05-056.00 Tetra Tech: Swale EvaluationAGREEN-IENT FOR PROFESSIONAL SERViCES
11<0M. Inc. dba Tetra Tech /KCM, Inc.)
THIS AGREEMENT is made by and between the City of Spokane Valley, a code City of the State of
Washington, hereinafter "City" and KCM, inc. dba Tetra 'tech / KCNI, inc. hereinafter "Consultant," jointly
referred to as "parties."
W CONSIDERATION of the terms and conditions contained herein the parties agree as follows:
1. Work to Be Performed. The Consultant will provide all labor, services and material to
satisfactorily complete the attached :Scope of Services.
A. Administration. The City Manager or designee shall administer and be the primary
contact for Consultant. Prig' to commencement of work, Consultant shall contact the City Manager or
designee to review the Scope of Work, 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 «pork, stop work
and promptly cure any failure in performance under this .Agreement.
B. Representations. The City has relied upon the qualifications of the 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 Work. No substitutions of personnel shall be made without the written
consent of the City.
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. Modifications. The City may modify this Agreement and order changes in the work
whenever necessary or advisable. The Consultant will accept modifications when ordered in writing by the
City Manager or designee. Compensation for such modifications or changes shall be as mutually agreed
between the parties. The Consultant shall make such revisions in the work as are necessary to correct errors or
omissions appearing therein when required to do so by the 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.
Either party may terminate this Agreement by ten (10) days Nvritten notice to the other party.
In the event of such termination, the City shall pay the Consultant for all work previously authorized and
satisfactorily performed in accordance Nvith the Scope of Services prior to the termination date.
3. Compensation. The City agrees to pay the Consultant a Lump Sum amount of $40,000 as
full compensation for Tasks l and 2 of the Scope of Services under this Agreement.
4. Pavment. The Consultant shall be paid monthly upon presentation of an invoice to the City
for the percent of the work completed since the prior month's invoice. Applications for payment shall be sent
Agreement for Professional Services Page 1 of 4
Cis -s�
to the City Clerk at the below stated address.
The City reserves the right to withhold payment under this Agreement which is determined in the
reasonable judgment of the City Manager or designee to be noncompliant with the Scope of Work, City
Standards, City ordinances and federal or state standards.
Notice. Notice shall be given in writing as follows:
TO THE CITY:
TO THE CONSULTANT:
Name: Christine Bainbridge, City Clerk Name: K. David Moss
Phone Number: (509)921 -1000 Phone Number: (509) 744 -9271
Address: 11707 East Sprague Ave, Suite 106 Address: 1235 N. Post, Suite 101
Spokane Valley, WA 99206 Spokane, WA 99201
6. Applicable Laws and Standards. The parties, in the performance of this Agreement, agree
to comply with all applicable Federal, State, local laws, ordinances, and regulations.
7. Relationship of the Parties. It is understood, agreed and declared that the Consultant shall be
an independent Consultant and not the agent or employee of the City, that the 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 the Consultant. Any and all employees who provide
services to the City under this Agreement shall be deemed employees solely of the Consultant. The Consultant
shall be solely responsible for the conduct and actions of all employees under this Agreement and any liability
that may attach thereto.
s. Ownership of Documents. All drawings, plans, specifications, and other related documents
prepared by the Consultant under this Agreement are and shall be the property of the City. Consultant will not
be held liable for the unauthorized reuse by the City or its representatives of documents or modifications
thereof, including documents on electronic media, for any purpose(s) other than those authorized under this
Agreement.
9. 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 the Consultant's records with respect to all
matters covered in this contract. Such representatives shall be permitted to audit, examine and make excerpts
or transcripts from such records and to make audits of all contracts, invoices, materials, payrolls and record of
matters covered by this contract for a period of three years from the date final payment is made hereunder.
10. Insurance. During the term of the contract; the Consultant shall maintain in force at its own
expense, the following insurance:
A. Workers' Compensation insurance in compliance with RCW 51.12.020, which
requires subject employers to provide workers' compensation coverage for all their subject workers and
Employer's Liability or Stop Gap Insurance in the amount of $1,000,000.00;
B. General Liability Insurance on an occurrence basis with a combined single limit of not
less than S1,000,000.00 each occurrence for bodily injury and property damage. It shall include contractual
liability coverage for the indemnity provided under this contract. It shall provide that the City, its officers,
employees and agents are additional insureds but only with respect to the Consultant's services to be provided
Agreement for Professional Services Page 2 of 4
under the contract;
C. Automobile Liability Insurance,.vith a combined single limit, or the equivalent, or not
less than $1,000,000.00 each accident for bodily injury and property damage, including coverage for owned,
hired or non -owned vehicles; and
D. Professional Liability Insurance with a combined single limit of not less than
$1,000,000.00 each claim, incident or occurrence. This is to cover damages caused by the error, omission, or
negligent acts related to the professional services to be provided under this contract. The coverage must
remain in effect for at least two (2) years after the contract is completed.
There shall be no cancellation, material change, reduction of limits or intent not to renew the
insurance coverage(s) without thirty (30) days written notice from the Consultant or its insurer(s) to the City.
As evidence of the insurance coverages required by this contract, the Consultant shall furnish
acceptable insurance certificates to the City at the time the Consultant returns the signed contract. The
certificate shall specify all of the parties who are additional insureds, and will include applicable policy
endorsements, the thirty (30) day cancellation clause, 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 the City. The Consultant shall be financially responsible for all pertinent deductibles, self - insured
retentions, and/or self- insurance.
IL indemnification anti Hold Harmless. Each party shall indemnify and hold the other, its
officers, employees, agents and volunteers harmless from and against any and all claims, demands, orders,
decrees or judgments for injuries, death or damage to any person or property arising or resulting from any
negligent act or omission on the part of said party or its agents, employees or volunteers in the performance of
this Agreement. Neither the City nor the Consultant shall be obligated to indemnify the other party in any
manner whatsoever for the other party's negligence.
12. 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.
13. Assipnrnent 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.
14. Subcontracts. Except as otherwise provided herein, the Consultant shall not enter into
subcontracts for any of the work contemplated under this Agreement without obtaining written approval of the
City. Two subconsultants anticipated for the work are: Stan Miller (Spokane) and GeoEngineers (Spokane).
15. Confidentiality. Consultant may from time to time receive information which is deemed by
the City to be confidential. Consultant shall not disclose such information without the express consent of the
City or upon order of a Court of competent jurisdiction.
Agreement for Professional Services Page 3 of
16. Jurisdiction and Venue. This Contract is entered into in Spokane County, Washington.
Venue shall be in Spokane County, State of Washington.
17. Cost and Attorney's Fees. In the event a lawsuit is brought with respect to this Agreement,
the prevailing party shall be awarded its costs and attorney's fees in the amount to be determined by the Court
as reasonable. Unless provided otherwise by statute, any attorney fees awarded under this section to the
prevailing party shall not exceed the total sum amount paid under this Agreement.
18. Entire Agreement. This written Agreement constitutes the entire and complete agreement
between the parties and supercedes any prior oral or written agreements. This Agreement may not be changed,
modified or altered except in writing signed by the parties hereto.
19. Anti - kickback. No officer or employee of the 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.
20. Business Registration. Prior to commencement of work under this Agreement, Consultant
shall register with the City as a business.
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:
• Scope of Services — dated June 27, 2005 [Tasks 1 and 2]
• Project Cost Estimate — dated June 27, 2005 [Tasks 1 and 2 and related expenses]
• Consultant's Certificate of Insurance Coverage for this project.
IN WITNESS WHEREOF, the parties have executed this Agreement this 27th day of June, 2005.
CITY OE-- SPOKANE VALLEY:
City Manager
A'
Clerk
Agreement for PTOfeSSi
CONSULTANT:
C
KCM, Inc. dba Tetra Tech / KCM, Inc.
Federal Tax ID No._ REDACTED
APPROVED AS TO FORM:
o�)
City Attoijey
This document contains confidential tax information and
has been redacted pursuant to RCW 82.32.330.
You may petition for a review of our findings pertaining to any
redacted or withheld documents pursuant to Spokane Valley
Municipal Code (SVMC) 2.75.080; and obtain judicial review
pursuant to RCW 42.56.550. _
Page 4 of 4
SWALE EVALUATION STUDY
TOPSOIL MIX DESIGN
SCOPE OF WORK
This scope of work outlines the tasks and services the team of Tetra Tech/KCM, Stan Miller, and
GeoEngineers will provide to the City of Spokane Valley. This scope constitutes the tasks and services to
be provided for the Topsoil Mix Design, which is an extension of the Stivale Evaluation Project, prepared
for the City of Spokane Valley by Tetra Tech /KCM.
Project Overview
The 2004 swale study involved the evaluation of three design methods for Bioln[iltration Swales, and one
design method for BioFiltration Swales based upon guidelines included in the June 2003 Final Draft
Siornnvater Management Manual for Eastern Washington (Manual). One of the design methods for
Biolnfiltration Swales was recommended and was defined in a report prepared for the City of Spokane
Valley entitled Swale Evaluation Project, November 2004. That study was funded by Spokane Valley.
Spokane County and the City of Spokane participated in the discussions and review of the report.
Implementation of Recommended Next Steps
The Stivale Evaluation project report listed several "Recorrunended Next Steps" that are necessary to
implement the recommendations of the study. Several key action steps for swalcs include:
1. Require use of an "engineered" topsoil
2. Review and update constriction procedures
3. Develop an effective post- construction inspection program
4. Require appropriate maintenance of swales, including replacement when needed
At this time, the scope of services described below will focus on providing support for action steps 1 & 4
above. It is understood that action steps 2 and 3 will be performed by the City of Spokane Valley,
however optional tasks can be included to assist the City, if desired.
Task 1 — TETRATECH PROJECT MANAGEMENT
Provide management of consultant staff and coordination with subconsultants. Prepare and maintain
project schedule. Provide monthly invoices and status reports of the work completed and the work
scheduled. Project meetings are generally scheduled in other tasks, however separate stratus review
meetings can be provided if desired.
Task 2 — DESIGN A TOPSOIL MIX FOR BIOINFILTRATION SWALES
This task shall be performed in several subtasks as listed below. These activities include essential work
for defining soil characteristics and swale installations (subtasks 2.1 through 2.7). These subtasks should
be completed over a 3 to 4 month period.
Subtask 2.1 — Start-up and progress meetings
Hold one start -up meeting to discuss the project, confirm the scope of work, and establish the critical
issues and expectations with key project stakeholders. Hold one or two progress meetings with key
stakeholders to discuss the work progress, results, and pertinent recommendations.
Deliverables:
• Summary of each meeting, together with action items and related discussion.
Tetra Tech/ KCM, Inc. - 1 - June 27, 2005
City of Spokane Valley �- Topsoil Mix Design
Subtask 2.2 — Describe soil characteristics and develop topsoil mix designs for testing
This subtavk will generally be performed by Starr Miller, with support from Tetra Tech staff.
(a) Perform a literature review of contaminant removal and soil characteristics applicable to the
treatment soil.
(b) Define needed physical and chemical characteristics. Generally the infiltration rate is desired to be at
or around 0.3 inches per hour (per the November 2004 Swale Evaluation Study), with a minimum of 0.08
inches per hour and a maximum of 1.0 inch per hour. The desirable chemical and organic properties that
support treatment of stormwater runoff will also be defined.
(c) Evaluate two native soils typical to the Spokane galley area (Mir #1 & Mix #2).
(d) Evaluate two available landscaping topsoils from local vendors (Mix #3 & Mix #4).
(e) Prepare two engineered soils mixes (ivlix #5 & Mix #6), based upon defined characteristics and the
results from the other mixes, probably by adding sand, gravel and /or compost to one or two of the mixes.
(f) Al. this time, the following mix designs are anticipated to be prepared and evaluated. The list may be
modified based upon the literature review and evaluation steps in this subtask. [The level of effort and
budget, however, are based upon this list and would require adjustment if the list is modified (expanded).
The list includes the six (6) mixes which are likely most applicable to the City of Spokane Valley.]
'iMix#
Base Soil or Mix
Additives
I
Garrison
None
2
Marble
None
3
Three -way Mix 1
None
4
Landscape Soil 2
None
5
Engineered Soil I
Add sand?
Add gravel?
Add compost'?
6
Engineered Soil 2
Add sand?
Add gravel?
Add compost'?
Deliverables:
• Literature review of contaminant removal and soil characteristics applicable to the treatment soil.
• Technical Memorandum describing the soil mix mixes to be prepared and tested, together with a
discussion of key characteristics. Define the range of desirable infiltration rates and the related
physical and chemical properties.
Tetra Tech/ KCM, Inc. - 2 - June 27, 2005
City of Spokane Valley ��f Topsoil Mix Design
Subtask 2.3 — Laboratory (bench) testing of physical properties
This subtask will be performed by GeoEngineers, with input front Stan Miller and Tetra Tec&KCM staff.
Estimate the porosity and permeability of selected topsoil mixtures and native soil by laboratory testing.
Each mixture or sample will be subjected to three tests for each parameter to be measured.
(a) Porosi r: Estimate porosity by measuring water content and specific gravity of selected topsoil
mixtures and natural soil samples. Moisture content tests will be completed in accordance with
ASTM D2216 -90 test procedures. Specific gravity will be tested in accordance with ASTM
D854 -83, ASTM C -127 or ASTM C -128, depending on size of soil particles. Porosity will be
estimated based on weights and volumes of soil and water components in each sample. Gradation
and hydrometer analyses might also be completed in accordance with ASTM D422 -63 to provide
particle size distribution of selected samples.
(b) Permeability: Estimate permeability of selected topsoil mixtures and natural soil samples by U.S.
Army Corps of Engineers Method EM 1110 -2 -1906, V11 -13.
(e) Infiltration: There are no known standard tests to measure infiltration rates in the laboratory.
When the hydraulic gradient is 1.0, then permeability = infiltration. Under non - saturated soil
conditions in the field, however, a surface tension exists which tends to decrease the infiltration
rate. The memorandum will discuss qualitative differences and will suggest what could be done
in field tests to explore the significance of such variable conditions.
Deliverables:
• Technical Memorandum detailing results of bench tests, and recommendations on which mix
designs should be considered further and evaluated for chemical properties (subtask 2.4).
Subtask 2.4 — Laboratory evaluation of chemical properties
This subtask will be perfonned by GeoEngineets, with input from Stan Miller and Tetra TechyKCMstaf
Complete CEC in accordance with Environmental Protection Agency (EPA) Method 9081, or other
applicable method, and organic matter content in accordance with ASTM D2974 on selected topsoil
mixes (from subtask 2.3), natural soil samples, and two commercially available topsoil products. Also,
submit selected samples to an accredited analytical testing laboratory for measurement of concentrations
of chromium, copper, lead, zinc; sodium, calcium, potassium and manganese by EPA Method
6010A/7000 Series. Analytes will be measured for only one sample of each topsoil mixture, natural soil
sample, or commercially available topsoil sample.
Deliverables:
• Technical Memorandum on soil and topsoil chemical properties.
Subtask 2.5 — Describe engineered topsoil manufacture and availability
This subtask will generally be performed by Stan Miller, with support from Tetra Tec/KCM staff.
(a) Develop manufacture and installation scenarios to meet the design requirements for local conditions.
Discuss how and who might manufacture the engineered topsoil, and what limitations apply to use of in
situ soils, with or without additives.
(b) Discuss anticipated cost for manufacture, and possible local vendors.
Deliverables:
• Technical Memorandum outlining key soil manufacture and availability scenarios, including
availability, prospective vendors, and anticipated costs.
T e t r a Tech/ KCM, Inc. - 3 - June 27, 2005
City of Spokane Valley
• Topsoil Mix Design
Subtask 2.6 — Describe engineered topsoil installation and O &M requirements
This subtask will generally be performed by Stun Miller, with support from Tetra Tech /KCw staff.
(a) Develop criteria for planting of vegetation (both irrigated and dryland grasses) and for maintaining
and monitoring the health of the swale (grass and topsoil).
(b) Propose a methodology for inspecting and measuring swale health and for requiring implementation
of appropriate rehabilitation measures over the life of the swale.
Deliverables:
Technical Memorandum outlining key construction conditions and modifications needed for defined
geologic conditions. Include typical swale detail that shows the type of recommended treatment
topsoil, recommended treatment layer depth, recommended infiltrative layer depth, vegetative cover,
etc. Note what criteria and tests are needed if a treatment material other than what is recommended
by the study is used, or proposed for use. incorporate basic construction notes and procedures. Also,
provide general guidance on Operation and Maintenance requirements necessary to keep the Swale
operating as designed.
Subtask 2.7 — Peer review
GeoEngineers - Spokane will be retained to perform a peer review of the work completed in subtasks 2.2,
2.5 and 2.6. Having worked on several studies pertaining to stormwater infiltration in the Spokane area,
GeoEngineers will provide continuity with those related efforts.
Also assisting with the peer review will be Dr. Harry Gibbons of Tetra `tech. Dr. Gibbons and Stan
Miller have a long history of professional association; of particular relevance in the Spokane area was
their collaboration on the Spokane County Stornnvater Quality and Best Management Practices Study
performed it 2000 - 2002, with the final report. published in February 2003.
Deliverables:
• Review Comments from GeoEngineers on guidance and recommendations for the topsoil mix design
effort in subtasks 2.27 2.5 and 2.6. Review comments and recommendations from Dr. Gibbons on
work perfornied by Stan Miller and GeoEngineers.
Subtask 2.8 — Draft report and Final report
A draft report will be prepared, generally by combining the technical memoranda and pertinent review
comments from the above subtasks. Five (5) copies will be submitted to the City for review and comment.
A final report will be prepared, by incorporating pertinent review comments received on the draft report.
Ten (10) copies, and one electronic file, will be submitted to the City.
Deliverables:
Five (5) draft copies and ten (10) final copies of the report will be submitted to the City.
Task 3 — PROVIDE SUPPLEMENTAL SUPPORT AS ASSIGNED (Optional)
If requested by the City, provide supplemental support as assigned. This may include scientific and
technical support; additional coordination meetings, preparing and/or making special presentations;
preparing and O&M brochure for shales, and other miscellaneous services needed to assist with
implementation of the Swale Evaluation study recommendations and action steps.
Tetra Tech/ KCM, inc. - 4 - June 27, 2005
DOCUMENTS EXEMPT FROM PUBLIC DISCLOSURE
The page entitled "TtKCM — Project Cost Estimate for Professional Services" contains
confidential cost and rate data is are withheld from public disclosure pursuant to 23 USC
112(2)(F).
Prenotification; confidentiality of data. A recipient of funds requesting or using the cost
and rate data shall notify any affected firm before such request or use. Such data shall be
confidential and shall not be accessible or provided, in whole or in part, to another firm or to any
government agency which is not part of the group of agencies sharing cost data under this
paragraph, except by written permission of the audited firm. If prohibited by law, such cost and
rate data shall not be disclosed under any circumstances.
You may petition for a review of our findings pertaining to any redacted or withheld documents
pursuant to Spokane Valley Municipal Code (SVMC) 2.75.080; and obtain judicial review
pursuant to RCW 42.56.550.
Ai;ORDry CERTIFICL_,,E OF LIABILITY INSURL'jCE page 1 of 2
09130DATE
/2005
PRODUCER 877 - 945 -7378
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Willie North Amorica, Inc. - Regional cast Center
26 Century Blvd.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC#
P. O. Box 305191
Nashville, TN 372305191
INSURED xC)+, Inc dba Totra Tech /XCM, Inc.
INSUREAk ACE American Insurance CompanX
122667-011
INSURERB:Continental Casualty Company
-
20443 -002
1917 Pirot Avenue
Seattlo, WA 98101
INSURERC:Indemnity insurance Company of North Amer
43575 -001
INSURERD:American International 92acialty Lines In
26883 -000
S 1.000 0 0 0
W \SURER E:
East Sprague Avonue
p
rrnvcceccc
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
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POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
WDO'L!
TVPEOFINSURANCE
POLICYNUMBER
POLICY EFFECTIVE
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POLICY EXPIRATION
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A
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
GENERAL LIABILITY
HDOG21724798
10/1/2005
10/1/2006
EACH OCCURRENCE
s 1 000 000
DAiI c S REIN u ortoe
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11707
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AUTHO ESENT�TiVE
Suite 106
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MED EXP (Any ono Derson
S 100,000
( CLAIMS MADE 7 OCCUR
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X 6ntract Liab.
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Max. Claim du 'no policy vear
DESCRIPTION OF OPERATIONSILOCA TIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: 3440019 Swale Evaluation Project
City of Spokane Valley is included as an Additional Insured with respects to General Liability and
Automobile Liability as required by contract.
rr0TIrIe'ATF Ianl ncR CANCELLATION
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City
of Spokane
Valley
IMPOSE NO OBLIGATION OR LIABILITY OF ANY IOND UPON THE INSURER, ITS AGENTS OR
Attn:
Christine
Bainbridge, City Clerk
11707
East Sprague Avonue
REPR E TIV
AUTHO ESENT�TiVE
Suite 106
Spokane Valley,
WA 99206ni
ACORD 25 (2001/08) Coll:1417193 Tpl:415820 Cert:6262751 ISIAL:vnUI,.UMI`VMAllvry ItO00
�. 7
Page 2 of 2
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ACORD CERTIFIC /j_^_,- OF LIABILITY INSURl_,�ICE Page 1 of 2
1 091 27DATE
/2004
PRODUCER -877-945-7378
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
'
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Willie North America, Inc. - Regional cart Center
26 Century Blvd.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. o. Box 305191
HDOG21707739
Nashville, TN 372305191
INSURERS AFFORDING COVERAGE
INSURED XCM, Inc dba Tetra Toch /RCM, Inc.
INSUR£RA: ACS American Insurance Cocpan 22667 -011
1917 First Avenue
Seattle, W A 98101
NSUa_RB: Continental Casualt y Company 20443 -002
INSURERC:American international S ecialty Lines in 26883 -000
}{ OOMMERCIALGENERALLIABILITY
I CLAIMSMADE OCCUR
USURER D:
INSURER E
I
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPEOFINSURANCE
I POLICY NUMBER
I POUCYEFFECTIVE
POLICY EXPIRATION
1
LIMITS
A
I GENERALUABILITY
HDOG21707739
10/1/2004
10/1/2005
EACHOCCURRENCE
S 1.000.000
FIRE DAMAGE (Anyone Era)
5-1L000. QQQ
}{ OOMMERCIALGENERALLIABILITY
I CLAIMSMADE OCCUR
MEDEXP(Anyonepsmorj
S 100,000
X Contract Liab.
PERSONALBADVInNRY
S 11000,000
X I
X,s, U Covosado
GENERALAGGREGATE
5 2,000,000
GEN'L AGGRE{ GGATTE LIMIT APPLIES PER:
POLICY I X I PROs LOC
PRODUCTS • 0OMP /0P AGG
S 2 0 0 0, 0 Q 0
B
AUTOMOBJLELIABILITY
X ANY AUTO
BUA2049225137
10/1/2004
10/1/2005
OOMBINED SINGLE LIMIT
IEaecddent)
$ 2,000,000
X ALLOWNEDAUTOS
SCHEDULED AUTOS
6001ILYINJURY
(Par por; on)
$
X HIRED AUTO
X ,I NION-OWNED AUTOS
BODILY[NJUAY
(Porocddmt)
S
IX $3000 Comp Ded.
PROPERTY DAMAGE
(Poroccidem)
S
723000 Coll Ded.
GARAGE LIABILITY
AUTO ONLY • EA ACCIDENT
S
OTHER THAN EA AOC
AUTOOXLY. AGG
$
ANY AUTO
5
A II
IfII
EXCESS LIABILITY
OCCUR AIMS MADE
X Ca..
1t
G21976167
10/1/2004
10/1/2005
EACH OCCURRENCE
S 2 000 000
`
AGGREGATE
S 2,000,000
S
u
DEDUCTIBLE
S
S
RETENTION S
A
VORKERSCOMPENSATIONAND
ADS WLRC43990196
10/1/2004
10/1/20Q5
OTIi-
X V FR
-E.L. EACH ACCIDENT
5 1,000.000
A
WT SCFC43990378
10/1/2004
10/1/2005
E.L. DISEASE• EA EMPLOYE El$
1,000 000
E.L. DISEAS E - POLICY LIMIT 1
S 1,000,000
C
OTHER
1952583
10/l/2004
170/l/2005
$,000,000 Each Claim
I
Profeaoional
$5,000,000 Aggregate
Pollution /EEO Legal Liab.
$ 250,000 Rentention Claim
Max. Claim during policy year
OESCRIPTION OF OPERATIONS /LOCATIONSIVEHECLESIEXCLUSIONS ADDED BY ENDORSEMENT15PECIAL PROVISIONS
RE: 3440019 Swale Evaluation Project
City of Spokane Valley is included as an Additional Insured with respects to General Liability and
Automobile Liability as required by contract.
VCn I It -11.rM I C fIV4✓Cr7 I A I AUUWTIONAL INSURED; INSURER LETTER: GAIVGtLLA I ILIN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Spokane Valley IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Attn: Christine Bainbridge, City Clerk RBPRESENTaT1vE5.
11707 East Sprague Avenue
Suite 106 A Ell REPRE NTATV
Spokano Valley, WA 99206
1
ACORD 25-S (7/97) C011:1099606 To1:301688 Cert:4809 55 MACnRnrnRanRATInN1oAA
S ,
W _ Page 2 of 2
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
AWKIJ25- 5(7797) C011:1099606 Tp1:301688 Cert:4809255