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22-050.03 Epic Land Solutions: Pines & Mission Intersection Improvements 2P .60.0. 03 Washington State V, Department of Transportation Supplemental Agreement Organization and Address Number 3 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 $23,110.80 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 into 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 appraisal review for reduced TCE as a result of negotiations with property owner. 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 Section V, PAYMENT, shall be amended as follows: Maximum amount payable is increased by $1,000 from $22,110.80 to$23,110.80. 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 lau-eh Consultant Signature Approving Authority Signature y - 27 - z3 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 I and Solutions, Inc. epicland.com April 17,2023 Glenn Ritter,PE Via email:GRitter itspokanevallev.orq Senior Engineers Project Manager City of Spokane Valley 10210 E.Sprague Ave,Spokane Valley,WA 99206 (509)720-5018 RE: Additional Services Proposal#3-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 which included a CV3 by John Amey,Epic is requesting an additional fee be added to the overall budget of the project The purpose of this proposal is to add an additional$1,000.00 in order to complete Certificate of Value#3 due to the change in Right of Way Plans. All terms of scope items and assumptions from Scope&Fee proposal dated March 24,2022 to remain the same.The$1,000.00 to be allocated towards Review Appraisals Task_ This additional budget would bring the total budget from $22,110.80 to S23,110.80. If you have any questions,please do not hesitate to contact Jessica Niella at(360)233-7656 or iniella0epidand_com. We look forward to working with the City of Spokane Valley on this and future opportunities. Sincerely,. e4 i4e C Vac/am Christine Nickerson,SRWA Epic Land Solutions,Inc. Vice President of Northwest Right of Way Services _.—.0 EPICLAN-01 MCCOWANA A`CO�RO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 9/14/2022 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 PHONE FAX 4370 La Jolla Village Drive (A/c,No,Ext):(619)574-6223 50203 (A/C,No):(619)574-6288 Suite 600 ADDREE-MAIL SS:Dana.Schwartz@ioausa.com San Diego,CA 92122 INSURER(S)AFFORDING COVERAGE NAIC# 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRINSD WVD (MM/DD/YYYYI (MM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 - CLAIMS-MADE X OCCUR X X 6079231941 10/1/2022 10/1/2023 pREMSESMoccurrDence) $ 1,000,000 X Cont Liab/Sev of Int MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Ded $ 0 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 lit (Ea accident) $ 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 AUUTOS ONLY PROPERTY 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 PER OTH- AND EMPLOYERS'LIABILITY 6079231924 10/1/2022 10/1/2023 STATUTE ER Y/N X 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (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 Valley TT )` 10210 E.Sprague Avenue, �AvV (Spokane.WA 99206 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CNA Blanket Additional Insured - Owners, Lessees or Contractors -with Products-Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused in whole or in part by your acts or omissions,or the acts or omissions of those acting on your behalf: A. in the performance of your ongoing operations subject to such written contract;or B. in the performance of your work subject to such written contract, but only with respect to bodily injury or property damage included in the products-completed operations hazard,and only if: 1. the written contract requires you to provide the additional insured such coverage;and 2. this coverage part provides such coverage. II. But if the written contract requires: A. additional insured coverage under the 11-85 edition, 10-93 edition,or 10-01 edition of CG2010, or under the 10-01 edition of CG2037; or B. additional insured coverage with"arising out of language; or C. additional insured coverage to the greatest extent permissible by law; then paragraph I.above is deleted in its entirety and replaced by the following: WHO IS AN INSURED is amended to include as an Insured any person or organization whom you are required by written contract to add as an additional insured on this coverage part, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of your work that is subject to such written contract. III. Subject always to the terms and conditions of this policy, including the limits of insurance,the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. IV. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: the rendering of, or the failure to render,any professional architectural, engineering,or surveying services, Insured Name: Epic Land Solutions, Inc. A. including: 1. the preparing, approving, or failing to prepare or approve maps,shop drawings, opinions, reports, surveys, field orders,change orders or drawings and specifications; and 2. supervisory, inspection,architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS,the Condition entitled Other Insurance is amended to add the following,which supersedes any provision to the contrary in this Condition or elsewhere in this coverage part: Primary and Noncontributory Insurance CNA75079XX(10-16) Policy No.:6079231941 Page 1 of 2 Insured Name: Epic Land Solutions, Inc. American Casualty Company of Reading, PA Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc„with its permission. CNA Blanket Additional Insured - Owners, Lessees or Contractors -with Products-Completed Operations Coverage Endorsement With respect to other insurance available to the additional insured under which the additional insured is a named insured,this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured;or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above,this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement,the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense,Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense,or settlement of the claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self-insurer,whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory,this paragraph 3. does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement,the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers,takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75079XX(10-16) Policy No.: 6079231941 Page 2 of 2 Insured Name: Epic Land Solutions, Inc. American Casualty Company of Reading, PA Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. CNA Primary and Noncontributory - Other Insurance Condition Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART It is understood and agreed that the condition entitled Other Insurance is amended to add the following: Primary And Noncontributory Insurance Notwithstanding anything to the contrary, this insurance is primary to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: a. the additional insured is a named insured under such other insurance; and b. the Named Insured has agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of the Policy remain unchanged. This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers,takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below,and expires concurrently with said Policy. CNA74987XX(1-15) Policy No: 6079231941 Page 1 of 1 Insured Name: Epic Land Solutions, Inc. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. CNA Waiver of Transfer of Rights of Recovery Against Others to the Insurer Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Blanket when required by written contract Information required to complete this Schedule, if not shown above,will be shown in the Declarations. It is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To The Insurer is amended by the addition of the following: Solely with respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named Insured's ongoing operations or your work done under a contract with that person or organization and included in the products-completed operations hazard. All other terms and conditions of the Policy remain unchanged. This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers,takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75008XX(1-15) Policy No:6079231941 Page 1 of 1 Insured Name: Epic Land Solutions, Inc. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. POLICY NUMBER: 6079231910 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Epic Land Solutions, Inc. SCHEDULE Name Of Person(s) Or Organization(s): Blanket as required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is Autos Liability Coverage in the Business Auto and an "insured" for Covered Autos Liability Coverage, but Motor Carrier Coverage Forms and Paragraph D.2. of only to the extent that person or organization qualifies Section I — Covered Autos Coverages of the Auto as an "insured" under the Who Is An Insured provision Dealers Coverage Form. contained in Paragraph A.1. of Section II — Covered CA 20 48 10 13 Copyright, Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: 6079231910 COMMERCIAL AUTO CA 04 4410 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Epic Land Solutions, Inc. SCHEDULE Name(s) Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT REQUIREMENT PRIOR TO LOSS. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 4410 13 Copyright, Insurance Services Office, Inc., 2011 Page 1 of 1 CNA BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement changes the policy to which it is attached. It is agreed that Part One-Workers'Compensation Insurance G.Recovery From Others and Part Two- Employers'Liability Insurance H.Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE-Refer to the Schedule of Operations The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure.The amount is Blanket Waiver of Subrogation Percentage Charge%. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: G-19160-B (11-1997) Named Insured:Epic Land Solutions,Inc. Policy No.:6079231924 Underwriting Company: Transportation Insurance Company © Copyright CNA All Rights Reserved.