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23-036.07GarcoConstructionCityHallPDB Spok4.11111°ane Community & Public Works Department 10210 E Sprague Avenue • Spokane Valley WA 99206 Phone: (509) 720-5000 • Fax: (509) 720-5075 • 41 Valley www.spokanevalleywa.gov CHANGE ORDER CITY OF SPOKANE VALLEY Contract Change Order City of Spokane Valley Design-Builder: Garco Construction, Inc. 4114 E. Broadway Ave. Spokane, WA 99202 Project Name: City Hall Remediation—CIP#0322 Change Order#: 07 PCO# Description of Change Change in Change in Contract Time GMP 017 CE049 PCO015/Owner PCCO 05 Credit for Deleted Scope ($32,165.41) 018 CE050 McKinstry Credit ($4,680.34) 019 CE052 Added Costs to Paint Masonry $5,257.61 020 CE053 Deduct to Reflect Non-Allowed 10% Sub Mark-Up (156,957.39) 021 CE054 Contract Reconciliation/Work Performed through 09/01/2024 $59,190.13 Total w/o WSST ($129,355.40) Original Guaranteed Maximum Price (GMP) $ 349,999.00 Net change by previous authorized Change Orders $ 3,822,632.73 Total net[check one] El Increase/ j Decrease in the GMP by this Change ($140,867.93) Order New GMP including this Change Order $3,681,764.80 The new Contract Time including this Change Order is: New Phase 1 Completion Date May 31,2023 New Interim Milestone Dates: Substantial Completion September 1, 2024 New Interim Milestone Date: Final Completion July 1,2025 The changes in the GMP and Contract Time identified in this Change Order include all costs and time extensions associated with performing the changes set forth herein. City of Spokane Valley Design-Builder: Garco Construction, Inc. By: �-- By gnature Signature John Hohman Scott Battaglia Title: City Manager Title: Project Manager Date: ;u — 3 / —2y Date: 09/30/2024 GAR CO PCCO #007 Garco Construction,Inc. Project:230200-City Hall Remediation Project 4114 E Broadway Ave 10210 E Sprague Ave Spokane,Washington 99202 Spokane Valley,Washington 99206 Phone:(509)535-4688 Phone:509-720-5018 Fax:(509)535-1384 Prime Contract Change Order #007: Owner Change Order 07, PCOs 17,18,19, 20, 21 TO: City Of Spokane Valley FROM: Garco Construction Inc 10210 East Sprague Avenue 4114 E Broadway Ave Spokane Valley,Washington 99206 Spokane,Washington 99202 DATE CREATED: 8/27/2024 CREATED BY: Brea LaRue(Garco Construction Inc) CONTRACT STATUS: Pending-In Review REVISION: 0 DESIGNATED REVIEWER: REVIEWED BY: DUE DATE: REVIEW DATE: INVOICED DATE: PAID DATE: SCHEDULE IMPACT: EXECUTED: No SIGNED CHANGE ORDER RECEIVED DATE: CONTRACT FOR: 230200-SPOVAL0000:230200 Prime TOTAL AMOUNT: ($129,355.40) Contract DESCRIPTION: CHANGE ORDER AND CONTRACT RECONCILIATION FOR WORK PERFORMED THROUGH 09/01/2024 ATTACHMENTS: POTENTIAL CHANGE ORDERS IN THIS CHANGE ORDER: PCO# Title Schedule Impact Amount PCO 017 CE#049-(Credit)PCO015/Owner CO05 Deleted Scope ($32,165.41) PCO 018 CE#050-McKinstry Credit from PC0003/Owner CO 02 ($4,680.34) PCO 019 CE#052-Added Cost to Paint Masonry $5,257.61 PCO 020 CE#053-Deduct to reflect 10%Non-Allowed Sub Mark-Up ($156,957.39) PCO 021 CE#054-Contract Reconciliation for Work Performed Through 09/01'2024 $59,190.13 Total: ($129,355.40) CHANGE ORDER LINE ITEMS: PCO#PCO 017:CE#049-(Credit)PCO015/Owner C005 Deleted Scope GC Self- Performance Fee Subcontract (15.00%Applies Mark-Up # Budget Code Description Amount to Labor, (10.00% Subtotal Equipment, Applies to Burden,Material, Subcontract.) Other,and Indirect.) 09001- Deleted Scope of Work Framing and 1 00.S FRAME/DRYWALL/PLAST Drywall Repair on 2nd and 3rd Floors $(24,500.00) $0.00 $(2,450.00) $(26,950.00) ER.Subcontract Garco Construction, Inc. Page 1 of 3 Printed On:9/30/2024 03:20 PM GAR CO PCCO #007 GC Self- Performance Fee Subcontract (15.00%Applies Mark-Up # Budget Code Description Amount to Labor, (10.00% Subtotal Equipment, Applies to Burden,Material, Subcontract.) t.) Other,and Indirect.) 2 01015-00.L FINAL JOB CLEAN Deleted Labor(2)Laborers,48 Hrs at $(2,688.00) $(403.20) $0.00 $(3,091.20) UP.Labor 56.70 Rate Subtotal: $(27,188.00) $(403.20) $(2,450.00) $(30,041.20) Liability Insurance(1.00%Applies to all line item types.): $(300.41) Payment and Performance Bond(0.60%Applies to all line item types.): $(180.25) B&O Tax( 0.47%Applies to all line item types.): $(141.49) GC Fee(5.00%Applies to all line item types.): $(1,502.06) Grand Total: $(32,165.41) PCO#PCO 018:CE#050-McKinstry Credit from PC0003/Owner CO 02 GC Self- Performance Fee (15.00%Applies # Budget Code Description Amount to Labor, Subtotal Equipment, Burden,Material, Other,and Indirect.) 1 15004-00.S HVAC.Subcontract McKinstry Credit $(4,680.34) $0.00 $(4,680.34) Subtotal: $(4,680.34) $0.00 $(4,680.34) Grand Total: $(4,680.34) PCO#PCO 019:CE#052-Added Cost to Paint Masonry GC Self- Subcontract Performance Fee Mark-Up (15.00%Applies (10.00% # Budget Code Description Amount to Labor, Applies to Subtotal Equipment, Subcontract Burden,Material, and GC/CM Other,and Subcontra.) Indirect.) 1 09005- Masonry Painting $4,464.00 $0.00 $446.40 $4,910.40 00.S PAINTING.Subcontract Subtotal: $4,464.00 $0.00 $446.40 $4,910.40 Liability Insurance(1.00%Applies to all line item types.): $49.10 Payment and Performance Bond(0.60%Applies to all line item types.): $29.46 B&O Tax( 0.47%Applies to all line item types.): $23.13 GC Fee(5.00%Applies to all line item types.): $245.52 Grand Total: $5,257.61 PCO#PCO 020:CE#053-Deduct to reflect 10%Non-Allowed Sub Mark-Up # Budget Code Description Amount 1 01090-01.0 Final Reconciliation.Other Credit for applied 10%Subcontractor mark-up invoiced previously and $(156,957.39) not allowed per contract. Subtotal: $(156,957.39) Grand Total: $(156,957.39) Garco Construction,Inc. Page 2 of 3 Printed On:9/30/2024 03:20 PM GARCO PCCO #007 PCO#PCO 021:CE#054-Contract Reconciliation for Work Performed Through 09/01/2024 # Budget Code Description Amount 1 01090-01.0 Reconciliation.Other CONTRACT RECONCILIATION WORK THROUGH 09/01/2024 $59,190.13 Subtotal: $59,190.13 Grand Total: $59,190.13 The original(Contract Sum) $321,395.00 Net change by previously authorized Change Orders $3,188,827.99 The contract sum prior to this Change Order was $3,510,222.99 The contract sum would be changed by this Change Order in the amount of ($129,355.40) The new contract sum including this Change Order will be $3,380,867.59 The contract time will not be changed by this Change Order. City Of Spokane Valley Garco Construction Inc 10210 East Sprague Avenue 4114 E Broadway Ave Spokane Valley,Washington 99206 Spokane,Washington 99202 SIGNATURE DATE SIGNATURE DATE SIGNATURE DATE Garco Construction,Inc. Page 3 of 3 Printed On:9/30/2024 03:20 PM 23-02 CITY HALL REMEDIATION DATE HOURS MATERIALS TOTAL 8/8/2024 $ 425.00 $ 124.80 $ 549.80 8/19/2024 $ 1,445.00 $ 356.06 $ 1,801.06 8/20/2024 $ 2,550.00 $ 2,550.00 8/21/2024 $ 1,700.00 $ 1,700.00 8/22/2024 $ 2,040.00 $ 287.13 . , TOTAL $ 8,160.00 $ 767.99 $ 8,927.99 : Costs to paint masonry to --- be split by Owner and Great Northern Masonry ooli" k9litkli P.O. Box 8438 Daily Project Tracking Sheet 484 D.08145aP14tleSpokane,WA 90203 0438 A.FI)iY_£;Eil'iVIC A:4CI .If`1:5::=c eS-f+W iser;r,-I:ItJ1t9 500-924-6120 Client: Date: 2 r R I 'Z,-f Client P.O. No. 4 L4t Job No. Description of Work: r �cV4;_f i ePI-. 4e - Cn1csf _�— Manpower Utilization Material Utilization _ Hours Base Coatings, Sundries,Consumables & Rentals Name S.T. O.T. Rate Amount Qty. Description Unit Cost Amount k.Pi Mtlak.e4kilh 5 85 Los00 4 a-)R -7(Q 43 &u) OO5`5 7 37 O - _ 1VA rt(O law tig,c 42-S op - 110-4 iklS 17s4 WD- sVl $O 4 - On Site Equipment (Contractor Owned) Authorizing Signatures Qty. Description _ Time Rate Amount ` S&S Representatives Title; pl - _ Dater fig it • Authorized for Client By: Title: Date: THE SHERWIN WILLIAMS CO. REPRINTED t 3200 E TRENT AVE BLDG 2 S DOCUMENT SHERW/N-WILLIAMS. SPOKANE WA 99202 4456 Visit www.sherwin-williams.com CHARGE Store 708258 INVOICE (509)536-9700 ACCOUNT:6685-1174-4 Fax:(509)536-9701 NO. 4427-9 JOB 1 S&S COATINGS IND INC TRC#635943 PAGE 1 OF 1 SHIPPED TO: PO#CITY HALL SHOP DATE:08/07/2024 S&S COATINGS IND INC 815 N.LILY ROAD TIME:07:13 AM PO BOX 8438 FAX 924-6121 2-6826 SPOKANE WA 99203 0438 SPOKANE WA 99201 E20/14852 MARK S. GARY S. KEN S. (509)924-6120 (509)924-6120 TERMS:NET PAYMENT DUE ON SEP.20th SALES NUMBER SIZE PRODUCT DESCRIPTION QTY PRICE VALUE 1017-28467 GALLON 3351 SMART STRIP PRO-GAL 1 82.49 82 49 DISCOUNT(%15 00) -12.37 Thank You SUBTOTAL BEFORE TAX 70.12 receipt required for refund 9.000%SALES TAX:1-489920100 6.31 CHARGE $76.43 MERCHANDISE RECEIVED IN GOOD ORDER BY: MONTE STORE HOURS SUNDAY:CLOSED MONDAY-FRIDAY.7:00 AM-5:00 PM SATURDAY:8:00 AM-12:00 PM THE SHERWIN WILLIAMS CO. REPRINTED 3200 E TRENT AVE BLDG 2 S SHERWIN-WILLIAMS. SPOKANE WA 99202 4456 DOCUMENT Visit www.sherwin-williams.com CHARGE Store 708258 INVOICE (509)536-9700 ACCOUNT:6685-1174-4 Fax:(509)536-9701 No. 0055-7 JOB 1.S&S COATINGS IND INC TRC#635943 PAGE 1 OF 1 SHIPPED TO: PO#CITY HALL ORDER:0E0142251A 708258 SHOP DATE:08/08/2024 S&S COATINGS IND INC 815 N.LILY ROAD TIME:12:31 PM PO BOX 8438 FAX 924-6121 2-6826 SPOKANE WA 99203 0438 SPOKANE WA 99201 E47/14864 (509)924-6120 TERMS:NET PAYMENT DUE ON SEP,20th MONTE 509-924-6120 SALES NUMBER SIZE PRODUCT DESCRIPTION QTY PRICE VALUE 6507-11450 GALLON CLRTP WBSTN TNTWHT 1 34.04 34.04N Color:SW7050 USEFUL GRAY CCE*Color Cast OZ 32 64 128 B1 Black - 9 1 R2 Maroon - - 1 - Y3 Deep Gold - 10 1 1 USEFUL GRAY 10 GOVT IMPOSED PAINT FEE 1 0.95 0.95N 180-3188 3 INCH 99081630 3"FOAM BRUSH 1 2.19 2.19 DISCOUNT(%15 00) -0.33 Thank You SUBTOTAL BEFORE TAX 36.85 receipt required for refund 9.000%SALES TAX:1-489920200 0.17 CHARGE $37.02 MERCHANDISE RECEIVED IN GOOD ORDER BY: THANKS MONTE STORE HOURS SUNDAY:CLOSED MONDAY-FRIDAY:7:00 AM-5:00 PM SATURDAY:8:00 AM-12:00 PM 7i•i P.O. Box 8438 Daily Project Tracking Sheet ..� ,, ( , ' "� li I C 4� '�' Spokane WA 99203 0138 A F4JL-I-s:E;rciria:rlr+;4il;na.uA1;1,;,PapAwd,glicrl{:r9 509-924-0120 Client: S. o1ca..s, �0.il <<kl ts� C' tll / 'ca Date: $- VA-VA Client P.O. No. Job No. SJ L. ( •ll Description of Work:_tMo o ;LA_ elw P 0, (*A s,tvrl & 5 A S ,.„......A- c��� S 4-,ell '6reswot►• ;3� \o of tz-• Sc.4 1 ScafFotA r &fe 1t1....w.o4 56...- S6-if V� -Ie ceww,r - An+ L-�.� : -cans cn04...N 4L cornet. . Ua.1.o u..., b c'rek (...1,N.lrl iS1 12 < of b , * A,p L 4si4 s.cw 01t.410 d,`Sto 1er4t1 loe-ie tv N G emel of burinat adi4tw.* 40 1,...,. t ea Manpoitbr tilization Materlaflltilization Hours Base Cootints, Sundries,Consumables & Rentals , Name S.T. O.T. Rate Amount Qty._ Description Unit Cost Amount ttwti 0V,Itta-1,—_f V 5.. _J_____td)(s`x ki-t' l'L.11i,.s sca14a)d vA. k,_-r ask e4-S _ 4Vit(o, • 7-% to — Pie 32 31 i1 Ssg 144S cc� 35 to oto La.(.ova — ► 4L1( 00 MuAialS 35(0 0 1601 Ofo - On Site Equipment(Contractor Owned) Authorizing Signatures Dili. Description Time Rate Amount 371 or- S&S Representative: ,c — _ Title:____,_5, .-N . Date: g- 19,- 2 y r Authorized for Client By: • Title: Dale:__ THE SHERWIN WILLIAMS CO. REPRINTED 3200 E TRENT AVE BLDG 2 S DOCUMENT 3' SHERWIN-WILLIAMS. SPOKANE WA 99202 4456 Visit www.sherwin-wllliams.com CHARGE Store 708258 INVOICE (509)536-9700 ACCOUNT.6685-1174-4 Fax:(509)536-9701 No. 4782-7 JOB 1 S&S COATINGS IND INC TRC#635943 PAGE 1 OF I SHIPPED TO: PO#CITY HALL ORDER:0E0142459A708258 SHOP DATE:06/15/2024 S&S COATINGS IND INC 815 N.LILY ROAD TIME:11:44 AM PO BOX 8438 FAX 924-6121 2-6826 SPOKANE WA 99203 0438 SPOKANE WA 99201 E20/14852 (509)924-6120 TERMS:NET PAYMENT DUE ON SEP.20th SALES NUMBER SIZE PRODUCT DESCRIPTION QTY PRICE VALUE 6507-11450 GALLON CLRTP WBSTN TNTWHT 1 34.04 34.04N Color:SW7052 GRAY AREA CCE*Color Cast OZ 32 64 128 B1 Black - 38 1 - R2 Maroon - 3 - - Y3 Deep Gold - 48 1 1 GRAY AREA 10 GOVT IMPOSED PAINT FEE 1 0.95 0.95N Thank You SUBTOTAL BEFORE TAX 34.99 receipt required for refund 9.000%SALES TAX:1-489920200 0.00 CHARGE $34.99 MERCHANDISE RECEIVED IN GOOD ORDER BY: MONTE STORE HOURS SUNDAY:CLOSED MONDAY-FRIDAY::7:00 AM-5:00 PM SATURDAY:8:00 AM-12:00 PM THE SHERWIN WILLIAMS CO, REPRINTED 3200 E TRENT AVE BLDG 2 S T.-.0 SHERWIN-WILLIAMS. DOCUMENT SPOKANE WA 99202 4456 Visit www.sherwin-williams.com CHARGE Store 708258 INVOICE (509)536-9700 ACCOUNT:6685-1174 4 Fax:(509)536-9701 No. 4891-6 JOB 1 S&S COATINGS IND INC TRC#635943 PAGE 1 OF 1 SHIPPED TO: PO#CITY HALL SHOP DATE:08/19/2024 S&S COATINGS IND INC 815 N LILY ROAD TIME:12:54 PM FAX 924-6121 PO BOX 8438 2-6826 SPOKANE WA 99203 0438 SPOKANE WA 99201 E07/14852 MARK S. GARY S. KEN S (509)924-6120 (509)924-6120 *INDICATES SALE PRICE TERMS:NET PAYMENT DUE ON SEP.20th SALES NUMBER SIZE PRODUCT DESCRIPTION QTY PRICE VALUE 6506-93997 EACH 6604-06 THICKSTRI4ML 50PK XL 1 19.49 19.49 DISCOUNT(%15.00) -2.92 1017-28467 GALLON 3351 SMART STRIP PRO-GAL 3 82.49 247.47 DISCOUNT(%20 00) -49.49 568-0632 EACH AMF48 AMF MASKING FILM 48" 1 15.39* 15.39 143-9488 2 INCH 99060320 2"CHIP BRUSH 24 0.55 13.20 402-5870 EACH 2020 48MM BULK PK 6 3.62 21.72 MFG NBR:2020-48A-BK Thank You SUBTOTAL BEFORE TAX 264.86 receipt required for refund 9.000%SALES TAX:1-489920100 23.84 CHARGE $288.70 MERCHANDISE RECEIVED IN GOOD ORDER BY: MONTE STORE HOURS SUNDAY:CLOSED MONDAY-FRI DAY.:7:00 AM-5:00 PM SATURDAY:8:00 AM-12:00 PM ia0' 1y?; , P 0 Box 8438 Daily Project Tracking Sheet Spokane,WA 99203-0438 & COATINGS` a 509-924-6120 $ ft• rirt A FULL SERVICE COATINGS CORPORATION Client .SPOV tne..... \tc-LIsy �' t�"`�/ �i c f(,�1 Date: S-20- Z Client P O. No o Job No SV G )4rLt Description of Work: p'i TjU^^��ct 5arcr} r ?rt. - c. -r'..� 4*F -&ra��� 4- r rr:mow e�.�cre�c to,Ir.rc4 be%c �ricic 1 w{�S Es, 4i4ic_ ,4. t��vrt< tt y�l7 f< p(�3� �Lrc �4 . gCv�G fn- • G cT t a3�. fJ- Si d�C- �vcA earr�iC� bov1. brtc L� -L • J I l Apt 5 rz./ti /v-..r,e brc.st Qlnel �ow�/„�4.61^. +,t} SH - L c.. lore'- a� b�.l� aGf tc.ee } -1,, wi lo.a. Manpower Utilizationt Material Utilization Hours For Office Use Only Coatings,Sundries,Consumables&Rentals For Office Use Only Name S T 0 T Rates Amount Qty Description Unit Cost Amount Kos CUle�k�,....� �n Z,„ r,,1 Se.v.v). l o t . lot x s X ZJ ;n5 tn/l A.'{'1 Lruc k ,U 308452515ocO oo On Site Equipment(Contractor Owned) Description Time Rate Amount r 3saJ Ps; r 'Authorizing Signatures S&S Representative �o L/L Title 4 1p1 Date: 8 •20 '2_ 1 Authorized fdr Client By. Title: Date: y,x 'ill, i„ P.O.Box 8436 Daily Project Tracking Sheet `~ • OAjI�}/r at Spokane,WA 99203-0438 • u 509-924-6120 .0I rHmn.lr, Fy .� I A FULL SERVICE COATINGS CORPORATION Client:. 5(ok.c.....t, Vc.lt-L' G: Date: g-Zt-2`1 Client P.O.No C�JJ Job No. S v Description of Work: c-' et_- -z ScoirC,L--b- -t t c-. d eo AD p lev � 1 Lu(..{- �-1 �� L �'1C:L f1 S ;0- Iv S 1 c LO.'ICi -L Co'-i CL rt/00 i. bi(,� W4.(A -'t 4c-i a On c�.4c9(ynLd� ih.6. tMc( tit bwild• [nclJc� 4w t z:.clv > a-�S+vw� tiler !A Ae.,14. t., S n. Manpower Utilization Material Utilization Hours For Office Use Only Coatings,Sundries,Consumables&Rentals For Office Use Only Name S.T. O.T. Rates Amount Qty. Description Unit Cost Amount VOA. 0 VA 04%.kL r. IC? t to,- la' X s'X tti' ,zctt~.� 20 1-7..3O op _sacA.Dcri 1 u 0 tart On Site Equipment(Contractor Owned) Qty. Description Time Rate Amount 35aep5 c va5l.cc Authorizing Signatures �" S&S Representative ti�,cw.{c r..� (D1 , ..,>`.,--,P Title. 5 }, Date. -Z(-2. Authorized for Client By. Title: Date: P.O Box 8438 Daily Project Tracking Sheet ti * OAxlNG Spokane,WA 99203-0438 �j trnwtut.lntu r 509-924-6120 NN �p .t ` `at A FULL SERVICE COATINGS CDRPOnATION Client: 5p o v.1e- Vc. r L+ �) / rcrCC? 1-6t( Date: 3 27 -2.`j Client P.O.No. Job No t./. C,la (.{-f.�4 Description of Work: A- I lit t`.m.* k $ C. Ca.1..,vkt, �1-ivt A. 40 E. �isL� (c. .,ek.ir e .-v+•c.t- cr.b..•c. :ti, 1/Juit. tN tYV S Vrl�0..7� /1✓.Z ,s.. n- 4404. 1/i c 411 CgfA.e y .� /S.4 •�5 �ln�{t� 5 'S Utw�o✓S _. * eL.si-t elms.:-. .o;s«to/+efi hriMks eri N , tm1•-•"‘"" 4-4e4u01/4 4,2 ...4-tL 5v,,,,�.,4..,,,5, Manpower Utilization Material Utilization Hours For Office Use Only Coatings,Sundries,Consumables&Rentals For Office Use Only Name S.T. O-T. Rates Amount Qty. Description Unit Cost Amount i? Irv14v4C-,xle 1n . _ ,'-- L n 1 L .t. i 'hpSIX +`� fZ7il �� W1,0 Lv Vuk- �G�s �ia 2.51 13 l,.n%-to r a-,--k o (Do c"307l.3 On Site E9ulpment(Contractor Owned) Qly. Description Time Rate Amount 1 1 t lC1A �t�. V- Authorizing Signatures S&S Representative: C,ki.4- k .a.,,-f Title: .6 +-, 1 Date. 8 -2.1-Zc{ Authorized for Client By: Title: Date: � y �A"^ • Valley Way ~ 7707 E.Valley Way Spokane,WA 99212 DATE :08/22/2024 TIME :13:16:56 TRAN# :8071 TYPE :CFN_FW CARD# :XXXXXX4259 O . 1.6 ODOM :000 PUMP :1 PROD :Mid Unlead GALS :16.349 The Above Price Does Not Reflect CFN Participant's Price THANK YOU BRAND> SAFWAY INVOICE Number 6850 -D029357 SERVICES" Date 8/19/24 `Type RENTAL BRANDSAFWAY SERVICES LLC 850 PAGE 1 6206 E TRENT AVE REMIT PAYMENT TO: BLDG. 3, SUITE A BR{WDSAFWAY SERVICES LLC 850 SPOKANE VALLEY,WA 99212 P.O.BOX 91473 Phone#: 509-534-2730 CHIC AGO,1 60693 Fax#: 509-534-3916 Customer#: 6850-S&SC248 Job Site#: 00950 S&S COATINGS, INC. RCZ*S&S COATINGS RENTAL 815 N. LILY RD 6206 E TRENT AVE BLDG 3 SUITE EIELSON AFB SPOKANE VALLEY,WA 99212 SPOKANE,WA 99212 ORDER#: 18496 Job Phone No. Job Cost#: 00950 Customer Contact (Customer P.O.# Customer Req.U Ordered By Office Phone Project Order Taken Sales Rep CITY HALL I RON 0 —y DHOFF2 10850 Ship Date Ship Via Bill Lading _ Terms Due Date Approved Pre-lien CUSTOMER PICK UP NET 30 9/18/24 Part No. Description Quantity BILLING CYCLE 8/19/24 TO 9/15/24 RT6QLH FR RL TOWER 6 '4 'H X 5 'W SHIPMENT# 23509 08/19/24 4 ENDING BALANCE 4 CPS COUPLING PIN W/SNAP BUTTON SHIPMENT# 23509 08/19/24 8 ENDING BALANCE 8 PTP PIN PIGTAIL SHIPMENT# 23509 08/19/24 8 ENDING BALANCE 8 B104 CROSS BRACE 10 ' X 4 ' SHIPMENT# 23509 08/19/24 4 ENDING BALANCE 4 ADP19H10 DECK ALUM PLY H-HK 19"X10 ' SHIPMENT# 23509 08/19/24 3 ENDING BALANCE 3 AL1S SCREW JACK W/F&B SHIPMENT# 23509 08/19/24 4 ENDING BALANCE 4 CGGRPF GUARD R POST F W/GL CORNER SHIPMENT# 23509 08/19/24 4 ENDING BALANCE 4 GR10 GUARD R 10' SHIPMENT# 23509 08/19/24 4 ENDING BALANCE 4 GR5 GUARD R 5' Duplicate BRAND) SA F WAY INVOICE "'Number 6850 -D029357 SERVICES~ Date 8/19/24 BRANDSAFWAY SERVICES LLC 850 ,Type RENTAL 1 PAGE 2 6206 E TRENT AVE BLDG.3, SUITE A REMIT PAYMENT TO: SPOKANE VALLEY,WA 99212 BRANDSAFWAY SERVICES LLC 850 Phone#: 509-634-2730 P.O.BOX 91473 Fax#: 509-534-3916 CHICAGO,IL 60693 Customer#: 6850-S&SC248 Job Site#: 00950 S&S COATINGS, INC. RCZ* S&S COATINGS RENTAL 815 N. LILY RD 6206 E TRENT AVE BLDG 3 SUITE EIELSON AFB SPOKANE VALLEY, WA 99212 SPOKANE, WA 99212 ORDER#: 18496 Job Phone No. Job Cost#: 00950 Customer Contact Customer P.O.# Customer Req.# Ordered By Office Phone Project Order Taken Sales Rep IITY HALL RON 0 DHOFF2 10850 Ship Date Ship Via Bill Lading Terms Due Date Approved Pre-lien CUSTOMER PICK UP NET 30 9/18/24 Part No. Description Quantity SHIPMENT# 23509 08/19/24 4 ENDING BALANCE 4 BILLING CYCLE 8/19/24 TO 9/15/24 NOTICE TO CUSTOMERS PAYING WITH CREDIT CARD We impose a surcharge of 3% when paying with a credit card, which is not greater than our cost of acceptance. The adjustment will appear on your receipt . We do not surcharge debit cards . Any purchases made with a debit card will not include a surcharge. RENTAL TOTAL: 175 .00 INVOICE TOTAL: 175.00 WA STATE TAX: 11.38 SPOKANE VALLEY CITY TAX: 2 . 80 DISTRICT TAX: 1.40 GRAND TOTAL: 190 .58 Duplicate -�� GARCCON-03 SSIMPSONI ACORD►" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) �---� 12/22/2023 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 CONTACT Stacia Simpson NAME: Hub International Northwest LLC PHONE FAX PO Box 3144 (A/C,No,Eat):(509)319-2912 (A/C,No): Spokane,WA 99220 ADDRESS:Stacia.Simpson@hubinternational.com INSURER(S)AFFORDING COVERAGE NAIC It INSURER A:Liberty Mutual Fire Insurance Company 23035 INSURED INSURER B:Liberty Insurance Corporation 42404 Garco Construction,Inc. INSURER c:Liberty Mutual 23043 P.O.Box 2946 INSURER D:Indian Harbor Insurance Company 36940 Spokane,WA 99220 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMM/DD/YYYYI IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR TB2Z914699540023 12/31/2023 12/31/2024 DAMAGE TO RENTED 100 000 X X PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4'000'000 POLICY X jECT LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: WA STOP GAP $ 1,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000 Ea accident) X ANY AUTO X X AS7Z91469954013 12/31/2023 12/31/2024 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY _ AUTOS BODILY INJURY(Per accident) $ X AUTOS ONLY X AUUTOS ONLYY (Perr accidenTY tDAMAGE C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ I0,000,000 EXCESS LIAB CLAIMS-MADE X x TH7Z91469954033 12/31/2023 12/31/2024 AGGREGATE $ 10,000,000 DED X RETENTION$ 0 '$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER 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 $ A WA STOP GAP EL2Z91469954043 12/31/2023 12/31/2024 Limit 1,000,000 D Prof/Poll Liability x x CE0742089708 12/31/2023 12/31/2024 $2MM EA OCCI$6MM AGG DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) PROJECT NO.0322-2 PROJECT DESCRIPTION:CITY HALL REMEDIATION-PROGRESSIVE DESIGN BUILD-SPOKANE VALLEY CAPITAL IMPROVEMENT CITY OF SPOKANE VALLEY,WASHINGTON,THEIR OFFICERS,DIRECTORS AND EMPLOYEES ARE ADDITIONAL INSUREDS AS IT RELATES TO GENERAL& AUTO LIABILITY&WAIVER OF SUBROGATION IS GRANTED AS IT RELATES TO GENERAL AUTO LIABILITY FOR ON-GOING AND COMPLETED OPERATIONS IN ACCORDANCE WITH TERMS AND CONDITIONS OF THE POLICIES. UMBRELLA FOLLOWS FORM AS IT RELATES TO ADDITIONAL INSUREDS. THE ABOVE COVERAGE IS PRIMARY AND NONCONTRIBUTORY WHERE REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SPOKANE VALLEY,WASHINGTON THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10210 E SPRAGUE AVENUE SPOKANE VALLEY,WA 99206 AUTHORIZED REPRESENTATIVE (tite L/ ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD