12-093.00 Allwest Testing: 2012 Street PreservationAGREEMENT FOR PROFESSIONAL SERVICES
For
2012 Street Preservation Project- Phase 1 Construction Materials Testing
Public Works Contract 12 -029
THIS AGREEMENT is made by and between the City of Spokane Valley, a code City of the State of
Washington, hereinafter "City" and ALLWEST Testing & Engineering, LLC, hereinafter "Consultant,"
jointly referred to as "Parties."
IN CONSIDERATION of the terms and conditions contained herein the Parties agree as follows:
1. Work to Be Performed. The Consultant shall provide all labor, services and material to satisfactorily
complete the attached Scope of Services for Construction Materials Testing, dated June 27, 2012.
A. Administration. The City Manager or designee shall administer and be the primary contact for
Consultant. Prior to commencement of work, Consultant shall contact the City Manager or designee
to review the Scope of Services, schedule and date of completion. Upon notice from the City Manager
or designee, Consultant shall commence work, perform the requested tasks in the Scope of Services,
stop work and promptly cure any failure in performance under this Agreement.
B. Representations. The City has relied upon the qualifications of the Consultant in entering into this
Agreement. By execution of this Agreement, Consultant represents it possesses the ability, skill and
resources necessary to perform the work and is familiar with all current laws, rules and regulations
which reasonably relate to the Scope of Services. No substitutions of agreed -upon personnel shall be
made without the prior written consent of the City.
Consultant 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, based upon proposed schedule by the City of Spokane Valley.
Consultant shall be responsible for the technical accuracy of its services and documents resulting
therefrom, and City shall not be responsible for discovering deficiencies therein. Consultant shall
correct such deficiencies without additional compensation except to the extent such action is directly
attributable to deficiencies in City furnished information.
C. Standard of Care. Consultant shall exercise the degree of skill and diligence normally employed by
professional consultants engaged in the same profession, and 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 Consultant will accept modifications when ordered in writing by the City
Manager or designee. Compensation for such modifications or changes shall be as mutually agreed
between the Parties. The Consultant shall make such revisions in the work as are necessary to correct
errors or omissions appearing therein when required to do so by the City without additional
compensation.
2. Term of Contract. This Agreement shall be in full force and effect upon execution and shall remain in
Agreement for Professional Services
Page 1 of 6
Co1�_-Dq 3
effect until completion of all contractual requirements have been met as determined by the City. Consultant
shall complete its work within 6 months of execution of this Agreement, unless the time for performance is
extended in writing by the Parties.
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 Consultant. In the event of termination without breach, the
City shall pay the Consultant for all work previously authorized and satisfactorily performed prior to the
termination date.
3. Compensation. The City agrees to pay the Consultant on a time and materials basis, not to exceed $10,988
for Construction Materials Testing Services as described in the attached proposal. The Consultant shall not
proceed with work that will exceed this billable cost without obtaining written approval from the City. A
Management Reserve Fund in the amount of $1,098 is also hereby established that maybe spent on the project,
if the City authorizes such expenditures by prior written consent. A total contract amount of $12,086 is
established as the maximum compensation for everything done under this agreement.
4. Payment. The Consultant shall be paid monthly upon presentation of an invoice to the City. Applications
for payment shall be sent to the City Clerk at the below stated address.
The City reserves the right to withhold payment under this Agreement which is determined in the reasonable
judgment of the City Manager or designee to be noncompliant with the Scope of Services, City standards, City
Code, and federal or state standards.
5. Notice. Notice shall be given in writing as follows:
TO THE CITY: TO THE CONSULTANT:
Name: Christine Bainbridge, City Clerk Name: Allwest Testing & Engineering, LLC
Phone: (509) 921 -1000 Phone: (509) 534 -4411
Address: 11707 East Sprague Ave, Suite 106 Address: 12928 E. Indiana Ave. #1, Spokane Valley,
WA 99206 Spokane Valley, WA 99216
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. Consultant 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 Consultant 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 Consultant. Any and all employees who provide services to the
City under this Agreement shall be deemed employees solely of the Consultant. The Consultant shall be solely
responsible for the conduct and actions of all its employees under this Agreement and any liability that may
attach thereto.
8. Ownership of Documents. All drawings, plans, specifications, and other related documents prepared by
the Consultant under this Agreement are and shall be the property of the City, and maybe subject to disclosure
pursuant to RCW 42.56 or other applicable public record laws. The written, graphic, mapped, photographic, or
Agreement for Professional Services Page 2 of 6
visual documents prepared by Consultant 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, distribute and otherwise use, in
whole or in part, any reports, data, drawings, images or other material prepared under this Agreement, provided
that the Consultant shall have no liability for the use of the Consultant'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 Consultant'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 Consultant shall procure and maintain for the duration of the Agreement, insurance
against claims for injuries to persons or damage to property which may arise from or in connection with the
performance of the work hereunder by the Consultant, its agents, representatives, employees or subcontractors.
A. Minimum Scope of Insurance. Consultant shall obtain insurance of the types described below:
1. Automobile liability insurance covering all owned, non - owned, hired and leased vehicles.
Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute
form providing equivalent liability coverage. If necessary, the policy shall be endorsed to
provide contractual liability coverage.
2. Commercial general liability insurance shall be written on ISO occurrence form CG 00 01
and shall cover liability arising from premises, operations, independent contractors and
personal injury and advertising injury. The City shall be named as an insured under the
Consultant's commercial general liability insurance policy with respect to the work performed
for the City.
3. Workers' compensation coverage as required by the industrial insurance laws of the State
of Washington.
4. Professional liability insurance appropriate to the Consultant's profession.
B. Minimum Amounts of Insurance. Consultant shall maintain the following insurance limits:
1. Automobile liability insurance with a minimum combined single limit for bodily injury and
property damage of $1,000,000 per accident.
2. Commercial general liability insurance shall be written with limits no less than $1,000,000
each occurrence, $2,000,000 general aggregate.
3. Professional liability insurance shall be written with limits no less than $1,000,000 per
claim and $1,000,000 policy aggregate limit.
C. Other Insurance Provisions. The insurance policies are to contain, or be endorsed to contain, the
following provisions for automobile liability, professional liability and commercial general liability
Agreement for Professional Services Page 3 of 6
insurance:
1. The Consultant'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 Consultant's insurance and shall not contribute with it.
2. Consultant shall fax or send electronically in .pdf format a copy of insurer's cancellation
notice within two business days of receipt by Consultant.
D. A.cceltability of Insurers. Insurance is to be placed with insurers with a current A.M. Best rating of
not less than ANIL
E. Evidence of Coverage. As evidence of the insurance coverages required by this Agreement, the
Consultant shall furnish acceptable insurance certificates to the City at the time the Consultant 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 Consultant shall be financially responsible for all pertinent deductibles, self -
insured retentions, and /or self - insurance.
11. Indemnification and Hold Harmless. The Consultant shall, at its sole expense, defend, indemnify and
hold harmless City and its officers, agents, and employees, from any and all claims, actions, suits, liability,
Ioss, costs, attorney's fees and costs of litigation, expenses, injuries, and damages of any nature whatsoever
relating to or arising out of the wrongful or negligent acts, errors or omissions in the services provided by
Consultant, Consultant's agents, subcontractors, subconsultants and employees to the fullest extent permitted
by law, subject only to the limitations provided below.
Consultant's duty to defend, indemnify and hold harmless City shall not apply to liability for damages arising
out of such services caused by or resulting from the sole negligence of City or City's agents or employees.
Consultant's duty to defend, indemnify and hold harmless City against liability for damages arising out of such
services caused by the concurrent negligence of (a) City or City's agents or employees, and (b) Consultant,
Consultant's agents, subcontractors, subconsultants and employees, shall apply only to the extent of the
negligence of Consultant, Consultant's agents, subcontractors, subconsultants and employees.
Consultant's duty to defend, indemnify and hold City harmless shall include, as to all claims, demands, losses
and liability to which it applies, City's personnel - related costs, reasonable attorneys' fees, and the reasonable
value of any services rendered by the office of the City Attorney, outside consultant costs, court costs, fees for
collection, and all other claim - related expenses.
Consultant specifically and expressly waives any immunity that may be granted it under the Washington State
Industrial Insurance Act, Title 51 RCW. These indemnification obligations shall not be limited in any by
any limitation on the amount or type of damages, compensation or benefits payable to or for any third party
under workers' compensation acts, disability benefit acts, or other employee benefits acts. Provided, that
Consultant's waiver of immunity by the provisions of this Addendum extends only to claims against Consultant
by City, and does not include, or extend to, any claims by Consultant's employees directly against Consultant.
Consultant hereby agrees that this indemnification provision was mutually negotiated.
Agreement for Professional Services Page 4 of 6
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 of this Agreement or any part thereof.
13. Assignment and Delegation. Neither Party shall assign, transfer or delegate any or all of the
responsibilities of this Agreement or the benefits received hereunder without first obtaining the written consent
of the other Party.
14. Subcontracts. Except as otherwise provided herein, the Consultant shall not enter into subcontracts for
any of the work contemplated under this Agreement without obtaining prior written approval of the City.
15. Confidentiality. Consultant may, from time to time, receive information which is deemed by the City to
be confidential. Consultant shall not disclose such information without the 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 Consultant shall be resolved in the Superior Court of the State of Washington in Spokane
County. Notwithstanding the foregoing, Consultant 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 Consultant's services under this Agreement. Consultant further agrees that
the Arbitrator(s) decision therein shall be final and binding on Consultant and that judgment maybe 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 attomey'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 supersedes 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.
M. Business Registration. Prior to commencement of work under this Agreement, Consultant shall register
with the City as a business.
21. Severability. If any section, sentence, clause or phrase of this Agreement should be held to be invalid for
any reason by a court of competent jurisdiction, such invalidity shall not affect the validity of any other section,
sentence, clause or phrase of this Agreement.
Agreement for Professional Services Page 5 of 6
22. Exhibits. Exhibits attached and incorporated into this Agreement are:
I. Scope of Services
2. Insurance Certificates
The Parties have executed this Agreement thisctLll day of -' , 20,9,.
CIT OKANE VALLEY
Mike cl on, City Manager
ATTEST:
'stine Bainbridge, City Clerk
Consultant:
By:
Its: Authorized Representative
APPROVED AS TO FORM:
Office Vf the City orney
Agreement for Professional Services Page 6 of 6
ALL-WEST
Testing & Engineering
June 27, 2012
Project No. 212 -122T
Mr: Craig Aldworth
City of Spokane Valley
11707 E. Sprague Avenue, Suite 106
Spokane Valley, Washington 99206
Materials Testing
Geotechnical Engineering
Environmental Services
RE: Scope. of Work for Construction Materials Testing
City of Spokane Valley 2012 Street Preservation Project — Phase .l
Vista Road; 4th Avenue, and Dishman -Mica Road
Spokane Valley, Washington
Dear Mr. Aldworth:
ALLWEST Testing & Engineering is pleased to provide you With the following cost
estimate for construction materials testing for the proposed 2012 Street Preservation
project located at the above - mentioned sites in Spokane Valley, Washington. Based on
at review .of the available information, we are confident that our firm will provide the
necessary testing sery ices in a cost effective, timely, and professional manner. This
cost estimate summarizes our unit prices and our estimated fees to provide our
services.
PROJECT DESCRIPTION
We understand that the proposed projects consist of roadway maintenance activities for
preserving pavement roadways at the above mentioned locations within Spokane
Valley. In general, the construction activities will include subgrade and base aggregate
preparation in localized repair areas and asphalt surface milling followed by overlyaing
of the asphalt surface with new asphalt pavement. Specifically, construction activities at
the three proposed Locations: will include the following work:
O 690 W. Capstone Court • Hayden, ID 83835 • (208) 762 -4721 • Fax (208) 762 -0942
0 12928 E. Indiana Avenue #1 + Spokane Valley, WA 99216 • (509) 534 -4411 • Fax (509) 534 -9326
0 2127 2nd Avenue N. • Lewiston, ID 83501 • (208) 743 -5710 * Fax (208) 743 -8270
Cost Estimate for Construction Materials Testing
2012 Street Preservation Project
Spokane Valley, Washington
Project No.. 212 -122T
Page 2
Schedule A — Vista Road between Mission Avenue and Nora Avenue:
Asphalt pavement from the western half of Vista Road will be removed down to
subgrade elevation, the subgrade will be compacted, a.2 -inch thick asphalt patch will be
placed above the subgrade, and a 2 -inch thick asphalt inlay will be placed above the
asphalt patch. For the remaining east half of Vista Road and adjacent portion of
Mission Avenue, the roadway surface will be milled and a 2 -inch thick asphalt inlay will
be constructed.
Schedule B — 4t' Avenue between Dishman Mica Road and Farr Road:
Along 0 Avenue at -Farr Road, a 140 -foot long portion of 0 Avenue west of Farr Road
will be removed to subgrade, the subgrade will be compacted, crushed surfacing top
course (CSTC) will be placed and compacted, a 2-inch thick asphalt patch will be
placed above the CSTC, and a 2 -inch thick asphalt inlay will be placed above the
asphalt patch. For the remainder of .0 Avenue, the roadway will be milled and a 2 -inch
thick asphalt inlay will be constructed.
Schedule C — Dishman Mica Road from approximately 25 feet south of 16"' Avenue to
and including the Schafer Road intersection:
For the majority of Dishman Mica Road, . the roadway surface will be.milled and a 2 -inch
thick asphalt inlay will be constructed. In localized areas near Schafer Road, full -depth
patches will be excavated and reconstructed for signaling.
This project will also include reconstruction of adjacent Portland cement concrete
sidewalks and pedestrian ramps. ALLWEST anticipates our materials testing services
will consist of in -place subgrade, CSTC, and hot -mix asphalt (HMA) density testing,
testing of fresh concrete for slump, air - entrainment; temperature, and unit weight, along
with compressive strength cylinders, and accompanying laboratory testing services for
soils, aggregate, concrete, and HMA. We understand that the project will commence in
July 2012, and will last approximately 25 working days.
Materlals Testing
ALLWEST Geotechnical Engineering
Testing & Engineering Environmental Services
Cost Estimate for Construction. Materials Testing
2012 Street Preservation Project
Spokane Valley; Washington
Project No. 212A 22T
Page 3
QUALIFICATIONS AND PERSONNEL
ALLWEST employs a staff of qualified engineers, inspectors, and technicians in our
three offices located in Hayden and Lewiston, Idaho and Spokane, Washington. These
include five registered professional engineers and over twenty inspectors and
technicians. Our Spokane office maintains a national accreditation through American
Association for Laboratory Accreditation (A2LA - http-%/www.A2LA.orq/Sco'0ePdf/2491-
al.gdf) and state accreditation through the Washington Association of Building Officials
(WABO htto: / /wv+ w wabo org index php ?pale= allwest- testing). All of our offices
employ ICC and WABO certified technicians and inspectors. Additionally, ou.r
inspectors and technicians maintain WAQTC and ACI certifications. We also provide
Non- Destructive Testing (NDT) to Level 11 and III ASNT practices. Our Spokane office
also employs PCI (Precast/Prestressed Concrete Institute) Quality Control Personnel
Certification Technician Level 1.
SCOPE OF SERVICES
ALLWEST's services will be performed on a time and expense basis. Our scope of
services will include the following items:
1. Earthwork Testing and Observations Associated with Roadway
Construction:
We will provide an engineering technician to perform density tests on fill placed
and to observe and evaluate the soils at subgrade elevations. Our testing
Services Wiil' inciUde the following:
• Density tests on structural fill placed using a nuclear densometer.
• Laboratory Proctor, Gradation, Fracture Face, and Sand Equivalent tests.
• Evaluation of subgrade soils prior to placing structural fill.
• Documenting removal of existing structures and foundations, including
subexcavation and oversizing, if necessary.
2. Concrete Testing:
We will provide an engineering technician to.observe placement of concrete and
for testing of concrete during placement.. Our services will include the following:
• Verify mix specifications including stump, air content, unit weight and
temperature.
• Cast compressive strength cylinders as required.
ALL UNEST Materials Testing
Geotechnical Engineering
Testing &Engineering
Environmental Services
DOCUMENTS EXEMPT FROM PUBLIC DISCLOSURE
The page entitled "Cost Estimate for Construction Materials Testing, Page 4" contains
confidential cost and rate data and is withheld from public disclosure pursuant to 23 USC
112(2)(F).
Prenotification; confidentiality of data. A recipient of funds requesting or using the cost
and rate data shall notify any affected firm before such request or use. Such data shall be
confidential and shall not be accessible or provided, in whole or in part, to another firm or to any
government agency which is not part of the group of agencies sharing cost data under this
paragraph, except by written permission of the audited firm. If prohibited by law, such cost and
rate data shall not be disclosed under any circumstances.
You may petition for a review of our findings pertaining to any redacted or withheld documents
pursuant to Spokane Valley Municipal Code (SVMC) 2.75.080; and obtain judicial review
pursuant to RCW 42.56.550.
DOCUMENTS EXEMPT FROM PUBLIC DISCLOSURE
The page entitled "Cost Estimate for Construction Materials Testing, Page 5" contains
confidential cost and rate data and is withheld from public disclosure pursuant to 23 USC
112(2)(F).
Prenotification; confidentiality of data. A recipient of funds requesting or using the cost
and rate data shall notify any affected firm before such request or use. Such data shall be
confidential and shall not be accessible or provided, in whole or in part, to another firm or to any
government agency which is not part of the group of agencies sharing cost data under this
paragraph, except by written permission of the audited firm. If prohibited by law, such cost and
rate data shall not be disclosed under any circumstances.
You may petition for a review of our findings pertaining to any redacted or withheld documents
pursuant to Spokane Valley Municipal Code (SVMC) 2.75.080; and obtain judicial review
pursuant to RCW 42.56.550.
Cost Estimate for construction Materials Testing
2012 Street Preservation Project
Spokane Valley_ , Washington
Project No. 212 -122T
Page 6
REMARKS
We appreciate the opportunity to submit this scope of work and time and materials cost
estimate, and we look forward to serving your materials testing needs. If you have any
questions or need additional information, please do not hesitate to call us at (509) 534-
4411.
Sincerely,
ALLWEST Testing & Engineering, LLC
Tyson Schroeder
Project Manager
atC/ v
Andy J. Eliason, P.E.
Project Engineer / Materials Testing Manager
Attachment: Professional Services Agreement
Materials Testing
ALLWEST Geotechnical Engineering
Testing & Engineering Environmental Services
ACORL�M CERTIFICATE OF LIABILITY INSURANCE
DATE(MM /DDfYYYY)
07/03/2012
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
Moloney, O'Neill, Corkery & Jones, Inc.
7950 Meadowlark Way #A
Coeur d'Alene, ID 83815
CONT CT
NAME: CPCU, AMIM, Debbie Johnston
HOONoE,d:208 -292 -1751 (A/C, N, :509- 325 -1803
AD RESS: djohnston @mo- ins.com
INSURER(S) AFFORDING COVERAGE
NAIC ft
INSURERA: Liberty Northwest
INSURED Allwest Testing & Engineering LLC
PO Box 3149
Hayden, ID 83835
INSURERS: ID State Insurance Fund
06/23/2012
INSURER C :
EACH OCCURRENCE
INSURERD:
PREMISES Ea occurrence
INSURER E:
A
INSURER F :
X
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.
IN
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
MM /DDIYYYY
MM /DDIYYYY
LIMITS
GENERAL LIABILITY
5511174
06/23/2012
06/23/2013
EACH OCCURRENCE
$ 1,000,00(
PREMISES Ea occurrence
$ 1 000 00
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FK OCCUR
X
MED EXP (Any one person)
$ 15,00(
PERSONAL & ADV INJURY
$ 1,000,00(
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X JECT LOC
PRODUCTS - COMP /OP AGG
$ 2,000,000
$
AUTOMOBILE LIABILITY
55111749
06/2312012
06/23/2013
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
A
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
BODILY INJURY (Per accident)
$
Per accident
$
$
UMBRELLA LIAB
EACH OCCURRENCE
$
HOCCUR
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION $
WORKERS COMPENSATION
_
X TORY LIMITS R
$
581522
04/01/2012
04101/2013
B
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIV �YIN
OFFICER /MEMBER EXCLUDED? I i
(Mandatory in NH)
If yes, desc be under
DESCRIPTION OF OPERATIONS below
NIA
E.L. EACH ACCIDENT
$ 1,000,00
E.L. DISEASE - EA EMPLOYEJ
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,00
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
roject: 212 -122T City of Spokane Valley
City of Spokane Valley
11707 E. Sprague Avenue #106
Spqkane Valley, WA 99206
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
Tom Corma
n 1988 -2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
Terra Insurance Company ' ' •
(A Risk Retention Group)
Two Fifer Avenue, Suite 100
Corte Madera CA 94925
CERTIFICATE OF INSURANCE
R kiSx BE *Etti'IDR 4ROU
DATE
07/03/12
NAME AND ADDRESS OF INSURED
Allwest Testing & Engineering, LLC
P.O. Box 3149
Hayden, ID 83835
This certifies that the "claims made" insurance policy (described below by policy number) written on forms in
use by the Company has been issued. This certificate is not a policy or a binder of insurance and is issued as
a matter of information only, and confers no rights upon the certificate holder. This certificate does not alter,
amend or extend the coverage afforded by this policy.
The policy of insurance listed below has 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 policy described herein is
subject to all the terms, exclusions and conditions of such policy. Aggregate limits shown may have been
reduced by paid claims.
TYPE OF INSURANCE Professional Liability
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE
212194 01/01/12 12/31/12
LIMITS OF LIABILITY $1,000,000 EACH CLAIM
$1,000,000 ANNUAL AGGREGATE
PROJECT DESCRIPTION
212 -122T City of Spokane Valley
CANCELLATION If the described policy is cancelled by the Company before its
expiration date, the Company will mail written notice to the certificate holder thirty (30)
days in advance, or ten (10) days in advance for non - payment of premium. If the
described policy is cancelled by the insured before its expiration date, the Company will
mail written notice to the certificate holder within thirty (30) days of the notice to the
Company from the insured.
CERTIFICATE HOLDER ISSUING COMPANY:
TERRA INSURANCE COMPANY
(A Risk Retention Group)
Spokane Office
12928 E. Indiana Avenue #1
Spokane Valley, WA 99216
President
Verify Workers' Comp Premium Status - Employer Liability Certificate
Washington State Department of
Labor and Industries
A .�
Department of Labor and Industries
Employer Liability Certificate
Date: 07/03/2012
UBI #: 602 216 413
Page 1 of 1
Employer Liability
Certificate
Legal Business Name: ALLWEST TESTING & ENGINEERING LLC
Account #: 067,668 -00
'Doing Business As' Name: ALLWEST TESTING & ENGINEERING
Estimated Workers Reported: Quarter 1 of Year 2012 "11 to 20 Workers"
(See Description Below)
Workers' Comp Premium Status: Account is current. Firm has voluntarily reported and
paid their premiums.
Licensed Contractor? No
Account Representative: T3 /ROBERT SCRIBNER (360)902 -4679 -Email:
SCRR235 @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 51.16.120).
https:H fortress. wa. gov/ lni/ crpsi lAcctInfoPrint.aspx ?Account1d= 06766800 &AccountManage... 7/3/2012