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HomeMy WebLinkAbout24-144.01ParmetrixIncSSullivanRdPreservationAlift Washington State Department of Transportation Supplemental Agreement Organization and Address Number 24-144.1 Parametrix 835 North Post, Suite 201, Spokane, WA 99201 Original Agreement Number 24-144 Phone: Project Number Execution Date Completion Date 366 8/13/2024 12/31 /2025 Project Title New Maximum Amount Payable S. Sullivan Rd Preservation 75,596 Description of Work Topographic survey for the S Sullivan Rd Preservation project. The Local Agency of City of Spokane Valley desires to supplement the agreement entered in to with Parametrix and executed on 8/13/2024 and identified as Agreement No. 24-144 All provisions in the basic agreement remain in effect except as expressly modified by this supplement. The changes to the agreement are described as follows: Section 1, SCOPE OF WORK, is hereby changed to read: N/A 11 Section IV, TIME FOR BEGINNING AND COMPLETION, is amended to change the number of calendar days for completion of the work to read: Completion Date: 12/31/2026 III Section V, PAYMENT, shall be amended as follows: N/A as set forth in the attached Exhibit A, and by this reference made a part of this supplement. If you concur with this supplement and agree to the changes as stated above, please sign in the Appropriate spaces below and return to this office for final action. By: K.J. Hanle By: Toi/./ i./,o N,..,.4 ..� ,-�\\VY on Itant Signature Approving Authority Signature Date DOT Form 140-063 Revised 09/2005 Exhibit "A" Summary of Payments Basic Agreement Supplement #1 Total I Direct Salary Cost $ 19,693 $ 0 $ 19,693 Overhead (including Payroll Additives) $ 34,159 $ 0 $ 34,159 Direct Non -Salary Costs $ 16,930 $ 0 $ 16,930 F�dFee $4,815 $0 $4,815 Total $ 75,596 $ 0 $ 75,596 DOT Form 140-063 Revised 09/2005 ACOR" CERTIFICATE OF LIABILITY INSURANCE Iik� DATE (MM/DD/YYYY) 1 10/30/2025 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 AssuredPartners Design Professionals Insurance Services, LLC 3697 Mt. Diablo Blvd Suite 230 Lafayette CA 94549 CONTACT NAME: Maurice Thornton PHONE FAX A/C N E : 510-272-1476 Arc No): ADDRESS: DesignProCerts@AssuredPartners.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Continental Insurance Company 35289 License#: 6003745 INSURED FIARAINC-01 Parametrix, Inc. 1019 39th Ave. SE Suite 100 INSURER B : XL Specialty Insurance Co. 37885 INSURERC: Valley Fore Insurance Company 20508 INSURER D: National Fire Insurance of Hartford 20478 Puyallup, WA 98374 (253) 604-6600 INSURER E : Continental Casualty Company 20443 INSURERF: Evanston Insurance Company 35378 COVERAGES CERTIFICATE NUMBER:171271398 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 LTR TYPE OF INSURANCE ADDL-SUBR INSD WVDPOLICY 14UMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS D X COMMERCIAL GENERAL LIABILITY Y Y 6050531366 11/1/2025 11/1/2026 EACH OCCURRENCE $1,000,000 CLAIMS -MADE LJ OCCUR DAMAGES ( RENTED PREMISES Ea occurrence) _ $ 1,000,000 X IVIED EXP (Any one person) $ 10,000 Contractual Liab X XCU Included PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 7 PRO - POLICY I JECT E LOC Rx PRODUCTS - COMP/OP AGG $ 2,000,000 WA Stop Gap $ 1,000,000 OTHER: WA Stop Gap/EL E AUTOMOBILE LIABILITY Y Y 6050531352 11/1/2025 11/1/2026 CEaOMBINED SINGLE LIMIT accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ A F X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y 6050531433 M KLV 7E U E 102296 11/1/2025 11/1/2025 11/1/2026 11/1/2026 EACH OCCURRENCE $15,000,000 X AGGREGATE $ 15,000,000 DED X I RETENTION $ n $ 0 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANYPROPRIETOR/PARTNER/EXECUTIVE Y 6050531383 6050531402 11/1/2025 11/1/2025 11/1/2026 11/1/2026 X STEATITE OERH WA Sto Gap E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NI N / A - (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Professional Liability& DPR5050088 11/1/2025 11/1/2026 Per Claim/1,000,000 $1,000,000/Agglmt Pollution Liability Included Claims Made Y Retroactive Date: 01/01/1969 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project Name: 0366 — S Sullivan Road Preservation / Spokane Valley, WA -- City of Spokane Valley is named as Additional Insured on General Liability and Auto Liability, per policy forms, with respect to the operations of the Named Insured as required by written contract. CERTIFICATE HOLDER CANCELLATION 30 Days Notice of Cancellation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Kelly Lynch AUTHORIZED REPRESENTATIVE 10210 East Sprague Avenue Spokane Valley WA 99206 A ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD