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12-125.00 Inland Asphalt: Sprague UIC Elimination Swale UpgradeContract THIS AGREEMENT, made and entered into this day of �&TT&:zW , 2012, between the City of Spokane Valley under and by virtue of Title 35 RCW, as amended and Inland Asphalt, Inc. Hereinafter called the Contractor. WITNESSETH: That in consideration of the terms and conditions contained herein and attached 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 for: Sprague Avenue UIC Elimination Project — Swale Upgrade — Thierman Road to Park Road SVPW Bid No. 12 -031 in accordance with and as described in the project plans and specification, 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 project plans and specification and the terms and conditions herein contained and hereby contracts to pay for the same according to the referenced 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. 0012 -1 Q"6 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. V. The project was awarded for the bid amount of $1,272,772.00. 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 27 , 2012. Date .Tim Ellingson Printed Name Estimating Manager Title � ` k�, Signature City of Spoka}ae Valley Printed Name C Mw ouI,-gr Title kJ Signature Spokane ,,;,OValley9 BOND NO; 09094806 CONTRACTOR'S PERFORMANCE AND PAYMENT BOND TO DUAL OBLIGEES KNOW ALL MEN BY THESE PRESENTS, that INLAND ASPHALT COMPANY (Contractor), as Principal, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND (Bonding Company), as Surety, a corporation of MARYLAND , whose principal office is located at 1400 AMERICAN LANE TOWER ONE 19TH FL. , SCHAUMBURG, IL 60196 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 of $ 1,272,772.00 (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 AUGUST 20, 2012 offered to enter into a Contract with the City of Spokane Valley for Contract No. 0163 pursuant to the terms and conditions set forth in the Contract Documents dated 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 loss, 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 terns 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 27TH DAY OF AUGUST FIDELITY AND DEPOSIT COMPANY OF MARYLAND SURETY Si INA DAVIS Type ame ATTORNEY -IN -FACT Title (SEAL) YEAR 2012. INLAND ASPHALnOMPANY P AL Signa ire Jim Ellingson Typed Name Title SURETY ACKNOWLEDGMENT STATE OF UTAH } COUNTY OF SALT LAKE } SS On this 27TH day of AUGUST, 2012, before me personally came TINA DAVIS to me known, who, being by me duly sworn, did depose and say that she is an Attorney -In -Fact of FIDELITY AND DEPOSIT COMPANY OF MARYLAND the corporation described in and which executed the within instrument; that she knows the corporate seal of said corporation, that the seal affixed to the within instrument is such corporate seal, and that she signed the said instrument and affixed the said seal as Attorney -In -Fact of the Board of Directors of said corporation and by authority of this office under the Standing Resolutions thereof. UNDSEY GATES' Notary Public, y State Of Utah s, �+ My Commission Expires October 15, 2012 age COMMISSION NUMBER 516343 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies "), by THOMAS O. MCCLELLEN, Vice President, in. pursuance of authority granted by. Article V, Section 8, of the By -Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Tina DAVIS, Lisa HALL, Lindsey PLATTNER and Jessica ARNOLD, all of Salt Lake City, Utah, EACH its true and lawful agent and Attomey -in -Fact, to make, execute, seal and deliver, for, and on its behalf as surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance of these presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected _officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certify that the extract set forth on the reverse side hereof is a true copy of Article V, Section 8, of the By -Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice - President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this 11th day of May, A.D. 2012. ATTEST: Assistant Secretary Gregory E. Murray ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND u, Fwa ocrpr�� G�A�q;iy's 88AL ` I tn= o :x' ipa ww � . N,P Vice President Thomas O. McClellen State of Maryland City of Baltimore On this 11th day of May, A.D. 2012, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, THOMAS O. MCCLELLEN, Vice President, and GREGORY E. MURRAY, Assistant Secretary, of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution of same, and being by me duly swom, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year fast above written. T hr11111�1 Maria D. Adamski, Notary Public My Commission Expires: July 8, 2015 POA -F 020 -8022W EXTRACT FROM BY -LAWS OF THE COMPANIES "Article V, Section 8, Attornevs -in -Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attorneys -in -fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney -in -fact to affix the corporate seal thereto; and may with or without cause modify of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power of Attorney is still in full force and effect on the date of this certificate; and I do further certify that Article V, Section 8, of the By -Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affixed by facsimile on any Power of Attomey...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 10th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice - President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this27THdayof AUGUST 2012. ea DUO,, . Qf�'0W,''•'�c+��'t t�WC�4 SEAL OVA James M. Carroll, Vice President 0 D RELEASE OF RETAINAGE BOND c�&4 Bond Number: 09094805 KNOW ALL MEN BY THESE PRESENTS, that we INLAND ASPHALT COMPANY as Principal, (the "Principal "), and Fidelity and Deposit Company of Maryland, a corporation organized under the laws of the State of Maryland as Surety, (the "Surety"), are held and firmly bound unto CITY OF SPOKANE VALLEY as Obligee, (the "Obligee "), in the penal sum of SIXTY THREE THOUSAND SIX HUNDRED THIRTY EIGHT AND 60/100 Dollars ($63,638.60), which is 5% of the Principal's bid for the payment of which sum well and truly to be made, the Principal and the Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has by written agreement dated entered into a Contract (the "Contract ") with the Obligee for SPRAGUE AVENUE UIC ELIMINATION which Contract is by reference made a part hereof. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that the Surety is held and bound unto the Obligee in the penal sum of 5% of the final contract cost, which shall include any increases due to change orders, increases in quantities of work or the addition of any new item of work. If the Principal shall indemnify and save harmless the Obligee against loss to which the Obligee may be subject by reason of the Obligee's release of retainage relating to the above described Contract, then this obligation shall be null and void; otherwise to remain in full force and effect. PROVIDED AND SUBJECT TO THE CONDITIONS PRECEDENT: 1. No right of action shall accrue on this bond to or for the use of any person or corporation other than the Obligee named herein or the heirs, executors, administrators or successors of the Obligee. 2. The Surety hereby waives notice of any alternation or extension of time made by the Obligee. 3. The liability of the Surety hereunder shall not exceed 5% of the total amount earned by the Principal if no monies are retained by the Obligee on estimates during the progress of construction. 4. Any claim must be presented in writing to Zurich North America Claims,.PO Box 968037, Schaumburg, IL 60196. DATED as of this 27TH day of AUGUST, 2012. WITNE S /ATT J es.Tibbits INLAND ASPHALT COMPANY (Seal) By: , Na e: m Ellingson Title: Estimating Manager Fidelity and eposikcompany of Maryland (Seal) By: -INA - a . .. .. ............ . . ....... .... sae sxare s = BUSINESS LICENSE d , uyn STATE OF WASHINGTON Unified Business ID #: 601 006 854 Domestic Profit Corporation Business ID #: 1 Location: 1 Expires: 07 -31 -2013 CPM DEVELOPMENT CORPORATION 5111 E BROADWAY AVE SPOKANE VALLEY WA 99212 0928 TAX REGISTRATION INDUSTRIAL INSURANCE UNEMPLOYMENT INSURANCE CITY LICENSES /REGISTRATIONS: LIBERTY .LAKE GENERAL BUSINESS SPOKANE VALLEY GENERAL BUSINESS LICENSING RESTRICTIONS: Not licensed to hire persons under age 18 at this location. REGISTERED TRADE NAMES: CPM DEVELOPMENT CORPORATION This document lists the registrations, endorsements, and licenses authorized for the business named above. By accepting this document, the licensee certifies the information on the application was complete, true, and accurate to the best of his or her knowledge, and that business will be conducted in compliance with all applicable Washington state, county, and city regulations. Director, Department of Re eo e Verify Workers' Comp Premium Status - Employer Liability Certificate Washington State Department of Labor and Industries Department of Labor and Industries Employer Liability Certificate Date: 08/27/2012 UBI #: 601 006 854 Business Name: INLAND ASPHALT COMPANY Legal Business Name: C P M DEVELOPMENT CORP Account #: 700,174 -00 'Doing Business As' Name: OLDCASTLE INC Estimated Workers Reported: N/A (See Description Below) Page 1 of 1 Employer Liability Certificate Workers' Comp Premium Status: Self- insured. Will not be liable for unpaid premiums unless they cease to be self - insured. Licensed Contractor? Yes License: Multiple Active Licenses Account Representative: (360)902 -4817 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:H fortress. wa. gov/ lni/ crpsi lAcctInfoPrint.aspx ?Account1d= 70017400 &AccountManag... 8/27/2012 Inland Asphalt Compan An2 Equal Opportunity Employer August 29, 2012 City of Spokane Valley 11707 E. Sprague Ave., Suite 106 Spokane Valley, WA 99206 Attn: Steve Worley SINCE 1934 CONTRACTOR REGISTRATION #INLANAC9840K RE: Contract No. 12 -031 Sprague Ave. UIC Elimination — Swale Upgrade Gentlemen: The following is a list of key personnel and their respective responsibilities on the above referenced project, along with their contact information: Al Hughbanks Project Manager/Estimator ' 536- 3130/979 -7665 ahughbanks@oldcastlematerials.com Steve Maier Project Superintendent, TCM 536 - 3117/979 -7666 & ESC Lead smaier @oldcastlematerials.con! Guy Anderson Grading/Paving Supt. 536 - 3116/979 -7670 ganderson@oldcastlematerials.com Jamie Tibbits Contract Administrator 536 -3141 jtibbits @oldcastlematerials.com Leanna Deaton EEO Officer 208 - 666 - 6123/208 -691 -2980 Ideaton@oldcastlematerrials.com Kevin Dill Safety Director 536- 3126/979 -7672 kdill@oldcastlematerrials.com The following persons are authorized to sign estimates and change orders: Jim Ellingson, Mark Murphy and Jamie Tibbits. Should the need for emergency contact arise, contact can be made during office hours through our Spokane office (534- 2657). In an after hours emergency you can contact Steve Maier (home = 276 -6282; cell = 979 - 7666), Al Hughbanks (cell = 979 -7665) or Jim Ellingson (home = 464 -1102; cell = 979 - 7633). Very truly yours Inla d As pany e Tibbits Contract Administrator S s v ' y.$ Spokane: 5111 E. Broadway, Spokane Valley, WA 99212 • P.O. Box 3366, Spokane, WA 99220 (509) 534 -2657 • Bid Fax (509) 536 -3137 • Fax (509) 536 -3051 Richland: 955 Lacy Rd., Richland, WA 99352 (509) 943 -0674 • Fax (509) 943 -9979 THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION. ONLY AND CONFERS NO RIGHT UPON YOU THE CERTIFICATE HOLDER THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. This is to Certify that Inland Asphalt Company CPM Development Corporation dba PO Box 3366 - Spokane, WA 99220 -3366 Li NAME AND be ADDRESS rt)1 OF INSURED Mutual —II is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions and r,...a:.:.... —A :.— .tte.nA t.., --i ­--t term or condition of anv contract or other document with resnect to which this certificate may be issued. - If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. SPECIAL NOTICE -OHIO: ANY PERSON WHO, WITH U411M TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD. IMPORTANT NOTICE TO FLORIDA POLICYHOLDERS AND CERTIFICATE HOLDERS: IN THE EVENT YOU HAVE ANY QUESTIONS OR NEED INFORMATION ABOUT THIS CERTIFICATE FOR ANY REASON, PLEASE CONTACT YOUR LOCAL SALES PRODUCER WHOSE NAME AND TELEPHONE NUMBER APPEARS IN THE LOWER RIGHT HAND CORNER OF THIS CERTIFICATE. THE APPROPRIATE LOCAL SALES OFFICE MAKING ADDRESS MAY ALSO BE OBTAINED BY CALLING THIS NUMBER Liberty Mutual Insurance Group NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: City of Spokane Valley W " 11707 E. Sprague Ave., Suite 106 Judith D REPRESENTATIVE Spokane Valley, WA 99206 Pi sburgn / 0387 AUTHORIZED REPRESENTATIVE P Y 12 Federal Street, Ste, 310 m Pittsburgh PA 15212 -5706 412 - 231 -1331 8/29/12 OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 EXP DATE TYPE OF POLICY El El CON EXTENDED CONTINUOUS colr POLICY NUMBER LIMIT OF LIABILITY Q POLICY TERM WORKERS COMPENSATION 9/1/2013 WA7 -C8D- 004095 -022 WC7 -C81- 004095 -012 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: ALL STATES EXCLUDING MONPOLISTICS STATES AND EMPLOYERS LIABILITY Bodily Injury by Accident $1,000,000 Each Accident NY Bodily Injury by Disease OR, WI $1,000,000 Policy Limit Bodily Injury by Disease $1,000,000 Each Person General Aggregate – Other than Products / Completed Operations GENERAL LIABILITY 9/1/2013 TB2 -C81- 004095 -112 $2,000,000 Q OCCURRENCE Products / Completed Operations Aggregate $2,000,000 Bodily Injury and Property Damage Liability $2,000,000 Per Occurrence ❑ CLAIMS MADE RETRO DATE PersonahInjury Included* Per Person /Organization Other Included in BI/PD Liability Other FIRE DAMAGE $100,000;PER PROJECT AGGREGATE AUTOMOBILE 9/1/2013 AS2 -C81- 004095 -122 B � t b Limit $2,000,000 AndpD.0 mn LIABILITY Each Person Q OWNED Q NON -OWNED Each Accident or Occurrence Each Accident or Occurrence Q HIRED OTHER Excess Workers' Compensation & Employers' Liability 9/1/2013 EW1 -68N- 025031 -011 SIR 250,000; EXCESS WC 20,000,000 (INCLUDES WA STOP GAP) EL $750,000 Auto: Comp Ded $10,000 /Coll Ded $10,000 PER OCC ADDITIONAL COMMENTS RE: Sprague Avenue UIC Eliminsation Project - Swale Upgrade - Thierman Road to Park Road, SVPW No. 12 -031 The City of Spokane Valley and its officers, elected officials, employees, agents, and volunteers are named as additional insured with respect to the above referenced project. Coverage is primary and non - contributory. - If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. SPECIAL NOTICE -OHIO: ANY PERSON WHO, WITH U411M TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD. IMPORTANT NOTICE TO FLORIDA POLICYHOLDERS AND CERTIFICATE HOLDERS: IN THE EVENT YOU HAVE ANY QUESTIONS OR NEED INFORMATION ABOUT THIS CERTIFICATE FOR ANY REASON, PLEASE CONTACT YOUR LOCAL SALES PRODUCER WHOSE NAME AND TELEPHONE NUMBER APPEARS IN THE LOWER RIGHT HAND CORNER OF THIS CERTIFICATE. THE APPROPRIATE LOCAL SALES OFFICE MAKING ADDRESS MAY ALSO BE OBTAINED BY CALLING THIS NUMBER Liberty Mutual Insurance Group NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: City of Spokane Valley W " 11707 E. Sprague Ave., Suite 106 Judith D REPRESENTATIVE Spokane Valley, WA 99206 Pi sburgn / 0387 AUTHORIZED REPRESENTATIVE P Y 12 Federal Street, Ste, 310 m Pittsburgh PA 15212 -5706 412 - 231 -1331 8/29/12 OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: RE: Sprague Avenue UIC Elimination Project - Swale Upgrade - Thierman Road to Park Road, SVPW No. 12 -031 The City of Spokane Valley and its officers, elected officials, employees, agents, and volunteers are named as additional insured with respect to the above referenced project. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. This endorsement is executed by the LIBERTY MUTUAL FIRE INSURANCE COMPANY Premium $ , Effective Date 09/01/12 Expiration Date 09/01/13 For attachment to Policy No. TB2 -C81- 004095 -112 Audit Basis Issued To SECRETAR Y PRESIDENT Countersigned by '0� Authorized Representative Issued Sales Office and No. End. Serial No. se Pgh 0387 CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 Policy Number.:, TB2 -C81- 004095 -112 Issued by: LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON - CONTRIBUTORY — SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Person or Organization: Any person or organization for which such coverage is required by written contract with the Named Insured. If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person or organization shown in the Schedule that is an additional insured on this policy, this policy will apply solely on the basis required by such written agreement If the applicable- written agreement does not specify on what basis the liability insurance will apply, this insurance shall be excess over any other valid and collectible insurance available to the additional insured, whether such insurance is on an excess, contingent or primary basis. Condition 4 Other Insurance of Section IV is revised accordingly. LD 24 10 06 11 1 © 2011 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 - Includes copyrighted material of Insurance Services Office, Inc., with its permission. SUPERIOR COURT OF WASHINGTON FOR SPOKANE COUNTY In the Matter of: ADVERTISEMENT FOR BIDS No. City of Spokane Valley Public Works Department Bid #12 -031 Sprague Avenue UIC Elimination Project AFFIDAVIT OF PUBLISHING (Swale Upgrade) - Park to Thierman Rd. ) NOTICE STATE OF WASHINGTON ) )ss. County of Spokane ) MICHAEL HUFFMAN . being first duly sworn on oath deposes and says that he is the EDITOR , of The Spokane Valley News Herald, a weekly newspaper. That said newspaper is a legal newspaper and it is now and has been for more than six months prior to the date of the publication hereinafter referred to, published in the English language continually as a weekly newspaper in Spokane County, Washington, and it is now and during all of said time was printed in an office maintained at the aforesaid place of publication of said newspaper, which said newspaper had been approved as a legal newspaper by order of the Superior Court of the State of Washington in and for Spokane County. That the following is a true copy of a public notice as it wa ublished in regular issues commencing on the 3rd day of August, 2012 and ending the 10th day of Au 20 a tes ' usive, and that such newspaper was regularly distributed to its subscribers during all of said period. ADVERTISEMENT FOR BIDS CITY OF SPOKANE VALLEY SUBS BED art ; SWORN to before me PUBLIC WORKS DEPARTMENT �,. SPRAGUE AVENUE U C3ELIMINATION this 10th day ofAuQust 2012 PROJECT (SWALE UPGRADE) — PARK RD. TO THIERMAN RD. State of Washin gton Notice is hereby given that the City of Spokane Valley, Spokane County, Washington, will ac- cept sealed bids for the Sprague Avenue UIC 11' / County of Spokane C 0 //O (Undergro und Injection Control) Ellmination Project toThlerman. The RAE . RA C ice I certify that I know have -Park project consists of reconstructing the outside lanes of Sprague •......• or satisfactory evidence that sStoN Ekp•• 41% "o Michael Huffman is the before Avenue, removing existing drainage structures person who appeared p� / •• r ph 9F; and installing new ones, installing roadside irrigation o me, and said person ac owledged that he signed kn swales with and trees, and grinding and overlaying the remaining asphalt. Copies the bid including N • this instrument and acknowledged it to be his free NOTARY of packet specifications _ and voluntary act for the uses and purposes men - • and plans may be obtained in PDF format by downloading from the Spokane Valley FTP site. • PugLIC Z tioned in the instrument. To obtain the FTP site password and to submit a bid for this project, Contractors must contact Darla Arnold, Spokane Valley Public Works, • O • r at 720- 5003orby email atdamold @spokanevalley. org, Monday through Friday from 8:00 a.m. to 5 •� �� r• $_ 1 . �( ••• ::•••• 5:00 p.m. Contractors will then be placed on �� `�� Jolene Rae Wentz ^� ^c JF '%� the City's Planholder's list. Any addenda to this be WA7 Title: l�lotar PUb11C y project will sent only to those listed on the Planholder's list. All bids be �� / / / / a My apps '' tment expires: 5 -16 -15 must 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. Failure to furnish a bid bond in compliance with the City's bid deposit surety bond form shall make the bid non - responsive and cause the bid to be rejected. Bids must be submitted in sealed envelopes addressed to the City Clerk of the City of Spo- kane Valley, 11707 E. Sprague Avenue, Suite 106, Spokane Valley, Washington, 99206, and received not later than 10:00 a.m. PSDT, Friday, August 17, 2012. Bid openings will be held im- mediately thereafter and read aloud in the City Council Chambers, Suite 101. The City of Spokane Valley reserves the right to waive any irregularities or informalities and to reject any or all bids: No bidder may withdraw his bid after the time announced for the bid opening, or before the award and execution of the contract, unless the award is delayed for a period exceeding sixty (60) days. Christine Bainbridge, MMC Spokane Valley City Clerk 8/3 & 8/10 ADVERTISEMENT FOR BIDS CITY OF SPOKANE VALLEY PUBLIC WORKS DEPARTMENT BID p 12 -031 SPRAGUE AVENUE UIC ELIMINATION PROJECT (SWALE UPGRADE) - PARK RD. TO THIERMAN RD. Notice is hereby given that the City of Spokane Valley, Spokane County, Washington, will accept sealed bids for the Sprague Avenue UIC (Underground Injection Control) Elimination Project - Park to Thierman. The project consists Of reconstructing the outside lanes of Sprague Avenue, removing existing drainage structures and installing new ones, installing roadside swales with irrigation and trees, and grinding and overlaying the remaining asphalt. Copies of the bid packet including specifications and plans may be obtained in PDF format by downloading from the Spokane .Palley FTP site. To obtain the FTP site password and to submit a bid for this project, Contractors must contact Darla Arnold, Spokane Valley Public Works, at 720 -5003 or by email at damold @spokanevalley.org, Monday through Friday from 8:00 a.m. to 5:00 p.m. Contractors will then be placed on the City's Planbolder's list. Any addenda to this project will be sent only to those listed on the Planholder's list. All bids must be 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 amouet.of the bid proposed. Failure to furnish a bid bond in compliance with the City's bid deposit surety bond form shall make the bid non- responsive and cause the bid to be rejected. Bids must be submitted in sealed envelopes addressed to the City Clerk of the City of Sp Valley, 11707 E. Sprague Avenue. Suite 106, Spokane Valley Washington, 99206, and receive( not later than 10:00 a.m. PSDT Friday, August 17,,2012. Bii openings will be held Immediatet ,thereafter and read aloud in th City Council Chambers, Suite 101. The City of Spokane Valle reserves the right to waive an irregularities or informalities an to reject any or all bids. No biddi may withdraw his bid after tt time announced for the bi opening, or before the award a( execution of the contract, unle: the award is delayed for a peril exceeding sixty (60) days. PUBLISH: VNH - 8/3 and 8/10 PUBLISH: S/R Valley Voice - 8/4 and 8/11 Christine Bainbridge, MMC Spokane Valley City Clerk SR24E "Federal Tax ID No. 68- 0617327 AFFIDAVIT OF PUBLICATION STATE OF WASHINGTON County of Spokane} ss Name: City of Spokane Valley Client ID: PO No. SR24852 No. Lines Total Cost: $213.68 i Ruth Sullivan 42365 86 Order No. 95070 do solemnly swear that I am the Principal Clerk of The Spokesman- Review, a newspaper established and regularly published, once each day in the English language, in and of general circulation in the City of Spokane County, Washington; and in the City of Coeur d'Alene, Kootenai County, Idaho; that said newspaper has been so established and regularly published and has had said general circulation continuously for more than six (6) months prior to the 23rd day of July, 1941; that said newspaper is printed. in an office maintained at its place of publication in the City of Spokane, Washington; that said newspaper was approved and designated as a legal newspaper by order of the Superior Court of the State of Washington for Spokane County on the 23rd day of July, 1941, and that said order has not been revoked and is in full force and effect; that the notice attached hereto and which is a part of the proof of publication, was published in said newspaper two time(s), the publication having been made once each time on the following dates: 4 & 11, 2012 That said notice was published in the regular and entire issue of every number of the paper during the period of time of publication, and that the notice was published in the newspaper proper and not in a supplement. Ae Subscribed and sworn to before me at the City of Spokane, this 6th day of September , 2012. �U S10NF +�2� ppp NOTARY 9N U+�N� PUBLIC a Notary Public in and for the State of Washington, v� E residing at Spokane County, Washington � R UF(,,, Notary Stamp Paper Affidavits