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22-050.02 Epic Land Solutions: Pines & Mission Intersection Improvements � Washington State �I/ Department of Transportation Supplemental Agreement Organization and Address Number 2 City of Spokane Valley Original Agreement Number 10210 E Sprague Avenue Spokane Valley,WA 99206 22-050 Phone: (509) 720-5018 Project Number Execution Date Completion Date 0300/#CM4060(001) 04/26/2022 12/31/2023 Project Title New Maximum Amount Payable Pines and Mission Intersection Improvements $22,110.80 Description of Work Right-of-Way Services to assist the City with acquisition of permanent and temporary rights for#0300 Pines and Mission Intersection Improvement project. The Local Agency of City of Spokane Valley desires to supplement the agreement entered in to with Epic Land Solutions.Inc. and executed on 04/26/22 and identified as Agreement No. 22-050 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: Added new AOS and revised offer package as a result of negotiations per attached additional services proposal (Exhibit A). I I Section IV, TIME FOR BEGINNING AND COMPLETION, is amended to change the number of calendar days for completion of the work to read: n/a III Section V, PAYMENT, shall be amended as follows: Maximum amount payable is increased by $3,000 from $19,110.80 to $22,110.80 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: Karen Starr. President By: John Hohman, City Manager Kateh Sf,uy- Karen Stan!Feb 9,2023 13:58 PST, Consultant Signature Approving Authority Signature Z —/3 -- e Date DOT Form 140-063 Revised 09/2005 Exhibit A Epic Land Solutions,Inc. EPIC Puget Sound Regional Office 1950 Black Lake Blvd SW,Suite B Olympia,WA 98512 Land Solutions, Inc. epicland.com February 3,2023 Glenn Ritter,PE Via email:GRitterna.spokanevalley.org Senior Engineer/Project Manager City of Spokane Valley 10210 E.Sprague Ave, Spokane Valley,WA 99206 (509)720-5018 RE: Additional Services Proposal#2—City of Spokane Valley 0300—Pines Road&Mission Avenue Intersection Improvement Project CM#4060(001) Dear Mr.Ritter: Epic Land Solutions, Inc. ("Epic"), is pleased to continue real property and right of way services for the City of Spokane Valley ("City") Pines Road and Mission Avenue Intersection Improvement Project. Due to the additional scope of work with the revised offer and creation an AOS. Epic is proposing an additional fee be added to the overall budget of the project.The purpose of this proposal is to add an additional$3,000.00 in order to complete the full project scope. All terms of scope items and assumptions from Scope&Fee proposal dated March 24, 2022 to remain the same.The$3,000.00 to be allocated towards Acquisition/ Negotiation Task. This additional budget would bring the total budget from $19,110.80 to $22,110.80. If you have any questions, please do not hesitate to contact me at(360)233-7666 or jniella(a.epicland.com. We look forward to working with the City of Spokane Valley on this and future opportunities. Sincerely, Epic Land Solutions, Inc. PeddiCCi, �4 Jessica Niella,RAN Project Manager 360-233-7666 jniella anepicland.com 0300 Pines and Mission-Epic ROW-Amend2 Final Audit Report 2023-02-09 Created: 2023-02-09 By: Colleen Hayes(chayes@epicland.com) Status: Signed Transaction ID: CBJCHBCAABAAiv9eEs4nbGWMt_w2fvzb-kOo1zkH8vGQ "0300 Pines and Mission-Epic ROW-Amend2" History '5 Document created by Colleen Hayes (chayes@epicland.com) 2023-02-09-9:11:30 PM GMT IZ Document emailed to kstarr@epicland.com for signature 2023-02-09-9:11:58 PM GMT t Email viewed by kstarr@epicland.com 2023-02-09-9:20:11 PM GMT Cs© Signer kstarr@epicland.com entered name at signing as Karen Starr 2023-02-09-9:58:19 PM GMT Cs© Document e-signed by Karen Starr(kstarr@epicland.com) Signature Date:2023-02-09-9:58:21 PM GMT-Time Source:server • Agreement completed. 2023-02-09-9:58:21 PM GMT si Adobe Acrobat Sign EPICLAN-01 MCCOWANA ACORD DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9114/2022 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER License#0E67768 CONTACT Dana Schwartz NAME: IOA Insurance Services 4370 La Jolla Village Drive �nHic°°,"N,Ext):(619)574-6223 50203 FAX No):(619)574-6288 Suite 600 AD RIEss:Dana.Schwartz@ioausa.com San Diego,CA 92122 INSURER(S)AFFORDING COVERAGE NAIL# INSURER A;American Casualty Company of Reading,Pennsylvania 20427 INSURED INSURER B:Continental Casualty Company 20443 Epic Land Solutions,Inc. INSURER C:Continental Insurance Company of New Jersey 42625 2601 Airport Drive Suite 115 INSURER D:Transportation Insurance Company 20494 Torrance,CA 90505 INSURER E:Underwriters at Lloyd's London(IL) 15792 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR ,INSD WVD IMM/DD/YYYYI IMM/DDIYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 6079231941 10/1/2022 10/1/2023 DAMAGETORENTED 1,000,000 X X PREMISES(Ea occurrence) $ X Cont Liab/Sev of Int MED EXP(Any one person) $ 15,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIESPER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Ded $ 0 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea acciden) ANY AUTO X x 6079231910 10/1/2022 10/1/2023 BODILY INJURY(Per person) $ — OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X AUTOS ONLY X AUUTOSWN ONLYY (PPOerr accidentDAMAGE X Autos'Owned C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE 6079231938 10/1/2022 10/1/2023 AGGREGATE $ 10'000'000 DED X RETENTION$ 10,000 $ D WORKERS COMPENSATION X STATUTE OERH AND EMPLOYERS'LIABILITY Y/" X 6079231924 10/1/2022 10/1/2023 1,000,000 OFFICER/MEMBERANY OPRIET EXCLUDED,ECUTIVE N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ E Prof Liab/Clms Made CSIB00188-01 10/1/2022 10/1/2023 Per Claim 3,000,000 E Ded.:$25K Per Claim CSIB00188-01 10/1/2022 10/1/2023 Aggregate 4,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Re:Right of Way Acquisition Services Proposal for City of Spokane Valley Pines Road and Mission Avenue Intersection Improvement Project#CM 4060(001) City of Spokane Valley are Additional Insured with respect to General and Auto Liability per the attached endorsements as required by written contract. Insurance is Primary and Non-Contributory.Waiver of Subrogation applies to General Liability,Auto Liability and Workers'Compensation in favor of the Additional Insureds. 30 Days Notice of Cancellation with 10 Days Notice for Non-Payment of Premium in accordance with the policy provisions. 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. AUTHORIZED REPRESENTATIVE City of Spokane TT 10210 E..Sprague A Avenue, on d�BvV Spokane.WA 99206 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD