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12-042.00 Michael Terrell: Pring Property Master PlanAGREEMENT FOR PROFESSIONAL SERVICES Michael Terrell — Landscape Architect Pring Property Master Plan 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 "Contracting Entity," 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 Contracting Entity shall provide all labor, services and material to satisfactorily complete the attached Scope of Services. A. Administration. The City Manager or designee shall administer and be the primary contact for Contracting Entity. Prior to commencement of work, Contracting Entity 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, Contracting Entity 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 Contracting Entity in entering into this Agreement. By execution of this Agreement, Contracting Entity 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 prior written consent of the City. Contracting Entity represents that the compensation as stated in paragraph 3 is adequate and sufficient compensation for its timely provision of all professional services required to complete the Scope of Services under this Agreement. Contracting Entity shall be responsible for the technical accuracy of its services and documents resulting therefrom, and City shall not be responsible for discovering deficiencies therein. Contracting Entity shall correct such deficiencies without additional compensation except to the extent such action is directly attributable to deficiencies in City furnished information. C. Standard of Care. Contracting Entity shall exercise the degree of skill and diligence normally employed by architects, professional engineers or consultants performing the same or similar services at the time such services are performed. D. Modifications. The City may modify this Agreement and order changes in the work whenever necessary or advisable. The Contracting Entity 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 Contracting Entity 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 Agreement for Professional Services Page 1 of 6 effect until completion of all contractual requirements have been met as determined by the City. Either party may terminate this Agreement for material breach after providing the other party with at least ten days' prior notice and an opportunity to cure the breach. The City may, in addition, terminate this Agreement for any reason by ten days' written notice to the Contracting Entity. In the event of termination without breach, the City shall pay the Contracting Entity for all work previously authorized and satisfactorily performed prior to the termination date. 3. Compensation. The City agrees to pay the Contracting Entity $4,150 as full compensation for everything done under this Agreement. Contracting Entity shall not perform any extra, further or additional services for which it will request additional compensation from the City without a prior written agreement for such services and payment therefor. 4. Payment. The Contracting Entity 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 Code, and federal or state standards. 5. Notice. Notice shall be given in writing as follows: TO THE CITY: Name: Christine Bainbridge, City Clerk Phone Number: (509) 921 -1000 Address: 11707 East Sprague Ave, Suite 106 Spokane Valley, WA 99206 TO THE CONTRACTING ENTITY: 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, and local laws and regulations. Contracting Entity warrants that its designs, construction documents, and services shall confirm to all federal, state and local statutes and regulations. 7. Relationship of the Parties. It is understood, agreed and declared that the Contracting Entity shall be an independent contractor, 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 Contracting Entity. Any and all employees who provide services to the City under this Agreement shall be deemed employees solely of the Contracting Entity. The Contracting Entity 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 Contracting Entity 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. The written, graphic, mapped, photographic, or visual documents prepared by Contracting Entity under this Agreement shall, unless otherwise provided, be deemed the property of the City. The City shall be permitted to retain these documents, including reproducible camera -ready originals of reports, reproduction quality mylars of maps, and copies in the form of computer files, for the City's use. The City shall have unrestricted authority to publish, disclose, Agreement for Professional Services Page 2 of 6 distribute and otherwise use, in whole or in part, any reports, data, drawings, images or other material prepared under this Agreement, provided that the Contractor shall have no liability for the use of the Contractor's work product outside of the scope of its intended purpose. 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 Contracting Entity's records with respect to all matters covered in this Agreement. 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 Agreement for a period of three years from the date final payment is made hereunder. 10. Insurance. The Contracting Entity 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 Contracting Entity, its agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance. Contracting Entity 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, 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 Contracting Entity'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 Contracting Entity's profession. B. Minimum Amounts of Insurance. Contracting Entity 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: Agreement for Professional Services Page 3 of 6 1. The Contracting Entity's insurance coverage shall be primary insurance with respect to the City. Any insurance, self - insurance, or insurance pool coverage maintained by the City shall be excess of the Contracting Entity's insurance and shall not contribute with it. 2. Contracting Entity shall fax or send electronically in .pdf format a copy of insurer's cancellation notice within two business days of receipt by Contracting Entity. D. Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, the Contracting Entity shall furnish acceptable insurance certificates to the City at the time the Contracting Entity returns the signed Agreement. 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 Contracting Entity shall be financially responsible for all pertinent deductibles, self - insured retentions, and/or self - insurance. 11. Indemnification and Hold Harmless. The Contracting Entity 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, subject only to the limitations provided below: Contracting Entity's duty to indemnify shall not apply to liability for damages arising out of bodily injury to persons or damage to property caused by or resulting from the sole negligence of the City, or its agents or employees. 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 Contracting Entity, its agents or employees, and the City, its officers, officials, employees, or volunteers, the Contracting Entity's duty to indemnify hereunder shall be only to the extent of the Contracting Entity's negligence. It is further specifically and expressly understood that the indemnification provided herein constitutes the Contracting Entity's waiver of immunity under Industrial Insurance, Title 51 RCW, solely for the purposes of this indemnification. Contracting Entity's obligation to defend, indemnify and hold the City harmless shall include, but not be limited to, the City's attorney and expert fees, court costs, and all other claim - related expenses. 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 a waiver of any other subsequent breach or nonperformance. All remedies afforded in this Agreement or by law, shall be taken and construed as cumulative, and in addition to every other remedy provided herein or by law. Failure of either party to enforce at any time any of the provisions of this Agreement or to require at any time performance by the other party of any provision hereof shall in no way be construed to be a waiver of such provisions nor shall it affect the validity ofthis Agreement or any part thereof. 13. Assignment and Delegation. Neither party shall assign, transfer or delegate any or all of the Agreement for Professional Services Page 4 of 6 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 Contracting Entity shall not enter into subcontracts for any of the work contemplated under this Agreement without obtaining prior written approval of the City. 15. Confidentiality. Contracting Entity may, from time to time, receive information which is deemed by the City to be confidential. Contracting Entity shall not disclose such information without the prior 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. Disputes between the City and Contracting Entity shall be resolved in the Superior Court of the State of Washington in Spokane County. Notwithstanding the foregoing, Contracting Entity agrees that it may, at the City's request, be joined as a party in any arbitration'proceeding between the City and any third party that includes a claim or claims that arise out of, or that are related to Contracting Entity's services under this Agreement. Contracting Entity further agrees that the Arbitrator(s) decision therein shall be final and binding on Contracting Entity and that judgment may be entered upon it in any court having jurisdiction thereof. 17. Cost and Attorney's Fees. The prevailing party in any litigation or arbitration arising out of this Agreement shall be entitled to its attorney's fees and costs of such litigation (including expert witness fees). 18. Entire Agreement. This written Agreement constitutes the entire and complete agreement between the parties and supercedes any prior oral or written agreements. This Agreement may not be changed, modified or altered except in writing signed by the parties hereto. 19. Anti - kickback. No officer or employee of the City, having the power or duty to perform an official act or action related to this Agreement shall have or acquire any interest in this Agreement, or have solicited, accepted or granted a present or future gift, favor, service or other thing of value from any person with an interest in this Agreement. 20. Business Registration. Prior to commencement of work under this Agreement, Contracting Entity 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 The parties have executed this Agreement this day of is '2012. Agreement for Professional Services Page 5 of 6 CITY OF SPOKANE VALLEY e Jack on, ity Manager Contr n nY Its: Authorized Representative APPROVED AS TO FORM: Office of e City Atidnf6y Agreement for Professional Services Page 6 of 6 Michael Terrell N Landscape Architect 5312 South Chapman Road Greenacres, WA 99016 Date: March 15, 2012 Client: City of Spokane Valley, WA Contact: Mr. Mike Stone Address: 2426 N. Discovery Place Spokane Valley, Washington 99216 Project: Pring Property Master Plan Address: Spokane Valley, Washington Phone: (509) 720 -5400 Fax: (509) 688 -0188 Michael Terrell ■ Landscape Architect Agrees To Perform The Following Scope of Services: Tasks Fees Phase I SiteJnvestigatlon & Conceptual Programming 1. Review existing site conditions and any available collateral site engineering drawings, surveys, street plans or other design documents provided by the City of Spokane Valley. 2. Meet with City of Spokane Valley staff to discuss concepts, schedules, and further define the scope of work. 3. Prepare site base map with ortho photo provided by City of Spokane Valley. 4. Prepare list of program elements for utilization in the development of two development strategies: a. Library and Park Expansion b. Park Expansion Phase I Subtotal $950.00 Phase U Concept, Development 1. Library and Park Expansion Option: Prepare two detailed concept designs that illustrate potential relationships, quantity and approximate sizes of park elements. Plan to incorporate future Library, parking and site requirements. 2. Balfour Park Expansion Option: Prepare two detailed concept designs that Illustrate potential relationships, quantity and approximate sizes of park elements. 3. Meetings: PROPOSAL AND CONTRACT Projects Pring Property Afaster Plan Project 9:12-004 Client: City of Spokane Valley a. Present options to Parks and Recreation Director for review, comment and direction on possible revisions. b. Present options to City Manager for review, comment and direction for revisions. 4. Prepare final plans as directed for presentation by staff to City Phase II Subtotal $3,300.00 Total $4,250:00 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" and Exhibit "A." 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. • Fountain and water features; mechanical, plumbing, and hydraulics consultants. • Design of retaining walls over four feet (4') in height. • Survey of property • Utility design • Entitlements: permits or planning approvals Michael Terrell ■ Landscape Architect Proposes To Provide the Above Services for a Fee Which Shall Be: Three Thousand Nine Hundred Fifty Dollars and No Cents ($3,950.00) accrued on a time and expense basis. We will bill reimbursable travel expenses based upon actual cost plus 10% for mileage and other miscellaneous expenses. Incidental expenses will be billed as incurred. These expenses will Include cost of reproduction, telephone, etc. as necessary. We estimate these costs will not exceed $200.00. PROPOSAL AAID COAMUCT Project: Pring Property Alaster Plan Project i#: 12 -004 Client: City of Spokane Palley DAS 16 A4CC>R ° CERTIFICATE OF LIABILITY INSURANCE R045 DATE IMM /DD /YYYYI 03 -29 -2012 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 ADDITIONALINSURED, 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: —gyp HONE. Ext: (888)242-1430 (AIXC N l: (877) 905 -0457 E -MAIL RODUCER CUSTOMER ID #: _ INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A : Hartford Casualty Ins Co MICHAEL TERRELL DBA MICHAEL TERRELL LANDSCAPE ARCHITECT 5312 S CHAPMAN RD GREENACRE S WA 99016 INSURER B: INSURER C INSURER D DAMAG _ET O WENTEI) PREMISES IEa occurrence) INSURER E 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF (MM /DD /YYYY) POLICY EXP (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1, 000, 0 0 0 DAMAG _ET O WENTEI) PREMISES IEa occurrence) 5 3 0 0, 0 0 0 COMMERCIAL GENERAL LIABILITY j IVIED EXP (Any one person) _. _..- ....... $ 10 , 0 0 0 -- _..... .... CLAIMS -MADE X OCCUR F 1 j A ____ X General Liab X 65 SBA PU5843 1 01/13/2012 01/13/2013 PERSONAL & ADV INJURY $ 1, 000, 000 GENERAL AGGREGATE $ 2, 000, 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG S 2, 000,000 $ PR X O- .__..... LOC POLICY _..— AUTOMOBILE ......... -.._- LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY IPer accident) $ ALL OWNED AUTOS PROPERTY DAMAGE $ SCHEDULED AUTOS HIRED AUTOS (Per accident) S NON -OWNED AUTOS S UMBRELLA LIAB [CLAIMS-MADE EACH OCCURRENCE $ _ AGGREGATE $ EXCESS LIAB _ DEDUCTIBLE -___ .....5 __ RETENTION $ $ WORKERS COMPENSATION ! WC STATU- OTH- LI.M ITS E ER R _.... AND EMPLOYERS' LIABILITY Y / N _TORY _ ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED? (Mandatory in NH) N/A E.L. - EA EMPLOYEE $ _DISEASE E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Those usual to the Insured's Operations. Certificate Holder is an Additional Insured per the Business Li- alaility Coverage Form SS0008 attached to this policy. rGRTIGIreTG HOLDER CANCELLATION © 1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED City of Spokane Valley BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Attn: Parks & Recreation Dept. DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2426 N DISCOVERY PL AUTHORIZED REPRESENTATIVE 4 SPOKANE VALLEY, WA 99216 7�_ 7a�/ © 1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (NIMIDD/YYY`n rJnz 0 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 lieu of such endorsement(s). PRODUCER LeatzoW Insurance 300 S. Riverside Plaza, Suite 2100 Chicago, IL 60606 CONTACT NAME RICH PIVARCYK PHONE (312) 930 -5556 FAX (866) 741 -2778 EMAIL ADDRESS rich @leatzowinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # ENSURERA: New Hampshire Insurance Company 23841 INSURED Michael Terrell- Landscape Architect 5312 South Chapman Road Greenacres, WA 99016 INSURER B: F-1 INSURER C: INSURER D: EACH OCCURRENCE INSURER E DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER F: MED EXP (Any one person) f.:UVI=KA4UtS CERTIFICATE NUMBER: RFVISION NDIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADD INSR SUB WVD POLICY NUMBER POLICY EFF fMMIDDUYYYY) POLICY FXP IMMIDDIYYYYI LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE FI OCCUR ❑ F-1 DOES NOT APPLY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL AND ADV INJURY $ GENERAL AGGREGATE $ GEML AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY a ANYAUTO Scheduled Autos ❑DOES ALL OWNED Non-owned AUTOS Auks ❑ Hired Autos F] � NOT APPLY COMBINED SINGLE LIMIT {Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAR OCCUR EXCESS LAB CLAIMS -MADE DED ❑ RETENTION $ DOES NOT APPLY EACH OCCURRENCE $ AGGREGATE $ $ WORKERS COMPENSATION AND EMPLOYERS! LIABILITY yny ANY PROPRIETORIPARTNER/DCECUTIVE❑ OFFICERIMEMBER EXCLUDED? N/A DOES NOT APPLY WC STATU- TORYUMRS g+ ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ EL. DISEASE - POLICY LIMIT $ A PROFESSIONAL LIABILITY 11:1 El 011193337 1/16/2012 111612013 1,000,000 each claim 1,000,000 aggregate DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: Spokane Valley Parks and Recreation Projects CERTIFICATE HOLDER CANCELLATION City of Spokane Valley Parks and Recreation Department Attn: Mr. Mike Stone 2426 N. Discovery Place 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. AUTHORIZED REPRESENTATIVE LEATZOW INSURANCE L @'1988- 20VCORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACCORD name and logo are registered marks of ACORD ADDL INFO ON NEXT PAGE PAGE 5 UNITED SERVICES AUTOMOBILE ASSOCIATION 1 'q (A RECIPROCAL INTERINSURANCE EXCHANGE) State 09 10 Veh POLICY NUMBER V$A® 9800 Fredericksburg Road - San Antonio, Texas 78288 00358 99 36U 7104 8 P25[1251 rerr WASHINGTON AUTO POLICY POLICY PERIOD: (12:01 A.M. standard time) RENEWAL DECLARATIONS EFFECTIVE FEB 20 2012 TO AUG 20 2012 ATTACH TO PREVIOUS POLICY Named Insured and Address MICHAEL D TERRELL CAPT USN 5312 S CHAPMAN RD GREENACRES WA 99016 -8832 Description of Vehicle(s) VEH USE* WORK/SCHOOL VEH YEAR TRADE NAME MODEL BODY TYPE ANNUAL MILEAGE IDENTIFICATION NUMBER SvM I Miles one way i Days Per week 09 98 TOYOTA 4RUNNERSR5 UTIL 4X4 5000 JT3HN86R7W0155361 P 10 12 SUBARU OUTBK2.51AWL UTL4X44D 10000 4S4BRBKCXC3219368 B The Vehlcle(s) described herein is princi all gars ed at the above address unless otherwise stated wiC= workischool; B= Business; F= Farm;P= Pleasure VEH 09 GREENACRES WA 991 -8832 VEH 10 GREENACRES WA 99016 -8832 This policy provides ONLY those coverages where a premium is shown below. The limits shown max be reduced by policy provisions and may not be combined regardless of the number of vehicles for which a premium is listed unless specifically authorized elsewhere in this policy. COVERAGES LIMITS OF LIABILITY VEH 09 6 -MONTH VEH 10 6 -MONTH VEH VI=_H ( "ACV" MEANS ACTUAL CASH VALUE) D =DED PREMIUM D =DED PREMIUM D =DED PREMIUM D =DED PREMIUM MOUNT $ MOUNT $ MOUN $ 4MOUNTI $ BODILY INJURY EA PER $ 500,000 EA ACC $1,000,000 245.30 104.83 PROPERTY DAMAGE EA ACC $ 300,000 133.45 59.26 PART B - PERSONAL INJURY PROTECTION 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 28.36 12.58 PART C - UNDERINSURED • MOTORISTS BODILY INJURY EA PER $ 500,000 - EA ACC $1,000,000 42.31 50.77 PROPERTY DAMAGE EA ACC $ 10,000 5.11 6.14 PART D - PHYSICAL DAMAGE COVERAGE COMPREHENSIVE LOSS ACV LESS D1000 42.84 1000 32.73 COLLISION LOSS ACV LESS D1000 156.76D1000 117.31 TOWING AND LABOR 4.00 4.00 TOTAL PREMIUM - SEE FOLLOWING PAGE(S) LOSS PAYEE EH 10 SUBARU OF KENNESAW - PKWY NW, KENNESAW GA E E H H E E H H In VVIINtJS WFitKtUt-, me JUDScnOers al UNIItU JtKVIGtS AUIUMUtSILt AJSU1,lAIIUIV nave causea inese presents to De slgnea Dy their Attorney -in -Fact on this date JANUARY 17, 2012 4— Laura Bishop 5000 U 07 -11 President, USAA Reciprocal Attorney -in -Fact, Inc. 53461 -07 -11 PAGE 6 UNITED SERVICES AUTOMOBILE ASSOCIATION — %q (A RECIPROCAL INTERINSURANCE EXCHANGE) USA® State veh POLICY NUMBER WA Twi 9800 Fredericksburg Road - San Antonio, Texas 78288 00358 99 36U 7104 8 WASHINGTON AUTO POLICY POLICY PERIOD: (12:01 A.M. standard time) RENEWAL DECLARATIONS EFFECTIVE FEB 20 2012 TO AUG 20 2012 ATTACH TO PREVIOUS POLICY Named Insured and Address MICHAEL D TERRELL CAPT USN 5312 S CHAPMAN RD GREENACRES WA 99016 -8832 Description of Vehicle(s) VEH USE' SYM WORK/SCHOOL Miles I Dppays 0 e Week VEH YEAR TRADE NAME MODEL BODY TYPE MILEAGE IDENTIFICATION NUMBER e e Ic e s described ereln Is pnnclpa y garaged at e above address un ess otherwise stated. W/c= Work/School; B= Business; F= Farm;P= Pleasure This policy provides ONLY those coverages where a premium is shown below. The limits shown may be reduced by policy provisions and may not be combined regardless of the number of vehicles for which a premium is listed unless specifically authorized elsewhere in this policy. VEH VEH VEH VEH COVERAGES LIMITS OF LIABILITY ( "ACV" MEANS ACTUAL CASH VALUE) D =DED I PREMIUM D =DED PREMIUM D =DED PREMIUM D =DED I PREMIUM MOUNT $ AMOUNT I $ AMOUNT $ I MOUNT $ VEHICLE TOTAL PREMIUM 658.13 387.62 6 MONTH PREMIUM $ 1788.08 EARNED ACCIDENT FORGIVENESS APPLIES WITH FIVE YEARS CLEAN DRIVING WITH US A. HE PREMIUM ON YOUR RENEWING POLICY IS $ 92.46 LESS THAN CN YOUR EXPIRING POLICY. HE FOLLOWING COVERAGE(S) DEFINED IN THIS POLICY ARE NOT P OVIDE FOR: VEH 05 - COMPREHENSIVE, COLLISIO , RENTAL REIMBURSEMENT VEH 06 - RENTAL REIMBURSEMENT VEH 07 - RENTAL REIMBURSEMENT VEH 08 - COMPREHENSIVE, COLLISION, RENTAL REI BURS MENT VEH 09 - RENTAL REIMBURSEMENT VEH 10 - RENTAL REIMBURSEMENT THIS POLICY INCLUDES ENDORSEMENT A155 F R VEHICLE( E) 05 08 IF DRIVEN, BODILY INJURY AND PROPE TY D AGE LIMITS 4RE TH MINI UM LIMITS EQUIRED I N YOUR LOCATION. COLLISION COVERA E ON APPLIES IF THERE I S A OSS PAYEE T WHICH E PAY THE LESSER OF ACV, LOAN AMO NT 0 COST T REPAIR. E E E H H E H E E H In WITNESS WHEREOF, the Subscribers at UNITED SERVICES AUTOMOBILE ASSOCIATION have their Attorney -in -Fact on this date JANUARY 17, 2012 5000 U 07 -11 President, 53461 -07 -11 caused ,these presents to be signed by Laura Bishop USAA Reciprocal Attorney -in -Fact, Inc. Verify Workers' Comp Premium Status - Employer Liability Certificate Washington State Department of Labor and Industries Department of Labor and Industries Employer Liability Certificate Date: 03/29/2012 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 4 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 / FEARAED FEROZE (360)902 -4797 - Email: FERH235 @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 51.16.190). https: // fortress. wa. gov/ lni/ crpsi /AcctInfoPrint.aspx ?AccountId= 07259401 &AccountManag... 3/29/2012