Coverage Form. or organization. The coverages provided by this endorsement apply SECTION II — COVERED AUTO LIABILITY per "accident" and, unless otherwise specified, are COVERAGE, Paragraph A.2.a. (2)—Supplementary subject to all of the terms, conditions, exclusions and Payments is replaced by the following: deductible provisions of the policy, to which it is attached. (2) Up to $10,000 for cost of bail bonds (including bonds for related traffic law SECTION II — COVERED AUTO LIABILITY violations) required because of an COVERAGE, Paragraph A.1. Who Is An Insured is "accident"we cover. We do not have amended to include: to furnish these bonds. d. Any "employee" of yours while operating SECTION II — COVERED AUTO LIABILITY an "auto" hired or rented under a COVERAGE, Paragraph A.2.a. (4)—Supplementary contract or agreement in an "employee's" Payments is replaced by the following: name, with your permission, while performing duties related to the conduct (4) All reasonable expenses incurred by of your business. the"insured" at our request, including actual loss of earnings up to $500 a e. Any person or organization for whom you day because of time off from work. have agreed in writing to provide insurance such as is afforded by this Coverage Form, but only with respect to liability arising out of the ownership, maintenance or use of"autos"covered by this policy. If such person or organization has other insurance then this insurance is primary to and we will not seek contribution from the other insurance. ANIC CA 1150 10 13 Page 1 of 4 irsilV Alaska National INSURANCE COMPANY C. "Loss" caused by falling objects or SECTION II — COVERED AUTO LIABILITY missiles. COVERAGE, Paragraph A.2.c.—Voluntary Property Damage is added as follows: However, you have the option of having glass breakage caused by a covered "auto's" c. Voluntary Property Damage collision or overturn considered a"loss" under Collision Coverage. At your written request, we may make a voluntary payment for Property Damage Glass Repair—Waiver of Deductible caused by an 'insured", but without liability to a third party, up to$25,000. We No deductible applies to glass breakage, if will not make a Voluntary Property the glass is repaired rather than replaced. Damage payment to anyone who is an "insured" under this policy. SECTION III — PHYSICAL DAMAGE COVERAGE, Paragraph A.4.a. — Transportation Expenses is SECTION III — PHYSICAL DAMAGE COVERAGE, replaced by the following: Paragraph A.2.—Towing is replaced by the following: a. Transportation Expenses Towing We will pay up to $200 per day to a We will pay up to $500 for towing and labor maximum of $1,500 for temporary costs incurred each time a covered "auto" transportation expense incurred by you that is a: because of the total theft of a covered "auto"that is a: a. Private passenger; (1) Private passenger; b. Truck; (2) Truck; c. Pick-up truck; (3) Pick-up truck; d. Panel ; or (4) Panel; or e. Van (5) Van type vehicle under 20,000 lbs. of Gross Vehicle Weight is disabled. However, the type vehicle under 20,000 lbs. of Gross labor must be performed at place of Vehicle Weight. We will pay only for disablement. those covered "autos"for which you carry SECTION III — PHYSICAL DAMAGE COVERAGE, either Comprehensive or Specified Paragraph A.3. — Glass Breakage — Hitting a Bird forCauses of LossryCoverage. We will pay or Animal — Falling Objects or Missiles is replaced temporary transportation expenses by the following: incurred during the period beginning 48 hours after the theft and ending, Glass Breakage—Hitting a Bird or Animal regardless of the policy's expiration, —Falling Objects or Missiles when the covered "auto" is returned to use or we pay for its"loss". If you carry Comprehensive Coverage for the damaged covered "auto", we will pay the following under Comprehensive Coverage: a. Glass Breakage; b. "Loss" caused by hitting a bird or animal; and ANIC CA 1150 10 13 Page 2 of 4 (4 / Alaska National INSURANCE COMPANY (2) Specified Causes of Loss only if the SECTION III — PHYSICAL DAMAGE COVERAGE, Declarations indicate that Specified Paragraph A.4.b. — Loss of Use Expenses is Causes of Loss Coverage is provided replaced by the following: for the "auto" withdrawn from service; or b. Loss of Use Expenses—Hired, Rented, (3) Collision only if the Declarations or Borrowed Automobiles indicate that Collision Coverage is provided for the "auto" withdrawn We will pay expenses for which an from service. "insured" becomes legally responsible to pay for loss of use of a vehicle hired, SECTION III — PHYSICAL DAMAGE COVERAGE, rented or borrowed without a driver under Paragraph A.4.d. — Airbag Coverage is added as a written rental contract or agreement. follows: We will pay for loss of use expenses, if caused by: d. Airbag Coverage (1) Other than Collision, only if the We will pay for the cost to repair, replace, Declarations indicate that or reset an airbag that inflates for any Comprehensive Coverage is provided reason other than as a result of a for the vehicle withdrawn from collision, if the Declarations indicate that service. the covered "auto" has Comprehensive Coverage or Specified Causes of Loss (2) Specified Causes of Loss only if the Coverage. Declarations indicate that Specified Causes of Loss Coverage is provided SECTION III — PHYSICAL DAMAGE COVERAGE, for the vehicle withdrawn from Paragraph A.4.e. — Rental Reimbursement service. Coverage is added as follows: (3) Collision only if the Declarations e. Rental Reimbursement Coverage indicate that Collision Coverage is provided for the vehicle withdrawn We will pay up to $75 per day for rental from service. reimbursement expenses incurred by you for the rental of an "auto" because of However, the most we will pay for any "loss"to a covered"auto"that is a: expenses for loss of use is$200 per day, to a maximum of$1,500. (1) Private Passenger; SECTION III — PHYSICAL DAMAGE COVERAGE, (2) Truck; Paragraph A.4.c.—Non-Transportation Loss of Use Expenses is added as follows: (3) Pick-up truck; c. Non-Transportation Loss of Use (4) Panel; or Expenses (5) Van We will pay up to $2,000 for non- transportation expense incurred by you, type vehicle under 20,000 lbs. of Gross because of "loss" to a covered "auto", if Vehicle Weight. Payment applies in caused by: addition to the otherwise applicable amount of each coverage you have on a (1) Other than Collision, only if the covered "auto". No deductibles apply to Declarations indicate that this coverage. Comprehensive Coverage is provided for the"auto"withdrawn from service; ANIC CA 1150 10 13 Page 3 of 4 AV Alaska National INSURANCE COMPANY (1) We will pay only for those expenses SECTION IV — BUSINESS AUTO CONDITIONS — incurred during the policy period Paragraph B.5.b. — Other Insurance is replaced by beginning 24 hours after the "loss" the following: and ending, regardless of the policy's expiration, with the lesser of the b. For Hired Auto Physical Damage following number of days: Coverage, the following are deemed to be covered "autos"you own: (a) The number of days reasonably required to repair or replace the (1) Any covered "auto" you lease, hire, covered"auto". rent, or borrow; and (b) 30 days. (2) Any covered "auto"" hired or rented by your "employee" under a contract (2) This coverage does not apply while in that individual "employee's" name, there are spare or reserve "autos" with your permission, while available to you for your operations. performing duties related to the conduct of your business. (3) The Rental Reimbursement Coverage described above does not However, any"auto" that is leased, hired, apply to a covered "auto" that is rented or borrowed with a driver is not a described or designated as a covered covered "auto". "auto" on Rental Reimbursement Coverage Form CA 99 23. SECTION V — DEFINITIONS — Paragraph C. — "Bodily injury" is replaced by the following: SECTION IV — BUSINESS AUTO CONDITIONS — Paragraph B.2. —Concealment, Misrepresentation Or C. "Bodily injury" means bodily injury, sickness or Fraud is amended by adding Unintentional Failure disease sustained by a person including death or to Disclose Hazards at the end of Paragraph B.2. as mental anguish resulting from any of these. follows: Mental anguish means any type of mental or emotional illness or disease Unintentional Failure to Disclose Hazards If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective April 10,2020 Policy No.20D AS 08913 Insured LaRiviere Incorporated Endorsement No. Countersigned By ©Insurance Services Office, Inc., 2009 ANIC CA 1150 10 13 Page 4 of 4 Alaska National INSURANCE COMPANY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from a written contract that requires you to obtain this anyone liable for an injury covered by this policy. We agreement from us.) will not enforce our right against the person or organization named in the Schedule. (This agreement This agreement shall not operate directly or indirectly applies only to the extent that you perform work under to benefit any one not named in the Schedule. SCHEDULE Any person or organization for whom the Insured has agreed by written contract to furnish this waiver. WC 00 03 13(04 84) Page 1 of 2 AV Alaska National INSURANCE COMPANY SCHEDULE This endorsement changes the policy to which it is attached and, unless otherwise stated, is effective on the date issued at 12:01 A.M. standard time at your mailing address shown in the policy. The information below is required only when this endorsement is issued subsequent to commencement of the policy. Endorsement Effective April 1,2020 Policy No. 20D WS 08913 Insured LaRiviere Incorporated Endorsement No. Countersigned By WC 00 03 13(04 84) Page 2 of 2 Spokane Va� l ley BOND NO: 3224497 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 LaRiviere,Inc.(Contractor),as Principal,a contract for the construction of the project designated as Browns Park Plavground and Shelter Project No. 0315 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 Great American 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$375,577.59 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 b•nd may be executed in two original counterparts,and shall be signed by the parties'duly authorized officers.This bond will o be • cepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the s ety. I C AL(CONTRACTOR) LaRiviere I orporated .SURETY Great American Insurance Company 4 1 Zp' Zo2v (/�' C y 12/28/2020 P ci r:1 Signature Date Surety Signature Date 1' 1&I Ar14S Judith C. Kaiser-Smith P ted Name Printed Name 641 rl Attorney-in-fact Title Title Name,address,and telephone of local office/agent of Surety Company is: PayneWest Insurance 501 N. Riverpoint Blvd., Suite 403, Spokane , WA 99201 509-838-3501 City of Spokane Valley _ Contract No.20-158 Browns Park Playground and Shelter • GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI,OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than 1 Bond No. 3224498 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the GREAT AMERICAN INSURANCE COMPANY,a corporation organized and existing under and by virtue of the laws of the State of Ohio,does hereby nominate,constitute and appoint the person or persons named below its true and lawful attorney-in- fact,for it and in its name,place and stead to execute on behalf of the said Company,as surety,the specific bond,undertaking or contract of suretyship referenced herein;provided that the liability of the said Company on any such bond,undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below.The bond number on this Power of Attorney must match the bond number on the bond to which it is attached or it is invalid. Name Address Limit of Power Judith C. Kaiser-Smith 501 N. Riverpoint Blvd., Suite 403 $loo,000,000.00 Spokane, WA 99202 Principal: LaRiviere Incorporated Obligee: City of Spokane Valley IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 28th day of December, 2020. Attest GREAT AMERICAN INSURANCE COMPANY ..... go4 . e. 3 Assistant Secretary Divisional Senior Pee President STATE OF OHIO,COUNTY OF HAMILTON-ss: MARK VICARIO(877-377-2405) On this 28th day of December , 2020 ,before me personally appeared MARK VICARIO,to me known, being duly sworn,deposes and says that he resides in Cincinnati,Ohio,that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company,the Company described in and which executed the above instrument;that he knows the seal of the said Company;that the seal affixed to the said instrument is such corporate seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto by like authority. SUSAN A KOHORST �, Notary Public State of OhioAL-44a/-rt, a alh.d�v �( ` •..,, '` My Comm.Expires May 18,2025 This Power of Attorney is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9,2008. RESOLVED: That the Divisional President,the several Divisional Senior lice Presidents,Divisional Vice Presidents and Divisonal Assistant Vice Presidents,or any one of them, be and hereby is authorized,from time to time,to appoint one or more Attorneys-in-Fact to execute on behalf of the Company, as surety,any and all bonds,undertakings and contracts of suretyship,or other written obligations in the nature thereof to prescribe their respective duties and the respective limits of their authority;and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certificate of either given for the execution of any bond, undertaking,contract of suretyship, or other written obligation in the nature thereof such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company,do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9,2008 have not been revoked and are now in full force and effect. Signed and sealed this 28th day of December, 2020. Assistant Secretary S1194E(05/20) jValleya BOND NO: 3224497 CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley,Washington,in Spokane County,has awarded to LaRiviere,Inc.(Contractor),as Principal,a contract for the construction of the project designated as Browns Park Plav>_round and Shelter Project No. 0315 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 Great American 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$375.577.59 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 cepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the sur . P 1 CIP (CONTRACTOR) LaRiviere Incorporated SURETY Great American Insurance Company l Z Z8" Z,OZ� ;c�lE�L C� 12/28/7020 P icip. Signature Date Surety Signature Date . �s Judith C. Kaiser-Smith P ' ted Name Printed Name 6.44 Attorney-in-fact Title Title Name,address,and telephone of local office/agent of Surety Company is: PayneWest Insurance 501 N. Riverpoint Blvd., Suite 403, Spokane , WA 99201 509-838-3501 City of Spokane Valley I Contract No.20-158 Browns Park Playground and Shelter Spokane . Valley BOND NO: 3224498 CONTRACTOR'S RETAINAGE BOND to City of Spokane Valley,Washington The City of Spokane Valley,Washington,in Spokane County,has awarded to La Riviere,Inc. ("Contractor"), as Principal,a contract for the construction of the project designated as Browns Park Playground and Shelter Project No.0315(the"Contract")in Spokane Valley,Washington. The Principal,existing under and by virtue of the laws of the State of Washington and authorized to do business in the State of Washington,and Great American Insurance Company organized and existing under the laws of the State of Ohio and authorized to transact business in the State of Washington as Surety, are jointly and severally held and bound unto the City of Spokane Valley, hereinafter called Obligee,and are similarly held and bound unto the beneficiaries of the trust fund created by chapter 60.28 RCW,in the penal sum of 5%of the Contract,which is eighteen thousand seven hundred seventy eight and 88/100 dollars($18,778.88),plus 5%of any increases in the Contract amount that have occurred or may occur,due to change orders,increases in the quantities,or the addition of any new item of work. WHEREAS,on the �.0 day of ,/GG- ,20 the said Principal and Obligee herein executed and entered into the Contract. WHEREAS,said Contract and chapter 60.28 RCW require the Obligee to withhold from the Principal the sum of 5% from monies earned by the Principal on estimates during the progress of the construction, hereinafter referred to as earned retained funds. WHEREAS, the Principal has requested that the Obligee accept a bond in lieu of earned retained funds as allowed under chapter 60.28 RCW. NOW THEREFORE,the condition of the obligation is such that the Principal and Surety are held and bound unto the beneficiaries of the trust fund created by chapter 60.28 RCW in the aforesaid sum. This bond, including any proceeds therefrom,is subject to all claims and liens and in the same manner and priority as set forth for retained percentages in chapter 60.28 RCW. The condition of this obligation is also such that if the Principal shall satisfy all payment obligations to persons who may lawfully claim under the trust fund purposes of chapter 60.28 RCW to the Obligee, and indemnify and hold the Obligee harmless from any and all loss, costs,and damages that the Obligee may sustain by release of the earned retained funds to the Principal,then upon notification of such satisfaction and release of the Surety by the Obligee,this obligation shall be null and void. PROVIDED HOWEVER,that: 1. The Surety shall be liable under this obligation as Principal. The Surety will not be discharged or released from liability for any act, omission or defenses of any kind or nature that would not also discharge Principal. 2. This obligation shall be binding upon and inure to the benefit of the Principal,the Surety,the Obligee, the beneficiaries of the trust fund created by chapter 60.28 RCW and their respective heirs,executors, administrators,successors and assigns. 3. Any suit under this bond must be instituted within the time provided by applicable law. 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. City of Spokane Valley 3 Contract No.20-158 Browns Park Playground and Shelter PRIN AL(CONTRACTOR)LaRiviere Incor orated SURETY Great American Insurance Company Z ZaZo 2. ,,i,,,,V.,,„ ',G 12/28/2020 Princi 1 Sig a e D to Surety Signature Date Judith C. Kaiser-Smith _ Printed Printed Name Attorney-in-fact Ti e Title Name,address,and telephone of local office/agent of Surety Company is: PayneWest Insurance 501 N. Riverpoint Blvd., Suite 403, Spokane , WA 99201 509-838-3501 City of Spokane Valley 4 Contract No.20-158 Browns Park Playground and Shelter GREAT AMERICAN INSURANCE COMPANY® Administrative Office: 301 E 4TH STREET • CINCINNATI,OHIO 45202 • 513-369-5000 • FAX 513-723-2740 The number of persons authorized by this power of attorney is not more than 1 Bond No.3224498 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS:That the GREAT AMERICAN INSURANCE COMPANY,a corporation organized and existing under and by virtue of the laws of the State of Ohio,does hereby nominate,constitute and appoint the person or persons named below its true and lawful attorney-in- fact,for it and in its name,place and stead to execute on behalf of the said Company,as surety,the specific bond,undertaking or contract of suretyship referenced herein;provided that the liability of the said Company on any such bond,undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below.The bond number on this Power of Attorney must match the bond number on the bond to which it is attached or it is invalid. Name Address Limit of Power Judith C. Kaiser-Smith 501 N. Riverpoint Blvd., Suite 403 $too,000,000.00 Spokane, WA 99202 Principal: LaRiviere Incorporated Obligee: City of Spokane Valley IN WITNESS WHEREOF the GREAT AMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate officers and its corporate seal hereunto affixed this 28th day of December, 2020. Attest GREAT AMERICAN INSURANCE COMPANY '04 w c 3 • Assistant Secretary Divisional Senior Vice President STATE OF OHIO,COUNTY OF HAMILTON-ss: MARK VICARIO(877-377-2405) On this 28th day of December , 2020 ,before me personally appeared MARK VICARIO,to me known, being duly sworn,deposes and says that he resides in Cincinnati,Ohio,that he is a Divisional Senior Vice President of the Bond Division of Great American Insurance Company,the Company described in and which executed the above instrument;that he knows the seal of the said Company;that the seal affixed to the said instrument is such corporate seal;that it was so affixed by authority of his office under the By-Laws of said Company,and that he signed his name thereto by like authority. SUSAN A KOHORST q� Notary Public t�ati a --+-=y State of Ohio `'•4.,.'' My Comm.Expires May 18,2025 This Power ofAttomey is granted by authority of the following resolutions adopted by the Board of Directors of Great American Insurance Company by unanimous written consent dated June 9,2008. RESOLVED: That the Divisional President,the several Divisional Senior Vice Presidents,Divisional Vice Presidents and Divisonal Assistant Vice Presidents,or any one of them,be and hereby is authorized,from time to time, to appoint one or more Attorneys-in-Fact to execute on behalf of the Company, as surety,any and all bonds,undertakings and contracts of suretyship,or other written obligations in the nature thereof to prescribe their respective duties and the respective limits of their authority;and to revoke any such appointment at any time. RESOLVED FURTHER: That the Company seal and the signature of any of the aforesaid officers and any Secretary or Assistant Secretary of the Company may be affixed by facsimile to any power of attorney or certfcate of either given for the execution of any bond, undertaking,contract of suretyship, or other written obligation in the nature thereof such signature and seal when so used being hereby adopted by the Company as the original signature of such officer and the original seal of the Company,to be valid and binding upon the Company with the same force and effect as though manually affixed. CERTIFICATION I,STEPHEN C.BERAHA,Assistant Secretary of Great American Insurance Company,do hereby certify that the foregoing Power of Attorney and the Resolutions of the Board of Directors of June 9,2008 have not been revoked and are now in full force and effect. Signed and sealed this 28th day of December, 2020. Ott) L c 3 Assistant Secretary Si 194E(05/20)