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23-109.00 Cameron Reilly, LLC Contract This agreement is entered into this PI° day ofJUrle, , 2023, between the City of Spokane Valley ("City")and Cameron Reilly,LLC ("Contractor"),pursuant to Title 35 RCW, as adopted or amended. In consideration of the terms and conditions contained herein and attached and made a part of this agreement,the parties agree as follows: I. The Contractor shall do all work and furnish all tools,materials, and equipment for: Broadway and Park Intersection Project#347 Contract 23-109 in accordance with and as described in the project plans and specification,and the standard specification of the Washington State of Department of Transportation which are by this reference incorporated herein and made part hereof and, shall perform any changes in the work in accord with the Contract Documents. The Contractor shall provide and bear the expense of all equipment, work, and labor, of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in these Contract Documents except those items mentioned therein to be furnished by the City. II. The City hereby promises and agrees with the Contractor to employ, and does employ the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with the project plans and specification and the terms and conditions herein contained and hereby contracts to pay for the same according to the referenced specifications and the schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this contract. III. The Contractor for himself/herself, and for his/hers heirs, executors, administrators, successors, and assigns,does hereby agree to full performance of all covenants required of the Contractor in the contract. IV. It is further provided that no liability shall attach to the City by reason of entering onto this contract, except as provided herein. V. The project was awarded for the bid amount of$2,383,383.00,plus applicable sales tax. IN WITNESS WHEREOF,the Contractor has executed this instrument,on the date below, and the City has caused this instrument to be executed on the date stated above. City of Spokane Valley C—1 Contract Forms Broadway&Park Intersection Project Executed by Contractor 5/31/23 ,2023. Date Mike Reilly Printed Name President Title Signature City of Spokane Valley John Holnnan Printed Name City Manager Title /400/7":„. Signature Revise: '-8-i5 City of Spokane Valley C-2 Contract Forms Broadway&Park Intersection Project CI'YOF 411 . \' r BOND NO: 107807715 CONTRACTOR'S PERFORMANCE BOND to City of Spokane Valley,Washington The City of Spokane Valley, Spokane County,Washington,has awarded to Cameron Reilly,LLC (Contractor),as Principal, a contract for the construction of the project designated as Broadway and Park Intersectiion,Project No.0347 in Spokane Valley, Washington,and said Principal is required under the terms of the Contract to furnish a performance bond in accordance with chapter 39.08 Revised Code of Washington(RCW). The Principal, and Travelers Casualty and Surety Company of America (Surety), a corporation, organized under the laws of Connecticut and licensed to do business in the State of Washington as surety and named in the current list of"Surety Companies Acceptable in Federal Bonds"as published in the Federal Register by the Audit Staff Bureau of Accounts,U.S.Treasury Dept.,are jointly and severally held and firmly bound to the City of Spokane Valley,as Obligee,in the sum of$ 2,396,434.77 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 be accepted if it is accompanied by a fully executed and original power of attorney for the officer executing on behalf of the surety. Cameron Reilly, LLC Travelers Casualty and Surety Company of America PRINCIPAL(CONTRA .-. " /e„, � 31-202 3 Principal Signature ate Surety Sign Date Mike Reilly Peggy A. Firth Printed Name Printed Name President Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: Alliant Insurance Services, Inc. 818 W. Riverside Ave.Suite 800,Spokane,WA 99201 (509) 325-3024 City of Spokane Valley C-3 Contract Forms Broadway&Park Intersection Project CITY OF --✓ x BOND NO: 107807715 CONTRACTOR'S PAYMENT BOND(FEDERALLY FUNDED PROJECT) to City of Spokane Valley,Washington The City of Spokane Valley, Spokane County,Washington, has awarded to Cameron Reilly,LLC (Contractor), as Principal, a contract for the construction of the project designated as Broadway and Park Intersection,Project No.0347 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)and chapter 60.28 RCW. The Principal, and Travelers Casualty and Surety Company of America (Surety), a corporation organized under the laws of Connecticut 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$ 2,396,434.77 total Contract amount,subject to the provisions herein. This payment bond shall cover any and all taxes incurred pursuant to Titles 50 and 51 RCW,taxes imposed on the Principal pursuant to Title 82 RCW,and any additional sales taxes. 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, 39.12, and 60.28 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;shall pay all taxes due pursuant to Titles 50,51,and 82 RCW;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 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. Cameron Reilly, LLC Travelers Casualty and Surety Company of America PRINCIPALPA (CONTRACTOR) STY ,f;A. � A. -31-2023 Principal Signature Date Surety Sign' td#eJ Date Mike Reilly Peggy A. Firth Printed Name Printed Name President Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: Alliant Insurance Services, Inc. 818 W. Riverside Ave.Suite 800,Spokane,WA 99201 (509)325-3024 City of Spokane Valley C-4 Contract Forms Broadway&Park Intersection Project Travelers Casualty and Surety Company of America ��► Travelers Casualty and Surety Company TRAVELERS J St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint PEGGY A FIRTH of SPOKANE , Washington , their true and lawful Attomey(s)-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed,and their corporate seals to be hereto affixed,this 21st day of April, 2021. oatO` 4r p OONL e a 7� State of Connecticut By: City of Hartford ss. Robert L.Rane , enior Vice President On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. IN WITNESS WHEREOF,I hereunto set my hand and official seal. Crow ~ My Commission expires the 30th day of June,2026Kaye " * �0,4(/ i���e.�'6 Anna P.Nowik,Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of the Companies,which resolutions are now in full force and effect,reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President,any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority;and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President,any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in- Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which remains in full force and effect. Dated this 31st day of May , 2023 . Aras n • Kevin E.Hughes,Ass�cretary To verify the authenticity of this Power of Attorney,please call us at 1-800-421-3880. Please refer to the above-named Attorney(s)--in-Factand the details of the bond to which this Power of Attorney is attached. .001;Val F BOND NO: 107807716 CONTRACTOR'S RETAINAGE BOND to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Cameron Reilly, LLC ("Contractor"), as Principal,a contract for the construction of the project designated as Broadway and Park Intersection Project No.0347(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 Travelers Casualty and Surety Company of America organized and existing under the laws of the State of Connecticut 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 the penal sum of 5% of the Contract, which is n undre ineteen ous'and light undre o Twenty One and 74/100ths dollars ($ 119,821.74 ),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 day of WV) ,2e3the 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. City of Spokane Valley C-5 Contract Forms Broadway&Park Intersection Project 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. Cameron Reilly, LLC Travelers Casualty and Surety Company of America PRINCIPAL(CONTRACTOR) 6/ SURETY G/ Z} / 1�r?� 5-31-2023 Principal � ��1 p Signature ! Date Surety S ; e Date - Mike Reilly Peggy A. Firth Printed Name Printed Name President Attorney-in-Fact Title Title Name,address,and telephone of local office/agent of Surety Company is: Alliant Insurance Services, Inc. 818 W. Riverside Ave.Suite 800,Spokane,WA 99201 (509) 325-3024 City of Spokane Valley C-6 Contract Forms Broadway&Park Intersection Project • Travelers Casualty and Surety Company of America �► Travelers Casualty and Surety Company TRAVELERS J St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint PEGGY A FIRTH of SPOKANE , Washington , their true and lawful Attomey(s)-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF,the Companies have caused this instrument to be signed,and their corporate seals to be hereto affixed,this 21st day of April, 2021. NM,w!►r (0:ab. �•ilk,s�t04. of. State of Connecticut By: City of Hartford ss. Robert L.Rane , enior Vice President On this the 21st day of April, 2021, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer. IN WITNESS WHEREOF,I hereunto set my hand and official seal. rly ei My Commission expires the 30th day of June,2026 * 4 * hll�d fL iwe`c Anna P.Nowik,Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of the Companies,which resolutions are now in full force and effect,reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President,any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority;and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in- Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of each of the Companies, do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which remains in full force and effect. Dated this 31st day of May , 2023 . y23 • gel Kevin E.Hughes,Assistant Secretary To verify the authenticity of this Power of Attorney,please call us at 1-800-421-3880. Please refer to the above-named Attorney(s)-in-Fact and the details of the bond to which this Power of Attorney is attached. t � ® DATE(MM/DD/YYYY) ,4� CERTIFICATE OF LIABILITY INSURANCE 06/01/2023 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 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 CONTACT NAME: Parker,Smith&Feek Insurance,LLC. PHONE 425 709 3600 FAX 425-709-7460 2233 112th Avenue NE E-MAILNo.Ext): (AIC,No): E-M Bellevue,WA 98004 ADDRESS:___ INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Middlesex Insurance Company INSURED INSURER B: Cameron-Reilly,LLC 309 N Park Rd INSURER C: Spokane,WA 99212 INSURER D: 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 SUBR POLICY EFF POLICY EXP LIMITS LTRINSR WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) A GENERAL LIABILITY A0163880005 03/01/2023 03/01/2024 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 500,000 X COMMERCIAL GENERAL LIABILITY X X PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 -7 POLICY X JEC X LOC $ A AUTOMOBILE LIABILITY A0163880001 03/01/2023 03/01/2024 COMB(EaaBI ED SINGLE LIMIT $ 1,000,000 X ANY AUTO X BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) A UMBRELLA LIAB X OCCUR A0163880006 03/01/2023 03/01/2024 EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB CLAIMS-MADE X AGGREGATE $ 2,000,000 DED RETENTION$ $ WORKERS COMPENSATION A0163880005 WC STATU- X OTH- A AND EMPLOYERS'LIABILITY 03/01/2023 03/01/2024 TORY I IMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WA Stop Gap Liability E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ , DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Project No.:0347;Project:Broadway and Park Intersection;Job Location:Spokane Valley. Per project aggregate applies on general liability per the attached endorsement/form... (See Attached Description) 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 Avenue AUTHORIZED REPRESENTATIVE Spokane Valley,WA 99206 jawittaiseviv, ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD DESCRIPTIONS (Continued from Page 1 ) City of Spokane Valley and the Contracting Agency and its officers,elected officials,employees,agents and volunteers,spoken County Water District#3,Welch- Corner engineers are additional insureds on the general liability,automobile,and excess liability policies per the attached endorsements/forms. Coverage is primary and non-contributory on the general liability,automobile,and excess liability policies per the attached endorsements/forms. Waiver of subrogation applies on the general liability policy per the attached endorsement/form. POLICY NUMBER: A0163880005 COMMERCIAL GENERAL LIABILITY CG20100413 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 you are required to add as Jobsites as described in written contracts with the an named insured. additional insured under a written contract or written Description: agreement in effect prior to any loss or damage. All Operations with written contract with the named insured. 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 additional organization(s) shown in the Schedule, but only exclusions apply: with"property to e" liabilityfor and"bodily t yv injury", This insurance does not apply to "bodily injury" or p p y g "personalg "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 your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or law; and subcontractor engaged in performing 2. If coverage provided to the additional insured operations for a principal as a part of the same is required by a contract or agreement, the project. 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 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 A0163880 12/23/2020 Middlesex 1 00001 0000000000 20358 0 N 024a7889-9d0c-47fa-a552-5db6b9933a44 POLICY NUMBER: A0163880005 COMMERCIAL GENERAL LIABILITY CG20370413 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) Location And Description Of Completed Or Organization(s) Operations Any person or organization you are required to add as Jobsites and Operations as described in written an contracts with the named insured. additional insured under a written contract or written agreement in effect prior to any loss or damage. 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, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations hazard". 1. Required by the contract or agreement; or However: 2. Available under the applicable Limits of 1. The insurance afforded to such additional Insurance shown in the Declarations; insured only applies to the extent permitted by whichever is less. law; and This endorsement shall not increase the 2. If coverage provided to the additional insured applicable Limits of Insurance shown in the is required by a contract or agreement, the Declarations. 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 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 A0163880 Middlesex 12/23/2020 1 00001 0000000000 20358 0 N 7d3e6762-6738-4d0c-8cc7-f7040984defc POLICY NUMBER: A0163880005 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): All construction projects away from premises owned by or rented to Insured 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 applicable Designated Construction Project "products-completed operations hazard", and General Aggregate Limit. for medical 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 ©Insurance Services Office, Inc., 2008 Page 1 of 2 A0163880 Middlesex 12/23/2020 1 00001 0000000000 20358 0 N Id19dbd1-8470-4e5d-84bf-507681a194d4 POLICY NUMBER: A0163880005 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 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: Any person or organization from whom you are required to waive your right to recover under a written contract or agreement in effect prior to any loss or damage. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV-Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard".This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 A0163880 12/23/2020 Middlesex 1 00001 0000000000 20358 0 N 665d958b-7a6c-4aed-abc5-18a353370fc1 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2)You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 © Insurance Services Office, Inc., 2012 Page 1 of 1 A0163880 12/23/2020 Middlesex 1 00001 0000000000 20358 0 N 526f5194-81e0-4c0e-a896-d3fd9bc01a3f POLICY NUMBER: A0163880005 IL 70 07 0816 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON NOTICE OF CANCELLATION TO OTHERS This endorsement modifies the coverage provided under the following: COMMERCIAL AUTO COVERAGE PART COMMERCIAL EXCESS/UMBRELLA COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name Of Person(s) Or Organization(s) Number of Days Notice Any person or organization you are required to add as 45 an additional insured under a written contract or written agreement in effect prior to any loss or damage. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following additional condition is added: c. Will not extend the cancellation effective A. Notice of Cancellation to Others date nor impact or negate any cancellation of the policy; 1. If we send notice of cancellation to the Named Insured shown in the declarations,for a reason 3. We are not obligated to notify the person(s) or other than nonpayment of premium, we will organization(s) shown in the schedule of the provide notice of such cancellation to the expiration, renewal on different terms or person(s) or organization(s) listed in the nonrenewal of the policy to which this schedule of this endorsement (the schedule); endorsement is attached; and 2. This notice: 4. The provisions of this endorsement do not entitle the person(s) or organization(s) listed in a. Will be provided not less than the number the schedule to any benefits, rights nor of days shown in the schedule prior to the protections not already provided for under the cancellation effective date indicated in the policy. schedule; All other terms and conditions of the policy remain b. If mailed,will be sent to the mailing address unchanged. known to us at that time, with proof of mailing constituting sufficient proof of notice; and IL 70 07 08 16 Page 1 of 1 A0163880 Middlesex 12/23/2020 1 00001 0000000000 20358 0 N c2091735-4a92-4c6d-9fa7-6d3adf506f2c POLICY NUMBER: A0163880001 COMMERCIAL AUTO CA 76 01 0615 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - PRIMARY AND NONCONTRIBUTORY - COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS 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 changes the policy effective on the inception date of the policy unless another date is indicated. Named Insured: Cameron Reilly LLC Endorsement Effective Date: 12/31/2020 SCHEDULE Name Of Person(s)Or Organization(s): Any person or organization you are required to add as an additional insured under a written contract or written agreement in effect prior to any loss or damage. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Each person or organization shown in the B. Primary And Noncontributory Insurance Schedule is an "insured" for Covered Autos This insurance is primary to and will not seek Liability Coverage, but only to the extent that contribution from any other auto insurance issued person or organization qualifies as an "insured" to the person or organization in the schedule under the Who Is An Insured provision contained under your policy provided that: in: h A.1. of Section II - Covered Autos (1) The person or organization is a Named Insured (1) Paragraph g p under such other insurance; and Liability Coverage in the Business Auto and Motor Carrier Coverage Forms; or (2) Prior to the "accident" you have agreed in D.2. of Section I - Covered Autos writing in a contract or agreement that this (2) Paragraph insurance would be primary and would not Coverages of the Auto Dealers Coverage seek contribution from any other insurance Form. available to the person or organization. CA 76 01 06 15 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 A0163880 with its permission. 12/23/2020 Middlesex 1 00001 0000000000 20358 0 N 9c1452ab-f7c5-4446-8a44-23ff918113b4 THIS PAGE INTENTIONALLY LEFT BLANK 2. When we have the right but not the duty to 2. Each of the following is also an insured: defend the insured and elect to participate in the a. Your "volunteer workers" only while defense, we will pay our own expenses but will performing duties related to the conduct of not contribute to the expenses of the insured or your business, your "employees", other the "underlying insurer". than either your "executive officers" (if you 3. These payments will not reduce the limits of are an organization other than a insurance. Partnership, Joint Venture or Limited 4. Under Coverage U, these payments are not Liability Company)or your managers (if you subject to the Retained Limit stated in the are a Limited Liability Company), but only Declarations. for acts within the scope of their employment by you or while performing Section II-Who Is An Insured duties related to the conduct of your The following persons or organizations are insureds business. However, none of these under this Coverage Part. "employees" or "volunteer workers" are an Coverage E- Excess Liability insured for: A. The Named insured shown in the Declarations; (1) "Bodily injury": and (a) To you, to your partners or members B. Any person or organization who is an insured or (if you are a partnership or joint an additional insured in the "underlying venture), to your members (if you insurance", but only to the extent the "underlying area limited liability company), to a insurance" applies. If coverage provided to an co- employee in the course of his additional insured is required by contract or or her employment or performing agreement, the most we will pay on behalf of the duties related to the conduct of your additional insured is the lesser of the amount business or to your other volunteer payable under Section III - Limits of Insurance workers" while performing duties or the amount of insurance required by the related to the conduct of your contract or agreement, less any amount payable business; by "underlying insurance". (b)To the spouse, child, parent, brother Coverage U - Umbrella Liability or sister of that co "employee" or "volunteer worker" as a A. Except for liability arising out of the ownership, (1 Paragraph conse uence ofa q )( ) maintenance or use of an "auto": above; 1. If you are designated in the Declarations as: (c) For which there is any obligation to a. An Individual, you and your spouse are share damages with or repay insureds, but only with respect to the someone else who must pay conduct of a business of which you are the damages because of the injury sole owner. described in Paragraphs (1)(a) or(b) b. A Partnership or Joint Venture, you are an above; or insured. Your members, your partners, and (d)Arising out of his or her providing or their spouses are also insureds, but only failing to provide professional health with respect to the conduct of your care services. business. (2) "Property damage"to property: c. A Limited Liability Company, you are an (a) Owned, occupied or used by; insured. Your members are also insureds, (b) Rented to, in the care, custody or but only with respect to the conduct of control of, or over which physical your business. Your managers are control is being exercised for any insureds, but only with respect to their duties as your managers. purpose by d. An organization other than a Partnership, You, any of your "employees", Joint Venture or Limited Liability Company, volunteer workers , any partner or you are an insured. Your "executive member (if you are a Partnership or officers" and directors are insureds, but Joint Venture), or any member (if you only with respect to their duties as your are a Limited Liability Company). officers or directors. Your stockholders are b. Any person (other than your "employees" also insureds, but only with respect to their or "volunteer worker"), or any organization liability as stockholders. while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die, but only: EU 70 00 12 07 Includes co ri hted material of Insurance Services Office, Inc., Page 9 of 17 A0163880 py g 12/23/2020 Middlesex with its permission. 9 00009 0000000000 20358 0 N 48b63a4e-db51-4278-b87e-61257bc1a5d6 POLICY NUMBER:A0163880006 COMMERCIAL EXCESS/ UMBRELLA EU 70 91 0515 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF OTHER INSURANCE CONDITION This endorsement modifies the coverage provided under the following: COMMERCIAL EXCESS/UMBRELLA COVERAGE PART With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE Name Of Person Or Organization: Any Additional Insured as required by written contract or written agreement executed prior to loss (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The following is added to Paragraph H. Other (4) Affords indemnification and/or defense of Insurance of Section IV-Conditions: the designated person or organization to 1. This insurance is primary to and will not seek the extent permitted by law. contribution from any other insurance available 2. This condition does not apply to: to the person or organization shown in the a. Other insurance, not included in Paragraph 1. Schedule above, provided that such designated above, that may be available to the person or organization: designated person or organization outside of a. Is identified as an additional insured in the your written contract or agreement; or "underlying insurance"; b. Liability which: b. Is a Named Insured under such other (1) May attach to the designated person or insurance; and organization and is not assumed by your c. Has agreed with you in a written contract or written contract or agreement; or agreement that: (2) Is assumed by the designated person or (1) Is signed and effective prior to an organization under any other written "occurrence" to which this insurance contract assuming the obligations of applies; another. (2) This insurance would be primary and would not seek contribution from such other insurance identified in Paragraphs 1.a. and 1.b. above; (3) Agrees to indemnify or defend the designated person or organization for liability and damages covered by the "underlying insurance"; and EU 70 91 05 15 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 A0163880 with its permission. 12/23/2020 Middlesex 1 00001 0000000000 20358 0 N d5c5e70c-431f-48df-adac-fc7a4029353c