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25-094.00RomneyFinancialForensicsProfessionalServices-ForensicsContract No. 25-094.00 AGREEMENT FOR PROFESSIONAL SERVICES Romney Financial Forensics, LLC THIS AGREEMENT is made by and between the City of Spokane Valley, a code City of the State of Washington, hereinafter "City" and Romney Financial Forensics, LLC, hereinafter "Consultant," jointly referred to as "Parties." IN CONSIDERATION of the terms and conditions contained herein, the Parties agree as follows: 1. Work to Be Performed. Consultant shall provide all labor, services, and material to satisfactorily complete the Scope of Services, attached as Exhibit A. A. Administration. The City Manager or designee shall administer and be the primary contact for Consultant. Prior to commencement of work, Consultant shall contact the City Manager or designee to review the Scope of Services, schedule, and date of completion. Upon notice from the City Manager or designee, Consultant shall commence work, perform the requested tasks in the Scope of Services, stop work, and promptly cure any failure in performance under this Agreement. B. Representations. City has relied upon the qualifications of Consultant in entering into this Agreement. By execution of this Agreement, Consultant represents it possesses the ability, skill, and resources necessary to perform the work and is familiar with all current laws, rules, and regulations which reasonably relate to the Scope of Services. No substitutions of agreed -upon personnel shall be made without the prior written consent of City. Consultant represents that the compensation as stated in paragraph 3 is adequate and sufficient for the timely provision of all professional services required to complete the Scope of Services under this Agreement. Consultant shall be responsible for the technical accuracy of its services and documents resulting therefrom, and City shall not be responsible for discovering deficiencies therein. Consultant shall correct such deficiencies without additional compensation except to the extent such action is directly attributable to deficiencies in City -furnished information. C. Standard of Care. Consultant shall exercise the degree of skill and diligence normally employed by professional consultants engaged in the same profession, and performing the same or similar services at the time such services are performed. D. Modifications. City may modify this Agreement and order changes in the work whenever necessary or advisable. Consultant shall accept modifications when ordered in writing by the City Manager or designee, so long as the additional work is within the scope of Consultant's area of practice. Compensation for such modifications or changes shall be as mutually agreed between the Parties. Consultant shall make such revisions in the work as are necessary to correct errors or omissions appearing therein when required to do so by City without additional compensation. 2. Term of Contract. This Agreement shall be in full force and effect upon execution and shall remain in effect until completion of all contractual requirements have been met as determined by City. Consultant shall complete its work by October 31, 2025 unless the time for performance is extended in writing by the Parties. Agreement for Professional Services (with professional liability coverage) Page I of 7 Contract No. 25-094.00 Either Party may terminate this Agreement for material breach after providing the other Party with at least 10 days' prior notice and an opportunity to cure the breach. City may, in addition, terminate this Agreement for any reason by 10 days' written notice to Consultant. In the event of termination without breach, City shall pay Consultant for all work previously authorized and satisfactorily performed prior to the termination date. 3. Compensation. City agrees to pay Consultant an agreed upon hourly rate of $400.00 USD per hour up to a maximum amount of $10,000.00 USD as full compensation for everything done under this Agreement, as set forth in Exhibit A. Consultant shall not perform any extra, further, or additional services for which it will request additional compensation from City without a prior written agreement for such services and payment therefore. 4. Payment. Consultant shall be paid monthly upon presentation of an invoice to City. Applications for payment shall be marked confidential and sent to the City Finance Department, attention Sarah Farr, Accounting & Finance Program Manager, at the below -stated address, or through email to accountspayable@spokanevalleywa.gov. City reserves the right to withhold payment under this Agreement for that portion of the work (if any) which is determined in the reasonable judgment of the City Manager or designee to be noncompliant with the Scope of Services, City standards, City Code, and federal or state standards. 5. Notice. Notices other than applications for payment shall be given in writing as follows: TO THE CITY: Name: Marci Patterson, City Clerk Phone: (509) 720-5000 Address: 10210 East Sprague Avenue Spokane Valley, WA 99206 TO THE CONSULTANT: Name: Lenore D. Romney, CPA, CFE, CVA Phone: 509-850-9632 Address: P.O. Box 30656 Spokane, WA 99223 6. Applicable Laws and Standards. The Parties, in the performance of this Agreement, agree to comply with all applicable federal, state, and local laws and regulations. Consultant states that its designs, construction documents, and services shall conform to all federal, state, and local statutes and regulations. 7. Certification Regarding Debarment Suspension and Other Responsibility Matters — Primary Covered Transactions. A. By executing this Agreement, the Consultant 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; Agreement for Professional Services (with professional liability coverage) Page 2 of 7 Contract No. 25-094.00 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. 8. Relationship of the Parties. It is understood and agreed that Consultant shall be an independent contractor and not the agent or employee of City, that City is interested in only 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 Consultant. Any and all employees who provide services to City under this Agreement shall be deemed employees solely of Consultant. The Consultant shall be solely responsible for the conduct and actions of all its employees under this Agreement and any liability that may attach thereto. 9. Ownership of Documents. All drawings, plans, specifications, and other related documents prepared by Consultant under this Agreement are and shall be the property of City, and may be subject to disclosure pursuant to chapter 42.56 RCW or other applicable public record laws. The written, graphic, mapped, photographic, or visual documents prepared by Consultant under this Agreement shall, unless otherwise provided, be deemed the property of City. City shall be permitted to retain these documents, including reproducible camera-ready originals of reports, reproduction quality mylars of maps, and copies in the form of computer files, for the City's use. City shall have unrestricted authority to publish, disclose, distribute, and otherwise use, in whole or in part, any reports, data, drawings, images, or other material prepared under this Agreement, provided that Consultant shall have no liability for the use of Consultant's work product outside of the scope of its intended purpose. 10. Records. The City or State Auditor or any of their representatives shall have full access to and the right to examine during normal business hours all of Consultant's records with respect to all matters covered in this Agreement. Such representatives shall be permitted to audit, examine, make excerpts or transcripts from such records, and to make audits of all contracts, invoices, materials, payrolls, and record of matters covered by this Agreement for a period of three years from the date final payment is made hereunder. 11. Insurance. Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by Consultant, its agents, representatives, employees, or subcontractors. A. Minimum Scope of Insurance. Consultant's required insurance shall be of the types and coverages as stated 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 0001. 2. Workers' compensation coverage as required by the industrial insurance laws of the State of Washington. Agreement for Professional Services (with professional liability coverage) Page 3 of 7 Contract No. 25-094.00 3. Professional liability insurance appropriate to Consultant's profession. B. Minimum Amounts of Insurance. Consultant shall maintain the following insurance limits: 1. Automobile liability insurance with a minimum combined single limit for bodily injury and property damage of $600,000 per accident. 2. Professional liability insurance shall be written with limits no less than $1,000,000 per claim and $2,000,000 policy aggregate limit. C. Other Insurance Provisions. The Consultant's policies are to contain, or be endorsed to contain, the following provisions for automobile liability and commercial general liability insurance: 1. Consultant's insurance coverage shall be primary insurance with respect to the City. Any insurance, self-insurance, or self -insured pool coverage maintained by City shall be in excess of Consultant's insurance and shall not contribute with it. 2. Consultant shall provide City and all additional insured for this work with written notice of any policy cancellation within two business days of their receipt of such notice. 3. If Consultant 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 Consultant, irrespective of whether such limits maintained by Consultant 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 Consultant. 4. Failure on the part of Consultant to maintain the insurance as required shall constitute a material breach of the Agreement, upon which the City may, after giving at least five business days' notice to Consultant to correct the breach, immediately terminate the Agreement, or at its sole discretion, procure or renew such 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 Consultant from the City. D. Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, Consultant shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Agreement before commencement of the work. 12. Indemnification and Hold Harmless. Consultant shall, at its sole expense, defend, indemnify, and hold harmless City and its officers, agents, and employees, from any and all claims, actions, suits, liability, loss, costs, attorney's fees, costs of litigation, expenses, injuries, and damages of any nature whatsoever relating to or arising out of the wrongful or negligent acts, errors, or omissions in the services provided by Agreement for Professional Services (with professional liability coverage) Page 4 of 7 Contract No. 25-094.00 Consultant, Consultant's agents, subcontractors, subconsultants, and employees to the fullest extent permitted by law, subject only to the limitations provided below. 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 Consultant and the City, its officers, officials, employees, and volunteers, the Consultant's liability, including the duty and cost to defend, hereunder shall be only to the extent of the Consultant's negligence. It is further specifically and expressly understood that the indemnification provided herein constitutes the Consultant's waiver of immunity under Industrial Insurance, Title 51, RCW, solely for the purpose 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. A waiver in one instance shall not be held to be a 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 prior written consent of the other Party. 15. Subcontracts. Except as otherwise provided herein, Consultant shall not enter into subcontracts for any of the work contemplated under this Agreement without obtaining prior written approval of City. 16. Confidentiality. Consultant may, from time -to -time, receive information which is deemed by City to be confidential. Consultant shall not disclose such information without the prior express written consent of City or upon order of a court of competent jurisdiction. 17. Jurisdiction and Venue. This Agreement is entered into in Spokane County, Washington. Disputes between City and Consultant shall be resolved in the Superior Court of the State of Washington in Spokane County. Notwithstanding the foregoing, Consultant agrees that it may, at City's request, be joined as a party in any arbitration proceeding between City and any third party that includes a claim or claims that arise out of, or that are related to Consultant's services under this Agreement. Consultant further agrees that the Arbitrator(s)' decision therein shall be final and binding on Consultant and that judgment may be entered upon it in any court having jurisdiction thereof. 18. Cost 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). 19. Entire Agreement. This written 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 hereto. Agreement for Professional Services (with professional liability coverage) Page 5 of 7 Contract No. 25-094.00 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. 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. 22. Exhibits. Exhibits attached and incorporated into this Agreement are: A. Scope of Services and fee proposal B. Insurajnce gertificates The Parties have executed this Agreement this AP day of a , 20 CITY OF SPOKANE VALLEY Consultant: . ofk;�— John Holtman, City Manager APPROVED AS TO FORM: ZX, /'0*/A0;1__ Offi of the ty Attorney UMIX"laym By: Its: Authorized Representative Agreement for Professional Services (with professional liability coverage) Page 6 of 7 Contract No. 25-094.00 Exhibit A — Scope of Services and Fees The scope of work shall include professional services to investigate Reclaim Project Recovery's potential mismanagement of grant and other funds under Contracts No. 23-166.00, 23-166.01, and 23-166.02 and Revival Contracting under Contracts No. 24-061.00 and 24-061.01 including but not limited to reviewing the pertinent financial documents, reimbursement requests, and other grant and financial documentation. The Consultant will • collaborate with City finance staff to identify records relevant to the investigation; • examine records provided by the finance staff through an electronic portal; • review and evaluate reimbursement requests, searching for discrepancy within the records; and • report to the City on potential areas of fraud, missing information, or misuse of funds. Consultant shall coordinate with the Accounting & Finance Program Manager and staff to identify and procure records for review. A final, written report containing any discrepancies, fraud, or material issues of concern shall be presented to City staff by October 31, 2025. City will promptly provide, upon request, all financial and non -financial information and documentation reasonably deemed necessary or desirable by Consultant in connection with the services in order to complete the objectives. The City will make available all personnel whose assistance is requested in order for Consultant to complete the objectives. Fees: Services will be furnished and billed on an hourly basis. Hourly rate: $400.00 USD; up to a maximum amount of $10,000.00 USD as full compensation for everything done under this Agreement. Consultant shall be paid monthly upon presentation of an invoice which shall be submitted electronically to accountspa ableC&spokanevalleywa.gov; Attn: Sarah Farr, Accounting and Finance Program Manager. Payment shall be made no later than 30 days of receipt of invoice. If additional financial resources are needed to complete the investigation, then the Parties may mutually agree to modify the maximum allowed compensation, but only by a written agreement signed by both Parties. Agreement for Professional Services (with professional liability coverage) Page 7 of 7 DECLARATIONS ACCOUNTANTS PROFESSIONAL LIABILITY POLICY --'----- --------- —--- -------- ------------ —--------------- ---- INSURANCE IS PROVIDED BY PRODUCER BRANCH PREFIX POLICY NUMBER CONTINENTAL CASUALTY COMPANY 151 N. Franklin Street, CHICAGO, IL 60606 003613 970 APL 625793220 A STOCK INSURANCE COMPANY —"---'-'---------- ------------------------------------------------- REFERRED TO IN THIS POLICY AS WE, US, OR OUR. 1. Named Insured and Mailing Address * * * * NOTICE * * * * Romney Financial Forensics, LLC Po Box 30656 THIS IS A CLAIMS -MADE AND REPORTED POLICY AND COVERS Spokane, WA 99223-3010 ONLY CLAIMS FIRST MADE AGAINST AN INSURED AND REPORTED IN WRITING TO THE COMPANY DURING THE POLICY PERIOD. PLEASE READ THIS POLICY CAREFULLY AND DISCUSS THE COVERAGE WITH YOUR INSURANCE AGENT. 2. POLICY PERIOD: FROM: 6/15/25 TO: 6/15/26 at 12:01 A.M. Standard time at your address shown above. 3. PRIOR ACTS DATE: 6/15/17 at 12:01 A.M. 4. DEDUCTIBLE: Per Claim Deductible or Aggregate Deductible $0 5. LIMITS OF LIABILITY: (INCLUDES CLAIM EXPENSES UNLESS AMENDED BY ENDORSEMENT) $1, 000, 000 PER CLAIM $2, 000, 000 AGGREGATE 6. FOR NON -RENEWAL: 0 days notice will be given you in accordance with policy conditions 7. PRINTED ENDORSEMENTS ATTACHED AT POLICY ISSUANCE INCLUDE: G-127136-A(1/16) Policy CNA8751OXX CPA NetProtect Endorsement G-127137-A(7/12) Declarations Page G-127157-A(6/97) Nuclear Energy & Pollution Excl G-127164-A46(6/97) Amend Termination Provisions - WA G-127165-A46(12/12) Amendatory Endorsement - WA CNA87547XXC Sole Own/Disabil Ext Cims Rptg Per G-141584-A(6/03) Policyholder Notice CNA90673XX-(11/17) Amend Limits of Liability Endorsement G-127152-AC(5/06) Claim Expenses Outside Limits G-127137-A(Ed. 7/12) 0 CNA All Rights Reserved Page 1 of 2 8. $1, 183 . 00 ANNUAL PREMIUM 9. WHO TO CONTACT TO REPORT A CLAIM OR POTENTIAL CLAIM: Director of Claims Accountants Professional Liability CNA Insurance Companies 151 N. Franklin Street Chicago, IL 60606 APLNewLoss@CNA.com THIS POLICY IS NOT VALID UNTIL SIGNED BY OUR AUTHORIZED REPRESENTATIVE. Authorized Representative G-127137-A(Ed. 7/12) 0 CNA All Rights Reserved Page 2 of 2 C 00 0 g 0 0 0 NETZ AGENCY LLC 12904 E NORA AVE D SPOKANE VALLEY, WA99216 FARMERS INSURANCE Auto Insurance Vehicle Replacement Your Farmers Policy GD65A250710 004666 Ki Policy Number: 18911-78-52 ROBERT K ROMNEY Effective 7/10/2025 12:01 AM LENORE D ROMNEY Expiration: 10/12/202512:01 AM 4822 S MYRTLE ST SPOKANE WA99223-7879 Your Farmers Agent Netz Agency LLC 12904 E Nora Ave D 7/11/2025 Spokane Valley, WA99216 (509) 535-3033 Dear Robert K Romney and Lenore D Romney, dnetz@farmersagent.com Thank you for giving us the opportunity to serve your auto insurance needs. This packet To file a claim log on to Farmers.com reflects recent changes made to your policy, or the Farmers® MobileApp or call 1-800-435-7764 A summary of your premium and policy change information is shown below. Premium at -a -glance ............................................. Did you know? Full -term Premium (excluding fees) $970,00 �® Manage Your Policy Online Prorated Premium (7/10/2025 - 10/12/2025) $233.22 Log onto farmers.com to pay your 10► Total for this Transaction $233.22 ill, get insurance ID cards, view policy documents, and more! Plus, access your account anytime using This is not a bill. the Farmers Mobile App! Text Your bill with the amount due will be mailed separately. GETAPP to 29141 to download it today'. Summary of Changes f Go Paperless Previous Current Save stamps, time and trees .... Go 2010 Audi A4 Quatt V:735 Covered Not Covered Paperless! You can choose to 2025 Audi A5 Quatt V:731 Not Covered Covered receive your Farmers policydocuments and/or billing statement Mileage 0 electronically. Enroll atfarmers.com and choose the paperless options! If you have any questions or would like to learn more about our other insurance products and services, please contact your agent. We appreciate your business. Sincerely, Farmers Insurance Group(D farmers.com 01 25.8164 1-14 FARMERS Auto Insurance Declaration Page INSURANCE Policy Number: 18911-78-52 Effective: 8/24/2025 12:01 AM Expiration: 10/12/2025 12:01 AM Namedlnsured(s): Robert K Romney Lenore D Romney 4822 S Myrtle St Spokane, WA 99223-7879 Underwritten By: Farmers Insurance Company of Washington 3120 139th Avenue SE Suite 300 Bellevue, WA 98005 Household Drivers Premiums ..................................................... Full -term Premium (excluding fees) $970.00 Prorated Premium (7/10/2025 - 10/12/2025) $233.22 0" Total for this Transaction This is not a bill. Your bill with the amount due will be mailed separately. Information on this declaration is effective 7/10/2025. $233.22 Are there drivers not listed below who either reside in your household (even if temporarily away from home) or are guests staying in your home for more than 90 days? If so, please contact us or your agent. If you have purchased coverage for loss to your insured car (for example, Collision Coverage), your deductible could increase to $5000 for a loss to your car (or an attached trailer) because your car was being operated by one of those unlisted drivers at the time of the loss. Details regarding this higher deductible can be found in your policy documents. Name Driver Status Name Driver Status Lenore D Romney Covered Robert K Romney Covered Vehicle Information Veh. # Year/Make/Model/V►N 1 2025 Audi A5 Quattro 4D 4Wd 2.OT Pr WAU3BCFU6SNO46731 Vehicle Level Coverage Items Limits Coverage (applicable to all vehicles) Bodily Injury Liability $500,000 each person $500,000 each accident Property Damage Liability $100,000 each accident Personal Injury Protection $35,000 each person Comprehensive Collision Underinsured Motorist Property Damage Towing and Road Service Loss of Use $100,000 each accident K5: $50 per day/ $1,000 max Coverage Deductible Limit Comprehensive: $100 Collision: $500 Premiums by Vehicle Vehicle 1 $122.70 $70.40 $24.30 $127.30 $450.80 $91.20 $9.50 $73.80 farmers.com Policy No. 18911-78-52 Questions? Manage your account: Call your agent Netz Agency LLC at Go to www.farmers.com to access (S09) 535-3033 or email your account any time: ON. dnetz@farmersagent.com 56-6176 2nd Edition 1-22 7/11/2025Page 1 of 3 Declaration Page (continued) Policy level Coverage Items Limits Coverage (for all vehicles) Per Policy Underinsured Motorist $500,000 each person Covered Bodily Injury $500,000 each accident 100' Full -term Premium $970.00 Discounts Discount Type Auto/Home EFT Applies toVehicle(s) Discount Type 1 Multiple Car 1 Auto/Specialty Other Policy Features and Benefits • Accident Forgiveness - prevents one accident from impacting your premium • Incident Forgiveness - protects your premium from increases due to minor traffic violations Policy and Endorsements Applies to Vehicle(s) This section lists the policy form number and any applicable endorsements that makeup your insurance contract Any endorsements that you have purchased to extend coverage on your policy are also listed in the coverages section of this declarations document. 56-5045 3rd ed.; J6284 1 st ed.; J6491 1 st ed.; J6674 1 st ed.; J6936A 1 st ed.; WA026 1 st ed ; WA027 1 st ed., WA028 1 st ed.; WA030A 2nd ed.; WA033 1 st ed.; WA034 2nd ed ; WA035 4th ed.; WA038 1 st ed.; WA039 1 st ed.; WA047A 2nd ed.; WA050A 1 st ed.; WA052 1st ed.; WA0552nd ed.; WA0562nd ed.; WA058 1st ed.; WA064 1st ed. Other Information • Vehicle i - Deductible waived if glass repaired rather than replaced. • Your policy provides Towing and Road Service Coverage for selected vehicles as shown in the Coverage Information section of your Declarations Page. Towing and Road Service Coverage is outlined in tree policy, and it extends for the duration of the policy period. This coverage will be removed from any vehicle upon renewal of your policy if three (3) or more Roadside claims are submitted on the same vehicle, or any vehicle that replaces it during the policy term, within a rolling 12-month period. If you have any questions, please contact Farmers customer service at 1-888-327-6335. • Go Green by logging onto Farmers com or contacting your Farmers Agent. • Contact your agent for a Farmers Friendly Review®to learn more about policy discounts, coverage options, and other products you may qualify for. Farmers has a newer Auto product that may be available to you. farmers.com Policy No. 18911-78-52 Questions? Manage your account: all your agent Netz Agency LLC at Go to www. farmers, com to access (509) 535-3U33 or email your account ary time: dnetz@farmersagent.com 56-6176 2nd Edition 1.22 Page 2 of 3 Declaration Page (continued) *Information on Additional Fees The "Fees" stated in the "Premium/Fees" section on Pagel apply on a per -policy, not an account basis. The following additional fees also apply: Service Charge per installment (in consideration of our agreement to allow you to pay in installments): For Automatic Bank Payment plans also enrolled in online billing (paperless): $0.00 (applied per account) For other Automatic Bank Payment plans: $2.00 (applied per account) For Automatic Debit Card plans: $3.00 (applied per account) For Automatic Credit Card plans: $5.00 (applied per account) For all non -automatic payment plans: $7.00 (applied per account) If this account is for more than one policy, changes in these fees are not effective until the revised fee information is provided for each policy. Countersignature Authorized Representative 2. Late Fee: $15.00 (applied per account) 3. Returned Payment Charge: $20.00 (applied per check, electron transaction, or other remittance which is not honored by your financial institution for reasons including, but not limited to, insufficient funds or a closed account) 4. Reinstatement Fee: $25.00 (applied per policy) One or more of the fees or charges described above maybe deemed apart of premium under applicable state law. farmers.com Policy No. 1891 1-78-52 Questions? Call your agent Net- Agency LL at (509) 535-3033 or email dnetzQfarmersagent.com 56-6176 2nd Edition 1-22 ,s Manage your account: G. to www.farmers.com to access your account any time. Page 3 of 3 Policy Endorsements Important Information About Your Policy FARMERS INSURANCE The following provides you with information regarding your auto policy. This endorsement WA047 2nd edition - Endorsement Adding Property Damage to Underinsured Motorist Coverage, has been revised to include a new available Limit of Liability ($250,000). If you wish to revise your Limits of Liability, please contact your Farmers' agent. This message is provided for informational purposes only. It is not a part of your policy and does not affect or provide coverage, in and of itself. Since the policywith all of its endorsements are your contract with us, they take precedence over this message. For a more detailed description of your coverage, please refer to your policy and to its endorsements. Endorsement Adding Property Damage to Underinsured Motorist Coverage - Washington (WA047A-2nd Edition) This coverage appliesonly to the vehicles)l for which this endorsement is listed on the Declarations page. For an additional premium, Underinsured Motorist Coverage is amended to include the following: We will pay damages for property damage which an insured person is legally entitled to recover from the owner or operator of an underinsured motorvehicle. The property damage must be causec by accident and arise out of the ownership, maintenance, or use of the underinsured motorvehicle. As used in this endorsement, property damage means physical injury or destruction of: 1) your insured car or 2) property contained in your insured car which is owned by an insured person. Limit of liability The property damage liability limit shall be the limit shown in the schedule below and designated in the Declarations. The total damages shall be reduced by the amount available from any party held liable for the accident. Coverage Designation Limit P1 $ 10,000 P8 $ 15,000 P2 $ 20,000 P3 $ 25,000 P4 $ 40,000 P5 $ 50,000 P6 $ 100,000 P 10 $ 250,000 P7 $ 500,000 P9 $ 1,000,000 A deductible of three hundred dollars will apply to property damage caused by a hit-and-run or phantom vehicle. A deductible of one hundred dollars will apply for property damage caused by all other underinsured motor vehicles. This coverage applies to property damage arising from an accident with a hit-and-run or phantom vehicle which does not make physical contact with you or your insured car or your insured vehicle, provided that: farmers -corn Policy No. 1891 1-78-52 (Continued Next Page) Page 1 of 2 II Policy Endorsements (continued) a) The facts of the accident can be verified by someone other than you or another person having an underinsured motorist claim from the same accident, and b) you or someone on your behalf reports the accident to the police within seventy-two hours. 94-2752 2nd Edition 12-12 This endorsement is part of your policy. It supersedes and controls anything to the contrary. It is otherwise subject to all other terms of the policy. farmers.com Policy No. 1891 1-78-52 Page 2 of 2