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11-188.00 Skillings Connolly: On Call ROW Acquisition & AppraisalSUPPLEMENTAL AGREEMENT ORGANIZATION AND ADDRESS No. 1 Skillings Connolly, Inc. PO Box 5080 AGREEMENT NUMBER Lacey, WA 98509 -5080 10016 PROJECT NUMBER PHONE ( 360)49 _3399 PROJECT TITLE NEW MAXIMUM AMOUNT PAYABLE On -Call Right of Way Acquisition and Appraisal Services DESCRIPTION OF WORK Time Extension Only The Local Agency of City of Spokane Valley desires to supplement the agreement entered into with Skillings Connolly, Inc. executed on January 20, 2010 and identified as Agreement No. 10016. All provisions in the basic agreement remain in effect except as expressly modified by this supplement. The changes to the agreement are described as follows: SECTION 1, SCOPE OF WORK, is hereby changed to read: Remains unchanged. SECTION IV, TIME FOR BEGINNING AND COMPLETION, is amended to change the completion date from December 31, 2011 to December 31, 2012. SECTION V, PAYMENT, shall be amended as follows: Remains unchanged. If you concur with this supplement and agree to the changes as stated above, please sign in the appropriate spaces below and return to this office for final action. Signed this day of1 By: Skillin s Connolly, In T r Principal By: Ci -y f oka a Valley i ning r y Skillings Connolly, Inc. Page 1 of 1 Project No. 10016 City of Spokane Valley On -Call Right of Way Acquisition and Appraisal Services w I I_ I 08 December 12, 2011 CliPntil- 32d969 �:41 A1150T91 k I ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 1 12/20/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lie of such e ndorsement(s). PRODUCER Kibble & Prentice, a USI Co PR CONTACT NAME: PHONE 206 F AX A/C No Ext : A/C, No 610- 362 -8528 601 Union Street, Suite 1000 Seattle, WA 98101 EMAIL I ce q uest k p com.com ADDRESS: p INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Indemnity Co. of Amer 25666 EEAA(C�HH RED PREMISES Ea INSURED INSURER B: XL Specialty Insurance Company 37885 Skillings Connolly, Inc. Charter Oak Fire Insurance C INSURER C : p 25615 5016 Lacey Blvd. SE Lacey, WA 98503 INSURER D $2,000,000 INSURER E PRODUCTS - COMP/OP AGG INSURER F: $ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT R TYPE OF INSURANCE NSR S WVD POLICY NUMBER MMtDDY EFF MM/DDY EXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR 680676OL011 2/1812011 12/18/2012 O $1, 000,000 EEAA(C�HH RED PREMISES Ea $1 1 000 1 000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: — 1 1 POLICY X PER OT- LOC PRODUCTS - COMP/OP AGG $2,000,000 $ C AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS NON -OWNED X HIRED AUTOS X AUTOS BA6752L594 2/18/2011 12/18/201 CO accdeD SINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPER TYDAMAGE Peraocident $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICERIMEMBER EXCLUDED? � (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 680676OL011 (WA Stop Gap) 2/18/2011 12118/201 X H- T C STATU - OT E.L. EACH ACCIDENT $1, 000,000 E.L. DISEASE - EA EMPLOYEE $1, 000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 B Professional Liability DPR9692241 3/02/2011 03/02/201 $1,000,000 per claim $1,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) Re: Project No. 10016, City of Spokane Valley On -Call Right -of -Way Acquisition and Appraisal Services. The Certificate Holder is named as an Additional Insured on the General Liability Policy, with respects to operations of the Named Insured. City of Spokane Valley THE SHO EXPIRAT DATE V THEREOF, E NOTICE C BE C DELIVERED N 11707 East Sprague Avenue, Suite 106 ACCORDANCE WITH THE POLICY PROVISIONS. Spokane, WA 99206 AUTHORIZED REPRESENTATIVE © 1988 -2010 ACORD CORPORATION. All ngnts reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S6747877/M6747876 MXTJU This page has been left blank intentionally: COMMERICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section II): Any person or organization that you agree in a "contract or agreement requiring insurance" to in- clude as an additional insured on this Coverage Part, but only with respect to liability for "bodily in- jury", "property damage" or "personal injury" caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing opera- tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products- completed operations hazard ". Such person or organization does not qualify as an additional insured for "bodily injury", "property damage" or "personal injury" for which that per- son or organization has assumed liability in a con- tract or agreement. INSURANCE (Section III) for this Coverage Part. B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if you specifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Cov- erage Part must apply on a primary basis, or a primary and non - contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such addi- tional insured as a named insured, and we will not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage is sought occurs; and (2) The "personal injury" for which coverage is sought arises out of an offense committed; The insurance provided to such additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which cover- C. age as an additional insured specifically is added by another endorsement to this Cover- age Part. e. This insurance does not apply to the render- ing of or failure to render any "professional services ". f. The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "contract or agreement requir- ing insurance" to provide for that additional insured, or the limits shown in the Declara- tions for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF after you have entered into that "contract or agreement requiring insurance ". But this insur- ance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured under any other insurance. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, under a "contract or agreement requiring insurance" with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insur- ance" with such person or organization entered into by you before, and in effect when, the "bodily CG D3 81 09 07 © 2007 The Travelers Companies, Inc. Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc., with its permission. COMMERICAL GENERAL LIABILITY injury" or "property damage" occurs, or the "per- sonal injury" offense is committed. D. The following definition is added to DEFINITIONS (Section V): "Contract or agreement requiring insurance" means that part of any contract or agreement un- der which you are required to include a person or organization as an additional insured on this Cov- erage Part, provided that the "bodily injury" and "property damage" occurs, and the "personal in- jury" is caused by an offense committed: a. After you have entered into that contract or agreement; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 © 2007 The Travelers Companies, Inc. CG D3 81 09 07 Includes the copyrighted material of Insurance Services Office, Inc., with its permission.