Loading...
24-114.00WAStateAndSpokaneHouseMoversLLC2024HouseRelocation AGREEMENT FOR STRUCTURE REMOVAL This Agreement for Structure Removal ("Agreement") is made by and between the City of Spokane Valley ("City"), a municipal corporation organized under the laws of the State of Washington, and Spokane House Movers, LLC ("Contractor"), a Washington company, collectively referred to herein as "the Parties." I. RECITALS WHEREAS,the City owns a residential building located at 5028 E. 2nd Ave, Spokane Valley, WA(the"Building"); WHEREAS,the City owns certain real estate located at the same address(the "Tract"); WHEREAS,the City intends to make the Tract available for development of multi-family housing for low-income individuals and/or families; WHEREAS,the City desires to have the Building removed in order to accommodate future development of the aforementioned multi-family housing; WHEREAS, Contractor has inspected the Building and the Tract and the surrounding terrain; and WHEREAS, Contractor is qualified to perform the work in removing the Building from the Tract; THE PARTIES HEREBY AGREE AS FOLLOWS: II. AGREEMENT 1. Work to Be Performed. Contractor shall remove the Building from the Tract(hereinafter "Work"). 2. Time for Performance. Contractor shall commence the Work within 10 days after this Agreement has been fully executed, and shall complete the Work within sixty (60) days. 3. Compensation. Contractor and City agree that Contractor, after removing the Building from the Tract, will be the owner of the Building and all of its components as full compensation for removing the Building from the Tract. Contractor expressly acknowledges that it will take ownership of the Building in its then current condition, and that City has not made any warranty as to the condition of the Building. Contractor will take ownership of the Building"as-is" without recourse against the City for the condition of the building or any injuries to person or property arising out of the Work and/or Building or the Building's fitness for any purpose whatsoever. 4. Notice. Notice other than applications for payment shall be given in writing as follows: Contract-Spokane House Movers TO THE CITY: TO THE CONTRACTOR: Name: Marci Patterson, City Clerk Name: Spokane House Movers, LLC Phone: (509) 720-5000 Phone:(509) 919-1719 Address: 10210 East Sprague Avenue Address:1303 E. Lacrosse Ave. Spokane Valley, WA 99206 Spokane, WA 99207 5. Applicable Laws and Standards. The Parties, in the performance of this Agreement, agree to comply with all applicable federal, state, and local laws, codes, and regulations. 6. Certification Regarding Debarment, Suspension, and Other Responsibility Matters. A. By executing this Agreement,the Contractor certifies to the best of its knowledge and belief,that it and its principals: 1. Are not presently debarred, suspended,proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; 2. Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local)transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement,theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 3.Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local)with commission of any of the offenses enumerated in paragraph(A)(2) of this certification; and 4. Have not within a three-year period preceding this application/proposal had one or more public transactions (federal, state, or local)terminated for cause or default. B. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this Agreement. 7. Prevailing Wages. Contractor, any subcontractor, or other person doing work under this Agreement, shall comply with the requirements of chapter 39.12 RCW, and shall pay each employee an amount not less than the Prevailing Rate of Wage, as specified by the Industrial Statistician of the Washington State Department of Labor and Industries ("L&I"). If employing labor in a class not shown, Contractor shall request a determination of the correct wage rate for the class and locality from the Industrial Statistician. Contractor shall provide a copy of any such determinations to City. Contract-Spokane House Movers Before commencing, during, and upon completion of the work, Contractor shall file all forms and pay all fees required by L&I and shall indemnify and hold City harmless from any claims related to its failure to comply with chapter 39.12 RCW. The following information is provided pursuant to RCW 39.12.030: A. State of Washington prevailing wage rates applicable to this public works project, published by L&I, are located at the L&I website address: https://lni.wa.gov/licensing-permits/public-works-projects/prevailing-wage-rates/ B. This Project is located in Spokane County. C. The effective prevailing wage date is the same date as the bid due date as referenced in the original request for bids and as may be revised by addenda. A copy of the applicable prevailing wage rates is also available for viewing at the City Community & Public Works Department located at 10210 East Sprague Avenue, Spokane Valley, WA 99206. Upon request, City will mail a hard copy of the applicable prevailing wages for this project. 8. Relationship of the Parties. It is understood and agreed that Contractor shall be an independent contractor and not the agent or employee of City, that City is interested only in the results to be achieved, and that the right to control the particular manner,method, and means in which the services are performed is solely within the discretion of Contractor. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Contractor. Contractor shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 9. Contractor to Be Licensed and Bonded. Contractor shall be duly licensed, registered, and bonded by the State of Washington at all times this Agreement is in effect. 10. Contractor to Provide Payment Bond. Contractor shall provide a payment bond in the amount of two thousand five hundred dollars ($2,500.00). 11. Insurance. Contractor shall procure and maintain insurance, as required in this Section, without interruption from commencement of the Contractor's work through the term of the Contract and for 30 days after the physical completion date, unless otherwise indicated herein. A. Minimum Scope of Insurance. Contractor shall obtain insurance of the types described below: 1.Automobile liability insurance covering all owned, non-owned,hired and leased vehicles. Coverage shall be at least as broad as Insurance Services Office (ISO) form CA 00 01. Contract-Spokane House Movers 2. Commercial general liability insurance shall be at least as broad as ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, stop gap liability,independent contractors,products-completed operations for a period of three years following substantial completion of the work for the benefit of the City,personal injury and advertising injury, and liability assumed under an insured contract. The Commercial General Liability insurance shall be endorsed to provide a per project general aggregate limit,using ISO form CG 25 03 05 09 or an endorsement providing at least as broad of coverage. There shall be no exclusion for liability arising from explosion, collapse or underground property damage. The City shall be named as an additional insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO Additional Insured endorsement CG 20 10 10 01 and Additional Insured-Completed Operations endorsement CG 20 37 10 01 or substitute endorsements providing at least as broad coverage. 3. Workers' compensation coverage as required by the industrial insurance laws of the State of Washington. B. Minimum Amounts of Insurance. Contractor shall maintain the following insurance limits: 1.Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of no less than$1,000,000 per accident. 2. Commercial general liability insurance shall be written with limits no less than $2,000,000 each occurrence, $2,000,000 general aggregate, and no less than a$2,000,000 products-completed operations aggregate limit. C. Other Insurance Provisions. The insurance policies are to contain, or be endorsed to contain,the following provisions for automobile liability and commercial general liability insurance: 1. Contractor's insurance coverage shall be primary insurance with respect to City. Any insurance, self-insurance, or insurance pool coverage maintained by City shall be excess of Contractor's insurance and shall not contribute with it. 2. Contractor shall fax or send electronically in .pdf format a copy of insurer's cancellation notice within two business days of receipt by Contractor. 3. If Contractor maintains higher insurance limits than the minimums shown above, City shall be insured for the full available limits of commercial general and excess or umbrella liability maintained by Contractor, irrespective of whether such limits maintained by Contractor are greater than those required by this Agreement or whether any certificate of insurance furnished to the City evidences limits of liability lower than those maintained by Contractor. Contract-Spokane House Movers 4. Failure on the part of Contractor to maintain the insurance as required shall constitute a material breach of this Agreement, upon which the City may, after giving at least five business days'notice to Contractor to correct the breach, immediately terminate the Agreement, or at its sole discretion,procure or renew insurance and pay any and all premiums in connection therewith, with any sums so expended to be repaid to City on demand, or at the sole discretion of the City, offset against funds due Contractor from the City. D. No Limitation. The Contractor's maintenance of insurance, its scope of coverage, and limits as required herein shall not be construed to limit the liability of the Contractor to the coverage provided by such insurance, or otherwise limit the City's recourse to any remedy available at law or in equity. E.Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. F. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, Contractor shall furnish acceptable insurance certificates to City at the time Contractor returns the signed Agreement,which shall be Exhibit C. The certificate shall specify all of the parties who are additional insureds, and shall include applicable policy endorsements, and the deduction or retention level. Insuring companies or entities are subject to City acceptance. If requested, complete copies of insurance policies shall be provided to City. Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions, and/or self-insurance. G. Failure to Maintain Insurance. Failure on the part of the Contractor to maintain the insurance as required shall constitute a material breach of contract,upon which the City may, after giving at least five business days'notice to Contractor to correct the breach, immediately terminate the Agreement or, at its discretion,procure or renew such insurance and pay any and all premiums in connection therewith, with any sums so expended to be repaid to the City on demand, or at the sole discretion of the City, offset against funds due Contractor from the City. H. Subcontractor Insurance. Contractor shall cause each and every subcontractor to provide insurance coverage that complies with all applicable requirements of Contractor-provided insurance as set forth herein, except Contractor shall have sole responsibility for determining the limits of coverage required to be obtained by subcontractors. Contractor shall ensure that the City is an additional insured on each subcontractor's Commercial General liability insurance policy using an endorsement as least as broad as ISO CG 20 10 10 01 for ongoing operations and CG 20 37 10 01 for completed operations. 12. Indemnification and Hold Harmless. Contractor shall defend, indemnify, and hold the City, its officers, officials, employees, and volunteers harmless from any and all claims, injuries, damages, losses, or suits including attorney fees, arising out of or in connection with the Contract-Spokane House Movers performance of this Agreement, except for injuries and damages caused by the sole negligence of the City. However, should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, its officers, officials, employees, and volunteers,the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence. It is further specifically and expressly understood that the indemnification provided herein constitutes the Contractor's waiver of immunity under Industrial Insurance, Title 51 RCW, solely for the purposes of this indemnification. This waiver has been mutually negotiated by the parties. The provisions of this section shall survive the expiration or termination of this Agreement. 13. Waiver.No officer, employee, agent, or other individual acting on behalf of either party has the power,right, or authority to waive any of the conditions or provisions of this Agreement. No waiver in one instance shall be held to be waiver of any other subsequent breach or nonperformance. All remedies afforded in this Agreement or by law shall be taken and construed as cumulative and in addition to every other remedy provided herein or by law. Failure of either party to enforce at any time any of the provisions of this Agreement or to require at any time performance by the other party of any provision hereof shall in no way be construed to be a waiver of such provisions nor shall it affect the validity of this Agreement or any part thereof. 14. Assignment and Delegation.Neither party shall assign,transfer, or delegate any or all of the responsibilities of this Agreement or the benefits received hereunder without first obtaining the written consent of the other party. 15. Disputes.All disputes arising under or related to this Agreement that cannot be resolved through informal discussion and negotiations shall be resolved by litigation filed in the Superior Court of the State of Washington for Spokane County, unless otherwise required by applicable federal or state law. 16. Costs and Attorney's Fees. The prevailing party in any litigation or arbitration arising out of this Agreement shall be entitled to its attorney's fees and costs of such litigation or arbitration (including expert witness fees). 17. Subcontractor Responsibility.As required by RCW 39.06.020, Contractor shall verify responsibility criteria for each first-tier subcontractor and its subcontractors of any tier that hires other subcontractors shall verify responsibility criteria for each of its subcontractors. Verification shall include that each subcontractor, at the time of subcontract execution, meets the responsibility criteria listed in RCW 39.04.350(1) and possesses an electrical contractor license, if required by chapter 19.28 RCW, or an elevator contractor license if required by chapter 70.87 RCW. This verification requirement shall be included in every subcontract of every tier. 18. Jurisdiction and Venue. This Agreement is entered into in Spokane County,Washington. Venue shall be in Spokane County, State of Washington. Contract-Spokane House Movers 19. Entire Agreement. This Agreement constitutes the entire and complete agreement between • the parties and supersedes any prior oral or written agreements. This Agreement may not be • changed,modified, or altered except in writing signed by the Parties. 20.Anti-Kickback. No officer or employee of City, having the power or duty to perform an official act or action related to this Agreement, shall have or acquire any interest in this Agreement, or have solicited, accepted, or granted a present or future gift, favor, service, or other thing of value from any person with an interest in this Agreement. 21. Business Registration. Prior to commencement of Work under this Agreement, Contractor shall register with the City as a business if it has not already done so. • 22. Assurance of Compliance with Applicable Federal Law. 23. Severability. If any section, sentence, clause, or phrase of this Agreement should be held to be invalid for any reason by a court of competent jurisdiction, such invalidity shall not affect the validity of any other section, sentence, clause, or phrase of this Agreement. 24. Exhibits. Exhibits attached and incorporated into this Agreement are: • A. Insurance Endorsements. B. Payment Bond. The Parties have executed this Agreement this /07' day ofJune,2024. CITY OF SPOKANE VALLEY: Contractor: cusiestir 04 SF.G'1 is Jo n Hohman,City Manager By: SAUL. age- , Its: Authorized Representative APPROVED AS TO FORM: • ffice the City Atto ey Contract-Spokane House Movers Spokane ��Valleyg BOND NO: 100861459 Premium:$500.00 CONTRACTOR'S PAYMENT BOND(NON-FEDERALLY FUNDED PROJECT) to City of Spokane Valley,Washington The City of Spokane Valley, Washington, in Spokane County, has awarded to Spokane House Moving, LLC(Contractor), as Principal, a contract for the relocation project designated as 5028 E. 2" STRUCTURE REMOVAL PROJECT 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). The Principal, and American Contractors Indemnity Company (Surety), a corporation organized under the laws California 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$2,500.00 total Contract amount(including Washington State sales tax),subject to the provisions herein. 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 and 39.12 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;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. PRIM (CONTRA TOR) SURETY May 30th 2024 Principal Signatureur Date ur Signa Date .Ji4t/L' gel f WA /P7' B' n Came Printed yyNam e Prin e erasee Attorney-in-Fact , Title Title Name,address,and telephone of local office/agent of Surety Company is: Cochrane&Company- Melanie Davis, 509-462-1112 1405 South Rustle Road, Spokane,WA 99224 TOKIO MARINE. H C C POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company of the State of California, a California corporation,does hereby appoint, BRIAN CARNEY its true and lawful Attorney-in-Fact, with full authority to execute on its behalf bond number 100861459 issued in the course of its business and to bind the Company thereby, in an amount not to exceed Three million and 00/100 ( $3,000,000.00 ). This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the Board of Directors of AMERICAN CONTRACTORS INDEMNITY COMPANY at a meeting duly called and held on the 1st day of September,2011. "Be it Resolved, that the President, any Vice-President,any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and on behalf of the Company,to execute, acknowledge and deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability thereunder,and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached." The Attorney-in-Fact named above may be an agent or a broker of the Company.The granting of this Power of Attorney is specific to this bond and does not indicate whether the Attorney-in-Fact is or is not an appointed agent of the Company. IN WITNESS WHEREOF, American Contractors Indemnity Company has caused its seal to be affixed hereto and executed by its President on this 18th day of April,2022. �4,perugs�,, ,tsv ••?cF`;: AMERICAN CONT CTORS INDEMNITY COMPANY =V` INCCRPCRPTEC i y: Z`.�•�r`a- y: SEP—.2,1000 2<E ey: ,�,/+ a� mod.• :o Ada S. Pessin, President A Notary Public or other officer completing this certificate lIYIIies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness,accuracy,or validity of that document. State of California County of Los Angeles On this 18th day of April,2022,before me,Sonia O. Carrejo,a notary public, personally appeared Adam S. Pessin, President of American Contractors Indemnity Company,who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person,or the entity upon on behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of CALIFORNIA that the foregoing paragraph is true and correct. WITNESS myhand and official seal M°t_ SONIAo.cARREjo Notary Public•California - Los Angeles County r Signature �,tlil � �� (seal) ] • Commission ir 2398710 3 0•^' My Comm.Expires APr23,2026■ I, Kio Lo,Assistant Secretary of American Contractors Indemnity Company,do hereby certify that the Power of Attorney and the resolution adopted by the Board of Directors of said Company as set forth above, are true and correct transcripts thereof and that neither the said Power of Attorney nor the resolution have been revoked and they are now in full force and effect. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this 30th day of May 2024 �PPc..... Bond No. 100861459 i NCORPoaATEO Kia La,Assists ecreta Agency No. 6948 yl, SEPr.25,188C '< ry 'C!IU n„,„„s HCCSOZZPOAACIC07/2023 Visit tmhcc.com/surety for more information „,,,,n,,,,,,,,opc` / ® DATE(MM/DD/YYYY) A�o CERTIFICATE OF LIABILITY INSURANCE 5/21/2024 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 CONTACT NAME: Rod Russell ROD RUSSELL INSURANCE INC PHONE (A/C.No Ext): (509)328 2962 FAX No): (509)328 7677 1623 W Nora Ave ADDRESS: rodArodrussellinsurance.com Spokane,WA 99205-4231 INSURERS)AFFORDING COVERAGE NAIC# License#:143991 INSURER A: Scottsdale Insurance Company 41297 INSURED INSURER B: SPOKANE HOUSE MOVING LLC INSURERC: 1303 E LACROSSE AVE INSURER D: Spokane,WA 99207 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. IN POLICY EFF POLICY EXP SR ,INSD WVD IIY TYPE OF INSURANCE ADDL SUER POLICY NUMBER ,(MM/DDYYY1 (MM DD/YYYY) LIMITS LT X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,1300 A Y N CPS7949792 2/27/2024 2/27/2025 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- X POLICY JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 $ OTHER: . AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ - OWNED >/ SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY /'s AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Spokane Valley is listed as additional insured. 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 AUTHORIZED REPRESENTATIVE 10210 E Sprague Ave Spokane Valley WA 99206I � it ©1988-201 AC RD ORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 5/20/24,2:32 PM SPOKANE HOUSE MOVING LLC STATE OF WASHINGTON Department of Labor& Industries Certificate of Workers' Compensation Coverage May 20, 2024 WA UBI No. 605 028 479 L&I Account ID 355,743-00 Legal Business Name SPOKANE HOUSE MOVING LLC Doing Business As SPOKANE HOUSE MOVING LLC Workers'Comp Premium Status: Account is current. Estimated Workers Reported Quarter 1 of Year 2024"0"Workers (See Description Below) Account Representative Employer Services Help Line, (360) 902-4817 Licensed Contractor? Yes License No. SPOKAHM771C8 License Expiration 02/28/2025 What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RCW 51.12.050 and 51.16.1 90). https://secure.lni.wa.gov/verify/Details/IiabilityCertificate.aspx?UBI=605028479&LIC=SPOKAHM771 C8&VI0=&SAW=false&ACCT=35574300 1/1 ACC)ACC)REP DATE(MMIDDIYWY) �� CERTIFICATE OF LIABILITY INSURANCE 6/7t2024 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 p)CONTACT Rod Russell ROD RUSSELL INSURANCE INC PHONE of ,Ex,t): (509)328-2962 Inrc,No); (509)328 7677 E•MAfL 1623 W Nora Ave ADDRESS: rod@sodrussellinsurance.com Spokane,WA 99205-4231 INSURER(S)AFFORDING COVERAGE NAIC# License#:143991 INSURER A: Scottsdale Insurance Company 41297 INSURED INSURER B: Columbia Insurance Company 27812 SPOKANE HOUSE MOVING LLC INSURER C: 1303 E LACROSSE AVE INSURER D: Spokane,WA 99207 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 SUER' POLICY EFF ' POLICY EXP LIMITSLTR# INSO ma[ POLICY NUMBER .(MMIDD/YYYYI I IMMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 000,000 1 DAMAGE TO RENTED CLAIMS-MADE l, - ii PRE Csrrenceel $ 100,000_.. 10I.S .iE o MED EXP(Any one person) $ 5,000 A [ Y ! N CPS7949792 [ 2/27/2024 2/27/2025 1}PERSONAL a ADV INJURY $ 14000,000 �GEEN'L AGGREGATE LIMIT APPLIES PER: [GENERAL AGGREGATE $ 2,000,000 /_�,?POLICY JEC L , LOC PRODUCTS-COMP/OP AGO $ 2,000,000 I OTHER: $ _ Ma=��EeDISINGLE LIMIT $ 1,000,000 AUTOMOBILE LIABILITY ANY AUTO BODILY INJURY(Per person) S I OWNED I SCHEDULED B I AUTOS ONLY X++AUTOS Y N 71TRR257716 5/1/2024 5/1/2025 BODILY INJURY(Per accident) $ , HIRED ' NON-OWNED PROPERTY DAMAGE I AUTOS ONLY 'AUTOS ONLY pPeraccldentL $ £ $ UMBRELLA LIAB ! !OCCUR EACH OCCURRENCE $ — EXCESS LIAB CLAIMS-MADE k AGGREGATE $ T DED [ RETENTIONS ' i $ WORKERS COMPENSATION 1 I PER I i OTH AND EMPLOYERS LIABILITY ( I__ STATUTE j ,_ER Y/N ANY PROPRIETOPJPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N 1 A ----- (Mandatory in NH) ! EL.DISEASE EA EMPLOYE S If yes.describe under DESCRIPTION Or.OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS t VEHICLES (ACORD 101,AdditIonal Remarks Schedule,may be attached if more space Is required) City of Spokane is listed as Additional Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Spokane Valley THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10210 East Sprague Avenue Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE I �41 � - ©19$$-201 AC RD ORPORAT All ngh s reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: CPS7949792 COMMERCIAL GENERAL LIABILITY CG 20 12 1219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: CITY OF SPOKANE VALLEY 10210 E SPRAGUE AVE SPOKANE VALLEY WA 99206-3682 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 2. This insurance does not apply to: include as an additional insured any state or a. "Bodily injury", "property damage" or governmental agency or subdivision or political "personal and advertising injury" arising out subdivision shown in the Schedule, subject to the of operations performed for the federal following provisions: government, state or municipality; or 1. This insurance applies only with respect to b. "Bodily injury"or"property damage"included operations performed by you or on your behalf within the "products-completed operations for which the state or governmental agency or hazard". subdivision or political subdivision has issued a permit or authorization. B. With respect to the insurance afforded to these additional insureds, the following is added to However: Section III — Limits Of Insurance: a. The insurance afforded to such additional If coverage provided to the additional insured is insured only applies to the extent permitted required by a contract or agreement, the most we by law; and will pay on behalf of the additional insured is the b. If coverage provided to the additional amount of insurance: insured is required by a contract or 1. Required by the contract or agreement; or agreement, the insurance afforded to such additional insured will not be broader than 2. Available under the applicable limits of that which you are required by the contract insurance; or agreement to provide for such additional whichever is less. insured. This endorsement shall not increase the applicable limits of insurance. CG 20 12 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 . I SAM.00v° Entities Search Results 0 Total Results Filter by: Entity Name Status "Spokane House Moving active LLC." Inactive ID Assigned May 22,2024 06:32:22 PM GMT