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20-172.02 KPFF Consulting Engineers: Sullivan/SR 290 Interchange Reconstruction 20. i72 .02- Washington State �1 Department of Transportation Supplemental Agreement Organization and Address Number 2 KPFF,Inc. Original Agreement Number 1601 Fifth Avenue,Suite 1600 Seattle,WA 98101 20-172 Phone: 206-926-0548 Project Number Execution Date Completion Date April 30, 2023 0311 October 6, 2020 December 31, 2023 Project Title New Maximum Amount Payable Sullivan Road/State Route 290 Interchange Reconstruction $284,854.87 Description of Work Further develop and evaluate the recommendations from the Sullivan Road Corridor Study as they relate to the Sullivan Road/SR-290 Interchange. This project is expected to take place in three phases, described in Exhibit A, Scope of Work. The Local Agency of City of Spokane Valley desires to supplement the agreement entered in to with KPFF.Inc. and executed on October 6. 2020 and identified as Agreement No. 20-172 All provisions in the basic agreement remain in effect except as expressly modified by this supplement. The changes to the agreement are described as follows: Section 1, SCOPE OF WORK, is hereby changed to read: No change. 11 Section IV, TIME FOR BEGINNING AND COMPLETION, is amended to change the number of calendar days for completion of the work to read: The completion date is revised to April 30. 2023. 111 Section V, PAYMENT, shall be amended as follows: No change. as set forth in the attached Exhibit A, and by this reference made a part of this supplement. If you concur with this supplement and agree to the changes as stated above, please sign in the Appropriate spaces below and return to this office for final action. By: aav i d tic. 4 C y' By: ,71)..o...) / AA/ L4D yhi Pr Consultant Signature Approving Authority Signature /i- 2i - 2. j- Date DOT Form 140-063 Revised 09/2005 Client#:25326 KPFFINCO ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)9/16/2022 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEACT Jerry Noyola Greyling Ins. Brokerage/EPIC PHONE 770-220-7699 FAX {A/C,No,Ext): (A/C,No): 3780 Mansell Road,Suite 370 Mass: erry no ola gre lin 'com Alpharetta,GA 30022 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:National Union Fire Ins.Co. 19445 INSURED INSURER e:The Continental Insurance Company 35289 KPFF, Inc. INSURER c:New Hampshire Ins.Co. 23841 1601 5th Ave Allied World Surplus Lines Ins 24319 INSURER D: P Suite 1600 INSURER E: Seattle,WA 98101 INSURER F: COVERAGES CERTIFICATE NUMBER: 22-23 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 SUBR POLICY EFF POLICY EXP W IY LIMITS LTR INSR VD POLICY NUMBER (MMIDDIYYYY) (MM/DDYYY) A X COMMERCIAL GENERAL LIABILITY GL5268336 04/01/2022 04/01/2023 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO $500,000 MED EXP(Any one person) $25,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X Ira LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY CA9775930 04/01/2022 04/01/2023 (EOa aocideDtSINGLE LIMIT $2,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) • B X UMBRELLA LIAB X OCCUR 6050399824 04/01/2022 04/01/2023 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED X RETENTION$0 $ C WORKERS COMPENSATION WCO22298245 AOS 04/01/2022 04/01/2023 X PER OTH- AND EMPLOYERS'LIABILITY (AOS) STATUTE ER Y/N C ANY PROPRIETOR/PARTNER/EXECUTIVE WCO22298244(CA) 04/01/2022 04/01/2023,E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 D Professional/ 03120067 10/10/2022 04/01/2024 Per Claim$10,000,000 Pollution Aggregate$10,000,000 Liability SIR: $250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Sullivan Road/State Route 290.City of Spokane Valley is named as an Additional Insured on the above referenced liability policies with the exception of workers compensation&professional liability where required by written contract.The above referenced liability policies with the exception of workers compensation and professional liability are primary&non-contributory where required by written contract. CERTIFICATE HOLDER CANCELLATION Cityof Spokane ValleySHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE p THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10210 East Sprague Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Spokane,WA 99206-0000 AUTHORIZED REPRESENTATIVE 12/A< ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S3406065/M3404086 JNOY1 POLICY NUMBER: GL5268336 COMMERCIAL GENERAL LIABILITY 04/01/2022 04/01/2023 CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACT OR AGREEMENT. BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II 6 Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", This insurance does not apply to "bodily injury" "property damage" or "personal and advertising or "property damage" occurring after: injury" caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on work, on the project (other than service, your behalf; maintenance or repairs) to be performed by in the performance of your ongoing operations or on behalf of the additional insured(s) at for the additional insured(s) at the location(s) the location of the covered operations has designated above. been completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to 1. The insurance afforded to such additional its intended use by any person or insured only applies to the extent permitted organization other than another contractor or by law; and subcontractor engaged in performing 2. If coverage provided to the additional operations for a principal as a part of the insured is required by a contract or same project. agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 12 19 ® Insurance Services Office, Inc., 2018 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable limits of additional insureds, the following is added to insurance; Section III — Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most applicable limits of insurance. we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 0 Insurance Services Office, Inc., 2018 CG 20 10 12 19 POLICY NUMBER: GL5268336 COMMERCIAL GENERAL LIABILITY 04/01/2022 04/01/2023 CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION PER THE CONTRACT OR AGREEMENT. WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III — Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, required by a contract or agreement, the most by "your work" at the location designated and we will pay on behalf of the additional insured described in the Schedule of this endorsement is the amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable limits of However: insurance; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the by law; and applicable limits of insurance. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 12 19 ® Insurance Services Office, Inc., 2018 Page 1 of 1