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11-083.00 Michael Terrell: Signage & Identity DevelopmentCITY OF SPOKANE VALLEY PARKS & RECREATION INFORMATIONAL COVER SHEET FOR DOCUMENTS REQUIRING CITY MANAGER SIGNATURE Date: July 1, 2011 Budget Account No: AGREEMENT TOPIC: Contract with Michael Terrell, Landscape Architect, to develop City of Spokane Valley Signage and Identity Development documents which include several concepts for consideration by the City Council. BACKGROUND: Michael Terrell was selected for this project from the Consultant Roster based upon his qualifications and experience in developing public signage. This agreement shall be in full force and shall remain in effect until the completion of all contractual requirements has been met. The City agrees to pay the Consultant on a time and materials basis not to exceed $3,600.00 as full compensation for everything done under this agreement. Reimbursable expenses such as mileage and reproduction will be billed as incurred not to exceed $600.00. Parks & RecreattPirector Date Date `7 ` Approved: 7r I I — Approved: Leg k (applicable only for Original Contract Agreements) Finance (applicable only for Original Contract Agre ments) Contract Language E] Selection Process Approval ❑ Letter f Credit ❑ Funding Source Approval 1E] Pe ormance & Pay nt Bond Approval Date 7111 Approved: isk Manager (applicable only for Original Contract Agreements) Insurance Certificates Approval DISTRIBUTION: Original to Vendor Original to City Clerk Copy to Submitting Department Copy to Finance Department ATTACHMENTS: Two copies of contract with original signatures AGREEMENT FOR PROFESSIONAL SERVICES Michael Terrell — Landscape Architect City of Spokane Valley Signage and Identity Development Project THIS AGREEMENT is made by and between the City of Spokane Valley, a code City of the State of Washington, hereinafter "City" and Michael Terrell, Landscape Architect, 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 The Consultant will provide all labor, services and material to satisfactorily complete the Scope of Services as outlined in the proposal from Michael Terrell, Landscape Architect, to Mike Stone dated June 22, 2011, a copy of which is attached and incorporated as an exhibit to this agreement. 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 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 Services. No substitutions of agreed upon 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 have been met. Either party may terminate this agreement by ten days' written 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 prior to the termination date. 3. Compensation The City agrees to pay the Consultant on a time and materials basis not to exceed $3,600.00 as full compensation for everything done under this agreement. Reimbursable expenses such as mileage and reproduction will be billed as incurred not to exceed $600.00 Agreement for Professional Services — City Signage Project Page 1 of 5 4. Payment The Consultant shall be paid monthly upon presentation of an invoice to the City. Applications for payment shall be sent 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 Services, City Standards, City ordinances and federal or state standards. Notice Notice shall be given in writing as follows: TO THE CITY Name: Christine Bainbridge, City Clerk Phone Number: (5 09) 921 -1000 Address: 11707 East Sprague Ave, Suite 106 Spokane Valley, WA 99206 TO THE CONSULTANT Name: Michael Terrell, Landscape Architect Phone Number: (509) 922 -7449 Address: 5312 South Chapman Road Greenacres, WA 99016 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 its employees under this agreement and any liability that may attach thereto. 8. 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, and may be subject to disclosure pursuant to RCW 42.56 or other applicable public record laws. 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 The 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 the Consultant, its agents, representatives, or employees. No Limitation. Consultant's maintenance of insurance as required by the agreement shall not be construed to limit the liability of the Consultant to the coverage provided by such insurance, or otherwise limit the City's recourse to any remedy available at law or in equity. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non - owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, Agreement for Professional Services — City Signage Project Page 2 of 5 the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors and personal injury and advertising injury. The City shall be named as an insured under the Consultant's Commercial General Liability insurance policy with respect to the work performed for the City. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. 4. Professional Liability insurance appropriate to the 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 $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. 3. Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability, Professional Liability and Commercial General Liability insurance: 1. The Consultant's insurance coverage shall be primary insurance as respect the City. Any insurance, self - insurance, or insurance pool coverage maintained by the City shall be excess of the Consultant's insurance and shall not contribute with it. 2. Cancellation of Consultant's insurance shall be governed by either: a. the policy shall be endorsed to state that coverage shall not be cancelled by either party, except after 30 days' prior written notice by certified mail, return receipt requested, has been given to the City, or b. the Consultant shall provide at least 30 days' prior written notice by certified mail, return receipt requested of a cancellation. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANN. E. Evidence of Coverage. 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, 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 Agreement for Professional Services — City Signage Project Page 3 of 5 financially responsible for all pertinent deductibles, self - insured retentions, and /or self - insurance. 11. Indemnification and Hold Harmless The Consultant shall defend, indemnify and hold the City, its officers, officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees, arising out of or in connection with the performance of this agreement, except for injuries and damages caused by the sole negligence of the City. 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 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 purposes of this indemnification. This waiver has been mutually negotiated by the parties. The provisions of this section shall survive the expiration or termination of the agreement. 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 ofthe 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. Assignment and Delegation Neither party shall assign, transfer or delegate any or all of the responsibilities of this agreement or the benefits received hereunder without first obtaining the written consent of the other party. 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 prior written approval of the City. Subcontractors that may be used include NAC, NMEC, Dumais Romans and TD &H. 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 written consent of the City or upon order of a Court of competent jurisdiction. 16. Jurisdiction and Venue This agreement 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, Consultant's attorney fees payable by the City 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. Agreement for Professional Services — City Signage Project Page 4 of 5 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 Redstration 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: 1. Scope of Services 2. Insurance Certificates WHEREOF, the parties have executed this agreement this 1 day of .2011. OKANE VALLEY: Consultant: 0 i Manager Fo dmg Principal Tax ID No Y Bainbridg ,City Clerk APPROVED AS TO FORM �"' � Office of th ity Atto This document contains personal confidential information and has been redacted pursuant to RCW 42.56.230(3). 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. Agreement for Professional Services — City Signage Project Page 5 of 5 L Michael Terrell ■ Landscape Architect 5312 South Chapman Road Greenacres, WA 99016 Date: June 30, 2011 Client: City of Spokane Valley, WA Phone: (509) 720 -5400 Contact: Mr. Mike Stone Fax: (509) 688 -0188 Address: 2426 N. Discovery Place Spokane Valley, Washington 99216 Project: City of Spokane Valley Signage and Identity Development Address: Spokane Valley, Washington Michael Terrell ■ Landscape Architect Agrees To Perform The Following Scope of Services: City of Spokane Valley Signage and Identity Development Tasks Duration Fees Phase I City Signage and Identity Development 1. Review existing city logo, previous sign concepts and 2 Weeks potential sign applications. 2. Develop 3 conceptual designs for City of Spokane Valley signs. Conceptual designs to address the following concepts: a. Free standing sign on base that reflects regional character b. Concept that utilizes engraved stone and foundation similar to Centerplace signs. c. Concept integrating metal, stone and timbers. 3. Deliverables: a. Presentation level concept drawings of each concept on a 24 "x36" board in color. b. Electronic files of each concept. 4. Meetings: a. Meet with city staff to review design concepts. b. Presentation to city council. Phase I Subtotal $3,600.00 Total $3,600.00 PROPOSAL Project: City of Spokane Valley Signage Development 1 Project #: 10 -022A Client: City of Spokane Valley L O NOTE: The above fee is based on an estimate of hours to complete the proposed Scope of Services at our current hourly rates. The actual fee may vary, but should be within 10% of this estimate. For services not listed as optional or included in this proposal see "Extended Services ". EXTENDED LANDSCAPE DESIGN SERVICES The following services are not included in the Scope of Services or fee and will be performed or coordinated as directed and authorized by the "client" at our current hourly rates or a negotiated fee if required. • Revisions to previously approved work. • Additional meetings, presentations, or site visits other than those listed in the Scope of Services. • Permitting or entitlements for building or construction. • Construction drawings and cost estimating. • Fountain and water features; mechanical, plumbing, and hydraulics consultants. • Design of retaining walls over four feet (4') in height. • Electrical or lighting design Michael Terrell ■ Landscape Architect Proposes To Provide the Above Services for a Fee Which Shall Be: Three thousand six hundred dollars and no cents ($3,600.00). Invoices will be billed incrementally as work progresses toward the lump sum price. We will bill all reimbursable expenses based upon actual cost plus 15% for mileage and other miscellaneous expenses. These expenses will include cost of reproduction, telephone, etc. as necessary. We estimate these costs will not exceed $600.00. This Proposal and Contract ithdrawn by Michael Terrell ■ Landscape Architect if not accepted within S. Signature: Date: 6/30/11 Michael D. Terrell, ASLA Acceptance Of Proposal: I have read the above proposal, fees, and terms and they are hereby accepted. Michael Terrell ■ Landscape Architect is authorized to commence work as specified and agreed to herein. Signature: Date: PROPOSAL Project: City of Spokane Valley Signage Development Project #: 10 -022A Client: City of Spokane Valley ® A� ° CERTIFi,,ATE OF LIABILITY INSUt ANCE DATE (MM /DD/YYYY) 11 -30 -2010 THIS CERTIFICATEIS 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 be endorsed. If SUBROGATIONIS 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 USAA INSURANCE AGENCY INC /PHS 812846 P:(888)242-1430 F: (877) 905 -0457 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: ( A /C,No,Ext): (888) 242 -1430 (A/c, No): (877) 905 -045 E -MAIL PRODUC CUSTOMER ID q: INSURER(S) AFFORDING COVERAGE NAIC q INSURED MICHAEL TERRELL DBA MICHAEL TERRELL LANDSCAPE ARCHITECT 5 312 S. CHAPMAN RD. GREENACRES WA 99016 INSURER A : Hartford Casualty Ins Co CLAIMS -MADE U OCCUR INSURER B $ 10,000 INSURER C PERSONAL & ADV INJURY INSURER D GENERAL AGGREGATE 5 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: INSURER E S 2,000,000 INSURER F $ rao-rrrrrnra 11n R1112PO• REVISION NUMBER: %,U V LnA%j CJ vim... . ,v,-., a....,..... �... CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING 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. INTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM /DDNY (MM /DDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1, 000, 000 COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) S 300,000 CLAIMS -MADE U OCCUR MED EXP (Any one person) $ 10,000 A X General Liab X 65 SBA PU5843 01/13/2011 01/13/2012 PERSONAL & ADV INJURY $ 1,000, GENERAL AGGREGATE 5 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG S 2,000,000 POLICY J Pno- U LOC JECT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) 5 ALL OWNED AUTOS ( - -' - - - - -__ _ PROPERTY DAMAGE $ SCHEDULED AUTOS _, - j (Per accident) HIRED AUTOS S NON -OWNED AUTOS $ I UMBRELLA LIAB I OCCUR ;" - _ f.'I�'J '_. EACH OCCURRENCE $ I_J EXCESS LIAB CLAIMS -MADE P. - - -"-- AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ WC STATU- OTH- WORKERS COMPENSATION TORV LIMITS ER E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR /PARTNER /EXECUTIVES I N/A E.L. DISEASE - EA EMPLOYE $ OFFICER /MEMBER EXCLUDED? u (Mandatory in NH) E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Those usual to the Insured's Operations. I It NULUtK City of Spokane Valley Attn Parks & Recreation Dept 2426 N DISCOVERY PL SPOKANE VALLEY, WA 99216 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZE R PRESENTATIVE ` i Goo 3nna ArnRn rnRPARATION All riahts reserved ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD Verify Workers' Comp Premium Status - Employer Liability Certificate Washington State Department of Labor and Industries Department of Labor and Industries Employer Liability Certificate Date: 07/11/2011 UBI #: 601 382 389 Legal Business Name: TERRELL MICHAEL DAVID Page 1 of 1 Employer Liability Certificate Account #: 072,594 -01 'Doing Business As' Name: MICHAEL TERRELL LANDSCAPE ARCH Estimated Workers Reported: Quarter 1 of Year 2011 "1 to 3 Workers" (See Description Below) Workers' Comp Premium Status: Account is current. Firm has voluntarily reported and paid their premiums. Licensed Contractor? No Account Representative: T1 / KHANH TRAN (360)902 -4802 - Email: TRAK235 @lni.wa.gov What does "Estimated Workers Reported" mean? Estimated workers reported represents the number of full time position requiring at least 480 hours of work per calendar quarter. A single 480 hour position may be filled by one person, or several part time workers. Industrial Insurance Information Employers report and pay premiums each quarter based on hours of employee work already performed, and are liable for premiums found later to be due. Industrial insurance accounts have no policy periods, cancellation dates, limitations of coverage or waiver of subrogation (See RCW 51.12.050 and 51.1.6.190 https: // fortress. wa. gov/ lni/ erpsi /AcctInfoPrint.aspx ?Accountld= 07259401 &AccountManag... 7/11/2011 PAGE 3 ADDL INFO ON NEXT PAGE MAIL MCH -M -1 t� UNITED SERVICES AUTOMOBILE ASSOCIA "PION RFNFWA(_ (7F C % (A RECIPROCAL INTERINSURANCE EXCHANGE) state 05 06 07 1 0 . 8 1 ven PbLICY NUMBER VVA P 25P 2b USA 9800 Fredericksburg Road - San Antonio Texas 78288 2bll Zbl Ter, 00358 99 36U 7104 8 POLICY PERIOD: (12:01 A.M. standard time) WASHINGTON AUTO POLICY RENEWAL DECLARATIONS EFFECTIVE FEB 20 2011 TO AUG 20 2011 OPERATORS 01 MICHAEL D TERRELL ATTACH TO PREVIOUS POLICY Named Insured and Address 03 KARA L TERRELL 06 PHILLIP C TERRELL MICHAEL D TERRELL CAPT USN 5312 S CHAPMAN RD GREENACRES WA 99016 -8832 D escrip tion o Veh VEH USE SYM WORMCHOOL Mlles One Das Days Week VEH YEAR TRADE NAME MODEL BODY TYPE ANN gGE IDENTIFICATION NUMBER 05 93 PONTIAC TRANS SPT SE WAG 4X2 250 1GMDU06D'IPT224947 P 06 98 GMC SIERRA 1500 PKP 4X4 4000 1GTEK19R1WR514466 B 07 05 CHEV TAHO /LS /LT UTL4X44D 10000 1GNEK13T85J264880 P 08 90 HONDA ACCORD LX SEDAN 4D 500 JHMCB7650LCO61062 P The Vehicles) described herein is principally garaged at the above address unless otherwise stated. * Wrc= Workrscnool; e= 6uslness; F= Fwm;P= Pleasure VEH 05 GREENACRES WA 99016 -8832 VEH 07 GREENACRES WA 99016 -8832 VEH 06 GREENACRES WA 99016 -8832 VEH 08 GREENACRES WA 99016 -8832 is o icy pro es ose_ coverages w ere a premium is shown below. a limits sown may p be reduced by policy provisions and may not be cpmbined regardless of the number of vehicles for which a rem>um Is listed unless s ecificall authorized elsewhere in this policy. VEH VEH VEH VEH COVERAGES LIMITS OF LIABILITY 05 6 -MONTH 06 6 -MONTH 07 6 -MONTH 08 6 -MONTH ("ACV" MEANS ACTUAL CASH VALUE) D =DED PREMIUM D =DED PREMIUM D =DED PREMIUM D =DED PREMIUM MOUNT $ MOUN $ MOUN $ NIVIOUN PART A — LIABILITY BODILY INJURY EA PER $ 500,000 EA ACC $1 ,000,000 104.04 128.98 124.22 104.04 PROPERTY DAMAGE EA ACC $ 300,000 57.15 70.62 66.77 57.15 PART B - PERSONAL INJURY PROTECTIO MEDICAL BENEFITS - EA PER $ 10,000 INCOME CONTINUATION - $200 PER WEEK LOSS OF SERVICES BENEFITS - $40 /DAY MAX, $200 /WK MAX, $5,000 MAXIMUM TOTAL FUNERAL EXPENSE - $2,000 10.37 11.61 11.71 12.96 PART C - UNDERINSURED MOTORISTS BODILY INJURY EA PER $ 500,000 EA ACC $1,000,000 36.38 46.20 42.31 36.38 PROPERTY DAMAGE EA ACC $ 10,000 4.40 5.58 5.11 4.40 TOTAL PREMIUM - SEE F LOWI G PAG (S) LOSS PAYEE VEH 07 WELLS FARGO AUTO FINANCE, NA, CORAOPOLIS PA ENDORSEMENTS: ADDED 02 -20 -11 - NONE EMAIN IN EFFECT(REFER TO PREVIOUS POLICY)- 5100WA(01) ACCFOR(01) A400WA(04) A401 CW(01) A100WA(03) AOASA(01) INFORMATION FORMS NOT PART OF POLICY)- 663WA 06 4 E P51 XXX40 00 0 I I I T" 1 RMM4 I I IRMF4 I I 8I xx 0 III I i n 000 A Tom: ^7 �� „� t by In VVIINtJS vvNtKCVr, uie Juuac1171a aL their Attorney -in -Fact on this date JANUARY 18, 201 1 Laura Bishop President, USAA Reciprocal Attorney -in -Fact, Inc. 5000 U ,�