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22-151.00 Revival General Contracting: ROW Landscape Maintenance Contract No. 22-151 AGREEMENT FOR SERVICES Revival General Contracting THIS AGREEMENT is made by and between the City of Spokane Valley,a code City of the State of Washington, hereinafter "City" and Revival General Contracting, hereinafter "Consultant," jointly referred to as"Parties." IN CONSIDERATION of the terms and conditions contained herein,the Parties agree as follows: 1. Work to Be Performed. Consultant shall provide all labor, services, and material to satisfactorily complete the Scope of Services,attached as Exhibit A. A.Administration. The City Manager or designee shall administer and be the primary contact for Consultant. Prior to commencement of work, Consultant shall contact the City Manager or designee to review the Scope of Services, schedule,and date of completion. Upon notice from the City Manager or designee, Consultant shall commence work, perform the requested tasks in the Scope of Services,stop work,and promptly cure any failure in performance under this Agreement. B. Representations. City has relied upon the qualifications of Consultant in entering into this Agreement. By execution of this Agreement, Consultant represents it possesses the ability, skill, and resources necessary to perform the work and is familiar with all current laws, rules, and regulations which reasonably relate to the Scope of Services. No substitutions of agreed-upon personnel shall be made without the prior written consent of City. Consultant represents that the compensation as stated in paragraph 3 is adequate and sufficient for the timely provision of all professional services required to complete the Scope of Services under this Agreement. Consultant shall be responsible for the technical accuracy of its services and documents resulting therefrom,and City shall not be responsible for discovering deficiencies therein. Consultant shall correct such deficiencies without additional compensation except to the extent such action is directly attributable to deficiencies in City-furnished information. C. Standard of Care. Consultant shall exercise the degree of skill and diligence normally employed by professional consultants engaged in the same profession, and performing the same or similar services at the time such services are performed. D. Modifications. City may modify this Agreement and order changes in the work whenever necessary or advisable. Consultant will accept modifications when ordered in writing by the City Manager or designee, so long as the additional work is within the scope of Consultant's area of practice. Compensation for such modifications or changes shall be as mutually agreed between the Parties. Consultant shall make such revisions in the work as are necessary to correct errors or omissions appearing therein when required to do so by City without additional compensation. 2. Term of Contract. This Agreement shall be in full force and effect upon execution and shall remain in effect until completion of all contractual requirements have been met as determined by City. Consultant shall complete its work by December 31, 2022, unless the time for performance is extended in writing by the Parties. Agreement for Services(without professional liability coverage) Page 1 of 8 Contract No. 22-151 Either Party may terminate this Agreement for material breach after providing the other Party with at least 10 days'prior notice and an opportunity to cure the breach. City may,in addition,terminate this Agreement for any reason by 10 days' written notice to Consultant. In the event of termination without breach, City shall pay Consultant for all work previously authorized and satisfactorily performed prior to the termination date. 3. Compensation City agrees to pay Consultant an agreed upon hourly rate up to a maximum amount of$50,000 as full compensation for everything done under this Agreement, as set forth in Exhibit B. Consultant shall not perform any extra, further, or additional services for which it will request additional compensation from City without a prior written agreement for such services and payment therefore. 4. Payment. Consultant shall be paid monthly upon presentation of an invoice to City. Applications for payment shall be sent to the City Finance Department at the below-stated address. City reserves the right to withhold payment under this Agreement for that portion of the work(if any)which is determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Scope of Services,City standards,City Code,and federal or state standards. 5.Notice. Notices other than applications for payment shall be given in writing as follows: TO THE CITY: TO THE CONSULTANT: Name: Christine Bainbridge, City Clerk Name: Revival General Contracting Phone: (509)720-5000 Phone: (509)435-6708 Address: 10210 East Sprague Avenue Address: 1804 W Broadway Ave. Spokane Valley,WA 99206 Spokane, WA 99201 6. Applicable Laws and Standards. The Parties, in the performance of this Agreement, agree to comply with all applicable federal, state, and local laws and regulations. Consultant warrants that its designs, construction documents,and services shall conform to all federal, state,and local statutes and regulations. 7. Certification Regarding Debarment, Suspension, and Other Responsibility Matters — Primary Covered Transactions. A. By executing this Agreement, the Consultant certifies to the best of its knowledge and belief that it and its principals: 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; 2. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or Agreement for Services(without professional liability coverage) Page 2 of 8 Contract No. 22-151 destruction of records,making false statements,or receiving stolen property; 3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph(A)(2)of this certification;and 4. Have not within a three-year period preceding this application/proposal had one or more public transactions(federal,state,or local)terminated for cause or default. B. Where the prospective primary participant is unable to certify to any of the statements in this certification,such prospective participant shall attach an explanation to this Agreement. 8. Relationship of the Parties. It is understood and agreed that Consultant shall be an independent contractor and not the agent or employee of City,that City is interested in only the results to be achieved, and that the right to control the particular manner,method,and means in which the services are performed is solely within the discretion of Consultant. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Consultant. The Consultant shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 9. Ownership of Documents. All drawings, plans, specifications, and other related documents prepared by Consultant under this Agreement are and shall be the property of City,and may be subject to disclosure pursuant to chapter 42.56 RCW or other applicable public record laws. The written, graphic, mapped, photographic, or visual documents prepared by Consultant under this Agreement shall, unless otherwise provided, be deemed the property of City. City shall be permitted to retain these documents, including reproducible camera-ready originals of reports,reproduction quality mylars of maps,and copies in the form of computer files, for the City's use. City shall have unrestricted authority to publish,disclose, distribute, and otherwise use,in whole or in part,any reports,data,drawings,images,or other material prepared under this Agreement, provided that Consultant shall have no liability for the use of Consultant's work product outside of the scope of its intended purpose. 10.Records. The City or State Auditor or any of their representatives shall have full access to and the right to examine during normal business hours all of Consultant's records with respect to all matters covered in this Agreement. Such representatives shall be permitted to audit, examine, make excerpts or transcripts from such records, and to make audits of all contracts, invoices, materials, payrolls, and record of matters covered by this Agreement for a period of three years from the date final payment is made hereunder. 11.Insurance. Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by Consultant,its agents,representatives,employees,or subcontractors. A. Minimum Scope of Insurance. Consultant's required insurance shall be of the types and coverages described below: 1. Automobile liability insurance covering all owned, non-owned, hired, and leased vehicles. Coverage shall be at least as broad as Insurance Services Office(ISO)form CA 00 01. 2.Commercial general liability insurance shall be at least as broad as ISO occurrence form Agreement for Services(without professional liability coverage) Page 3 of 8 Contract No. 22-151 CG 00 01 and shall cover liability arising from premises,operations,stop-gap independent contractors and personal injury, and advertising injury. City shall be named as an additional insured under Consultant's commercial general liability insurance policy with respect to the work performed for the City using an additional insured endorsement at least as broad as ISO CG 20 26. 3. Workers' compensation coverage as required by the industrial insurance laws of the State of Washington. B.Minimum Amounts of Insurance. Consultant shall maintain the following insurance limits: 1.Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of$1,000,000 per accident. 2. Commercial general liability insurance shall be written with limits no less than $2,000,000 each occurrence,and$2,000,000 general aggregate. C.Other Insurance Provisions. The Consultant's policies are to contain,or be endorsed to contain, the following provisions for automobile liability and commercial general liability insurance: 1. Consultant's insurance coverage shall be primary insurance with respect to the City. Any insurance, self-insurance, or self-insured pool coverage maintained by City shall be in excess of Consultant's insurance and shall not contribute with it. 2.Consultant shall provide City and all additional insured for this work with written notice of any policy cancellation within two business days of their receipt of such notice. 3. If Consultant maintains higher insurance limits than the minimums shown above, City shall be insured for the full available limits of commercial general and excess or umbrella liability maintained by Consultant, irrespective of whether such limits maintained by Consultant are greater than those required by this Agreement or whether any certificate of insurance furnished to the City evidences limits of liability lower than those maintained by Consultant. 4. Failure on the part of Consultant to maintain the insurance as required shall constitute a material breach of the Agreement, upon which the City may, after giving at least five business days' notice to Consultant to correct the breach, immediately terminate the Agreement, or at its sole discretion, procure or renew such insurance and pay any and all premiums in connection therewith, with any sums so expended to be repaid to City on demand, or at the sole discretion of the City, offset against funds due Consultant from the City. D.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.Best rating of not less than A:VII. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, Consultant shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Agreement before commencement of the work. Agreement for Services(without professional liability coverage) Page 4 of 8 Contract No. 22-151 12. Indemnification and Hold Harmless. Consultant shall, at its sole expense, defend, indemnify, and hold harmless City and its officers,agents,and employees,from any and all claims,actions, suits,liability, loss, costs, attorney's fees, costs of litigation, expenses, injuries, and damages of any nature whatsoever relating to or arising out of the wrongful or negligent acts,errors,or omissions in the services provided by Consultant, Consultant's agents, subcontractors, subconsultants, and employees to the fullest extent permitted by law, subject only to the limitations provided below. However, should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115,then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, and volunteers, the Consultant's liability, including the duty and cost to defend, hereunder shall be only to the extent of the Consultant's negligence. It is further specifically and expressly understood that the indemnification provided herein constitutes the Consultant's waiver of immunity under Industrial Insurance, Title 51, RCW, solely for the purpose of this indemnification. This waiver has been mutually negotiated by the parties. The provisions of this section shall survive the expiration or termination of this Agreement. 13.Waiver. No officer,employee,agent,or other individual acting on behalf of either Party has the power, right,or authority to waive any of the conditions or provisions of this Agreement. A waiver in one instance shall not be held to be a waiver of any other subsequent breach or nonperformance. All remedies afforded in this Agreement or by law shall be taken and construed as cumulative and in addition to every other remedy provided herein or by law. Failure of either Party to enforce at any time any of the provisions of this Agreement or to require at any time performance by the other Party of any provision hereof shall in no way be construed to be a waiver of such provisions nor shall it affect the validity of this Agreement or any part thereof. 14. Assignment and Delegation. Neither Party may assign, transfer, or delegate any or all of the responsibilities of this Agreement or the benefits received hereunder without prior written consent of the other Party. 15. Subcontracts. Except as otherwise provided herein, Consultant shall not enter into subcontracts for any of the work contemplated under this Agreement without obtaining prior written approval of City. 16. Confidentiality. Consultant may, from time-to-time,receive information which is deemed by City to be confidential. Consultant shall not disclose such information without the prior express written consent of City or upon order of a court of competent jurisdiction. 17. Jurisdiction and Venue. This Agreement is entered into in Spokane County, Washington. Disputes between City and Consultant shall be resolved in the Superior Court of the State of Washington in Spokane County. Notwithstanding the foregoing, Consultant agrees that it may, at City's request, be joined as a party in any arbitration proceeding between City and any third party that includes a claim or claims that arise out of, or that are related to Consultant's services under this Agreement. Consultant further agrees that an arbitrator's decision therein shall be final and binding on Consultant and that judgment may be entered upon it in any court having jurisdiction thereof. 18. Cost and Attorney's Fees. The prevailing party in any litigation or arbitration arising out of this Agreement shall be entitled to its attorney's fees and costs of such litigation(including expert witness fees). Agreement for Services(without professional liability coverage) Page 5 of 8 Contract No. 22-151 19. Entire Agreement. This written Agreement constitutes the entire and complete agreement between the Parties and supersedes any prior oral or written agreements. This Agreement may not be changed, modified,or altered except in writing signed by the Parties hereto. 20.Anti-kickback. No officer or employee of City,having the power or duty to perform an official act or action related to this Agreement shall have or acquire any interest in this Agreement, or have solicited, accepted,or granted a present or future gift,favor, service,or other thing of value from any person with an interest in this Agreement. 21. Assurance of Compliance with Applicable Federal Law. During the performance of this Agreement, the Consultant,for itself, its assignees,and successors in interest agrees as follows: A. Compliance with Regulations. Consultant shall comply with the federal laws set forth in subsection G, below ("Pertinent Non-Discrimination Authorities") relative to non-discrimination in federally-assisted programs as adopted or amended from time-to-time, which are herein incorporated by reference and made a part of this Agreement. B. Non-discrimination. Consultant,with regard to the work performed by it during this Agreement, shall not discriminate on the grounds of race,color,or national origin in the selection and retention of subcontractors, including procurements of materials and leases of equipment. Consultant shall not participate directly or indirectly in the discrimination prohibited by the Acts and the Regulations, including employment practices when the contract covers any activity, project, or program set forth in Appendix B of 49 CFR Part 21. C. Solicitations for Subcontracts, Including Procurements of Materials and Equipment. In all solicitations, either by competitive bidding, or negotiation made by Consultant for work to be performed under a subcontract, including procurements of materials, or leases of equipment, each potential subcontractor or supplier shall be notified by Consultant of Consultant's obligations under this Agreement and the Acts and the Regulations relative to non-discrimination on the grounds of race,color,or national origin. D. Information and Reports. Consultant shall provide all information and reports required by the Acts,the regulations, and directives issued pursuant thereto, and shall permit access to its books, records,accounts,other sources of information,and its facilities as may be determined by the City or the WSDOT to be pertinent to ascertain compliance with such Acts,regulations,and instructions. Where any information required of Consultant is in the exclusive possession of another who fails or refuses to furnish the information, Consultant shall so certify to the City or the WSDOT, as appropriate,and shall set forth what efforts it has made to obtain the information. E. Sanctions for Noncompliance. In the event of a Consultant's noncompliance with the non- discrimination provisions of this Agreement,the City will impose such contract sanctions as it or the WSDOT may determine to be appropriate,including,but not limited to: 1. Withholding payments to Consultant under the Agreement until Consultant complies; and/or 2. Cancelling,terminating,or suspending the Agreement, in whole or in part. Agreement for Services(without professional liability coverage) Page 6 of 8 Contract No. 22-151 F. Incorporation of Provisions. Consultant shall include the provisions of paragraphs of these Contract Clauses in every subcontract, including procurements of materials and leases of equipment, unless exempt by the Acts, regulations and directives issued pursuant thereto. Consultant shall take action with respect to any subcontract or procurement as the City or the WSDOT may direct as a means of enforcing such provisions, including sanctions for noncompliance. Provided,that if Consultant becomes involved in, or is threatened with litigation by a subcontractor or supplier because of such direction,Consultant may request that the City enter into any litigation to protect the interests of the City. In addition,Consultant may request the United States to enter into the litigation to protect the interests of the United States. G. Pertinent Non-Discrimination Authorities: During the performance of this Agreement, the Consultant agrees to comply with the following non-discrimination statutes and authorities; including but not limited to: Title VI of the Civil Rights Act of 1964(42 U.S.C. §2000d et seq., 78 stat.252),(prohibits discrimination on the basis of race,color,national origin);and 49 CFR Part 21;and 49 Part 26; 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 U.S.C. §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); Agreement for Services(without professional liability coverage) Page 7 of 8 Contract No. 22-151 Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations, which ensures Non-discrimination against minority populations by discouraging programs, policies, and activities with disproportionately high and adverse human health or environmental effects on minority and low-income populations; Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency, and resulting agency guidance, national origin discrimination includes discrimination because of Limited English proficiency(LEP). To ensure compliance with Title VI,you must take reasonable steps to ensure that LEP persons have meaningful access to your programs(70 Fed.Reg.at 74087 to 74100); and Title IX of the Education Amendments of 1972, as amended, which prohibits you from discriminating because of sex in education programs or activities(20 U.S.C. §1681 et seq.). 22. Business Registration. Prior to commencement of work under this Agreement, Consultant shall register with the City as a business if it has not already done so. 23. 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. 24.Exhibits. Exhibits attached and incorporated into this Agreement are: A. Scope of Services B. Fee proposal C.Insurance Certificates The Parties have executed this Agreement this 3"day of Oc.rc C?•f� ,2022, CITY OF SPOKANE VALLEY Consultant: J Hohman,City Manager By: tiv, /� .e Its: Autl94'Ized Repres tativvee APPROVED AS TO FORM: I 1P- - Office e City A orney Agreement for Services(without professional liability coverage) Page 8 of 8 Exhibit A: Scope of Work Right-of-Way Cleanup • The following work tasks will be performed in the CITY'S rights-of-way: a. Weed abatement (no chemicals); b. Vegetation control (no chemicals); c. Non-irrigated swale maintenance; d. Litter control; e. Landscape, manual labor. CITY has purchased small equipment for these activities for use by CONTRACTOR on behalf of the CITY that CONTRACTOR keeps stored at its facility. CONTRACTOR agrees to perform minor maintenance on this equipment on an as-needed basis. For the purposes of this Agreement, "minor maintenance" shall include maintenance which would be performed by an individual if he/she owned this equipment and used it for personal use. a. No lifting beyond 50 pounds; b. Trimming (weed whacking and raking) c. Litter to be discarded at Street Maintenance Facility Dumpster or taken to Sunshine Disposal or Spokane County Transfer Station. d. All work occurs on public right of way. e. Required equipment: work gloves, safety glasses, ear protections (as applicable), weed eaters, shovels (spade and snow) and rakes, and inclement weather clothing. CITY staff will coordinate directly with work crew supervisors on schedule and location of work. • c rrfRAL ACTINCI Revival General Contracting Ihy%t:nr.h!Y Ave. srokync.w:,..mi Right-Of-Wm and City Property Landscape Maintenance Services The City of Spokane Valley agrees to provide Revival General Contracting tic with a work trucker,hauling trailer and all necessary tools and materials as required by Contract Number z2-142 (Right-of-Way and City Property Landscape Services). Revival General Contracting tic will store and maintain the aforementioned work truck,trailer and tools. The following table defines the wage for each of the three employee positions utilized to fulfill the terms of the contract: Position Wage Description Leader Supervisor S34.00/hour Site management. Driver. Communication liaison with Spokane Valley contact. General Labor $3o.00/hour Landscape maintenance. Experienced. Reentry Labor Sz8.00/hour Landscape maintenance. Individuals transitioning from addiction,homelessness, and/or incarceration. Scanned with CamScanner ACo DATE(MNIIDD/Y'fYY)CERTIFICATE OF LIABILITY INSURANCE o9/20/2022 THIS E CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: FAX PHONE I (AIC,Not: Anthonie Barnes Agency LLC (A/C,No,Ext): E-MAIL 9507 N Division St Ste J ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Spokane WA 99218 INSURER A: Atlantic Casualty Insurance Co. 42846 INSURED INSURER B: Revival General Contracting LLC INSURER C: 1804 W Broadway INSURER D: INSURER E: Spokane WA 99201 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 ICY EFF PAID CO TYPE OF INSUNSRRANCE INSD WVD LAIIMS.LICY LIMITS IEXP LTR AUULSUHH POLICY NUMBER (MM!DD/YYYY) (MM!DDIYYYY) - 2.000.000 X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADEI 1 OO,000 X(OCCUR PREMISES(Ea occurrence) $ MEG EXP(Any one person) $ 5,000 A Y L125004289-2 08/05/2022 08/05/2023 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LOLGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 PRO- LOC $ X POLICY JECT OTHER: qqgg �I^ COMBINED SINGLE LIMB $ AUTOMOBILE LIABILITY ka -' sp® �,,I—ice✓l (Ea accident) 11 ���111 BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ d- PROPERTY DAMAGE AUTOS AUTOS NON-OWNED ^l S I,/{Gt�ti��s i' 4 (Per accident) $ HIRED AUTOS AUTOS CO $ UMBRELLA LIAB OCCUR 'lam-L/n'Pr, ("r 1 �j 4 1,� . / EACH OCCURRENCE $ EXCESS LIAB AGGREGATE $ CLAIMS-MADE fl6/ /9_ ,�ccn DED I I RETENTION$ k(// P� r��AI L///TI/ /y $ WORKERS COMPENSATION / '' s I STATUTE I I EORH AND EMPLOYERS'LIABILITY Y 1 N /1-- j� / 'µ�� ✓✓✓QQQ E.L.EACH ACCIDENT S OFFIANYCER/MEETOR/PARTNER/EXECUTIVE IN/A � '(� TTT lY 1 ,(Man t lME NHR EXCLUDED? N ^ � / E.L.DISEASE-EA EMPLOYEE $ (Mandatory in NH) 0 n /�4- If yes,describe under fL� LJ E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS below qulred) DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (A CERTIFICATE HOLDER IS NAMED ADDITIONAL CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF SPOKANE VALLEY 10210 E.Sprague Ave. AUTHORIZED REPRESENTATIVE f f Spokane WA 99201 Gi f _ I ©1988-2014 ACORD CORPORATION. All rights reserved ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ti7A Fire Insurance Exchange(A Reciprocal Insurer) FA R M E R A Part Of The Farmers Insurance Group Of Companies® INSURANCE Home Office:6301 Owensmouth Ave.,Woodland Hills,CA 91367 POLICY DECLARATIONS BUSINESS AUTO v 04.00 ITEM ONE Named REVIVAL GENERAL CONTRACTING Insured Mailing 1804 W BROADWAY AVE Address SPOKANE,WA 99201-1820 Policy Number 60679-19-23 P 07-27-2022 Policy From Period To 04-30-2023 12:01 A.M.Standard time at your mailing address shown above. In return for the payment of premium and subject to all the terms of this policy, we agree with you to provide insurance as stated in this policy. We provide insurance only for those Coverages described and for which a specific limit of insurance is shown. The following premium credits and discounts applied to the premium associated with this coverage part: Multiple Policy Discount-Homeowners And Personal Auto Insurance Multiple Policy Discount-Commercial Property Insurance There may be other credits and discounts you may be able to enjoy,please contact your agent for full details. Your Agent Anthonie Barnes x 9507 N Division St#j Spokane,WA 99218 (509)467-5127 Email:abarnes2@farmersagent.com License#:983667 56-6190 2ND EDITION 07-17 C6190201 Page 1 of 8 Policy Number: 60679-19-23 Effective Date: 07-27-2022 ITEM TWO-SCHEDULE OF COVERAGES AND COVERED AUTOS *This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those"autos" shown as covered "autos". "Autos" are shown as covered"autos"for a particular coverage by the entry of one or more of the symbols from the COVERED AUTO Section of the Business Auto Coverage Form next to the name of the coverage. *Covered Auto Coverage Designation LimltOf insurance Premium Symbols ;> Liability 7 8 $300,000 $2,399 Medical Payments 7 See ITEM THREE $281 Uninsured Motorist 7 See ITEM THREE Included Underinsured Motorist 7 See ITEM THREE $222 Uninsured Motorist 7 See ITEM THREE Included Property Damage Underinsured Motorist 7 See ITEM THREE Included Property Damage Comprehensive 78 Actual Cash Value or Cost of Repair,whichever is $1,140 less,minus applicable deductible for each covered auto. But no deductible applies to loss caused by Fire or Lightning.See ITEM FOUR for hired or borrowed"Autos". Collision 7 8 Actual Cash Value or Cost of Repair,whichever is $1,413 less,minus applicable deductible for each covered auto.See ITEM FOUR for hired or borrowed"Autos". Towing And Labor 7 $500 $44 **Premium for Other Coverages and Endorsements $689 Total Premium $6,188 **For details of "Other Coverages",see ITEM FOUR,ITEM FIVE,and POLICY FORMS AND ENDORSEMENTS. 56-6190 2ND EDITION 07-17 C6190202 Page 2 of 8 Policy Number: 60679-19-23 Effective Date: 07-27-2022 ITEM THREE-SCHEDULE OF COVERED AUTOS YOU OWN(DETAIL) Covered Auto No 004 ViN 1'GN D1103 E4XD296003 Descrip#iora: 1999CHEVROI ETVENTURE Garaging 99201` Coverage Limit OfinsuranceOrDeductible Premium Liability $300,000 $1,024 Medical Payments $1,000 $59 Uninsured Motorist Included Included Underinsured Motorist $300,000 $122 Uninsured Motorist Property Damage See Endorsement Included Underinsured Motorist Property Damage Included Included Comprehensive $1,000 Deductible $685 Collision $1,000 Deductible $959 Towing And Labor $500 $25 Rental Reimbursement $30 per day,30 days $33 • Vehicle Total Premium $2,907 r, 0 o GoveredAuto.N.0 0Q5 VIN .4RADU'i425NN1.78012:;. N Descrip#ian 2a22 iN EERSTATE WEST ;: Garaging zip 99201 LL, n Coverage Limit Of insurance Or Deductible Premiutrr 0 Liability $300,000 $63 a, Medical Payments $1,000 $59 o Comprehensive $1,000 Deductible $111 o Collision N $1,000 Deductible $63 CO 0 0 0 0 • f .fig Vehicle Total Premium $296 56-6190 2ND EDITION 07-17 C6190204 Page 3 of 8 Policy Number: 60679-19-23 Effective Date: 07-27-2022 ITEM THREE-SCHEDULE OF COVERED AUTOS YOU OWN(DETAIL) Covered Auto No 006 : VlN 2SV1lt3W 11 A65S025170 Llescriptiorr 2006 RAOYAL CARGO Garaging XIP, 992• Q1 • Coverage Limit Of Insurance Or Deductible Premium Liability $300,000 $102 Medical Payments $1,000 $59 Comprehensive $1,000 Deductible $81 Collision $1,000 Deductible $58 Vehicle Total Premium $300 ::Covered Auto:No 0O7 ..... .:.. VIN 1NA98229884 �escriptian f998 BtCa TF�f. Gatagirag Xip 992 Coverage Limitof I nsurance Or Deductible Premium Liability $300,000 $106 Medical Payments $1,000 $59 Comprehensive $1,000 Deductible $65 Collision $1,000 Deductible $112 Vehicle Total Premium $342 56-6190 2ND EDITION 07-17 C6190204 Page 4 of 8 Policy Number: 60679-19-23 Effective Date: 07-27-2022 ITEM THREE-SCHEDULE OF COVERED AUTOS YOU OWN(DETAIL) Covered Auto;!No 008 VIN: 1',FTSW3a:P93EC99294 Descriptpon 2003.FOFD F350 S RW S<' Garaging Zip::9920t. Coverage. Limit Of Insurance Or Deductible Premium. Liability $300,000 $1,104 Medical Payments $1,000 $45 Uninsured Motorist Included Included Underinsured Motorist $300,000 $100 Uninsured Motorist Property Damage See Endorsement Included Underinsured Motorist Property Damage Included Included Comprehensive $1,000 Deductible $198 Collision $1,000 Deductible $221 Towing And Labor $500 $19 Rental Reimbursement $30 per day,30 days $25 Vehicle Total Premium $1,712 00 CO Covered Auto:N4 VIN O ; N fescriFtion Garaging ZiR z m Coverts a Limit Of Insurance Or Deductible Premium g _ 0 Ql 0 n O 0 0 N M 0 O O O _ m • O Vehicle Total Premium 56-6190 2ND EDITION 07-17 C6190204 Page 5 of 8 Policy Number: 60679-19-23 Effective Date: 07-27-2022 ITEM FOUR-HIRED OR BORROWED COVERED AUTO Cost of hire means the total amount you incur for the hire of"autos"you don't own (not including "autos" you borrow or rent from your employees or their family members).Cost of hire does not include charges for services performed by motor carriers of property or passengers. Liability Coverage:Rating Saris,Cost Of Hire: ::; ' 5t�te .. •:: ;::Estimated Annual Cost Of Hire Premium WA :::;. .. . $57 Subtotal $57 Physical Damage Coverage, :: .•:»;>;> Coverage Limit Of Insurance Estimated Annual ....,: ;. :.: /nd Deductible Cost Ofi Hlre Premium `. Comprehensive Actual Cash Value,Cost of Repair or$100,000,whichever $1 $27 is less,minus$100 deductible for each covered auto. But no deductible applies to loss caused by Fire or Lightning. Collision Actual Cash Value,Cost of Repair or$100,000,whichever $1 $37 is less,minus$1,000 deductible for each covered auto. Subtotal $64 ITEM FIVE-NON-OWNERSHIP LIABILITY Non-Ownership Liability covers bodily injury or property damage arising out of the maintenance or use of a non-owned automobile in the business by any person other than the insured. ;Named insured's Business Rating Basis Number Premium .:: Other than a Number of Employees Social Service Agency Number of Partners Number of Employees Social Service Agency Number of Volunteers Subtotal 56-6190 2ND EDITION 07-17 • C6190205 Page 6 of 8 Policy Number: 60679-19-23 Effective Date: 07-27-2022 POLICY FORMS AND ENDORSEMENTS Number , Title 25-9230ED3 Reminder-Review Your Coverages 56-5166ED5 Additional Policy Conditions CA00010310 Business Auto Policy CA01350108 Changes In Policy CA21340108 Washington Uim Coy CA23920106 Washington Exclusion Of Terroris CA23940306 Silica Or Silica-Related Dust Ex CA99230310 Rental Reimbursement Coverage E2013-ED1 Farm Tow Coverage E2016-ED1 Auto Medical Payment Coverage E3027-ED1 No Covg-Cert Computer Rel Losses E4277-ED1 Policy Changes IL00030498 Calculation Of Premium IL01231113 Washington Changes-Defense Costs IL01460810 Common Policy Conditions-Wa IL01980900 Wa-Nuclear Energy Liab Excl End J6738-ED1 Two Or More Coverage Forms J7118-ED1 Auto Rideshare Exclusion J7119-ED3 Ded For Unlisted Employee Driver J7153-ED1 Additional Benefits And Services J7499-ED2 Bus Auto Coverage Amendatory End S7918-ED1 Wa-Amend To Membership/Policy Fe 00 0 N 0 O N N Lu co co O rn N Ql to 0 LO 0 O r O O O LOSS PAYEES O !OA- Countersigned(Date) By Authorized Representative 56-6190 2ND EDITION 07-17 C6190206 Page 7 of 8 Policy Number: 60679-19-23 Effective Date: 07-27-2022 DRIVERS THAT ARE LISTED UNDER THIS POLICY H rst Name Last Name . irfcense Driver License Staff Aaron Allen WA XXXXXX78O7 Shawn Kingsbury WA XXXXXXF1SB Kevin Choate WA XXXXXXF65B Excluded drivers will be listed in the Excluded Driver Endorsement or Restriction Endorsement,if attached. 56-6190 2ND EDITION 07-17 C6190208 Page 8 of 8 •"1 .1 M' STATE OF WASHINGTON Department of Labor&Industries Certificate of Workers' Compensation Coverage September 21, 2022 WA UBI No. 604 476 221 L&l Account ID 699,874-00 Legal Business Name REVIVAL GENERAL CONTRACTING LLC Doing Business As REVIVAL GENERAL CONTRACTING LL Workers'Comp Premium Status: Account is current. Estimated Workers Reported Quarter 2 of Year 2022"4 to 6 Workers" (See Description Below) Account Representative Employer Services Help Line, (360)902-4817 Licensed Contractor? Yes License No. REVIVGC814NG License Expiration 10/11/2023 What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial Insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RCW 51.12.050 and 51.16.190). Cd t7s _..__......_....D/ —, GATE(MM/OD%YYYY) �,,,,,, CERTIFICATE OF LIABILITY INSURANCE 09n9n022 • 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 i 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). I AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 'IMPORTANT:If tyre certificate holder is an ADDITIONAL INSURED.the poiicy(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 enddraement(s), PRODUCER CONTACT NAME: Anthonie Bames(793436K) + PHONE FAX 9507 N Division St Ste J (A/C,NO,EXT):509-467-5127 (A/C.No):509-166 2022 E-MAIL Spokane WA 99218-1553 ADDRESS: abgmes2(d�tarmersagentcom INSURER(S)AFFORDING COVERAGE I NAIC it —"" INSURED INSURER A: Truck Insurance Exchange 21709 INSURER B: Farmers Insurance Exchange 21652 REVIVAL GENERAL CONTRACTING , _ .y_. INSURERC: Mid Century Insurance Company 21687 1804 W BROADWAY AVE 1----............. ._._ INSURERD: Fire Insurance Exchange 21660 INSURER E._......,...._..._.. i SPOKANE WA 99201 t__--....._..- !INSURER F: 1 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: (THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BE i.OW HAYS BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POUCY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT ORC.:711ER DOCUMENT WITH RESPECT TO WHICH Dili CERTIFICATE MA'rBE.ISSUED OR MAY PERTAIN.THE ITcURANCE AFFORDED BY THE I POLICIES DESCRIBED HEREIN IS SURIECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED Er PAID CERIMS. { INSR ADOTL. SUER f ...—._TYPEOFINSURANCE POLICYNUMBER (MMIDD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ I f DAMAGE TO RENTED • iS I CLAIMS-MADE I OCC::R J i PRE4IISE5(Ea C�...urrence) f i MED EXP(AnY One pers„n3 • 1 __—..._._._...._.._.._._._.._�__�._ R'EPSL`E4fiD:AOV 1NlUY jc R ` GENE AGGREC.ATE LIMITMIT AP PUESPER' CENERAL AGGREGATE IS POLICY IT ? OJtt? 1 ItOC PRODUCTS•COMP/CPAGG b I OTHER: S 1 AUTOMOBILELABIUTY COMBINED SINGLE UMIT 'S 1,000,0001 a accident) 1. ANY AUTO B.ODILY INJURY(Pe(person) $ D I OWNEL'AW 45 ,v SCHEDULED ONLY /1 C i' BOtXLY!WAY(Per ctdent)R _� 606791923 , 04/30/2022 04/30/2023 { ............ .; •• ItIREDA=UTOS NON-OWNED PROPERTY DAMAGE• �S ' ONLY j AUTOS ONLY (Per accident) _... 1 • .----- -- ._....__....._..._.._............................._._._ S i _ -;-UMBRELLAUAB OCCUR EACH OCCURRENCE IS ---`-_...... • ! EXCESS UAB CLAIMS-MADE: AGGREGATE 'b ..—'.....__._ 1. • • DIXIS . I 1 RE1 ENT)ON$ --_ I i WORKERS COMPENSATION }� _- ,PER AND EMPLOYERS'UABIUTY STATUTE 'Hf OER iS I ANY PROPRITTTOR PARTNERf Y/ri iffilS i EXECUTIVE OFFICER,MEMBER N/A j F.1.UIStASF-FA EMIT0YER: EXCLUDED.?(Mandatary in NH) If yes,dr&re.'e;mdrr DESCRIPTION OF ' • • OPERATIONS Ecioer E.L.DISEASE-POLICY.LIMIT 1c _.. T. _._._....__.._I I --.._ I a i DESCRIPTION OF OPERATIONSi LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) :Endorsement-(IF APPLICABLE,WILL BE DELIVERED WITH POLICY), i 1 CERTIFICATE HOLDER CANCELLATION I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL LED BEFORE THE EXPIRATION j DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. • • • 1 AUTIORIZEDREPRESENTATIVE ACORD 25(2016/03) E)1988-2015 ACORD CORPORATION.All Rights Reserved 31-1769 1 t-15 The ACORD name and logo are registered marks of ACORD •