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11-107.00 West Company: Sullivan Bridges Expansion Joint & Surface Repair
Contract THIS AGREEMENT, made and entered into this I 5-44 day of 071 2011, between the STATE OF WASHINGTON, acting through the City of Spok. "- Valley under and by virtue of Title 35 RCW, as amended and West Company,Inc. Hereinafter called the Contractor. WITNES SETH: That in consideration of the terms and conditions contained herein and made a part of this agreement, the parties hereto covenant and agree as follows: I. The Contractor shall do all work and furnish all tools, materials, and equipment per their bid proposal for: Bridge# 4501 & 4507 Expansion Joint and Surface Repair Project Spokane Valley Public Works Contract# 11-006 In accordance with and as described in the plans and specifications (dated 7/6/11), and the standard specification of the Washington State of Department of Transportation which are by this reference incorporated herein and made part hereof and, shall perform any changes in the work in accord with the Contract Documents. The Contractor shall provide and bear the expense of all equipment, work and labor, of any sort whatsoever that may be required for the transfer of materials and for constructing and completing the work provided for in these Contract Documents except those items mentioned therein to be furnished by the City of Spokane Valley. II. The City of Spokane Valley hereby promises and agrees with the Contractor to employ, and does employ the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same in accord with the attached plans and specification and the terms and conditions herein contained and hereby contracts to pay for the same according to the attached specifications and the schedule of unit or itemized prices at the time and in the manner and upon the conditions provided for in this contract. III. The Contractor for himself/herself, and for his/hers heirs, executors, administrators, successors, and assigns, does hereby agree to full performance of all covenants required of the Contractor in the contract. IV. It is further provided that no liability shall attach to the City of Spokane Valley by reason of entering onto this contract, except as provided herein. IN WITNESS WHEREOF, the Contractor has executed this instrument, on the day and year first below written and the City of Spokane Valley has caused this instrument to be executed by and in the name of the said City of Spokane Valley the day and year first above written. Executed by Contractor August 11 , 2011. Date Jason A. West Printed Name President 'tle ignature City of Spokane Valley /l"&e ✓ CesO1 Printed Name cI /04 H as. Title • Signature BIDDERS PACKET Bridge 4501 &4507 Expansion Joint and Surface Repair Project BID NO. 11-008 BID PROPOSAL CHECKLIST This Checklist and the documents listed below constitute a complete Bid Proposal. Failure to execute any of the following documents, or any addition, condition or limitation in writing to the form of the bid, not explicitly invited in the Bid Documents or Specifications may become cause for rejection of the bid as irregular. The BIDDER shall check each respective box indicating inclusion of each signed and dated Item: [7-Proposai Form [Contractor's Administrative Information [Vidder Qualification Statement LYBid Deposit Form [7 Bid Deposit Surety Bond (Use only if submitting Bond for Bid Deposit) Representations and Certifications The above forms have been inserted in a sealed envelope, properly identified and delivered at the place and time described in the Notice to Contractors form. • Signature: Fii Date: SA-s. A-. u Title: A s »t�T Company: LL7 ,-r c o m�,4 t., , )sL c CITY OF SPOKANE VALLEY,BRIDE 4501&4507 5 BID PROPOSAL DOCUMENTS EXPANSION JOINT AND SURFACE REPAIR PROJECT BID NO 11.008 PROPOSAL FORM PROJECT NUMBER: 11-006 PROJECT TITLE: Bridge 4501 &4507 Expansion Joint and Surface Repair Project NAME OF FIRM SUBMITTING BID: E S T Ca I. f'°rt \1 1 tiU C_ Each bid shall constitute an offer to the City of Spokane Valley as outlined herein and no bidder may withdraw his bid after the hour set for the bid closing except under the conditions explained in the information to Bidders Section. RECEIPT OF ADDENDA: Bidder acknowledges receipt of the following addenda: Addendum No. Date Addendum No. Date REJECTION: The City reserves the right to reject any or all proposals, portions or parts thereof and to waive all minor irregularities In bidding. Special attention will be directed to the qualifications of the bidders when considering awarding a contract. TIME TO COMPLETE: The contract shall be completed by July 29, 2011. The Notice to Proceed is Intended to be issued with minimal delay upon receiving project bids. BID IS NOT ELIGIBLE FOR CONTRACTOR'S BOND ELECTION to withhold 50% retainage in lieu of furnishing a Contractor's Bond(Performance And Payment Bond), FREIGHT: Bid price(s)to include all freight costs to the job site, The undersigned hereby certifies that (he/they) (has/have) personally examined the location and construction details of work as outlined on the plans and specifications for the above project and (has/have) read thoroughly and understands the plans, specifications, and contract governing the work embraced in this improvement and the method by which payment will be made for said work and hereby proposes to undertake and complete the work embraced in this Improvement in accordance with said plans, specifications, and contract in accordance with the unit prices provided below. The Bidder, to be considered responsible, shall provide in legible figures (not words) hand written In ink or typed, a unit price (except Lump Sum items) and total for each of the items shown on the following schedules: Person/Entity Name: T Asc,1.3 A-, � �T Signature of Bidder: . (�1 CITY OF SPOKANE VALLEY,BRIDE 4501&4507 6 BID PROPOSAL DOCUMENTS EXPANSiON JOINTAND SURFACE REPAIR PROJECT HID NO: 11.008 ITEM DESCRIPTION UNIT QUANTITY PRICE/ AMOUNT UNIT 1 MOBILIZATION LS LS 4!Z,goo-oc 12.1i-100.0o 2 PROJECT TEMP.TRAFFIC CONTROL LS LS 4 Ib,5bb`c' )8,Soo` b0 3 SAW CUT BRIDGE OVERLAY AT JOINTS LF 260 4)1,. 0 0 4 f,5-6)04 o 0 4 REMOVE OVERLAY A T JOINTS SY 15 '4 2 0 g.0 0 *3 01-c• 00 5 REMOVE EXISTING EXPANSION JOINT MATERIAL LF 130 4)10,6C' 1/)y,300+00 6 REMOVE EXISTING MOD.CONCRETE OVERLAY SY 30 )2 S,o b ' 3, .5D.0 0 7 BRIDGE DECK PATCH CF 30 'L)ST, 00 1)13,goo, 00 8 HMA.CL.%IN.PG 70-28,.17 FT DEPTH SY 620 4)(c), 00 4I 1))b0 60 9 PLANING BITUMINOUS PAVEMENT SY 620 -426,,oo it,, j204 OD 10 ASPHALTIC PLUG JOINT LF 130 A ZZ S,'b Zgl zL-v,00 { 11 ASPHALTIC PLUG JOINT SEAL MATERIAL CY 0.5 45 obb,oo 2 soo,00 12 PAINT TRAFFIC LINES LS LS 1+00. 00 -0b. 0b SUB-TOTAL k 2(0, 21G.00 SALES TAX 8.7% 111032.q CO OTAL 131-I(31-11-n 9i s /• �L'Pers on/Enfify Name: Z�rs o� R.1.0� Signature Of Company: I. 9 cr Comp y i+.�c, Date: 7"/11 t - CITY OF SPOKANE VALLEY,BRIDE 4501&4607 7 BID PROPOSAL DOCUMENTS EXPANSION JOINT AND SURFACE REPAIR PROJECT BID NO: 11-008 "gcvk Air CONTRACTOR'S ADMINISTRATIVE INFORMATION 1. PERSON/ENTITY a. Name as registered with the State of Washington: I ce,n, y j I k) . b. Physical Address: zom S. FA-rR V,sw t+�s mil . L,4-L'E J toil 99n zz c. Mailing Address including zip code: o,B.ov sw Alb.0A-y 11-E l 6 WM, uM qc/O d. Remit To Address Including zip code: P.o, sox .5/9 4tiewAy Ft-V►vHxs, M 4 740n e. Telephone number including area code: .c-09--41,A-i3_5- s f. Fax number including area code: sd9- tIM-R3'4-83 g. Email address for business correspondence: rr xr.k,Q hve,41,,ay. c� h. Washington State Contractors License Number: I. Federal Tax Identification Number: REDACTED j. Washington State UBI Number: 4o/ 3'9 45/Z k. State Industrial Account Identification Number: g 14.i (o Z S— 0 O I. City of Spokane Valley Business License Number: (aO 13mq (a`i_- tab I sL 2. INSURANCE COMPANY: a. Name of company: II/X257 5'779r4 b. Mailing Address Including zip code: 57)/y Piv�,e ��r �3GVla S 4i)3' lug 992.,0 c. Insurance Agent Name: BiiG Deis d. Insurance Agent Telephone number including area code: X69-A3A-.3.s`o/ e. Insurance Agent Fax number including area code: .sg-. 3>i 63/A 3. BONDING COMPANY: a. Surety Name: /!%,,0_ -47ir7E,ave.�n/ b. Surety Mailing Address including zip code: 9=1-5' ;V, KUtrrwubALE- I. 6rE. 8so 5441.AUmRu t.65 )t 6614 c. Bonding Agent Name: v9.,eo- d. Bonding Agent Mailing Address including zip code: z 2. i? r w./F lv�9gao e. Bonding Agent Telephone number including area code: yes- 9-.�ti9/ f. Bonding Agent Fax number Including area code: y2. 9.v 9- yd Person/Entity Name: `-Aso. A-, to Signature Of Bidder V e Company: in c-r- M p41,-1.4 1 G. Date: $ I I CITY 0 BID PROPOSAL DOCUMENTS EXPAN This document contains confidential tax information and BID NO: 11-006 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. BIDDER QUALIFICATION STATEMENT The following statements of experience, personnel, equipment, and general qualifications of the Bidder are submitted with the assurance that the owner can rely on its accuracy and truthfulness. if more space is required for your answers please attach a continuation sheet(s) to the corresponding bid response page referencing the Item number. 1. The company has been in business continuously from (month and year) 1J//91/ 2.The company has had experience comparable to that required under the proposed contract: a.As a prime contractor for 20 years. b.As a subcontractor for Z o years. 3. The following is a partial list of work completed that was on an order of magnitude equal to or greater in scope and complexity to that required under the proposed contract. Year Owner& Person to contact Phone No. Location Contract Value .0 ITA° rnAtlJ - f£NIJ Zog°$2Z /Z ° /D,9h'O 1�'gy3 4/57). bU 700$ )'r1)- 1.1 Fo3),J 11))9110 Be, !Too. 00 4.A list of supervisory personnel currently employed by the Bidder and available for work on the project(Construction Manager, principal foreman, superintendents and engineers) is as follows: Years of Name Title Experience {3t3r�loNY D� � I A-NS 3 5- 5. Please attach a resume of the qualifications, previous employers, and experience of the project manager who is proposed to be assigned to the project. If a resume is not included in the bid documents the bidder agrees to furnish a resume within 24 hours of notice by the City, 6. Following is a listing of all projects the company has undertaken in the last five years, which have resulted in: a.Arbitration or litigation. 1J pr b. Claims or violations being filed by the Federal Government or the Washington State Departments of L& I, Employment Security or Revenue, I A_ c. Liens being flied by suppliers or subcontractors. 1.)1A- Person/Entity Name: A, Signature Of Bidder: IA I /P Company:. L )e4,--r- Cam Qec"1 y i lJ C. Date: 4/g( I I CITY OF SPOKANE VALLEY,BRIDE 450i&4507 9 BID PROPOSAL DOCUMENTS EXPANSION JOINT AND SURFACE REPAIR PROJECT BID NO it-005 Nathan R. McKinley 1852 E.Dipper Loop Phone:509-939-8533 Post Falls,ID 83854 Email:natem @westway.cc Objective To demonstrate my abilities,knowledge and work ethic while continuing to learn, teach and be challenged in the field of construction and contract administration. Education 01/2009—05/09 AGC—Project Manager Development Spokane,WA Program 08/1998—05/2001 University of Idaho Moscow,Idaho Pre-requisites for Civil Engineering courses 08/1997—05/1998 Lewis and Clark State College Lewiston,Idaho 09/1994—05/1997 Lewiston High School Lewiston,Idaho Diploma Work Experience 05/2007—present Westway Construction, Inc. Airway Heights,WA Project Manager (509)468-8535 09/2005--05/2007 Idaho Transportation Department Coeur d'Alene,Idaho Transportation Technician Principal (208)772-1234 Project Management& Contract Administration 11/2004—09/2005 Idaho Transportation Department Coeur d'Alene, Idaho Transportation Technician Senior (208) 772-1270 Construction Inspection 04/2004— 11/2004 Idaho Transportation Department Sandpoint,Idaho Transportation Technician (208)265-4312 Construction Inspection 09/2002—04/2004 Idaho Transportation Department Banners Ferry,Idaho Transportation Technician—Maintenance (208)267-3531 Highway Maintenance 04/2002—07/2002 Associated Land Surveyors Craigmont,Idaho Land Surveyor (208)924-6659 Surveying 04/2001 —04/2002 Progressive Engineering Group Lewiston,Idaho Construction Inspector and Surveyor (208)746-5406 Skills Contract Administration Computer Skills Project&Personnel Management Project Documentation Problem Solving Project Inspection Storm Pollution Control Public Awareness WAQTC Certified Leadership/Training Surveying ITD Inspector Certified Major Job Duties Performed • Storm Water Pollution Control design and implementation • Quantity Calculations (Structures/Roadway) • Change Order Processing • Utility Coordination • Contract Compliance • Submittal Review(Schedules,Shop Drawings,Materials, etc.) 1 • Claims Analysis and Review • Constructability Reviews Project Experience • Major Highway Realignments/Construction • Urban Renewal Construction • Bridge and Structure Construction • Wet and Dry Utility Construction • Private Development Construction References Provided Upon Request 2 BID DEPOSIT FORM OF BID DEPOSIT-CHECK ONE: Please submit this sheet with the bid deposit. CASH.Attach the deposit behind this sheet. , SURETY BOND - Attach bid bond behind this sheet. IT IS STRONGLY RECOMMENDED THAT YOU USE THE ATTACHED FORM. BID DEPOSIT REQUIRED. No bid may be considered for public work unless it is accompanied by a bid deposit in the form of a surety bond, postal money order, cash, cashier's check or certified check in an amount equal to five percent(5%) of the amount of the bid proposed. If the bidder to whom the contract Is awarded fails to enter into the contract and furnish the contractor's bond as required within ten days after notice of the award, exclusive of the day of notice, the amount of the bid deposit shall be forfeited to the City and the contract awarded to the next lowest and best bidder. if the deposit Is "cash„ and Is In the form of a postal money order, cashier's check, or certified check the checks are to be made payable to the City of Spokane Valley. Cash bid deposits are to be accompanied by this form. Cash bid deposits of all unsuccessful bidders shall be returned after the contract is awarded and the required contractor's bond and proof of insurance given by the successful bidder Is accepted by the City of Spokane Valley, if the bid deposit is in the form of a surety bond it must be of a corporate surety licensed to do business in the State of Washington. The City strongly recommends the use of the attached City Bid Deposit Surety Bond Form. if the City's Bid Deposit Surety Bond Form is not used, the bidder is warned to take special care in assuring that the form used does not materially alter, qualify or conflict with the terms and conditions set forth in the City's Bid Deposit Surety Bond Form. The failure to furnish a bid bond in compliance with the City's Bid Deposit Surety Bond Form shall make the bid non-responsive and shall cause the bid to be rejected by the City. Person/Entity Name: TA..s o►J .A, W z Signature Of Bidder: CITY OF SPOKANE VALLEY,BRIDE 4501&4607 10 BID PROPOSAL DOCUMENTS EXPANSION JOINT AND SURFACE REPAIR PROJECT I3ID NO; 11-005 C lUt' lie BOND NO: Bid Bond ,0, Valley BID DEPOSIT SURETY BOND FORM NAME OF PROJECT: BRIDGE 4501 & 4507 EXPANSION JOINT/SURFACE REPAIR PROJECT PROJECT/BID NUMBER: 11-006 - NAME OF FIRM: West Company, Inc. Was West Company, Inc. as Principal,and North American Specialty Insurance Company as Surety,are held and firmly bound unto the CITY OF SPOKANE VALLEY,a Washington State Municipality, In the penal sum of FIVE PERCENT(5%)OF THE TOTAL AMOUNT BID, for the payment of whloh we jointly and severalty bind ourselves, and our legal representatives and successors. THE CONDITIONS OF THE OBLIGATION are that If the City of Spokane Valley shall make timely award to the Principal according to the terms of the bid documents; and the Principal shall,within ten(10)days after notice at the award, exclusive of the day of notice, enter into the contract with the City of Spokane Valley and furnishes the contractor's bond (performance and payment bond)with Surety satisfactory to the City of Spokane Valley In an amount equal to one hundred percent (100Q%o) of the amount of the bid proposed including Washington State Sales Tax then this obligation shall be null and void; otherwise if the Principal falls to enter into the contract and furnish the contraotoes bond within ten (10) days after notice of the award, exclusive of the day of notice,the amount of the bid deposit shall be forfeited to the City;but in no event will the Surety's liability exceed this bond's face amount. SIGNED AND SEALED THIS 8th DAY OF July YEAR 20 11 North American Specialty Insurance Company West Company, Inc. SURETY P IPA„icZ) Signature Sig ature Lillian Tse , �/kSes Typed Name Typed Name Attorney in Fact .3Z-F._6 I I j k12T Title Title (SEAL) - CITY OP SPOKANE VALLEY,BRIDE 4501&4907 11 BID PROPOSAL DOCUMENTS EXPANSION JOINT AND SURFACE REPAIR PROJECT BID NO: 11-005 NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Manchester,New Hampshire,and Washington International insurance Company,a corporation organized and existing under the laws of the State of New Hampshire and having its principal office in the City of Schaumburg,Illinois,each does hereby make,constitute and appoint: STUART A.O'FARRELL,KAREN P.DEVER,SUSAN B.LARSON,LILLIAN TSE,SCOTT FISHER,JILL A.BOYLE,0 U DEANNA M.MEYER,BENJAMIN L.WOLFE,ELIZABETH R.HAHN,JANA M.ROY and SCOTT McGILVRAY JOINTLY OR SEVERALLY Its true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by law,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION($50,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International insurance Company at meetings duly called and held on the 24'"of March,2000: "RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seat shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached." Yjf7( ea,GOQPO4,iT.(� g2 F gi s �J, aR�,�.,4°1zP Rqr:G g `al SIAI. VS Steven P.Anderson,President Chief Eie cutive Officer of Washington International Insurance Company �' SEAL' `s0 zm 1973 0.0 &Senior Vice President of North American Specialty Insurance Company ; cm • r t9 i rA By David ill.Layman,Senior Vice Presides of Washington International Insurance Company & Vice President of North American Specialty Insurance Company IN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 15th day of December 2010 North American Specialty Insurance Company Washington International Insurance Company State of Illinois County of Cook ss: On this 15th day of December ,2010 before me,a Notary Public personally appeared Steven P.Anderson ,President and CEO of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M.Layman, Senior Vice President of Washington International Insurance Company and Vice President of North American Specialty Insurance Company, personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective companies. / "OFFICIALSEAU 4 4 DONNAD.SKLENS I -090 ta 11 AAi Notary Public,State ofl Him is Donna D.Sklens,Notary Public My Commission Ewes 14'06f2011 I, James A.Carpenter , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect. IN WITNESS WHEREOF,1 have set my hand and affixed the seals of the Companies this 8th day of July ,20 1 • James A Carpenter,Vice President&Assistant Secretary-of Washington International Laurance Company& North American Specialty Insurance Company REPRESENTATIONS AND CERTIFICATIONS ANTI-KICKBACK: No officer or employee of the City of Spokane Valley, having the power or duty to perform an official act or action related to this submittal, shall have or acquire any interest In this submittal, or have solicited, accepted or granted a present or future gift,favor, service, or other thing of value from or to any person Involved In this submittal. REPRESENTATION: In submitting this bid we represent that the bid documents have been read and understood, that the site has been visited and or that we have familiarized ourselves with the local conditions under which the work is to be performed,that by signature of this proposal we acknowledge all requirements and that we have signed all certificates contained herein. REPRESENTATION: In submitting this bid we acknowledge the requirements and conditions applicable to bid deposits in the form of a cash bid deposit or surety bond bid deposit. NON-COLLUSION: That the undersigned person(s), firm, association or corporation has(have) not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the project for which this bid is submitted. I CERTIFY that no final determination of violation of RCW 50.12.070(1)(b), 50.16,070(1)(b), or 82.32.070(1)(b) has been made by the Washington State Departments of Employment Security, Labor And Industries or Revenue respectively dated within two years of the date of the closing of this bid. I understand further that no bid may be submitted, considered or contract awarded for a public work to any person or entity that has a determination of violation of the above referenced statutes within two years from the date that a violation Is finally determined and the date of this bid closing. I CERTIFY that to the best of my knowledge the information contained in this proposal is accurate and complete and that I have the legal authority to commit this Firm to a contractual agreement. I realize the final funding for any service Is based upon budget levels and the approval of the City of Spokane Valley. I CERTIFY that by signing the signature page of this bid, I am deemed to have signed and have agreed to the provisions of this declaration. Name: '12h,es6,3 A , t0. ,'"K" Person tity ubmitting bid (print) Signature: Title: Date: L1 CITY OF SPOKANE VALLEY,BRIDE 4501&4507 12 BID PROPOSAL DOCUMENTS EXPANSION JOINT AND SURFACE REPAIR PROJECT BID NO: 11-006 SOokane , p Valley BOND NO: 2143219 CONTRACTOR'S PERFORMANCE AND PAYMENT BOND TO DUAL OBLIGEES KNOW ALL MEN BY THESE PRESENTS,that Nest Company, Inc. (Contractor),as Principal,and North American Specialty Insurance Company (Bonding Company),as Surety,a corporation of Bellevue, WA ,whose principal office is located at 650 Elm Street, Manchester, NH 03101 ,are firmly bound unto the State of Washington and the City of Spokane Valley,a political subdivision the State of Washington,as Obligees,to fulfill the obligations of the Principal and the Surety under the Contract to which reference is hereafter made,in the amount as 137,847.91 (including Washington State sales tax)for payment whereof Principal and Surety bind themselves,their heirs,executors,administrators,successors and assigns jointly and severally, firmly by these presents, WHEREAS,Principal has by written Proposal dated 3.1.)ty d$, z o i i offered to enter into a Contract with the City of Spokane Valle for Contract No. 11-006 ,pursuant to the terms and conditions set forth in the Contract Documents dated g��f��/ NOW,THEREFORE,the condition of this obligation is such that if the Principal shall faithfully perform all the provisions of the Contract on its part,and pay all laborers,mechanics,subcontractors and material suppliers,and all persons who supply such person or persons or subcontractors with provisions and supplies for the carrying on of such work,and indemnify and hold harmless the Obligees from all lass,cost or damage which it may suffer by reason of the failure to do any of the foregoing,then this obligation shall be null and void;otherwise it shall remain in full force and effect. All persons who have furnished labor,materials or supplies for use in and about the work provided for in the Contract shall have a direct right of action under this bond,to the extent and in the manner set forth in RCW 39.08. The said Surety for value received hereby stipulates and agrees that no change,extension of time,alteration or addition to the terms of the Contract or to the WORK to be performed thereunder or the SPECIFICATIONS accompanying the same shall in any way affect its obligation on this BOND,and it does hereby waive notice of any such change,extension of time,alteration or addition to the terms of the Contract or to the WORK or to the SPECIFICATIONS. No final settlement between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder,whose claim may be unsatisfied, SIGNED AND SEALED THIS 12 DAY OF August YEAR 20 11 North American Specialty Insurance Company West pany, c. AMIE Si aturc rgna fe Sill A. Boyle Jason A. West Typed Name Typed Name Attorney-in-Fact President Title Title (SEAL) NAS SURETY GROUP NORTH AMERICAN SPECIALTY INSURANCE COMPANY WASHINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS,THAT North American Specialty Insurance Company,a corporation duly organized and existing under laws of the State of New Hampshire,and having its principal office in the City of Manchester,New Hampshire,and Washington International Insurance Company,a corporation organized and existing under the laws of the State ofNew Hampshire and having its principal office in the City of Schaumburg,Illinois,each does hereby make,constitute and appoint: STUART A.O'FARRELL,KAREN P.DEVER,SUSAN B.LARSON,LILLIAN TSE,SCOTT FISHER,JILL A.BOYLE,t1 t7 DEANNA M.MEYER,BENJAMIN L.WOLFE,ELIZABETH R.HAHN,JANA M.ROY and SCOTT McGILVRAY JOINTLY OR SEVERALLY Its true and lawful Attomey(s)-in-Fact,to make,execute,seal and deliver,for and on its behalf and as its act and deed,bonds or other writings obligatory in the nature of a bond on behalf of each of said Companies,as surety,on contracts of suretyship as are or may be required or permitted by Iaw,regulation,contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amount of: FIFTY MILLION($50,000,000.00)DOLLARS This Power of Attorney is granted and is signed by facsimile under and by the authority of the following Resolutions adopted by the Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 24d'of March,2000: "RESOLVED,that any two of the Presidents,any Managing Director,any Senior Vice President,any Vice President,any Assistant Vice President, the Secretary or any Assistant Secretary be,and each or any of them hereby is authorized to execute a Power of Attorney qualifying the attorney named in the given Power of Attorney to execute on behalf of the Company bonds,undertakings and all contracts of surety,and that each or any of them hereby is authorized to attest to the execution of any such Power of Attorney and to attach therein the seal of the Company; and it is FURTHER RESOLVED,that the signature of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any certificate relating thereto by facsimile,and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon the Company when so affixed and in the future with regard to any bond,undertaking or contract of surety to which it is attached." "', SFAL - 161 Steven P.Anderson,President&Chief Executive Officer of Washington International Insurance Company Zf SEAL F.4 ibi3 `yo,U &Sector Vice President of north American Specialty Insurance Company I-1 ;rt g 6`%`4hk5/45?::ate Z_ %RI �INUtWN+ • B3, j�/j�'' * David M.lay man,Senior Vice Presfden of Wf hington International Insornnce Company &Vice President of North American SpedaTty Insurance Company iN WITNESS WHEREOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their official seals to be hereunto affixed,and these presents to be signed by their authorized officers this 15th day of December 2010 North American Specialty Lnsurance Company Washington International Insurance Company State of Illinois County of Cook ss: On this 15th day of December ,2010 before me,a Notary Public personally appeared Steven P.Anderson ,President and CEO of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and David M.Layman, Senior Vice President of Washington international insurance Company and Vice President of North American Specialty Insurance Company, personally known to me,who being by me duly sworn,acknowledged that they signed the above Power of Attorney as officers of and acknowledged said instrument to be the voluntary act and deed of their respective comnanies. "OFFICIAL.SRA1° �/}� DONNA D.SKEINS e41/RQ a'V- diehA.0 Notary Public,Slate of Illinois Donna D.Sklens,Notary Public My Commission Expires 10106/2011 I, James A.Carpenter , the duly elected Assistant Secretary of North American Specialty Insurance Company and Washington International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney given by said North American Specialty Insurance Company and Washington International Insurance Company,which is still in full force and effect. IN WITNESS WHEREOF,I have set my hand and affixed the seals of the Companies this bS day of 20/ . James A.Carpenter,Vice President&Assistant Secretary ofWnl ingten International Insurance Company& North American Specially Insurance Company '�'�' , °tea CERTIFICATE OF LIABILITY INSURANCE OP ID 20' DATE(MM/DDIYYYY) WESTW-7 08/09/11 PRODUCER THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Western States Ins. - Spokane HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 501 N Riverpoint Blvd, Ste 403 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Spokane WA 99202-1649 Phone: 509-838--3501 Fax:509-838-3511 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Charter Oat sire Insurance Co INSURER B: travelers Indemnity Co of Conn I West Company, Inc, Westway Construction, Inc. INSURER C: Travelers Property Casualty Co PO Box 519 INSURER D: Airway Heights WA 99001 I INSURER E: 1 . 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 4 POLICY NUMBER POLICY EFFECTIVE (DATE(MTIXDD/YYYrr} LIMITS LTR!NERD TYPE OF INSURANCE GENERAL LIABILITY EACH OCCURRENCE $ 1000000 llAMAVE IUltENIEU A X Xl COMMERCIAL GENERAL LIABILITY DTC0526D7064COF11 07/01/11 07/01/12 PREMISES(Eaoccrence) $300000 CLAIMS MADE X OCCUR MED EXP(Any one person) S 5000 PERSONAL&ADV INJURY I$1000000 X !Emp Liability GENERAL AGGREGATE I$2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM?/OPAGG ($2000000 X JRa 7 POLICY LOC Emp Liab I 1000000 I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT B X ANY AUTO DT810526D7064TCT11 07/01/11 07/01/12 (Ea accident) 5 1000000 ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY (Per accident) S X NON-OWNED AUTOS PROPERTY DAMAGE $ . (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG_$ ( EXCESS!UMBRELLA LIABILITY EACH OCCURRENCE I$4000000 C X I OCCUR CLAIMS MADE DTSMCUP526D7064TIL11 07/01/11 07/01/12 AGGREGATE I s 4000000 1$ DEDUCTIBLE 1$ X RETENTION s10000 1$ WORKERS COMPENSATION WC STATU- 01}4- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETORIPARTNER/EXECUTIVE EL EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Spokane Valley, its officers, elected officials, employees, agents and volunteers and the State of Washington and its officers, elected officials, employees, agents and volunteers are added as additional insureds per attached form as respects to: Bridge 4501 & 4507 Expansion Joint/Surface Repair Project SVPW Bid No. 11-006 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYOFV DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR CITY OF SPOKANE VALLEY REPRESENTATIVES. 11707 E SPRAGUE #106 RUTH IZEDREPRESENTA VE 'SPOKANE VALLEY WA 99206 ACORD 25(2009/01) 01988-2009 CORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD f` Y 1 IJ IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies) 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 This Certificate of Insurance 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. • ACORD 25(2009/01) f OOMMERCfni_GENERAL LIABILITY. • THIS-E DORSEMENT CHANGES THE POLICY, PLEASE TZEAD IT CA EFL) .LY• • • , BLANKETADDITIOtat INSURED 1 This endorsement modifies insurance provided under iefollovl ng: ' GOMMMERDIAL GENERAL LIABILITY COVERAGE PART • - • .• -t. WI-0 Is AN INSUrRE.D—(Section II) is amended a). The Insurance provided to the additional in- to include any person or organization that you sured•does riot,apply to "bodily injury" or acres.in a."written contract requiring insurance' 'property damage" caused by ''your work" to include as an additional insured on this Cover- : • and included in the "products-completed op- age Part,but .. erations hazard" unless the 'written Contract• • a) Drily with respect to liability for"bodily injury", requiring insurance"specifically requires you "property damage"or"personal injury";and to provide such coverage for that additional insured, and•=then.tnc Insurance provided to . b) If, and only to the ex e?it that,the injury or the -additional insured applies only to such _ . damage is caused by acts. or omissions of "bodily injury" or "properly damage"that bd- . you or your subconttraor In the performance • cu s before `she end of the period of time.for of "your work" to which the "written co:�liact • which the "written contract.requiring irlsur- requiring insurance" applies. The parson or ante"requires you to provide such coverage organization does npt qualify as an additional - or the end of tha policy periods whichever Ia insured with respecter the independent.acts earlier. or omissions cif•such person ororganizatfon. 3,. The insurance provided to the additional insured . 2. The insurance provided to the additional insured • by this enddrse.ment is excess over any valid and ' by this endorsement is limited as follows: collectible "other insuranoe", whether primary, a) In the event that the .Limits of insurance of • excess, contingent or on any other basis, that is this Coverage Part shown'in the Declarations available to the additional insured for a loss we . exceed the limits of liability required by the cover under this endorsement,. However, if tie• "written contract requiring insurance", the in- "wren contract requiring insurance" specifically • • surance provided to'the additional Insured requires that this insurance apply on a primary, • shall •pe limited to the limits of liability're- basis or a primary and non-contributory basis, quired by:that 'written Contract requiring in- - this insurance Is primary to "other insurance" surance". This endorsement shall not in- available. to the additional insured which covers • crease the limits Of insurance described'in • •that person or organization as a warned Insured. • . Section iii—Limits Of Insurance. • • for such loss,,and we will not share with that "other €neuranbe" But the insurance provided to b}•The.insurance provided to the additional in the addition al.insu red by this endorsement still is . surer does not apply to"bodily injure, "prop- excess over-any•gelid and collectible "other in- . rty damage" or'personal injury`"arising out sur ice", whether primary, e csss, ntingerit or • ' • • of the rendering of, or failure to render, any on any other basis, that is.available 10 the addl- . professional architectural, engineering or sur- - iitonal insured when that..•parson for organisation is • • •ve rig service`, including: . .• • an 'additional insured urrder••such "other insur-• I. The. preparing, approving, or'riling to ance".- _ , pr epare dr approve, maps, shop.draw- 4.. As a condition •of coverage provided to the • • . • trigs, opinions,.reports, surveys, field or • • additional insured by this endorsement • . Oars or charge orders, or the preparing, }• The addrtionai insures must.give us v�ritien . approving, .or failing to 'prepare or ap- • . prove, drawings andspedifications;and notice as soon as practicable of an "occur- • • rence" or err Offense.which may result in a • ii. Supervisory, inspection, architectural or claim. To the extent possible, such notice • • • engineering aotivitiet. should include: . C$:1]2.0 O8 05 . . 0 2005 The St.Paul Travelers Companies;Inc. " , Page 1 of2 ; .• r COMMERCIAL GENERALLIAS1LUTY ' • I. How, when and where the "occurrence" any pmvlder of"other insurance"which would oroffensetook place; cover the additional insured for a loss we • -• • ii. The names and addresses of any injured cover under this endorsement. However, this . persons and witnesses,and .. condition dpes not.affect whether the insur- ance•provided to the additional Insured by Iii. The nature and lobation of any Injury or this 'endorsement is primary t0 '"other incur damage arising out of the"occurrence"or once" '.available to -the additional Insured • offense. which covars'that person or organization as a Ic) If a claim is made or"suit"is brought against named insured.as described in paragraph 3, • the additional insured, the additional insured above. must E. The following definition is added to'SECTION V. • ' i, Immediately record the speolrics of the DEFThl1TiOWS: . claim or"suit'and the date received;and. '"iNritten contract requiring insurance"means • IL Notify us as soon ae practicable: that part of any written cataract or agreement The additional Insured must see to it that we • under which .you are required to Include a in- receive written notice of the Claim or"suit"2s person•or organization as an additional in- sured on this Coverage Part, provided that • soon as practicable. . the "bodily injury" and*property damage"DD- . o) The additional insured must immediately curs and the"personal Injury"is caused by an send us copies of all legal papers received in offense Committed; • . . =nectar'with the claim ar°calf cooperate • ,a. Afferthe signing and execution of the - iiiih us in the Investigation or se=ttlement of r or agreement byyou: the claim or defense against the "suit", and • otherwise comply with all policy conditions. b. WnIJe that part of the contract or dd) The additional insured must tender the de- agreement Is In affect;and • • fens and indemnity of any claim or"suit'to c. pet-ore-the end of the policy period. 7 • • • M • • �-=-- . ■ . Q. . • 0 • . •.. . • • . . . • •• ' �� . . . . - • • m • •. Page 2 of 2 • 0 200.5 The St.Paul Travelers Companies,Inc.: CG A2 46 D8-03 ' plasm • • • 4 CDh,4MI RDIAL GENERAL LIABIl_1TY TH S ENDORSEMENT SEMfEN T CHANGES THE PDLUCY, PI:EASE•REAO IT CA.1EFULL.' • - O TRACTORS XTEND E D SE E T . Tii,is endorsement modifies Insurance provided unbar the-following: COMMERCIAL.GENERAL LIABILiTY COVERAGE PART ' . Glr1,4RAL DESCRIPTION DF•CGVER.AGE Provisions A.-N.and..l.-N,of this endorsement broaden courage, and provision I, of this endorsement may limit coverage,The following lisng is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all/he PRDVISiONS of this endorsement • carefullyta determine rights,duties,and what is and is not covered. A. Broadened Named Insured . E-i. Additional insured—State or Political Subdivisions. B. Extension of Coverage—DamageTo Premises L Other Insurance Condition Ranted To .t, 'increased Supplementary Payments, Perils of:fire,a iosion,lightning,smoke, water 'Cos-.of bail bonds Increased to$2,5D0 ' - Lim t increased to$3D0,00Q • ''') LOSS 4f earnings increased to D0 per day Blanket Waiver of Subrogation i:. K.novuledge and Notice of Occurrence or Offense • D. BianketAddtional Insured—Managers or Lessors L. UnintentonalOrrrission • • of Premises M Personal lnju:y—A=q�rtneol by Contract '• E. Incideritai Medico]Wialpra ce N.•Blanket Additional insured—Lessor of.Leased F. 5,1-dens-ion of Coverage—Bodily injury Equipment .. G. Contractual Liability—Palircads , ' 'PROVISIONS • •. 2. This Provlsion.A..•daes rrot apply to any per- A,. BROADENED NAMED INSURED - son or organization for which coverage is ex eluded by endorsement .`, The Named Insured in Item I. of the Declare- . B r"itislar� OF CC�VEF# = — DAM 70 lions is as foliovr: PREMISES RENTED TO YD U• . ' • The.person or.argan tioq'named in Item I. ; The last paFagraph.nf ODVERACI= A. I3tJD- of the Declarations and any o[ 2nJ�atiorr, iL7'•iNSURY ? PROPERTY DA1s1U3G< LI- • . other than. a partnership, joint venture or tire- A83i_iTY (GeLtyor, 1 Coverages) is deleted L Jted iraioiIlty company, of which You maintain -and replaced b by the t following: _ • • ownership or in which you maintain tyre major • Sty interest on the effective date of the policy. Exclusions c.through n: do not apply-to dam- ' • However, coverage for ally such additional • age io premises while.rented-to you, or tern- - or anfzation Will cease as of the data, if arry, - .porarily occupied by you -with permission.of . . during the policy period, that you.bo longer . • the owner,caused by: . maintain ownership of, Or the majority lnteresl a, Fire; . . . . • in,such.organization, b. Explosion • . : •2. WHO IS-AN INSJREP (Section It) Ite,,,.4.a. ' • c Lightning; . is deleted and replaced b the following: , a, Coverage under this provision is afforded • d. •Dmbke resulting fr om such tire,explosion; - • - only until the 180th day after you acquire - . • orJightning;or . • • -or form the.erganizatiori or the end of the ' . •a, • iNater. .,. • . poiioy pfiifod,.Y�filich8Ve is earlier. A separate limit of Insurance applies to this • . ' . coverage as described in SeOtion III Limits Of • • Insurance: ' ... .. • CG OS.1'6 07 04 ' Copyright; The Travelers Indemnity Company,2P1D4- • , -Pagel of S. • - . • • . r CDitnMr`RCIAL GENERAL LIA13ILITY • 2. This insurance does not'apply to damage to . • •E. This Provision B:does not apply if'coverage • • premises while rented to you, oriarnporarily • , for Damage To Prerriises Rented To You of • acoupied by you with perfiission of the COVERAGE A. BODILY .INJURY AND • owner,caused by: PROP_ERTYDAMAGE LIABILITY(Section I-- • a. Rupture, bursting,.or operation of prey- • coverages)is excluded by endorsement • . sure reliefdevices; C. BLANKET T WATER DF'SLi'I3RDGA'TlDN b. Rupture or bursting due to expansion or We waive any right of recovery we may have ' - swelling of the contents of any building or • against any person or organization because of • structure,caused by or resuitingfrom we- payments we make for injury or damage arising ter; out of: premises owned or occupied by or rented • L. E plosion of steam boilers, steam pipes, or loaned to you; ongoing operations performed steam Engines,or steam turbines. by you or on your behalf, done under a contract • with that person or organization; "your work:"; or 3. Paragraph 6. of LIMITS, DP INSURANCE '"your products". We waive this right where you (Section lit) is rieleted and replaced by the have agreed to do so as part of.a written coi,irect, • following: • executed by you before the "bodily injury" or. Subject to S. above, the Damage To'Pram- . "property damage"occurs orthe"personal injury" . • • ises Rented To You Liir+it is the most we will or"advertising Injury''•offense is committed. ' • pay under COVERAGE A.for the sum of all D. BLANKET ADDITIONAL INSURED »-•I frANAG-• damages because of'"property damage" to BRS DR LESSORS OF PREMISES • • any one premises while rented -to you, or idvi i0 IS AN INSURED(Section II) Is amended to temporarily occupied by you with'permission • of the owner, caused by�fire;explosion;Eight include as an insured any person or organi7 lon • Wing; smoke resulting from such •ire, •expio- . (referred to below-as additional insured') with sion,.or fghtr►Ing; or water. The Damage To whom you have agreed in a written contract, axe- . ... Premises Rented To You Limit will apply to ail outed before the"bodily injury" or"property dam- • i • - "propertydamage"proximately caused by the • age" occurs or the "personal injury" or "advertis- • . ...•• same "occurreore", whether such damage in injury" offense is committed, to name as an i° . . results from;fire; explosion; lightning;smoke additional insured,but only with.respept to llahi]rty . resulting from such fire, .explosion, or light- arising out of the ownership, maintenance or use Wing, or vrater, or any coinbinaUan of any or" of that part of any premises leased to you,supleot . . these causes. to the following provisions . . The Damage To Premises Rented'Ta You 'f• Li[nifs,of Insurance. The limits of insurance arivaMa limit aril!be the higher of afforded to the additional insured shall be the ' • limits which you agreed to provide in the writ• g. a. . OD,DDD;or . ,• ten contract, orthe limits shown onthe Deals- . '-'-- • . b. The amount•shcwti on the Declarations. • ' • •rations,wtiicheverare less. . • for Damage a Premises Rented To You 2. •The insurance aforded to the additional in-. • • Lirnif sured does riot spply to:• . '.4, Paragraph a. of the definition of°insured con- • • a, Any ".boil#y injury" or"property damage" •• tract" (DEFINITIONS'•, IONS-Section Vy.is d.leted $t occurs,ar"personal inJur�"ar'edver• • and replaoed by the following: tising injury" caused by an.offense which a. A contract for a•lease of premises. How- • is committed,after you•cease to be a ten- • .ever,that portion• of the, contract for al • • . • •ant ir/that premises • . .. . . • lease of premises;that indemnifies any, } b. Any premises for which.coverage is ex °� - person co' organizatiofi for damage to- . eluded by endorsement;or • . •.• - •premises while rented,to you,: or tempo- .Structural alterations, new constrtuatlon or • • • rarity occupied by you with permission c. demolition operation performed by noon ._ : the owner, caused by; fire; explosion: behalf ofsuch additional insured.. • • . • - lightning;.smoke.resulting.from such.fire,- • • . .. •• explosion,•or lightning, or water,IS not.an . 3, The insurance afforded fo the additional in- .' • insured contract';. - • • • • cured is excess over any�raiid and collectible. - ' • • •• .- age 2.of S Copyright,The Travelerstndemnity Company,2004 •GG D3'15 a7 Del . . • 01813112 . • • . . • . . • • CDM MM] RCIAL GENERAL LIABILITY • "other insurance available to such additional • .together with all related acts or omissions in insured: unless you have agreed in the writ- the furnishing of the services described in ten contract that this insurance must be pri- paraareph'f, above•ta any one person will be . rary'to, or non-contributory with,such "other deemed one"occurrence". insurance". S. This Provision E,does not apply if you are in ' E. INCIDENTAL MEDICAL MALPRACTICE the business or occupation of providing any of I. The foffflv�i is added to paragrapf�I. irtsur-the services described in paragraph"f.above, ing Agreement of COVERAGE A.—BODILY Z. The insurance provided by this Provision E, . INJURY AND PROPERTY DAMAGi=LiABiL- shall be excess over any valid and cellectibie . IVY(Section i—.Coverages): "other insurance„ available to the insured, "13cdtly injury" arising out cf the rende irtg o=, whether primary, excess, contingent or on. or failure to render the tollavtinu will any other basis, except for insurance that you deemed to be caused by an"occurrence" bought specifically to apply In excess of the Limits of Insurance shown on the Declare- . - a. litiedical,surgical,dental, laboratory,x-ray lions ofthis Coverage Part. . or nursing service, advice or inst3vc ion_ F. EXTENSION •OF DOVERAGE — BODILY IN- or the related furnishing of food or bever- TE ages; . • b. The furnishing or dispensing of drugs or The definition of"bodily injury" (DEFlNiTiOh S— medical, dental, or.surgical supplies or Section V) is deleted and replaced by ths follow- appl:iances; ing: . • - c. First aid; or "Bodily, injury" means .bodily injury, mental an- . mental injury, shook, fright, disability, hu- e, "Good Samaritan services T' As used in miliation,sickness Cr disease sustained by a per- this Provision E, "Good Samaritan set- . son,including death resultinci.from any of these at vices" are those medical services ren- anytime, • dared r provided in an emergency e rd G, CONTRACTUAL L, IASELITY—P.kff_R© DS • for which no remuneration is demanded or received. 1. Paragraph e, of the definition:of"insured con}- 2.a.i d of WHO IS AN' IN- • tract"'(DEFINITIONS— Section V) is deleted . Paragraph ( #( � d b y the following: SURER (Seption Ii) does not apply Lo anjr and replaced S registered nurse, licensed practical nurse; • .c. Any easement-or license agreement; • b of "Insured emergency medical technician or paramedic 2. • Paragraph-,-.('i) of the definition o, insar..d . .•' employed by you, but only while performing cent-act` (DEFINITIONS—Section V) is de- the services described in paragraph 1. above later!, and while acting within the scope,of their ern- AOgITIDRIAL ENSURED —:STATE O pOLiTt- :plogment by you. Any"employees" rendering CAL SUgDIlriaidNS PERMITS- . . ' "Good Samaritan services"will be deerried to . • be acting within the scope of their employ- • WHO IS AN INSURED (Section .10.1s atnended to mentby you include esan insured any state or political subdi- 3. The fcliowing.e olusion is added to paragraph .vision,subject to the following provisions: • P. Exclusions of COVERAGE A. -- BODILY .1„This insurance applies Only when required to . 'iNJ1JRY AND PROPERTY DAMAGE LABEL- - be provided by you by an ordinance, law'or .• !TS'(Section,I—Coverages):' • bullring code and only with i respect to opera- . ' • (This insurance does not apply to:)"Bodily in- trons,performed by you or on your behalf for - jury" or"property damage" arising out of the which the state or•peiltical subdivision.hae is- willful violation of a penal statute or ordinance •sued a permt.. . = relatdne to the sale of pharmaceuticals corn • 2.. This insurance does:not apply.to: • . pitted by or with the knowledge or consent of • a, "Bodily injury," "property damage," "peit , the Insured. . • - . sons!injury" or"advertising Injury"arising - -• 4. For the purposes of'detennining the appiica- • • •out of operations performed for the etate ' - . ble limits of insurance, •any act or omission• , ,, or political subdivision;or ...•co b3 16 07 04 . Copyright,The Trevelerr Indemnitty Company,2084 • Page 3 of 6 • . • 1 . I COMMERCIAL GENERAL LIABILITY b. "3,odiiy injury" or•"property damage" In- • • insured under any other policy, eluded in the "products-completed opera- including any umbrella or excess tions hazard" . policy. • • I. D-rIiER INS I ANCE CONDITION When this insurances is excess, we . will have no duty under Coverages A • A. COMMERCIAL GENERAL LIABILITY CON- or '3 to defend the insured against DiTIONS (Section Iv), paragraph 4. (Other arty fault" If any provider of"other In- lnsureooe),Is deleted and replaced by the.fol- snrancs" has a duty to defend-the In- . lowing. sured against that "suit". if no pro- . .¢ Other insurance eider of '`other insurance" defends, If valid and collectible "otherinsurance is . • • we will undertake to do se,but we will be entitled to the insureds rights available to the insured for a loss we against all those providers of "other cover under Coverages ,� or S of this insurance". Coverage Part,our obligations are limited When ibis insurance is•excess over as follows: .''"other insurance", we will tray only ' . • •a .Primary Insurance our share of the amount of the loss, if 'This insurance is Ornery except any,that exceeds the,sum of when is. below applies.'If this Inst r- ( ) The total •amount that all such ance is.primary, our obligations are "other insurance" would pav for not affected unless any of the "other the loss in the absence of this In- insurance"is also primary,Then, we • siren=and .will share with all that."other insur- ance" by the method described in c- M Tile total of all deductible and + self-insured amounts under that . • below. "other insurance". • • !a. • Excess insurance Ws will share the remaining Joss,•if• This insurance is excess over any of any, any"ottrer insurance"that Is • the "other insurance", whether psi- not described hi this Excess, Insures - I° • mar}y, exoess, contingent or on any • • anoe provision.' • • other bests; c, I IetE s}d Gf Sharing (f) Th,,at is Fire, E landed Coverage, • Builder's Disk, Irsstallat€oh Risk, If all of the "other Insurance" permits • �= Dr similar coverage •for 'your contrlbu on by equal shares, we u l . m= work"; • -follow this method also, Under this . approach each provider of insurance • • (2) That is Fire insUransa for prerrl- contributes equal amounts until it has • ' • • , '= Ism rented to you or temporarily paid its applicable limit of insurance . °= .occupied by you with permission ' or none of the loss remains, which • of the owner; • _ • ' ever comes first. • (3) That is insurance purchased by If any of the "Dtiier insurance" does • • you to-cover your liability as a • • . -.not permit acntrfbution by •equal ,w tenant for "property damage' to , • shares, we -will contribute by linttts. _ premises rented to you-or tempo- Under-this method,•the share of each . redly occupied b�+ you with per- provider of insurance is based on the • . mission of the owner; or • , ratio of it applicable 'limit of.incur- . • . ' (4) If the loss arises out of the main- • • , ance to the total applicable limits of . • •• ' tenai we . or use of.•aircraft, insurance of-all providers of insur-- • • . "autos", or watercraft to the. ex-• . • erica. • ' • • tent riot subject to ciusion•g.of • B. -The following definition is added.to DEFINITIONS • • ' . Section I Coverage A—Bodily . (seitiorr•S): • . • • Injury And Property Damage Li- • - • • • .ability;or "Other insurance": . - (C) Thai Js.available to the insured. • . a. Means insurance, or the,funding of losses, • . when the Insured Is an additional • That is provided by,through or ors behalf of: ,••Page 4 of B . ,.' ' Copyright,The Travelers indemnity Company,2004' CG D3.1s d7 0 013E82 - • . . . . • . • . laEa2 • • • • . ,COMMERc1AL GENERAL I_IABILTY ' ' (1) Another insurance company; 2. Notice of an "occurrence" or of an offense •- (2) Lis or any of our affiliated insurance corn- which may result In a claim will be deemed to . panies, except when the Non cumulation .be given as soon as practicable to ors if it is of Each Occurrence Lime section of given In good faith 25 soon as practicable to Paragraph n of LIMITS OF INSURANCE your workers' compensation Insurer.This ap- plies only if you subsequently give notice of (Sector;Ili)orthe Non cumulation of Per- the "occur once" or offense to us as Soon as sons!and Advertising, Injury limit.sections practicable after you, one of your "executive of Paragraph 4 of LIMITS OP INSUR- ANCE ocers" if you are a corporation),one of your (Secfin[El) applies; partners who is an Individual (if you are a' (3) Any risks retention group; partnership), one of your managers(If you are , (4) Any self-insurance method or program, a limited liability oompany), or an "employee". other than any funded by you and over, (such as an insurance, loss control or risk whist this Coverage Part applies;or. , manager or administrator) designated by you to jIve such notice discovers that the "occur- 45) Any similar risk transfer or risk manage- rence"or offense may irtvolvethis policy, , met method, Does cr or a:: . Z. This. Provision,•K.does not apply as resper • umbrella ail i u~an tide m ns + b. cars net irnci r the specific number of days within which you • sees Insurance,that you bought specifically to are required•to notify us in writing of the apply in. excess of the Limits of insurance of the of tics Coverage abrupt. oanvnepcement of a discharge, re shown on th "pollutants'''.lease or escape o; pollutants that causes Par, "bodily Injury" or 'property damage" which j, INCREASED SUPPLEMENTARY PAYMENTS. may otherwise be covered under this policy, Paragraphs-tkb. and 1.d. of SUPPLEMENTARY L. LiNiNTENTIO€CIF .,t SSION . PAYMENTS—COVERAGES AAND B (Section 1 The following is added to COMMERCIAL fi=ll- -Coverages)are amended as follows ' ER,AL LIABILITY CONDITIONS (Section iV), 1, •In paragraph'Lb..,the arnci.rn.i we will pay for . paragraph S., (Representations): ' ... r the cost of bail bonds increased to$2503. The unintentional omission of or unintentional . • • .2> In paragraph 14-,the amount we will pay for • .error in, any information provided by you which loss of earnings is increased,to •500 a day, nWe relied .upon in issuing this policy shall not K. KNOWi-E G--E AND NOTICE OF f3CLiP- prejudice your dolts under this insurance. How. PENCE OR.ct=!~;=l�ka!~ ever,this Provision L. does not affect our right to t. The following is added to COMMERCIAL collect additional premium pr to exermise our right GENERAL LIABILITY CONDITIONS (Section of cancellation or nonrenewal in accordance with Ell}, paragraph (Duties In The Event o;Oc- applicable state insurance laws, codes or regule- ourrence, Offense,.Clarrn or Su"rt)i . dons. . Notice of an "occurrence" or of an offense I ., PERSONAL INJURY — ASSUMED BY CON- • which may result Ina claim must be given es TRACT • , soon as practicable after knowledge of.the 1. The following is added to Exclusion a. {1) of • • 'occurrence"or offense has been reported to Paragraph 2., 1=xc€usi'os of Coverage B. • you, one of,your "executive officers" (r you • Personal Iriicsry,•Advertising Injury, and. , are a corporation), one of your•,partners who . Web Site Injury Liability of the Web,.XTEND Is an individual(if you are a partnership). one : Liability endorsement: . . of yo:ir.managers (if you are a'limited liability' Solely for the.purposes of liability assumed in company); or'an 'employee" (such as an in-' an.+'insured contract", reasonable aattorney ' surance, loss control or risk manager.or ad- fees and necessary litigation expenses in •` ' . minisfrator) designated by yoq to give such . cured.by or for a party pther than an insured notice. • • . • . . are deemed to-be damages because of'!per . • • Knowledge.by any other "e,,xploYee Hof an • . sonal injury"provided: . • . "occurrence" or offense does not imply that . ° •{a) .Liability to such:party for, or for the cost you also have such knowledge. of that party's defense has also been as- ' ' CGD31,6 07 04 - • . Copyright,The Travelers Indemnity Company,20,04 Page 5 of 5 . , i • COMIVIERCIAL GENERAL LIABILITY • sumed in.•the same' "insured contract"; N. BLANKET ADDITIONAL INSURED— L.ESSDR• • and . OF LEASED EQUIPMENT • (6) Such attorney fees and Iftigation ex- WHO IS AN INSURED (Section II) Is amended to' penses •are for defense of that party • include as an Insured any person or organization . • against a civil or•alternrn ative dispute reso- (referred to below as "additional Insured") with • lotion proceeding in which damages to . whom you have agreed In a written contract, exe- which this insurance appIles,are alleged;' muted before the"bodily injury" or"prcperty'dan3- • ,Z, Paragraph 2.d, of SUPPLEMENTARY'PAY- age" occurs or the"personal Injury" or•"advertia- MENTS—.COVERAGES A AND E (Section I •ing injury" offense Is committed, to name 25 an Coverages) is deleted and replaced by the additional insured, but only with respect to their R- . — following: ability for"bodily injury", "property damage", 'per- - , sone! injury or advertising injury caused, in •d, The allegations in the "suit" end the in- whole or in part, by your acts or omissions in the formation we know about the "occur maintenance, operation or use of equipment rence"or offense are such that no conflict • leased to,you by such additional.Insured,'subject appears to exist between the interests of to the following'provisions: • the Insured and the interests of the In- -1. _Limits of Insurance. The limits of•insurance dernnitee; ' afforded to the additional insured'shall be the • 3. •The'third sentence of Paragraph 2 of SUP- limits which you agreed to provide In the writ • ' PLEMENTARY PAYMENTS— COVERAGES '• •ten contract,orthe limits shown on the Dacia- . ' , A AND B (Section 1— Coverages) Is deleted - rations,whichever are less, . and replaced by;he following: .2. The insurance afforded to the additional.in- Notwithsanding the provisions of Paragraph • Sired lines not apply to any"bodily injury" or 2.b.(2)of Section I—Coverage A—Bodily In- . "property damage"-that occurs, or ''personal . jury And Property Damage Liability, or-the injury"or"advartieing injury"caused by an of- . • provisions of Paragraph 2:e.(-1)of Section I— • fense which Is committed,after the equipment Coverage$—Personal injury,Advertising In- lease expires. • jury And Web Site Injury Liabili y, such pay- 3. The insurance afforded to the additional In- ntetrts will not be deemed to be damages for . sure is excess war any valid-and colleotib1e "bodily injury" and "properly 'damage,., •or •"other insurance" available to such additional damages for"personal lr�jut3�,and will not re� Insured, unless you have agreed in the writ - duce the limits of insurances, ten contract filet this insurance must lie pri- • m 4, This provision M. does not apply if coverage ' . many to,or pbn-contributory with,such "other - •,= for "personal injury' liability is excluded by -insurance". •c,.s. endorsement, PIO - - • tea . v•.%� • h .rte . rim • • • cam—° • • • , '• •, m= � •• ' • • •- Page'6.of 6- Copyright The Travelers lndernnrty Company,2004 CG D3 IS 07 04 . • DIM ,• • • . , • OP ID:2J ACCT?E, DATE(M M/DDIYYYY) EVIDENCE OF PROPERTY INSURANCE 08/09/2011 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE OF PROPERTY INSURANCE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. AGENCY PHONE o Extl:509-538.3501 COMPANY Western States Ins.-Spokane Travelers Indemnity of America 501 N Riverpoint Blvd,Ste 403 Spokane,WA 99202-1649 Tom and Bill Davis FAX No):609-838-3511 E-MAIL DSS: CODE: SUB CODE: AGENCY WESTW-7 CUSTOMER ID*: INSURED West Company, Inc. LOAN NUMBER POLICY NUMBER PO Box 519 QT6600683B381TIA-11 Airway Heights,WA 99001 EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 07/01111 07/01/12 f TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION/DESCRIPTION Jobsite installation Floater Coverage-Bridge Spokane ValleyWA 4501 &4507 Expansion Joint/Surface Repair Project SVPW Bid No. 11-006 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE Installation Floater $400,000 5,000 REMARKS(Including Special Conditions) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE ADDITIONAL INTEREST NAMED BELOW,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. ADDITIONAL INTEREST NAME AND ADDRESS _ MORTGAGEE X ADDITIONAL INSURED LOSS PAYEE X Owner LOAN# City of Spokane Valley 11707 E.Sprague#106 AUTHORIZED REPRESENTATIVE Spokane Valley,WA 99206 ACORD 27(2006/07) ©ACORD CORPORATION 1993-2006. All rights reserved. The ACORD name and logo are registered marks of ACORD