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23-084.01 Plateau Archaeological Investigations LLCCONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND PLATEAU ARCHAEOLOGICAL INVESTIGATIONS, LLC Spokane Valley Contract #23-084.01 For good and valuable consideration, the legal sufficiency of which is hereby acknowledged, City and the Consultant mutually agree as follows: 1. Purpose: This Amendment is for the Contract for the Greenacres Park Phase 2 Project Cultural Resource Survey by and between the Parties, executed by the Parties on April 19, 2023. Said contract is referred to as the "Original Contract" and its terms are hereby incorporated by reference. 2.Original Contract Provisions: The Parties agree to continue to abide by those terms and conditions of the Original Contract and any amendments thereto which are not specifically modified by this Amendment. 3. Amendment Provisions: This Amendment is subject to the following amended provisions, which are as follows. All such amended provisions are hereby incorporated by reference herein and shall control over any conflicting provisions of the Original Contract, including any previous amendments thereto. - Extend the time for performance to September 30, 2023. 4. Compensation Amendment History: This is Amendment #1 of the Original Contract. The history of amendments to the compensation on the Original Contract and all amendments is as follows: Date Compensation Original Contract Amount 04/19/23 $5,460.00 Amendment #1 *to be executed Total Amended Compensation $5,460.00 The parties have executed this Amendment to the Original Contract this ! 1`04 day of �ne, 2023. CITY OF SPOKANE VALLEY: John Hohman City Manager APPROVED AS TO FORM: ffi of the ity ttorney PLATEAU ARCHAEOLOGICAL INVESTIGATIONS LC: �rA BS June 23, 2023 PI ATARC-n9 FAI RY r ACORN" CERTIFICATE OF LIABILITY INSURANCE `--� DATE4/6/2 D/YYYY) /6/2023 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 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 Hub International Northwest LLC 375 S. Grand Avenue Pullman, WA 99163 CONTACT NAME: PHONE FAX (A/C, No, Ext): (509) 332-3535 (A/C, No):(509) 332-2914 n DRlEss: eliza.alby@hubinternational.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: National Fire Insurance Company of Hartford 20478 INSURED INSURER B: Continental Casualty Company 20443 INSURER C : Plateau Archaeological Investigations LLC INSURER D : PO Box 714 Pullman, WA 99163 INSURER E : INSURER F : COVERAGES CFRTIFICATF NII IMRFR• IZPVICIn K1 wIMRCG• 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 EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [X] OCCUR X X 5094448613 8/24/2022 8/24/2023 EACH OCCURRENCE $ 2,000,000 DAMAGE AMA PREMISES (Ea R NTU ence $ MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 AGGREGATE LIMIT APPLIES PER: POLICY � JECT LOC GENERAL AGGREGATE $ 4,000,000 GEN'L PRODUCTS - COMP/OP AGG $ 4,000,600 WA STOP GAP $ 1,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ X BODILY INJURY Perperson) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS SSWN X X 5094380314 8/24/2022 8/24/2023 BODILY INJURY Per accident $ PROPERTY DAMAGE $ AUTOS ONLY NON ONEY B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAB CLAIMS -MADE 5094448935 8/24/2022 8/24/2023 DED I X I RETENTION$ 10,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 5094448613 8/24/2022 8/24/2023 I PER X OTH- TATLITE ER E.L. EACH ACCIDENT 110001000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Professional Liab EEH591871292 2/21/2023 2/21/2024 Each Claim 1,000,000 B Professional Liab EEH591871292 2/21/2023 2/21/2024 Aggregate Limit 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: Cultural Resources Instructions for LWCF Project #53-00785, RCO Project #22-1694 City of Spokane Valley is an additional insured with regard to general liability arising out of the operations of the named insured when required by written contract per attached form SB146968B 6/16. Coverage is primary and non-contributory when required by written contract. Waiver of subrogation applies when required by written contract per attached form SB146968B 6/16. City of Spokane Valley is an additional insured with regard to auto liability arising out of the operations of the named insured when required in written contract per form SCA23500D 10/11. Waiver of subrogation applies when required by written contract City of Spokane Valley Spokane Valley Parks and Recreation 2426 N Discovery Place Spokane Valley, WA 99216 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 AL;URD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CNA SB146968C (Ed. 10-19) IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C., OF THIS ENDORSEMENT FOR THESE DUTIES. BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS -COMPLETED OPERATIONS COVERAGE AND BLANKET WAIVER OF SUBROGATION Architects, Engineers and Surveyors This endorsement modifies insurance provided under the following: BUSINESSOWNERS LIABILITY COVERAGE FORM BUSINESSOWNERS COMMON POLICY CONDITIONS A. Who Is An Insured is amended to include as an insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement; but the written contract or written agreement must be: 1. Crrently in effect or becoming effective during the term of this policy; and 2. Executed prior to the: a. "Bodily injury" or "property damage'; or b. Offense that caused the "personal and advertising injury'; for which the additional insured seeks coverage B. The insurance provided to the additional insured is limited as follows: The person or organization is an additional insured only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations specified in the written contract or written agreement; or c. "Your work" that is specified in the written contract or written agreement, but only for "bodily injury" or "property damage" included in the "products -completed operations hazard," and only if: m (1) The written contract or written agreement requires you to provide the additional insured such coverage; a and N 0 (2) This Coverage Part provides such coverage. 0 N N 2. The Limits of Insurance applicable to the additional insured are those specified in the written contract or written agreement or in the Declarations of this policy, whichever is less. These Limits of Insurance are inclusive of, and not in addition to, the Limits of Insurance shown in the Declarations. 3. The insurance provided to the additional insured does not apply to "bodily injury," "property damage" or "personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services including: a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications by any architect, engineer or surveyor performing services on a project of which you serve as construction manager; or b. Inspection, supervision, quality control, engineering or architectural services done by you on a project of which you serve as construction manager. 4. The insurance provided to the additional insured does not apply to "bodily injury," "property damage" or "personal and advertising injury" arising out of construction or demolition work while you are acting as a construction or demolition contractor. SB146968C (Ed. 10-19) Copyright, CNA All Rights Reserved. Page 1 of 3 SB146968C (Ed. 10-19) C. Under Businessowners Liability Conditions, the condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended to add the following: An additional insured under this endorsement will as soon as practicable: 1. Give written notice of an occurrence or an offense to us which may result in a claim or "suit" under this insurance; 2. Tender the defense and indemnity of any claim or "suit" to us for a loss we cover under this Coverage Part; 3. Except as provided for in paragraph D.2. below: a. Tender the defense and indemnity of any claim or "suit" to any other insurer which also has insurance for a loss we cover under this Coverage Part; and b. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a claim or "suit" from the additional insured. D. With respect only to the insurance provided by this endorsement, the condition entitled Other Insurance of the BUSINESSOWNERS COMMON POLICY CONDITIONS is amended to delete paragraphs 2. and 3. and replace them with the following: 2. This insurance is excess over any other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, But if required by the written contract or written agreement, this insurance will be primary and noncontributory relative to insurance on which the additional insured is a Named Insured. 3. When this insurance is excess, we will have no duty under Business Liability insurance to defend the additional insured against any "suit" if any other insurer has a duty to defend the additional insured against that "suit" If no other insurer defends, we will undertake to do so, but we will be entitled to the additional insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self -insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. E. Additional Insured — Extended Coverage When an additional insured is added by this or any other endorsement attached to this Coverage Part, the section entitled Who Is An Insured is amended to make the following natural persons insureds: If the additional insured is: 1. An individual, then his or her spouse is an insured; 2. A partnership or joint venture, then its partners, members and their spouses are insureds; 3. A limited liability company, then its members and managers are insureds; 4. An organization other than a partnership, joint venture or limited liability company, then its executive officers, directors and shareholders are insureds; or 5. Any type of entity, then its employees are insureds; but only with respect to locations and operations covered by the additional insured endorsement's provisions, and only with respect to their respective roles within their organizations. Furthermore, employees of additional insureds are not insureds with respect to liability arising out of: (1) "Bodily injury" or "personal and advertising injury" to any fellow employee or to any natural person listed in paragraphs 1. through 4. above; SB146968C (Ed. 10-19) Copyright, CNA All Rights Reserved. Page 2 of 3 SB146968C (Ed. 10-19) (2) "Property damage" to property owned, occupied or used by their employer or by any fellow employee; or (3) Providing or failing to provide professional health care services. F. The condition entitled Transfer of Rights of Recovery Against Others to Us of the BUSINESSOWNERS COMMON POLICY CONDITIONS is amended to deleted paragraph 2. and replace it with the following: 2. We waive any right of recovery we may have against any person or organization with whom you have agreed to waive such right of recovery in a written contract or agreement 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 within the "products -completed operations hazard." All other terms and conditions of the Policy remain unchanged. SB146968C (Ed. 10-19) Copyright, CNA All Rights Reserved. Page 3 of 3 Business Auto Policy Policy Endorsement .. 7777 E TENQEQ OV*GE ENQ SSE NT A US h .,P ,. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. LIABILTY COVERAGE A. Who Is An Insured The following is added to SECTION II, Paragraph A.1., Who Is An Insured: 1. a. Any incorporated entity of which the Named Insured owns a majority of the voting stock on the date of inception of this Coverage Form; provided that, b. The insurance afforded by this provision A. 1. does not apply to any such entity that is an insured under any other liability policy providing auto coverage. 2. Any organization you newly acquire or form, other than a limited liability company, partnership or joint venture, and over which you maintain majority ownership interest. The insurance afforded by this provision A.2.: a. Is effective on the acquisition or formation date, and is afforded only until the end of the policy period of this Coverage Form, or the next anniversary of its inception date, whichever is earlier. b. Does not apply to: (1) Bodily injury or property damage caused by an accident that occurred before you acquired or formed the organization; or (2) Any such organization that is an insured under any other liability policy providing auto coverage. 3. Any person or organization that you are obligated to provide Insurance where required by a written contract or agreement is an insured, but only with respect to legal responsibility for acts or omissions of a person for whom Liability Coverage is afforded under this policy. 4. An employee of yours is an insured while operating an auto hired or rented under a contract or agreement in that employee's name, with your permission, while performing duties related to the conduct of your business. Policy, as used in this provision A. Who Is An Insured, includes those policies that were in force on the inception date of this Coverage Form but: 1. Which are no longer in force; or 2. Whose limits have been exhausted. B. Bail Bonds and Loss of Earnings SECTION II, Paragraphs A.2.a.(2) and A.2.a.(4) are revised as follows: 1. In a.(2), the limit for the cost of bail bonds is increased from $2,000 to $5,000, and 2. In a.(4), the limit for the loss of earnings is increased from $250 to $500 a day. C. Fellow Employee SECTION 11, Paragraph B.5 does not apply. Form No: SCA 23 500 D (10-2011) Policy No: BUA 5094380314 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 08/24/2019 Endorsement No: 21 ; Page: 1 of 5 Policy Page: 67 of 83 Underwriting Company: National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 60606 Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission. CNA Business Auto Policy Policy Endorsement Such coverage as is afforded by this provision C. is excess over any other collectible insurance. II. PHYSICAL DAMAGE COVERAGE A. Towing SECTION III. Paragraph A.2., is revised to include Light Trucks up to 10,000 pounds G.V.W. B. Glass Breakage — Hitting A Bird Or Animal — Falling Objects Or Missiles The following is added to SECTION III, Paragraph A.3.: With respect to any covered auto, any deductible shown in the Declarations will not apply to glass breakage if such glass is repaired, in a manner acceptable to us, rather than replaced. C. Transportation Expenses SECTION III, Paragraph A.4.a. is revised, with respect to transportation expense incurred by you, to provide: a. $60 per day, in lieu of $20; subject to b. $1,800 maximum, in lieu of $600. D. Loss of Use Expenses SECTION Ill, Paragraph A.4.b. is revised, with respect to loss of use expenses incurred by you, to provide: a. $1,000 maximum, in lieu of $600. E. Personal Property The following is added to SECTION III, Paragraph A.4. c. We will pay up to $500 for loss to Personal Property which is: (1) Owned by an insured; and (2) In or on the covered auto. This coverage applies only in the event of a total theft of your covered auto. This insurance is excess over any other collectible insurance and no deductible applies. F. Rental Reimbursement The following is added to SECTION III, Paragraph A.4.: d. We will pay for rental reimbursement expenses incurred by you for the rental of an auto because of loss to a covered auto. Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered auto. No deductibles apply to this coverage. 1. We will pay only for those expenses incurred during the policy period beginning 24 hours after the loss and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a) The number of days reasonably required to repair or replace the covered auto; or, (b) 15 days. 2. Our payment is limited to the lesser of the following amounts: (a) Necessary and actual expenses incurred; or, (b) $25 per day subject to a maximum of $375. Form No: SCA 23 500 D (10-2011) Policy No: BUA 5094380314� Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 08/24/2019 Endorsement No: 21 ; Page: 2 of 5 Policy Page: 68 of 83 Underwriting Company: National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 60606 Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission. [M/A'7/ A Business Auto Policy Policy Endorsement 3. This coverage does not apply while there are spare or reserve autos available to you for your operations. 4. If loss results from the total theft of a covered auto of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Physical Damage Coverage Extension. G. Hired "Autos" The following is added to SECTION III. Paragraph A.: 5. Hired Autos If Physical Damage coverage is provided under this policy, and such coverage does not extend to Hired Autos, then Physical Damage coverage is extended to: a. Any covered auto you lease, hire, rent or borrow without a driver; and b. Any covered auto hired or rented by your employee without a driver, under a contract in that individual employee's name, with your permission, while performing duties related to the conduct of your business. c. The most we will pay for any one accident or loss is the actual cash value, cost of repair, cost of replacement or $75,000 whichever is less minus a $500 deductible for each covered auto. No deductible applies to loss caused by fire or lightning. d. The physical damage coverage as is provided by this provision will be limited to the types of physical damage coverage(s) provided on your owned autos. e. Such physical damage coverage for hired autos will: (1) Include loss of use, provided it is the consequence of an accident for which the Named Insured is legally liable, and as a result of which a monetary loss is sustained by the leasing or rental concern. (2) Such coverage as is provided by this provision G.e.(1) will be subject to a limit of $750 per accident. H. Airbag Coverage The following is added to SECTION III, Paragraph 13.3. The accidental discharge of an airbag shall not be considered mechanical breakdown. I. Electronic Equipment SECTION III, Paragraphs B.4.c and 13.4.d. are deleted and replaced by the following: c. Physical Damage Coverage on a covered auto also applies to loss to any permanently installed electronic equipment including its antennas and other accessories d. A $100 per occurrence deductible applies to the coverage provided by this provision. J. Diminution In Value The following is added to SECTION III, Paragraph B.6. Subject to the following, the diminution in value exclusion does not apply to: a. Any covered auto of the private passenger type you lease, hire, rent or borrow, without a driver for a period of 30 days or less, while performing duties related to the conduct of your business; and Form No: SCA 23 500 D (10-2011) Policy No: BUA 5094380314 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 08/24/2019 Endorsement No: 21; Page: 3 of 5 Policy Page: 69 of 83 Underwriting Company: National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 60606 Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission. CNA Business Auto Policy Policy Endorsement b. Any covered auto of the private passenger type hired or rented by your employee without a driver for a period of 30 days or less, under a contract in that individual employee's name, with your permission, while performing duties related to the conduct of your business. c. Such coverage as is provided by this provision is limited to a diminution in value loss arising directly out of accidental damage and not as a result of the failure to make repairs; faulty or incomplete maintenance or repairs; or the installation of substandard parts. d. The most we will pay for loss to a covered auto in any one accident is the lesser of: (1) $5,000; or (2) 20% of the auto's actual cash value (ACV) 111. Drive Other Car Coverage — Executive Officers The following is added to SECTIONS 11 and III: 1. Any auto you don't own, hire or borrow is a covered auto for Liability Coverage while being used by, and for Physical Damage Coverage while in the care, custody or control of, any of your executive officers, except: a. An auto owned by that executive officer or a member of that person's household; or b. An auto used by that executive officer while working in a business of selling, servicing, repairing or parking autos. Such Liability and/or Physical Damage Coverage as is afforded by this provision will be: (1) Equal to the greatest of those coverages afforded any covered auto; and (2) Excess over any other collectible insurance. 2. For purposes of this provision, executive officer means a person holding any of the officer positions created by your charter, constitution, by-laws or any other similar governing document, and, while a resident of the same household, includes that person's spouse. Such executive officers are insureds while using a covered auto described in this provision. IV. BUSINESS AUTO CONDITIONS A. Duties In The Event Of Accident, Claim, Suit Or Loss The following is added to SECTION IV, Paragraph A.2.a. (4) Your employees may know of an accident or loss. This will not mean that you have such knowledge, unless such accident or loss is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager. The following is added to SECTION IV, Paragraph A.2.b. (6) Your employees may know of documents received concerning a claim or suit. This will not mean that you have such knowledge, unless receipt of such documents is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager. B. Concealment, Misrepresentation or Fraud The following is added to SECTION IV, Paragraph B.2. Your failure to disclose all hazards existing on the date of inception of this Coverage Form shall not prejudice you with respect to the coverage afforded provided such failure or omission is not intentional. C. Policy Period, Coverage Territory SECTION IV, Paragraphs 7.(5).(a). is revised to provide: Form No: SCA 23 500 D (10-2011) Policy No: BUA 5094380314 —` Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 08/24/2019 Endorsement No: 21; Page: 4 of 5 Policy Page: 70 of 83 Underwriting Company: National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 60606 Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission. CMA Business Auto Policy Policy Endorsement a. 45 days of coverage in lieu of 30 days V. DEFINITIONS SECTION V. Paragraph C. is deleted and replaced by the following: Bodily injury means bodily injury, sickness or disease sustained by a person, including mental anguish, mental injury or death resulting from any of these Form No: SCA 23 500 D (10-2011) Policy No: BUA 5094380314 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 08/24/2019 Endorsement No: 21 ; Page: 5 of 5 Policy Page: 71 of 83 Underwriting Company: National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 60606 ® Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office, Inc., used with its permission. A^ -hip .SWeoew,o f `%Labor & industries .(https://Ini.wa.gly) Contractors PLATEAU ARCHAEOLOGICAL INVESTIGATIONS LLC Owner or tradesperson JENNY HARDER 1515 SW CASEY CT Doing business as PULLMAN, WA 99163 PLATEAU ARCHAEOLOGICAL WA UBI No. 602 547 834 Certifications & Endorsements OMWEIE Certifications No active certifications exist for this business. Governing persons JENNY HARDER DAVID ANDREW HARDER; Apprentice Training Agent No active Washington registered apprentices exist for this business. Washington allows the use of apprentices registered with Oregon or Montana. Contact the Oregon Bureau of Labor & Industries or Montana Department of Labor & Industry to verify if this business has apprentices. Workers' Comp Do you know if the business has employees? If so, verify the business is up-to-date on workers' comp premiums. L&I Account ID 993,819-01 ...............I................ Account is current. Doing business as PLATEAU ARCHAEOLOGICAL Estimated workers reported Quarter 1 of Year 2023 "11 to 20 Workers" L&I account contact T2 / DALE RIUTTA (360) 902-4834 - Email: RIUD235@lni.wa.gov Public Works Requirements Verify the contractor is eligible to perform work on public works projects. Required Training— Effective July 1, 2019 Needs to complete trainini.g. Contractor Strikes ....................................................... No strikes have been issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace Safety & Health Check for any past safety and health violations found on jobsites this business was responsible for. No inspections during the previous 6 year period. 2-ceq °oo •o i PLATARC-02 FAI RY AFRO CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 7/18/218/2023 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 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 Hub International Northwest LLC 375 S. Grand Avenue Pullman, WA 99163 N NTACT PHONE FAX (A/C, No, Ext): (509) 332-3535 A/C, No):(509) 332-2914 AILADDRESS. eliza.alby@hubintemational.com INSURE S AFFORDING COVERAGE NAIC # INSURER A: National Fire Insurance Company of Hartford 20478 INSURED INSURER B: Continental Casualty Company 20443 INSURER C : Plateau Archaeological Investigations LLC PO BOX 714 Pullman, WA 99163 INSURER D : INSURER E INSURER F : COVERAGES CFRTIFICATF NIIIMRFR• GCVlclnhl to U12CO• 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 OF INSURANCE ADDLTYPE INSD SUER WVD POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR X X 5094448613 8/24/2023 8/24/2024 EACH OCCURRENCE $ 2,000,000 PAMAGETSESOERaENTED $ 300,000 MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 AGGREGATE LIMIT APPLIES PER: X JECT LOC GENERAL AGGREGATE $ 4,000,000 GEN'L FIPOLICY PRODUCTS - COMP/OP AGG $ 4,000,000 IWA Stop Gap 11000,000 OTHER: A AUTOMOBILE X LIABILITY ANY AUTO OWNAUTOS ONLY SCHEDULED SyUyLNED X X 6094380314 8/24/2023 8/24/2024 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY Per person)$ BODILY INJURY Per accident $ AUTOS ONLY AUTO ONLDY PPerOacadent AMAGE $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 5094448935 8/24/2023 8/24/2024 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED I X I RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETCR/PARTNER/EXECUTIVE QF E gER (Mandatary In NH)CLUDED? If yes, describe under DESCRIPTION OF OPERATIONS below NIA A PER OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ B Professional Liab EEH591871292 2/21/2023 2/21/2024 Each Claim 1,000,000 B Professional Liab EEH591871292 2/21/2023 2/21/2024 Aggregate Limit 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule may be attached if more space is required) RE: Cultural Resources Instructions for LWCF Project #63-00785, RCO Project #a2-1694 City of Spokane Valley is an additional insured only with respect to liablity for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by the operations of the named insured when required by written contract per attached form SB146968B 6116. Coverage is primary and non-contributory when required by written contract. Waiver of subrogation applies when required by written contract per attached form SB146968B 6/16. City of Spokane Valley is an additional insured with regard to auto liability when required in written contract per form SCA23500D 10/11. Waiver of subrogation applies when required by written contract City of Spokane Valley Spokane Valley Parks and Recreation 2426 N Discovery Place Spokane Valley, WA 99216 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 �& AL;UKU Lb (ZU151U3) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD